Saturday, May 24, 2014

The Veterans Scandal: Socialized Medicine on Trial
Many have wondered about Barack Obama’s prolonged silence concerning the disastrous situation at the Veterans Administration hospitals and then his odd detached demeanor (well, maybe not that odd for him) when he finally did discuss it at a press conference.

The answer is simple. His lifetime dream of a free public (single payer) healthcare system for all just disintegrated in front of him. Forget the wildly ambitious and pervasive “Affordable Care Act,” the government couldn’t even handle the health of our wounded servicemen, acknowledged for years to be by far the group most deserving of medical attention in our country. With veterans dying while waiting lists are falsified, it’s hard to see government healthcare as anything but incompetent, disgraceful and quite possibly criminal.

Government has failed utterly. Does anyone have any doubt that Halliburton or even the dreaded Koch brothers could have better handled the health of our wounded warriors? Probably almost any business would have. There at least would have been some accountability. (It’s interesting to see the quaint Bernie Sanders, the one self-described socialist in the Congress, as opposed to the closeted ones, being the most outspoken defender of VA malfeasance and urging us not to “rush to judgement” on a three page bill.)

But it’s not just healthcare, although it’s certainly prominent, important and symbolic. The Obama administration has been the best advertisement for libertarianism across the board in recent memory....

The VA’s Socialist Paradise
...As my National Review colleague Jonah Goldberg points out, the usual excuses don’t apply here. The existence of the VA isn’t politically controversial. No one is trying to repeal it, or “sabotage” it. It hasn’t lacked for funds. Its budget has been increasing at a rapid clip. What we’re seeing is simply unaccountable bureaucracy in action....

In 2012, PolitiFact Rated Obama's Promise to "Make the VA a Leader in National Health" A "Promise Kept"
Is that embarrassing? Well, PolitiFact has revisited that old "promise kept" rating. It now rates it... "promise stalled."...

Krugman, Kristof, and Klein All Praised the "Success" of the VA's Socialized Medicine Model
...But the stupidity of the left is its abject refusal to see that The Government is a corporation, and is in fact the most powerful, richest, and most heavily armed corporation in the history of the world.

The left endlessly rages against misbehaving corporations with one-one thousandth of the resources of the government, and of course none of the government's armed agents and prison wardens, and endlessly fights to take power out of the hands of the misbehaving, selfishly-motivated unarmed corporation... and put that power into the hands of the misbehaving, selfishly-motivated armed corporation.

They're never quite able to understand this: The conservative preference for power in private hands isn't that we love big, unaccountable, guild-agenda-serving corporations.

It's that the alternative ever proposed by the left is just an even bigger, more unaccountable, more guild-agenda-serving corporation called the US Government.

And you can't quit the US Government without quitting the the United States itself.

Socialist Supermodel
Not long ago, the left raved about the VA.

...Krugman is far from alone in having oversold the VA. Timothy Noah, then with Slate.com, proclaimed in 2005: "Socialized medicine has been tried in the United States, and it has proven superior to health care supplied by the private sector. . . . The socialized medicine to which I refer is the complex of hospitals managed by the Veterans Administration." His post, "The Triumph of Socialized Medicine," was based on a Washington Monthly article by Phillip Longman, which carried the slightly more modest headline "The Best Care Anywhere." And in 2009, Ezra Klein revealed that "one of my favorite ideas" is "expanding the Veterans Health Administration to non-veterans."...

Left's VA-Worship Comes Back to Bite
...Similarly, Nicholas Kristof of the Times wrote in 2009:

Take the hospital system run by the Department of Veterans Affairs, the largest integrated health system in the United States. It is fully government run, much more “socialized medicine” than is Canadian health care with its private doctors and hospitals. And the system for veterans is by all accounts one of the best-performing and most cost-effectiveelements in the American medical establishment.

Just last year, Uwe Reinhardt of Princeton wrote in the pages of the Times:

Remarkably, Americans of all political stripes have long reserved for our veterans the purest form of socialized medicine, the vast health system operated by the U.S. Department of Veterans Affairs (generally known as the V.A. health system). If socialized medicine is as bad as so many on this side of the Atlantic claim, why have both political parties ruling this land deemed socialized medicine the best health system for military veterans? Or do they just not care about them?...

...Jonathan Golob of The Seattle Stranger has written in the same vein: “Every time I read about a Teabagger ranting about how socialized medicine will destroy this country I think of the VA system. There it is, a huge and vastly important universal healthcare system—government run, single payer and therefore socialist—right here in the brave and privatized United States: The Veterans Affairs hospitals.”...

Liberals touted Veterans Affairs hospitals as evidence government-run health care works
...Both authors cited Phillip Longman, who wrote an influential book on the Left titled Best Care Anywhere: Why VA Health Care is Better Than Yours. Longman, in a 2005 article for the Washington Monthly that led to the book, wrote, “It turns out that precisely because the VHA is a big, government-run system that has nearly a lifetime relationship with its patients, it has incentives for investing in quality and keeping its patients well--incentives that are lacking in for-profit medicine.”

The description of the system offered by liberals stands in stark contrast to the horrifying reality depicted in recent reports on how the veterans' health care system has neglected patients and covered up wait times – at a deadly cost....

Veterans scandal risks engulfing Obama
Amid contrived outrage over Benghazi and the improving fortunes of its healthcare reform, the Obama administration could be facing a genuine scandal about its treatment of military veterans that has the potential to attract broad political condemnation of its competence.

The Department of Veterans Affairs (VA) is facing mounting evidence that some of the hospitals it runs have been keeping two sets of books to make it look as if they were reducing waiting times to see a doctor.

More damning, the department is investigating the claims of a whistleblower doctor in Arizona that dozens of patients at one hospital died while they were languishing on a hidden waiting list without ever being given an appointment....

Obama warned about VA wait-time problems during 2008 transition
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 memo shows that the VA knew of records manipulation in 2010
...Petzel admitted that he knew of the issue after Sen. Johnny Isakson (R-Ga.) questioned him about the memo below, in which a top VA executive warned the directors of all VA health networks that questionable scheduling practices would “not be tolerated.”

The message summarized at least 17 tactics that VA hospitals were known to have used to hide treatment delays and give the impression they were meeting the department’s goal of seeing patients within 14 to 30 days....

Report: Obama transition team was warned about unreliable wait times at VA in 2008
...There are three steps in Hopenchange crisis management: (1) they profess to be “mad as hell”; (2) they accept a resignation/announce the retirement/place on “administrative leave” some relatively low-ranking officials; (3) as time wears on and media interest fades, they pronounce the whole thing a phony scandal. Their problem with the VA mess is that, no matter how long it drags out, they don’t dare pronounce this one “phony”; they can laugh at “#Benghazi” but they won’t laugh at wounded troops. So they need a Plan B for defusing the crisis, which, in this case, will be to claim that it’s another problem they’ve inherited from Bush. For, er, five and a half years....

Pauly Krugnuts: Health Care Confidential
..I know about a health care system that has been highly successful in containing costs, yet provides excellent care. And the story of this system's success provides a helpful corrective to anti-government ideology. For the government doesn't just pay the bills in this system -- it runs the hospitals and clinics.

No, I'm not talking about some faraway country. The system in question is our very own Veterans Health Administration, whose success story is one of the best-kept secrets in the American policy debate....

...The secret of its success is the fact that it's a universal, integrated system. Because it covers all veterans, the system doesn't need to employ legions of administrative staff to check patients' coverage and demand payment from their insurance companies. Because it covers all aspects of medical care, it has been able to take the lead in electronic record-keeping and other innovations that reduce costs, ensure effective treatment and help prevent medical errors.

Moreover, the V.H.A., as Phillip Longman put it in The Washington Monthly, ''has nearly a lifetime relationship with its patients.'' As a result, it ''actually has an incentive to invest in prevention and more effective disease management. When it does so, it isn't just saving money for somebody else. It's maximizing its own resources. In short, it can do what the rest of the health care sector can't seem to, which is to pursue quality systematically without threatening its own financial viability.''...

...For the lesson of the V.H.A.'s success story -- that a government agency can deliver better care at lower cost than the private sector -- runs completely counter to the pro-privatization, anti-government conventional wisdom that dominates today's Washington....

VA Budget Skyrockets Despite Federal Spending Cuts
DAYTON -- The Department of Veterans Affairs spends more today in inflation adjusted dollars than it did after World War II and the Vietnam War, when millions of troops returned from the battlefield, according to federal budget figures.

By the next fiscal year, the VA budget is projected to rise 58 percent since 2009 to $152.7 billion, more than double the $70.9 billion spent in 2005, agency figures show.

At the Dayton VA, spending has risen to a projected $285.3 million this year compared to $131.2 million in 2001.

Two factors more than any others have driven health care costs higher at the Dayton VA Medical Center, officials said. Aging Vietnam veterans who have more health needs as they grow older, and the return home of thousands of veterans from the battlegrounds of Iraq and Afghanistan.

"It's the number of veterans returning from the war, but it's also the conditions they are returning with," said Dr. William J. Germann, Dayton VA chief of primary care service and a retired Air Force brigadier general. "There are a number of veterans coming back dysfunctional and as a result may not be able to hold a job."

Straining under the national debt, budget cutters have slashed billions in federal spending and ordered unpaid furloughs of hundreds of thousands of Department of Defense civilian employees, but the VA's spending has more than doubled in little more than a decade and keeps climbing....

The Veterans Health Administration Really Does Offer 'Lessons' in 'Socialized Medicine'
Just a couple of years ago, Paul Krugman pointed to the Veterans Health Administration (VHA) as a "huge policy success story, which offers important lessons for future health reform." He gloated, "yes, this is 'socialized medicine.'"

Similarly, a letter touted by Physicians for a National Health Program trumpeted "the success of 22 wealthy countries and our own Department of Veterans Affairs, which use single-payer systems to provide better care for more people at far less cost."

How could a bloated government bureaucracy achieve such low-cost success? As we found out recently, it's by quietly sticking veterans on a waiting list and putting off their treatment for months—sometimes until the patients are far too dead to need much in the way of expensive care. Which is to say, calling it a "success" is stretching the meaning of the word beyond recognition.

And, while the White House insists it learned from press reports about the secret waiting lists, Press Secretary Jay Carney acknowledges that the administration long knew about "the backlog and disability claims" that have accumulated in the VHA.

This should surprise nobody. Canada's government-run single-payer health system has long suffered waiting times for care. The country's Fraser Institute estimates "the national median waiting time from specialist appointment to treatment increased from 9.3 weeks in 2010 to 9.5 weeks in 2011."

Likewise, once famously social democratic Sweden has seen a rise in private health coverage in parallel to the state system because of long delays to receive care. "It's quicker to get a colleague back to work if you have an operation in two weeks' time rather than having to wait for a year," privately insured Anna Norlander told Sveriges Radio

An article in The Local noted that "visitors are sometimes surprised to learn about year-long waiting times for cancer patients."

Britain's single-payer National Health Service (NHS) is up front about wait times for care, with the organization's website promising, "you have the legal right to start your NHS consultant-led treatment within a maximum of 18 weeks from referral." Last year, the Daily Telegraph reported that "waiting lists, which have hovered around 2.5 million patients in recent years, reached 2.88 million in June, the highest level since May 2008."...