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Friday, May 16, 2014

VA Problems Point to Our Future?

For John, BLUFThere is blame for the VA Scandal all the way up and down the chain, and back into the last century.  Nothing to see here; just move along.

Over at The Daily Call Ms Elizabeth Price Foley, a Law Professor at Florida International University, asks the "if this, then that" question.  She examined the question of if the VA scandal raises the question of health care rationing.  This is an ugly question.  Here are her first paragraphs:
Whistleblowers within the Veterans’ Administration health system are coming forward with tales of brutal disregard for the health and life of those who served our country.  Allegations of extensive wait times for lifesaving care, deaths while waiting, and horrific mismanagement have triggered outrage.

Unfortunately, the VA abuses are just the tip of a much larger, more menacing iceberg.  The iceberg is covert health care rationing, and it’s inherent in single-payer systems like the VA.

The obvious question to ask about the VA scandal is:  Why?  Why would a VA hospital administrator direct doctors not to perform colonoscopies until patients had three positive tests for bloody stools?  Or why were VA employees ordered to “cook the books” and hide long wait times that veterans faced when seeking care from heart, cancer, or other specialists?  Why did some VA administrators go so far as to create a secret waiting list to hide year-plus wait times?

There’s only one plausible answer to these questions: rationing.  The VA is but a smaller version of the sort of government-run, single-payer health care with which the political left is so enamored.

My understanding is that the Veterans Administration (now the Department of Veterans Affairs) spends about $60 billion a year on health care.  Against this there are some 9 million veterans enrolled in the system and 6 million actually receiving benefits.  Is it enough, too much or not enough?  The outcomes would indicate it is either not enough or the $60 billion is being mismanaged in many locations.

On the other hand, the VA's capital investments are from decades ago.  When I was in high school the VA Hospital in Long Beach, California, was long established at the corner of East 7th and Bellflower Blvd, and that was the 1950s.  Today's veterans are not necessarily living where VA planners in the 1940s and 50s put their massive facilities.  One of the hospitals in trouble is in Phoenix, Arizona.  Turns out that today Maricopa County, which is home to Phoenix has the second largest vet population in the country, with 275,000, just behind Los Angeles County (which includes the aforementioned Long Beach).  This large population of vets in Maricopa county didn't exists two or three decades ago.  People moved there or retired out of military bases in the area.

Perhaps the Phoenix VA operation was just overwhelmed and the VA couldn't articulate the need for capitol investment or the US Congress just wasn't paying attention.  At the end of the day, this does fall at the door step of Capitol Hill, since they have the oversight responsibility.  For sure, what we don't want is some sort of an Action T4 (Tiergartenstraße 4) Program somewhere down the road.

Hat tip to the Instapundit.

Regards  —  Cliff


C R Krieger said...

Here is the thing.  Rance has not yet learned how to post comments, but just sends them to me.

On the other hand we have the evidence from the article I sent you today showing that where a single payer sets a price often the more expensive providers come into line.

Maybe what we need is something like the UK where the basic services are provide by the single payer and the individual can pay for additional services via cash or insurance. For veterans and military retirees we need to recognize what they have sacrificed physically and mentally for this nation and subsidize them to the extent that they can't afford to pay for themselves. And we need to capitalize the capacity to do that, or let the market do that, but for sure we need to modernize the system so that claims are promptly acted upon and adjudicated.

But in the end we may not be able to afford, collectively or individually, all the health care demand for the highest level of service and the most modern of procedures and I don't think that makes me, saying it, a Nazi.



The thing is the seeds for the T-4 program were scattered amongst the people before Mr Hitler tried his Beer Hall Putsch.  The book Allowing the Destruction of Life Unworthy of Life came out in 1920.  The Nazi Government executed but the idea of rationing was there before.

C R Krieger said...

Frankly, I am not that impressed with the British Health Care System.  And I lived there for a year, several decades after the National Health Service was created by Aneurin Bevan, the newly appointed Minister of Health.

Single payer won't fix what is broken in the US.  More providers in low density areas and patient education is what is called for.  And insurance for those without.  But please, not single payer.

Regards  —  Cliff

Neal said...

$500M in new furniture for VA facilities, lavish conference destinations, huge bonuses for managers who fudge their numbers.......and a VA Director who like Obama....didn't know anything about this until "just the other day."

This has nothing to do with health care or its future in America. It has everything to do with criminal and incompetent behaviors as well as a demonstrable regard for military veterans as a dirty little secret that we don't want to talk about......they are second class citizens at best...and domestic terrorists most likely.