Free Markets, Free People

VA


How centralized bureaucracies work

In another indicator of how low a priority veterans have with this administration, a whistleblower in Atlanta has revealed that VA employees were switched from processing VA applications to those of the Affordable Care Act, aka ObamaCare.

Scott Davis told the Atlanta Journal Constitution:

“We don’t discuss veterans. We do not work for veterans. That is something that I learned after working there. Our customer is the VA central office, the White House and the Congress. The veterans are not our priority. So whatever the initiatives are or the big ticket items, that is what we focus on.”

He later appeared on the Neil Cavuto show and claimed that 17,000 applications for VA Healthcare were destroyed.  He also said  they’re “also looking into a backlog of over 600,000 pending applications for VA Healthcare.” Davis said the applications were purged as a way to deal with pressure from Washington D.C.

Davis: What I think happened, Neil, is that there was pressure by people in Washington for us to hit our numbers. You’ve heard a lot about the 14-day turn around time for the hospitals. But what most people don’t know is that there’s a five-day turn around time for health applications. And if we don’t hit that five-day turn around time, it affects performance goals for people in senior leadership positions.

Cavuto: So if you don’t have that, and you’re not paying that out, it looks like you’re meeting your numbers and then some, right?

Davis: Absolutely. But what also happens, Neil, is that we’re currently neglecting not only the right thing to do, which is to process applications, not delete them. We have a huge system integrity issue at VA. For example, the VA right now can’t even tell the investigators what happened to those applications, because they can’t verify where they are, what happened to them, if they were deleted, why were they deleted, and why there was no paperwork showing the justifications for those deletions.

Cavuto: We’ve asked for a statement out of the VA on this and we have yet to get one, Scott. I’m trying then to give them the benefit of the doubt here. It seems like a crazy situation. Did you or any of your co-workers ever get so overwhelmed — not you specifically — but they just say the heck with it, more files, more applications, just dump them in the trash, we’re overwhelmed. Do you think that has gone on?

Davis: I know that there was rumors that suspect those activities before I started work thing in 2011. What I can tell you is that there’s so much pressure on the employees to get stuff done so management can meet goals, it’s easy to make mistakes, it’s easy to have mishaps. What happens is, instead of the VA focusing on doing what’s right for our nation’s veterans — meaning taking time, processing each application diligently and appropriately — pressure is placed on front line employees to overwork themselves, rush through the application process, to hit goals for members of management.

Cavuto: When you say to hit goals, is the goal a dollar goal or is it get the applications complete? Sometimes keep on top of this so there are no delays, or is it keep on top of it and get rid of something that could hurt our numbers?

Davis: Well, for what I’ve witnessed, it’s based on a performance goal.

Cavuto: How is that performance measured?

Davis: That performance is measured based on our ability to turn around an application from beginning to end within a five-day turn around. There’s an acceptable percentage that we have to have, which is in excess of 80% for all applications that comes into that office. What you find is that there’s extensive pressure on the staff to process applications, to focus our attention to applications based on specific campaigns. For example, I shared with your producer that we actually put incoming applications aside so we could focus on the ACA related applications that came in over last summer. That’s wrong. We should treat each veteran equally and focus on applications, as they come in, not because of special campaigns coming out of D.C.

His statement is precisely how veteran’s applications should be treated.  But they weren’t because of partisan politics and the heavy hand of the administration.   Naturally the VA  bureaucracy cooperated.  When your “customer” is Washington DC and not the veteran then that’s unsurprising.

This is outrageous, but my guess is, as they dig deeper into the VA, this is only the tip of the iceberg.

This is the face of government run health care.  It is fair warning.  Just as Soviet bureaucracies fudged whatever numbers necessary to “meet” the government’s “5 year plans”, the government bureaucracies here are not above doing the same.  The bonus system along with identification of Washington as their “customer” was all the incentive the bureaucrats needed to let veterans down … again.

~McQ


The bureaucratic state

While the enemies of freedom certainly are made up of politicians who would limit or take away your freedom, probably the most insidious of those enemies is the bureaucrat. As we’ve seen for decades, politicians come and go, but bureaucracies run the day to day machine of government. And as we’re seeing right now with the IRS, they’re both unelected and unaccountable, despite the volume of the outrage.

But remember, on the political side of this, one of the goals of the current administration was to help us believe that “big government” was a good thing … much better for many things than the private markets out there. One of the goals of ObamaCare was to take a giant step toward fully government run, single payer health care. But we’ve been feeding you stories for years about how badly the UK’s NHS performs and we’ve also pointed out that theirs isn’t an “exception” to the rule. If there is a rule, it is the rule of bureaucracies which says they exist to expand and protect themselves and really don’t much care about the original mission, in terms of performance. However, they’ll do just about anything to protect themselves. As I pointed out yesterday, the IRS director has committed himself to one of the most improbable stories about the fate of Lois Lerner’s emails since Bill Clinton uttered his infamous “I didn’t have sex with that woman …”. Everyone in the room knew he had. Everyone. And everyone in the Congressional hearing, including the witness, knew that his excuse for the loss of those emails was bogus.

Back to the point about “big government” being the best way to go and the liberal wet dream of government run health care (single payer) becoming reality. If, in fact, we want the American version of the NHS, we simply need to look at the only government run health care system in the America – VA (yes, I realize the military also runs a “single payer” system, but it isn’t set up for long care, etc – it’s a necessity that goes with the job). And what do we find in VA? Well check this out and tell me it doesn’t remind you of some of the horror stories you’ve seen from NHS. As you’ll see, it could very well be the NHS. As you’ll also see, the fault lies where? With the uncaring bureaucracy that has grown up around this system and its abuses are now coming to light:

Two psychiatric patients at a veterans facility in Brockton received no regular evaluations of their condition for years, part of a “troubling pattern of deficient patient care” that federal investigators say they have confirmed at veterans health care facilities nationwide.

One of the neglected patients at the Brockton Community Living Center who had been admitted for “significant and chronic mental health issues” was living in the 106-bed facility for eight years before he received his first psychiatric evaluation, investigators reported.

The other unidentified patient, although he was classified as 100 percent mentally disabled due to his military service, had only a single “psychiatric note” placed in his medical file between 2005 and 2013.

Let me make a prediction – as they get more and more into this, they’ll find this is just the proverbial “tip of the iceberg”. Of course, making such a prediction is certainly no high-risk venture.  Just look around you and take a gander at how well Leviathan is doing on almost any front.  Let’s just say “poorly” would be a compliment.  Justice?  Trashed.  Political influence of agencies?  See IRS.  See the misnamed Justice Department.  Bureaucratic overreach – see EPA and others.  Criminal incompetence?  See VA.   Etc.

Americans are going to have to make a choice and they’re going to have to make it quickly.  The bureaucratic state or the state of freedom.  Some would argue that we’re at the tipping point.  Some argue we’re beyond it.  That we’re looking at our future and the future is all down hill as the bureaucratic state transitions from servant to master.  Unelected, unaccountable and, frankly, uncaring – except to further its existence.

~McQ


A few things to note

I don’t mind at all saying “I told you so” when it comes to the alarmists and “climate change”.  You’ll remember a few weeks ago when the alarmists began screeching about the collapse of an ice shelf in Antarctica and how that was going to raise sea levels by feet, not inches and that there was nothing we could do about it?  Oh, and it was because of man-made global warming?

We found out subsequently, that the “rise in sea levels” might occur with this melting of the ice shelf, but that it would likely take a 1,000 years.  And, at that time, I put forward an article I’d written for QandO in 2009 where I noted that volcanic activity (aka geothermal activity) was responsible for an ice melt then.  I further posited that it was entirely possible it was responsible for the most recent ice shelf melt (since it is very close to the shelf itself) and had nothing to do with man.

Vindication:

Thwaites Glacier, the large, rapidly changing outlet of the West Antarctic Ice Sheet, is not only being eroded by the ocean, it’s being melted from below by geothermal heat, researchers at the Institute for Geophysics at The University of Texas at Austin (UTIG) report in the current edition of the Proceedings of the National Academy of Sciences.

The findings significantly change the understanding of conditions beneath the West Antarctic Ice Sheet where accurate information has previously been unobtainable.

The Thwaites Glacier has been the focus of considerable attention in recent weeks as other groups of researchers found the glacier is on the way to collapse, but more data and computer modeling are needed to determine when the collapse will begin in earnest and at what rate the sea level will increase as it proceeds. The new observations by UTIG will greatly inform these ice sheet modeling efforts.

Using radar techniques to map how water flows under ice sheets, UTIG researchers were able to estimate ice melting rates and thus identify significant sources of geothermal heat under Thwaites Glacier. They found these sources are distributed over a wider area and are much hotter than previously assumed.

The geothermal heat contributed significantly to melting of the underside of the glacier, and it might be a key factor in allowing the ice sheet to slide, affecting the ice sheet’s stability and its contribution to future sea level rise.

Oh my.  Who knew?  Uh, we did. Or at least we were able to apply facts and logic to the event and give a credible hypothesis as to why what was happening was happening.  Nice.

On another subject, the Bergdahl fiasco, it appears that Mr. Obama, who was perfectly fine about taking all the credit for his release when it appeared it would be to his political advantage (thus the Rose Garden announcement with the family), has now found someone he can throw under the bus since it has all gone wrong.  It’s Hagel’s fault:

FInal approval for the prisoner exchange that freed Sgt. Bowe Bergdahl was made by Secretary of Defense Chuck Hagel, members of Congress learned on Monday from administration officials.

‘They indicated (it was) Secretary Hagel (who made the final call),’ Rep. Buck McKeon (R-CA) said after a classified briefing, ABC points out.

‘It was the president of the United States that came out (in the Rose Garden) with the Bergdahls and took all the credit and now that there’s been a little pushback he’s moving away from it and it’s Secretary Hagel?’

Yup … I’ve lost count of all those who’ve found themselves looking at the underside of the Obama bus.  And for those who don’t think that this was an attempt to divert attention from the VA scandal, check this little tidbit out:

The final agreement was brokered in a week by Qatar and dovetailed with Obama’s announcement of a complete withdrawal from Afghanistan by the end of 2017. Engulfed in a scandal over hospital care for veterans, it also provided him an opportunity to demonstrate he was helping those who had served.

So it was Hagel’s final call?  Yeah, right. Again, the administration insults our intelligence.

Meanwhile we find more and more neglect and corruption in the VA, an agency that Mr. Obama criticized when his predecessor was in charge and vowed to clean up:

The agency said more than 57,000 new patients have waited at least 90 days for their first appointments and that about 13 percent of VA schedulers indicated they were told to falsify appointment-request dates to give the impression that wait times were shorter than they really were.

Remember, this is pure government run health care aimed at a very small population, relatively speaking.  And it is a disaster.

The agency also found evidence that in the past 10 years, nearly 64,000 veterans who sought VA care were simply never seen by a doctor.

“Simply”.  Not simply at all. This is mind numbing incompetence and corruption.  This was Ezra Klein’s ideal example for touting the benefits of government run (single payer) health care back when he was shilling so hard for the ACA.  Obama has done nothing to change the situation.  Congress, as usual has simply thrown money at it assuming that would fix it.  But its not just Obama’s problem.  This is a decades old institutional problem driven by a corrupt and incompetent bureaucracy that has given short shrift to the care of our veteran population.  This is the face of “government run healthcare”.

~McQ


Redefining incompetence

I remember well the liberal Democrat echo chamber calling G W Bush “incompetent”.  It was their mantra.  Their rehearsed talking point.  And the went on the weekend shows and in front of every camera they could find to repeat it.  Over and over and over.

If Bush was incompetent, what in the world does that make Obama?  This inept and incompetent White House just outed their own CIA station chief in Afghanistan in a picture of the Obama trip there over the Memorial Day weekend.  A trip clearly designed to distract from the growing VA scandal goes south in a heartbeat because of  … gross incompetence.

Anyone remember Valerie Plame?  That pales in comparison to this idiocy. Pales? It doesn’t even get on the radar screen in comparision.

And don’t get me started about the VA.

But speaking of VA, it does indeed again make the point that the government  - and especially under this particular administration – can’t run health care … period.  And no, I’m not saying a more competent administration could.  The VA has been plagued by problems for decades.  The fact that they’ve gotten worse under this President doesn’t at all surprise me.  But what may surprise you is this:

Since 9/11, the VA budget has increased by 235%, from FY2001′s $45 billion annual budget to FY2014′s $150.7 billion. On a percentage basis, the only Cabinet agencies that had larger budget increases over that arc have been State (271%) and Homeland Security (245%), the latter of which barely existed at the start of that period. In the Bush era, comparing the final budget with his signature (FY08) to the final Clinton budget (FY01), VA spending rose 88.3% to $84.7 billion. Defense spending rose 104% in the same period.

Barack Obama ran in 2007-8 on failures at the VA, promising more resources and better management. In comparison to that final Bush budget — don’t forget that Obama signed the FY2009 budget in March 2009 with the omnibus spending bill after a Democrat-controlled Congress refused to deal with Bush — VA spending has risen dramatically as well. The annual budget rose 78% in six budget cycles, with double-digit increases in four of the six years — while Defense spending was flat. No other Cabinet agency had a larger budget increase by percentage during Obama’s tenure. The closest was Agriculture (64%), followed by State (59%, which tends to discredit the canard about the Benghazi failure being caused by a lack of resources). Only HHS had a larger annual budget increase in terms of dollars spent, but it amounts to a 37% increase in spending from the FY2008 baseline. The amount of increase in the VA’s budget in the Obama era, $65.9 billion, exceeds the entire VA budget in the FY2004 budget.

So it wasn’t money.  As usual it was leadership.  How many freakin’ times do we have to hear this incompetent who is President say he learned about the latest scandal from television news?  For 6 years it has been all his and he has no idea what is going on in his own executive departments.  For that matter, neither do his secretaries.  The Health and Human Services absolutely blew the launch of the health care website.  Something that is done successfully everyday in the commercial world.  And where did Mr. Obama learn about it?  TV.  He certainly had no idea that it was a bust before then.

Why?  Because he didn’t bother to check.  Didn’t bother to ask hard questions or require a demonstration.  He didn’t lead.  He had already waved his magic hand and told them to get it done.  Words equal action in his world.

Same with the VA.  After lambasting the former administration for its failures in reference to the VA, he, in 6 years and billions of dollars, hasn’t improved it on iota.  And more grating than anything is he didn’t care enough to check.  He didn’t KNOW!  His secretary didn’t know!   An pattern of failure repeated in this administration since the beginning.  Instead the usual liberal panacea was applied: throw money at it and the problems will go away.  Just check out public education to see how well that’s worked – or the “War on Poverty”, etc.

Nope, this was a culture problem and a leadship problem.  The culture still survives and thrives and the leaders are nowhere to be found.  Oh the guys who are supposed to be in charge are still kicking, but they’re sitting in front of their television sets to see if there have been any new developments.  Meanwhile, this is going on and has been going on:

The VA department has been directly providing health care to millions of veterans for decades and evidence is growing that relying on the system can literally be a fatal decision. The Washington Examiner’s Mark Flatten reported May 12 that a Texas VA clinic implemented a cost-cutting measure in 2010 that required a patient to undergo three positive bloody stool screens before the government would approve a colonoscopy. Dr. Paul Krugman, who protested the policy while serving in the VA facility, told Flatten that “by the time that you do the colonoscopies on these patients, you went from a stage 1 to a stage 4 [colorectal cancer], which is basically inoperable.”

As many as 15,000 vets were subjected to this treatment. There is no way of knowing how many died because they spent their final days at home or in a private facility. Suffering and dying in obscurity due to a cost-cutting measure by a government-run health care system is the ultimate SNAFU, and nobody can guarantee it won’t be an commonplace under Obamacare.

Hell of a way to treat our veterans, isn’t it – but then when its all about bureaucrats and budgets, the focus isn’t on patients is it?  That’s government run health care in a nutshell.

Silver lining?  The VA, with a population of 9 million to serve, can’t get the job done competently and has, for the most part never been able to do so. THAT is the story of government run health care.  And all you need to cement that fact firmly in your head is to read the open letter one of our veteran triple-amputees penned this past week:

I remember candidate Obama promising to overhaul the VA and reduce the backlog.  You claimed that America’s support for its veterans is obvious by the way we treat our vets. You really nailed that one didn’t you?

Just like you were going to fix Detroit or fix foreign policy.  Your high school like approach to solving complex issues can’t be fixed by tweeting hashtags with propaganda to people who want to kill us. Anyone with an ounce of common sense can see you’re unfit to lead our nation, let alone act as our Commander In Chief.  What our country needs now, more than ever is real leadership, someone who doesn’t wait for a crisis, but is able to foresee an issue and deal with it before it happens. Unfortunately for America, you’ve been too busy campaigning and don’t have time to deal with the health care crisis of our veterans. The only thing you seem to care about is your own radical agenda, and now our vets are paying for your negligence with their lives.

As I sit here typing this out I’m dealing with my own VA nightmare which involves the Phoenix VA.  I have given 3 limbs for this country, but apparently that is not enough.  A “clerical error” made by a VA employee has resulted in nearly a year of abuse and mismanagement of my case. In other words, the VA is stealing over $7000 from my disability compensation that I earned when I lost 3 of my limbs for our country.

On this Memorial Day, as I battle your incompetent bureaucrats my family would like to thank you for once again failing our veterans. We can’t help but wonder about the disastrous socialized medicine program that we will surely be dealing with if Obamacare is allowed to be fully implemented. If our incompetent VA cannot handle government healthcare for a fraction of our population, who would be foolish enough to believe a massive health care system designed to provide health care for all American’s would be any different?  You can’t even find someone to build a competent website to work for your socialized medicine program when you had your name attached to it, so why would you care about our veterans when you could so easily push the blame off on someone else?

And the irony of it all?

The Department of Veterans Affairs says it will let more veterans obtain health care at private hospitals, VA Secretary Eric Shinseki announced Saturday.

That’s right … just like Canada used US private hospitals to bail its government run system out when it came to wait times, the VA is planning the same thing.  To anyone with an IQ above a donkey, that ought to tell you something.

~McQ


Analyzing Last Night’s Vote

Michael is of the opinion that last night’s results tell us fiscal conservatism is back in vogue. I think there’s certainly a hint of that in the VA win. What is certainly true is voters in VA rejected the Democratic message. And more remarkable was the fact that they rejected it down ticket as well – a sweep for the Reps. Not only that, they picked up majorities in heavily Democratic suburbs.  The size of the victory was stunning, to say the least.

But was it a rejection of the Democrat’s principles, an embrace of fiscal conservatism, a repudiation of the Obama administration or simply a reflection of the unease people feel with the economy and a belief Republicans handle that better? Or was it a little of all of those things?

What I’m driving at is both sides have a tendency to read too much into electoral wins, take off on a tear and find themselves on the losing side the next time around. The VA win, of all of the votes last night, was the biggest win for the GOP. But they need to temper their assessment so they, like the Democrats have, don’t overreach.

NJ, on the other hand, was a horse of a different color – or should I say donkey. Corzine had abysmal poll numbers well in front of the election. One of the biggest concerns among voters there was the corruption in government – it was rampant. And interestingly, the Republican candidate for governor, Chris Christie, had lead the fight against corruption, quite successfully I might add. So I’m not so sure that NJ, while still a huge win for the R’s, was so much a repudiation of Democrats and their principles as it was a repudiation of a specific incumbent. Again, the GOP should tread carefully to avoid reading too much into the NJ win.

That, of course, brings us to NY-23. The lesson in NY-23 can be summed up in one sentence, uttered last night by Brit Hume: “That’s why you have primaries”. The story here isn’t necessarily that the Democrat won. Given the disarray on the Republican side, I’m surprised it was as close as it was. Instead, it is about how badly the establishment GOP screwed up their selection process. Someone needs to tell them that the days of backroom selections which don’t reflect the desire or mood of the constituency were over a century ago. Had they had their primary and Hoffman won then it is hard to believe that the same level of support from the NRCC with no Scozzafava on the ballot siphoning off 5% of the vote (or campaigning for the Democrat) wouldn’t have yielded a much different outcome. In other words, establishment Republicans blew the election, not the activists. The good news for Republicans is they get to do this again in NY-23 in 2010. Let’s see if they can do a better job this next time.

All in all, a pretty decent night for the party that was in the wilderness not 6 months ago. But caution in interpreting the results should indeed be their watchword. In my opinion, establishment GOP types have not yet quite figured out the conservative insurgency which is now going on among them (and reflected in the Tea Parties, etc). Look for other challenges to Scozzafava-type candidates to continue in the future. They need to understand that much of their base has already rejected the usual approach to identifying candidates for office and that part of the base is willing to buck the establishment picks as they did in NY-23. In fact, NY-23, although a loss, will only encourage them.

The last observation I’ll make has to do with so-called independents. Indies went heavily for the GOP in the two governor’s races last night. That, if anything, should worry Democrats. Independents were the swing vote that decided the last presidential election. In a single year, they’ve found at least some Republicans worth their vote.

Additionally, this time it was the Republican base which was motivated. Democratic turnout was much lower in almost all areas of NJ and VA. And, unlike 2008, the young reverted to form and stayed home. Those are trends for the GOP to build on. However, as noted, they need to avoid over reaching as they do so.

~McQ


So How Are The Special Elections Shaping Up?

Right now, if you believe the final Public Policy Polling surveys in New Jersey and New York’s 23rd Congressional district, it looks like wins for the right side of the ideological curve.

In NY-23, PPP has Hoffman at 51%, Owens at 34% and Scozzafava – the GOP’s favored nominee – at 11%. So the insurgent conservative candidate who the GOP is now quite happy to claim, is pulling a majority in the district. Head to head, PPP has Hoffman at 51% and Owens at 38%. The former GOP candidate has chosen to act as conservatives thought she would – she’s endorsed the candidate which most closely matches her politics – the Democrat. Joe Biden will be in the district today to try and push Owen’s numbers up.

PPP’s analysis:

“Polling the race was a little haphazard in a weekend with many twists and turns but Hoffman showed a similar lead at all junctures… The bottom line though is that Hoffman led by double digits during every segment of the poll, an indication that he may have been headed for a definitive victory regardless of Scozzafava’s actions over the course of the weekend.”

We’ll see.

In the NJ governor’s race, PPP has Christie at 47%, Corzine at 41% and Daggett at 11%.

PPP points out that in NJ, the difference is independents going over to Christie’s side in a big way:

“Christie’s advantage is due largely to his support from independents and because he has Republicans more unified around him than the Democrats are around Corzine. Christie leads Corzine 52-29 with indies, as Daggett’s support with that group has declined to 16%. Christie is getting 82% of Republicans to Corzine’s 72% of Democrats.”

Of course this is NJ we’re talking about and 6% would seem to be a pretty significant lead, but there are factions at work which will most likely do whatever is necessary to overcome that.  But the defection of independents to the Republican candidate has to worry Democrats.

And I’d guess that what is happening in the VA Governor’s race is much the same as what is being seen in NJ – McDonald leads Deeds mostly because of a more unified Republican base and the defection of Independents.

Should all 3 go to the Republicans, it will be very interesting to see the spin – from both sides.  Democrats will most likely downplay the significance while privately being very concerned with 2010 right around the corner.  And Republicans will most likely misread the results as some sort of mandate for them and their “big tent” compromising ways.

Suffice it to say these are 3 specials that I’ll actually be interested in following tomorrow, if for no other reason than to hear the establishment party types on both sides explain what happened.

~McQ


Government Health Care – VA’s “Shoddy Standards … Put Veterans At Risk”

We had a little dust-up this week when I mentioned Ezra Klein’s propensity for government run health care and that he held the VA up as a shining example of what that can be.

Apparently it is a no-no among the crowd that follows Klein to include the government run military hospital system with the government run VA hospital system in a general critique of government run health care. And as is typical of drive-by commenters, they ignored the gist of the post to concentrate on pretending that two government run health care systems were not at all alike (because both have major problems).

So today, we’ll just talk about VA and the latest findings that support precisely what I said in the last post – VA has major systemic problems which are dangerous and, as Rep. Harry Mitchell,(D-AZ) who chairs the House Veterans’ Affairs Subcommittee on Oversight and Investigations said:

“[T]here is no question that shoddy standards — systemic across the VA — put veterans at risk and dealt a blow to their trust in the VA,”

And then there’s the growing controversy over procedures that exposed 10,000 veterans to the AIDS and hepatitis viruses.

What have those interested in veteran care found when they looked at the system?

An official with the American Legion who visits and inspects VA health centers said complacency, poor funding and little oversight led to the violations that failed the cancer patients in Philadelphia and possibly infected 53 veterans with hepatitis and HIV from unsterilized equipment at three VA health centers in Florida, Tennessee and Georgia.

“Lack of inspections, lack of transparency” were likely to blame, said Joe Wilson, deputy director of the Veterans Affairs and Rehabilitation Commission for the American Legion, who testified before Congress this month on transparency problems in a budgeting arm of the VA.

What’s he talking about? Well apparently the VA is discovering standards and procedures that have been commonplace in the civilian health care system for decades. Remember the problem with endoscopic procedures in multiple locations which led to contamination?

But investigations conducted by the VA last month show that systemic problems remain. Under half of VA centers given surprise inspections had proper training and guidelines in place for common endoscopic procedures.

Many believe the state of the VA is due to chronic underfunding:

Richard Dodd, a litigator who has represented veterans in lawsuits against the government, said that poor funding has lowered the quality of care and interest from some physicians.

“They’re generally under-funded … and I think the interest of the doctors suffers to some degree,” he told FOXNews.com. “Generally speaking, the physicians that work at the VA work there because they have no interest in private health care, and in some situations are unable to find jobs in private industry.”

Of course “underfunded” is always the claimed “root cause” of any problems with government run entities, isn’t it? Take education, for instance.  But underfunding has little to do with procedural failures. That’s just flat bureaucratic incompetence. It is also a persistent problem for top down, bureaucratic systems like – government run health care.

VA Secretary Gen. Eric Shinseki and senior leadership “are conducting a top to bottom review of the Department,” a VA representative told FOXNews.com. “They are implementing aggressive actions to make sure the right policies and procedures are in place to protect our veterans and provide them with the quality health care they have earned.”

But, of course, Gen. Shinseki, for all his military competence, wouldn’t know a proper endoscopic procedure from a walnut tree. And, apparently, neither to those in the system who’ve overseen the present ones. Or said another way, confidence isn’t real high that an apparently inept bureaucracy can suddenly discover competence.

For example, something as simple as drug inventory:

The Office of Inspector General (OIG) conducted an audit to determine how accurately the Veterans Health Administration (VHA) could account for inventories of non-controlled drugs at increased risk for waste and diversion in its health care facilities (facilities). VHA needs to improve its ability to account for non-controlled drugs to reduce the risk of waste and diversion. VHA cannot accurately account for its non-controlled drug inventories because it has neither implemented nor enforced sufficient controls to ensure pharmacy inventory practices are standardized and pharmacy data is accurate.

How can you tell me how “cost-effective” your pharmacy program has been when you don’t even know what your non-controlled drug inventories are and have never bothered to implement or enforce control over them?

Systemic problem.  But this is the shining example of government run health care according the Klein and others.  Underfunded, shoddy, overburdened, old facilities and equipment, a lack of transparancy and controls, insufficient training and poor procedures all driven by a top down bureaucracy.

Yeah, sign me up.

~McQ

[HT: Looker]


Government Health Care – A Cautionary Tale

Dale and I once interviewed Ezra Klein about health care on our podcast. Klein held the VA system up as a shining example of good government health care. Of course that was before the shameful condition of Walter Reed had been discovered. Since then other problems (for instance, contaminated colonoscopy equipment in various locations) have been discovered.

A commenter once asked “if VA is good enough for our veterans, why isn’t it good enough for us.” My answer was “it isn’t good enough for our veterans, it is instead what they’re stuck with.”

Today brings another example of the problems this sort of medicine is bound to have. It is a bureaucratic nightmare, even at the relatively small size of VA.

For patients with prostate cancer, it is a common surgical procedure: a doctor implants dozens of radioactive seeds to attack the disease. But when Dr. Gary D. Kao treated one patient at the veterans’ hospital in Philadelphia, his aim was more than a little off.

Most of the seeds, 40 in all, landed in the patient’s healthy bladder, not the prostate.

It was a serious mistake, and under federal rules, regulators investigated. But Dr. Kao, with their consent, made his mistake all but disappear.

He simply rewrote his surgical plan to match the number of seeds in the prostate, investigators said.

The revision may have made Dr. Kao look better, but it did nothing for the patient, who had to undergo a second implant. It failed, too, resulting in an unintended dose to the rectum. Regulators knew nothing of this second mistake because no one reported it.

That as they say, was the tip of the iceberg. No one reported the problem because there was no peer review. And, this was one of many mistakes made by this doctor that apparently no one knew about:

Had the government responded more aggressively, it might have uncovered a rogue cancer unit at the hospital, one that operated with virtually no outside scrutiny and botched 92 of 116 cancer treatments over a span of more than six years — and then kept quiet about it, according to interviews with investigators, government officials and public records.

The team continued implants for a year even though the equipment that measured whether patients received the proper radiation dose was broken. The radiation safety committee at the Veterans Affairs hospital knew of this problem but took no action, records show.

Six years and no one had a clue. In fact, if you read the article in full, as you should, you’ll see that the discovery of this was essentially an accident.

This is government health care. This is what our vets are stuck with. This is not something we, as a society, should want any part of.

~McQ


This Is Why Veterans And The Military Don’t Trust Democrats

Or perhaps a better way to say that is this is a typical reason Democrats aren’t well thought of, for the most part, by the military community:

Several veterans groups “are lashing out” at the Obama administration over a policy proposal they say would “dramatically alter” how the Department of Veterans Affairs handles health insurance claims for veterans, The Hill reports. Under the policy, which is included in President Obama’s fiscal year 2010 budget proposal, VA would bill health insurers for treatment of injuries and conditions sustained as a result of veterans’ military service. Currently, VA covers those costs and bills health insurers only for treatment for conditions unrelated to veterans’ military service.

The “you got it, you pay for it” method of saving money on the back of wounded vets. This after all the rhetoric and promises about taking better care of our veterans than ever before because they’ve “earned it”?

Remember?

Of course, as soon as this trial balloon is discovered, the mealy mouth nonsense begins:

According to OMB spokesperson Tom Gavin, although concerns about policy changes in coverage are understandable, no official proposal is on the table. He said, “The details of the VA budget are being worked out right now and the details won’t be available until April,” adding, “The administration is committed to providing the VA with substantial resources to provide for our veterans” (Tiron, The Hill, 3/9).

And, of course, with the federal government spending money on social issues disguised as “stimulus”, followed by a porked up spending bill and now an almost 4 trillion dollar budget, where is the one place that they decide they should try and save money?

On the backs of wounded vets.

Sorry, but that cost was prepaid by the terms of their service and wounds. But obviously, more interested in social issues within the military than keeping promises, the administration begins the ground work for backing out on another of its promises (to their credit, some Democrats, such as Sen. Patty Murray (D-WA), have declared such a proposal would be “dead on arrival” should it make it into the budget – a tip of the hat to her).

~McQ

michael kors outlet michael kors handbags outlet michael kors factory outlet