Monday, May 19, 2014

The VA. No scandal here, just move on.




If our government has any obligation to fulfill its many promises on health care, it should be first and foremost to the men and women who served in our armed forces. But the scandal over hidden waiting lists at a growing number of veterans’ hospitals (seven so far) — wherein dozens of veterans died while waiting months for vital treatment, and the VA covered up the lengthy wait times — should make everyone wonder whether we can place our trust in a government-managed health-care system. The Dayton Daily News reported on Sunday that its investigation of a database of claims paid by the Department of Veterans Affairs shows that the words “delay in treatment” were used 167 times. The VA paid out a total of $36.4 million to settle the claims. There could well be many more cases of “death by delay” at the VA that never came to light.
Are there lessons in the VA scandal for the rest of us if Obamacare survives and even expands?
You betcha. The first lesson is that as government expands taxpayer subsidies for health care, the demand will always outstrip supply.  Here is President Obama in a speech to disabled veterans in August 2013:
The last time I was with you, I pledged to cut the backlog, slash those wait times, deliver your benefits sooner. And I’m going to be honest with you; it has not moved as fast as I wanted. Part of it is all these new veterans in the system who came in — Agent Orange, PTSD. It means a lot more claims, and despite additional resources, it’s resulted in longer waits. And that’s been unacceptable — unacceptable to me, unacceptable to [Department of Veterans Affairs] Secretary [Eric] Shinseki.
A few weeks later, President Obama had to admit that he found the fiasco of the HealthCare.gov website also “unacceptable.” Last week, his aides told reporters he was “madder than hell” over the veteran waiting-list scandal.
There’s a lot to be mad about at the Department of Veterans Affairs. Michael Tanner of the Cato Institute notes that more than 344,000 claims for veterans’ care are backed up and waiting to be processed. It takes an average of 160 days for a veteran to be approved for health benefits, and the VA itself estimates that is has an error rate of at least 9 percent in processing claims. According to VA figures for 2012, as reported by the Washington Post, “a veteran who takes an appeal through all available administrative steps faces an average wait of 1,598 days.” That’s more than four years of waiting.
Obamacare will dramatically expand access to the health-care system at the same time that many surveys show doctors are likely to retire or cut back their hours. It is almost inevitable that we’ll see more waiting-list scandals as the need to ration care grows.
This is the record of many single-payer health-care systems, and both Obama and the Senate majority leader, Harry Reid, have said that establishing a single-payer system is their long-term goal. In 2003, Obama, then an Illinois state senator, told an AFL-CIO conference: “I happen to be a proponent of a single-payer universal health-care program. . . . But as all of you know, we may not get there immediately.” Similarly, Majority Leader Reid told a PBS interview show in Nevada, in October 2013: “What we’ve done with Obamacare is have a step in the right direction, but we’re far from having something that’s going to work forever.” When he was asked by a panelist whether he meant that ultimately the country would need a health-care system that abandoned insurance as the means of accessing it, Reid said: “Yes, yes. Absolutely yes.”
But, if the experience of other countries is any guide, a single-payer health-care plan or even government-managed care brings all kinds of waiting lists with it. In 2012, it was discovered that more than 7,000 patients in just a few Scottish hospitals had been wrongly removed from waiting lists for surgery in order to pretend to meet government targets for treatment. One trick was offering to perform surgery on a date when hospital officials knew a patient would be away on holiday, then dropping the patient from the wait list for “refusing” the date.
Sarah Boyack, a member of the Scottish Parliament, called the figure of 7,000 “astonishing,” given that “an extra five million pounds [$8 million] has been pumped into the NHS [National Health Service] to help cut the waiting list” in the affected hospitals.
Not that NHS patients in hospitals without waiting-list scandals are that much better off. In all of the United Kingdom, NHS patients wait an average of about eight weeks for treatments that require admission to a hospital, four weeks for out-patient treatments, and two weeks for diagnostic tests. While NHS patients have a choice of hospitals, they cannot always choose their specialist.
The situation in Canada, a nation whose government-run health-care system has long been touted by liberal supporters of government in health care, is also dire. Last year, the respected Fraser Institute published a study on Canadian wait times for surgery. Among its finding are these:
In 2013, those requiring orthopaedic surgery were forced to endure waits of more than nine months (39.6 weeks) to receive treatment, while others had to wait for slightly more than four months (17.4 weeks) just to receive an appointment with a neurosurgeon. On the other hand, cancer patients in line for radiation therapy faced the shortest expected wait times for treatment after referral by a general practitioner (3.5 weeks).
Currently, one in 34 Canadians may be in pain, off work, or suffering from depression as they wait their turn for treatment.
The 2013 median waiting time of 18.2 weeks is about three days longer than 2012, and substantially longer than 1993 when it was just 9.3 weeks. 
Bacchus Barua, the Fraser Institute’s senior health-policy analyst and the report’s lead author, writes: “Simply putting someone on a list is not the same as providing necessary medical attention in a timely manner.”
The veterans’ hospital scandals now in the news in the United States show just how bad things can get when the pressure of patient demand and waiting lists affects bureaucratic behavior. As many as 40 veterans reportedly died at a Phoenix veterans’ facility because they couldn’t get the care they needed. VA administrators there and at other hospitals apparently covered it up by establishing secret waiting lists and falsifying reports.
No one is suggesting that such scandals are widespread in the general health-care system. But they should serve as a warning sign of what could happen as the pressure to ration, inherent in all government-managed health care, is applied to the general population.

16 comments:

  1. At the root, this is just what happens when you try to defy economic gravity as progressives are wont to do.

    You can not give $10 worth of treatment after having spent $15 on administration on a $20 budget.

    The question of what have we gained to have so many vets needing care is begged, but that's for another thread.

    How do libs not see this as a foreshadowing of what obamacare is certain to evolve in to.

    And finally, Obama's ridiculous "mad as hell" statement. He's so mad the he forced the retirement of an already retiring cadre.

    The circus isn't even entertaining anymore.

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    1. As I said, nothing to see here, just move on.

      I'm mystified why the MSM gives the administration a pass. No one is fired, no disciplinary action. They will delay, pretend it doesn't exist, then in a month or 2, they will say it's old news, move on. repeat as often as necessary.

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    2. It's not just the media, Rick will carry the piss bucket too. And not even wear gloves.

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    3. See how wrong you are Jimbo. I think it's a god damn shame that we sent so many of our youth to fight one unnecessary war and now we can't take care of them. It's a shame that because of that unnecessary war that we bogged down fighting the one we should have been fighting and our troops became sitting ducks for the insurgents. It's a shame that we pussyfooted around in southeast Asia and so many others were un necessarily harmed physically and mentally. But I also know that we don't house them anymore in cheap run down rat infested hotels awaiting treatment. Oh wait you didn't believe that one.
      We need to see if this is the norm or an isolated incident. My father and my father in law one a WW2 vet and the other Korea both swore by the care they received at the VA. My father in law who passed about 2 years ago refused to go anywhere else. He was 81 when he left us so they must do some things right.

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    5. Geez you are all over the place...

      First, what am I wrong about?

      Which war was unnecessary? Iraq? Ok. Afghanistan? Ok. Libya? Ok. Egypt, Yemen, Syria....

      It's all a sham. Btw, none of that is war and "sitting ducks" is a function of the rules of engagement which are as bad as they've ever been. We all have Bush's fault fatigue already, so give it a rest.

      SE Asia..whole other discussion, but similar issues I'll grant you.

      Is this the norm as far as vet treatment? Of course it is.

      Rat infested hotels? Is that not any of them? What don't I believe? That one flew right by me.

      81 is the new 150 I reckon. I mean what the heck sort of argument is that? Literally that anecdote is completely devoid of supporting data and jumps directly to a conclusion.

      The government sucks because people are inherently sucky. Why do you support giving sucky people fiat authority over yourself and me? Government is in the stage where itself is its greatest priority. There are underlying agendas, but the low levels are happy to ride the bus as long as it's moving.

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    6. Growing evidence points to systemic troubles in VA healthcare system
      The growing evidence suggests a VA system with overworked physicians, high turnover and schedulers who are often hiding the extent to which patients are forced to wait for medical care.


      Faces of VA healthcare: Patients and would-be whistle-blowers

      The 1,700 hospitals and clinics in the VA system — the nation's largest integrated healthcare network — now handle 80 million outpatient visits a year. Veterans Affairs Secretary Eric K. Shinseki promised to solve growing problems with patient access when he took over in 2009, and he has been successful in some respects: Iraq and Afghanistan veterans are using VA healthcare at rates never seen in past generations of veterans, and a growing number of Vietnam veterans are receiving VA care as they age.

      The agency reports it also made substantial progress in reducing wait periods last year, 93% of the time meeting its goal of scheduling outpatient appointments within 14 days of the "desired date."

      But several VA employees have said the agency has been manipulating the data.

      "The performance data the VA puts out is garbage — it's designed to make the VA look good on paper. It's their 'everything is awesome' approach," said Dr. Jose Mathews, chief of psychiatry at the VA St. Louis Health Care System. "There's a 'don't ask, don't tell' policy. Those who ask tough questions are punished, and the others know not to tell."
      http://www.latimes.com/nation/la-na-va-delays-20140518-story.html#page=1

      He KNEW! Obama told of Veterans Affairs health care debacle as far back as 2008
      The Obama administration received clear notice more than five years ago that VA medical facilities were reporting inaccurate waiting times and experiencing scheduling failures that threatened to deny veterans timely health care — problems that have turned into a growing scandal.

      Veterans Affairs officials warned the Obama-Biden transition team in the weeks after the 2008 presidential election that the department shouldn’t trust the wait times that its facilities were reporting.

      “This is not only a data integrity issue in which [Veterans Health Administration] reports unreliable performance data; it affects quality of care by delaying — and potentially denying — deserving veterans timely care,” the officials wrote.

      The briefing materials, obtained by The Washington Times through the Freedom of Information Act, make clear that the problems existed well before Mr. Obama took office, dating back at least to the Bush administration. But the materials raise questions about what actions the department took since 2009 to remedy the problems.

      In recent months, reports have surfaced about secret wait lists at facilities across the country and, in the case of a Phoenix VA facility, accusations that officials cooked the books to try to hide long wait times. Some families said veterans died while on a secret wait list at the Phoenix facility.
      http://www.washingtontimes.com/news/2014/may/18/obama-warned-about-va-wait-time-problems-during-20/?page=all

      AUSTIN, Texas (AP) _ A retired Department of Veterans Affairs doctor says efforts to meet national performance measures hid potentially life-threatening delays for patients seeking care at an Austin VA clinic.

      The claims by Doctor Joseph Spann are similar to ones made against VA hospitals in Phoenix and other parts of the country.

      The Austin American-Statesman reports Spann alleges that the chief of radiology at a VA medical center in Temple regularly asked doctors to change their requested date for ultrasounds, MRIs and CT scans to hide long backlogs for tests required before life-saving treatment can begin.
      http://wtaw.com/2014/05/15/conflicting-reports-va-patient-problems/

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    7. Jimbo see you missed the whole rat infested hotel thing a few years back....or you didn't want to here it...or refused to believe it.......or Faux news didn't report it. Unnecessary war yes that would be Iraq. Libya was not a war but a series of bombing runs in which little American resources were used. Rules of engagement yes we have seriously changed from take and hold to take and leave. That is the problem with our war machine since Vietnam.
      Wars are fought between governments not people. But we will never win another until we return to the take and hold strategy. Who cares if we win hearts and minds in the initial phases. If we aren't going to go fight then we need to stay home.
      I would not stay in a rat infested hotel would you? If I saw a rat I am going to the desk getting my money back and leaving immediately. The father in law living to 81 was not bad. I hope to live to about 82 and get out. Why? I don't want to burden anyone including you the tax payer and the people with your attitude well there won't be anything here in the
      U S worth living for. 82 and out been my motto for years. If I have to be pumped full of drugs and pills to go on, well no I'll go peacefully.
      Lou it has become the norm because we fight wars in which we do great physical and mental damage to our young people. They wander through foreign countries without a clear mission or the impossible one of winning hearts and minds not winning the war. They soon feel "what's the use" but are still stuck there mentally becoming degraded and facing serious physical harm. that's what today's terrorists do. They maim you not kill you so you are destined to a life of suffering. We did at one time take care of our returning soldiers but since Vietnam that hasn't happened. we fight govt led wars that the public doesn't back and don't believe in so we treat our vets as criminals. The systems choked with this influx of injured and disturbed young people who should have never been sent where they were sent.

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    8. Rick, are you talking about the Walter Reed moldy walls fiasco? Are you harping on one particular aspect of that story RE rat infested hotels? I'm not sure, either way it only supports my argument that the government is not fit to administer healthcare. At all.

      And, for the record, I find a person that uses the phrase "Faux News" in a discussion that is not directly related to Fox or media in general to be...well...an imbecile. Sort of reminds me of Soccermon. I don't watch TV. I'm one of those weirdos.

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  2. The interesting thing is there's the faithful on both sides. The people who supported Bush, Nixon, Clinton. Didn't matter how bad the transgression, it was all justified in their minds.

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    1. True. My whole perspective changed in Fall 2008 when the economy collapsed. Everything changed. Business as usual was no longer OK for me.

      I mean, I never liked Clinton being president, but everyone was fat, dumb, and happy so who could complain? Bush got a lot of leeway because of 9/11. I supported war because I was sold on the ostensible goals.

      Now, we have all the realities laying naked before us. Bad foreign, economic, and domestic policy have led us to this hopeless situation we are in. Any and every jackass that comes around looking to double down needs to be rejected.

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    2. In 2006 the Democrats were screaming loudly at the massive spending by the Government. Barack being one of the loudest protestors of over spending condemned it to no end. Fast forward 2 years and the story is just kidding, it was only politics. Pretty sad as the American people accept his spending as he is close to a double and still nothing from the media, nothing from the Democratic party. The spend thrift repub's have exchanged positions and now claim foul.

      Hypocrites, one and all.

      I think back and often wonder what if they didn't bail out the banks, dump trillions into whatever the flavor of the day is. Would we have a limp economy with millions unemployed? What would have happened if they dumped all free trade agreements, escorted the illegals to the border, would there be more or less work today?

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    3. Yeah, the hypocrites...Gowdy is playing political games RE Benghazi, but Obama never did RE debt ceiling. Well, we're on the other side of history for the latter. It's a proven fact Obama played politics then. But he's black so it's cool....opps, I'm sorry for being racist. /sarc

      You're cued in to all the right questions. I no longer thing inside the box created by my own paradigms. These things they call "conspiracies" sometimes make my list of possible answers.

      So what if no Tarp and bailouts? I'm not sure, but it's pretty evident certain entities benefitted and I doubt it was by any accident that they did.

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    4. The sad part of Benghazi is the questions will likely never be answered.

      Were there political reasons why requests for additional security were ignored, suggesting that American lives were not as critical as President Obama’s reelection?
      At what time on the night of the attack did the president go to bed, and who made decisions not to order military assistance?
      What was the CIA doing in Benghazi, and what effect did its activities have on our security status?
      Were reports that the hit was retaliation for a U.S. drone attack accurate?
      What exactly did top-ranking officials of the CIA initially testify about the attacks, and were their original statements contradicted by later assertions?
      Who in the administration massaged intelligence synopses and sent out memos to head off accusations of failed leadership?
      Did the administration pressure (as if pressure were needed) media outlets to downplay the story?
      Why did our U.N. ambassador assert falsehoods, and why was she selected to be such a spokesman?
      Who ordered Mr. Nakoula jailed and kept him behind bars?
      Why were the real perpetrators never seriously pursued as promised? Did the personal problems of CIA director David Petraeus, the administration’s initial reaction to them, his various testimonies, and his sudden post-election resignation have any interconnections?
      Have all those who participated in the defense of the Benghazi facilities been fully heard from?
      Have those who were in the chain of command responsible for holding back succor on the night of the attack?
      What information was redacted in documents requested by Congress or under the Freedom of Information Act, and by whom?

      Under the excuse of every administration has done similar things, the media has laid this one to rest and the American went back to sleep.

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    5. Probably the most operative question, if a republican were in charge, would Democrats sweep it under the carpet and say nothing to see here, just move on.

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    6. I think only Hillary gets to question an administration!

      But yeah. Along with why was the CIA there add Why was Chris Stevens with them?

      Is it common practice to run spook OPs with the State Dept? If so, since when and how widespread is that practice?

      Would that be classified? For what purpose? National security or to protect an administration?

      And yes, Democrats would be all over it. Remember GitMo torture chambers? When's the last utterance of that have you heard? Or daily war body count tallies?

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