Free Markets, Free People
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.