Free Markets, Free People

VA


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