Tag Archives: Waiting List

Hillary Clinton downplays VA scandal: 307,000 veterans died on VA waiting lists

VA health care wait times
VA health care wait times

Before we find out what Hillary Clinton thinks of the Department of Veterans Affairs health care scandal, let’s find out what the problem is, using this article from Breitbart News.

Excerpt:

The Department of Veterans Affairs office Inspector General has released a report revealing that about 307,000 sick veterans have died while waiting for care on the VA’s eligibility waiting list. In fact, the report finds that many have been dead for more than four years.
The report confirms the worst-case scenarios about the long VA wait times that have made news reports and sparked questions in Congress since last year.

On Wednesday, the OIG revealed that of the 800,000-some records stalled in the VA’s health care enrollment system, 307,000 veterans have already died anywhere from months ago to more than four years ago.

“As of September 2014, more than 307,000 pending [enrollment system] records, or about 35 percent of all pending records, were for individuals reported as deceased by the Social Security Administration,” the report discovered.

But even that number was disputable because the VA’s databases are in such disarray.

“[D]ue to data limitations, we could not determine specifically how many pending [enrollment system] records represent veterans who applied for health care benefits,” the report continued. “These conditions occurred because the enrollment program did not effectively define, collect, and manage enrollment data.”

The study resulted after whistleblowers warned of the utter mismanagement at the Veteran Affairs offices that included incorrectly making unprocessed applications and the deletion of thousands of records over at least the last five years.

The OIG found one veteran who had been on a waiting list for 14 years and another veteran who died in 1988 but still had unprocessed applications in the VA system.

Scott Davis, a program specialist at the VA Health Eligibility Center, told CNN that millions of veterans are still at risk because of these failures.

“People who fought, and who earned the right to VA health care were never given VA health care,” Davis said. “They literally died while waiting for VA to process their health care application.”

Now let’s see what Hillary Clinton said about the VA scandal.

Hillary Clinton look bored about the deaths of 4 Americans who asked for her help
Hillary Clinton look bored about the deaths of 4 Americans who asked for her help

Here she is, in her own words, before a friendly audience:

She says this about the VA problems: “It’s not been as widespread as it has been made out to be”.

Single-payer health care

This is health care policy expert Sally Pipes, writing in Investors Business Daily, about the VA single-payer health care system.

She writes:

A new report from the Government Accountability Office has confirmed that the Department of Veterans Affairs can’t take care of those it’s supposed to serve.

The GAO has placed the VA’s health system on the “high risk” list of federal programs that are vulnerable to “fraud, waste, abuse, and mismanagement.” The agency is still struggling to recover from an 8-month-old internal audit that revealed that returning soldiers had to wait more than 90 days for care. Some patients died while waiting.

The GAO’s findings apply far beyond the VA. The agency’s problems — which include long wait-times and out-of-control costs — demonstrate what happens in any government-run, single-payer health care system.

[…]Defenders of government-run health care claim that it will control costs by cutting out middlemen such as insurance companies. The evidence shows otherwise. According to the GAO, the VA budget more than doubled between 2002 and 2013 even as enrollment increased by less than a third.Single-payer’s “guarantee” of access to high-quality care is a myth, too.

“Despite these substantial budget increases,” the GAO report says, “for more than a decade there have been numerous reports … of VA facilities failing to provide timely health care.”

[..]Last summer, lawmakers allocated $10 billion to a program intended to reduce wait times by permitting veterans to see private doctors outside the VA system. So far, the agency has only authorized 31,000 vets to seek private care — out of a possible 8.5 million.That has to change — 88% of veterans say that they want the ability to choose where they receive their care.

The VA health care system is the purest single-payer health care system in the United States. Every claim billed and processed by the government. Customers have ZERO CHOICES if they want to go to a competitor for better service, or less cost. They pay their money to the government in mandatory taxes, and then take their places in line to wait for bureaucrats to act. Bureaucrats face no pressure from competitors to perform for their customers. They have already been paid, and their customers cannot go anywhere else.

In single-payer system, health care is doled out to those customers whose votes are desired by the government. And if you get to the point where you need more health care than you are paying for in your mandatory in taxes… well, that’s what euthanasia is for. It’s very popular in countries that have single-payer, as a way of cutting costs. Canada has a single-payer system, and they just legalized euthanasia.

We have single-payer health care already in the VA system – is it working?

VA health care wait times
VA health care wait times

This is health care policy expert Sally Pipes, writing in Investors Business Daily.

She writes:

new report from the Government Accountability Office has confirmed that the Department of Veterans Affairs can’t take care of those it’s supposed to serve.

The GAO has placed the VA’s health system on the “high risk” list of federal programs that are vulnerable to “fraud, waste, abuse, and mismanagement.” The agency is still struggling to recover from an 8-month-old internal audit that revealed that returning soldiers had to wait more than 90 days for care. Some patients died while waiting.

The GAO’s findings apply far beyond the VA. The agency’s problems — which include long wait-times and out-of-control costs — demonstrate what happens in any government-run, single-payer health care system.

The VA’s failings ought to give pause to the liberal politicians and policy analysts who would love to introduce single-payer health care for all Americans. But they don’t seem to have heeded the GAO report. Within a week of its release, Rep. John Conyers, D-Mich., called for “Medicare for All.”

Champions of socialized medicine used to point to the VA as proof that single-payer worked. In 2011, economist Paul Krugman called it “a huge policy success story, which offers important lessons for future health reform.” In a 2009 debate with me, Princeton professor Uwe Reinhardt said that there’s an example of a single-payer system in the U.S. that works — the VA.

The VA offers lessons about health reform — just not the ones single-payer’s proponents have in mind.

Defenders of government-run health care claim that it will control costs by cutting out middlemen such as insurance companies. The evidence shows otherwise. According to the GAO, the VA budget more than doubled between 2002 and 2013 even as enrollment increased by less than a third.

Single-payer’s “guarantee” of access to high-quality care is a myth, too.

“Despite these substantial budget increases,” the GAO report says, “for more than a decade there have been numerous reports … of VA facilities failing to provide timely health care.”

Over the last decade, more than 63,000 veterans have been unable to get a doctor’s appointment. At least 40 veterans have died because of long waits.

Things aren’t likely to get better anytime soon. The VA has yet to act on more than 100 GAO recommendations for improving care.

Last summer, lawmakers allocated $10 billion to a program intended to reduce wait times by permitting veterans to see private doctors outside the VA system. So far, the agency has only authorized 31,000 vets to seek private care — out of a possible 8.5 million.

That has to change — 88% of veterans say that they want the ability to choose where they receive their care.

However, there is one military person who is getting health care – convicted traitor Bradley Manning. He’s getting sex-change surgery while he is in jail for leaking national security secrets to our enemies. He won’t have to wait at all for his health care. This is what happens when you take money out of your wallet, give it to the government, and then hope that when you get sick, someone in the government will decide that you are worthy of treatment. Which you aren’t, unless they want your vote.

It’s not just the VA health care system – government-run health care doesn’t work in other places:

The United Kingdom’s National Health Service, for instance, is notorious for denying patients everything from certain cancer medications to hip replacements.

The program is also financially unsustainable. According to its own medical director, Bruce Keogh, “if the NHS continues to function as it does now, it’s going to really struggle to cope because the model of delivery and service that we have at the moment is not fit for the future.”

In Canada’s single-payer system, the average wait time between referral from a general practitioner and the actual receipt of treatment by a specialist was more than four months in 2014. That’s nearly double the wait time of two decades ago.

The Canadian system is the one that Democrats want to emulate – but Canada’s rich left-wing politicians come here when they want care. They don’t want to wait in line. Why should we want to wait in line? We need to prefer consumer-driven health care over government-controlled health care.

White House review of VA finds “corrosive culture” to blame for poor patient care

The Wall Street Journal reports.

Excerpt:

A White House review of the VA health system points to a culture that has degraded the timely delivery of care and requires a restructuring to improve transparency and accountability.

Acting Secretary of Veterans Affairs Sloan Gibson and Rob Nabors, White House deputy chief of staff, told President Barack Obama on Friday that significant further action was needed to address systemic problems.

Six weeks after the president dispatched Mr. Nabors to assess problems within the VA, the president’s aide outlined a long list of issues affecting access to timely care at VA medical facilities.

Mr. Nabors’s work is the latest in a series of reviews and reports issued in the past two months, including those from the VA’s independent inspector general, the Office of the Special Counsel and the VA itself. The new report found what Mr. Nabors described as a “corrosive culture” that affects employee performance and patient care. He added that the Veterans Health Administration structure has “impeded appropriate management, supervision and oversight.”

The review also found that the VA’s goal for scheduling many medical appointments within 14 days is “arbitrary, ill-defined and misunderstood.” That goal had been set in 2011. The VA recently eliminated that 14-day target.

Mr. Gibson praised the report. “We know that unacceptable, systemic problems and cultural issues within our health system prevent veterans from receiving timely care,” he said in a statement.

The White House has scrambled to respond to evidence of widespread mismanagement within the VA and to fill a growing number of vacancies in top posts. An internal assessment also revealed improper appointment-scheduling procedures and efforts to hide long wait times across the VA health system.

Another interim report from the VA inspector general confirms that:

The VA’s independent inspector general office has said it would likely issue in August its full report on its sweeping review of the department. An interim report, issued just days before Mr. Shinseki’s resignation, showed problems throughout the VA. They included employees tinkering with official patient appointment wait times to make them seem much shorter than the actual times veterans were having to wait.

In case you were wondering why this is all happening in the VA health care system and not in the private health care system, it’s because the VA is 100% pure government-run health care, as health care expert Avik Roy explains in Forbes magazine. The VA is not scandal is not some sort of aberration from government-run health care. Long wait times and patient deaths are essential to government run health care, in practice.

American health care: does it cause poor life-expectancy and high infant mortality?

Probably one of the best health care policy experts writing today is Avik Roy, who writes for Forbes magazine.

Here is his latest column, which I think is useful for helping us all get better at debating health care policy. (H/T Matt from Well Spent Journey)

Excerpt:

It’s one of the most oft-repeated justifications for socialized medicine: Americans spend more money than other developed countries on health care, but don’t live as long. If we would just hop on the European health-care bandwagon, we’d live longer and healthier lives. The only problem is it’s not true.

[…]If you really want to measure health outcomes, the best way to do it is at the point of medical intervention. If you have a heart attack, how long do you live in the U.S. vs. another country? If you’re diagnosed with breast cancer? In 2008, a group of investigators conducted a worldwide study of cancer survival rates, called CONCORD. They looked at 5-year survival rates for breast cancer, colon and rectal cancer, and prostate cancer. I compiled their data for the U.S., Canada, Australia, Japan, and western Europe. Guess who came out number one?

Here is the raw data:

Health care outcomes
Health care outcomes by country and type of treatment

Click here to see the larger graph.

So, what explains this?

The article continues:

Another point worth making is that people die for other reasons than health. For example, people die because of car accidents and violent crime. A few years back, Robert Ohsfeldt of Texas A&M and John Schneider of the University of Iowa asked the obvious question: what happens if you remove deaths from fatal injuries from the life expectancy tables? Among the 29 members of the OECD, the U.S. vaults from 19th place to…you guessed it…first. Japan, on the same adjustment, drops from first to ninth.

It’s great that the Japanese eat more sushi than we do, and that they settle their arguments more peaceably. But these things don’t have anything to do with socialized medicine.

Finally, U.S. life-expectancy statistics are skewed by the fact that the U.S. doesn’t have one health-care system, but three: Medicaid, Medicare, and private insurance. (A fourth, the Obamacare exchanges, is supposed to go into effect in 2014.) As I have noted in the past, health outcomes for those on government-sponsored insurance are worse than for those on private insurance.

To my knowledge, no one has attempted to segregate U.S. life-expectancy figures by insurance status. But based on the data we have, it’s highly likely that those on private insurance have the best life expectancy, with Medicare patients in the middle, and the uninsured and Medicaid at the bottom.

I know that my readers who like to dig deep into economics and policy will love the links at the bottom of the article:

For further reading on the topic of life expectancy, here are some recommendations. Harvard economist Greg Mankiw discusses some of the confounding factors with life expectancy statistics, citing this NBER study by June and Dave O’Neill comparing the U.S. and Canada. (Mankiw calls the misuse of U.S. life expectancy stats “schlocky.”) Chicago economist Gary Becker makes note of the CONCORD study in this blog post. In 2009, Sam Preston and Jessica Ho of the University of Pennsylvania published a lengthy analysis of life expectancy statistics, concluding that “the low longevity ranking of the United States is not likely to be a result of a poorly functioning health care system.”

The funniest thing I have found when talking to people from countries with socialized health care systems, like Canada and the UK, is that they are woefully uninformed about American health care. They literally do not know about free emergency room care, which is free for anyone regardless of insurance – including illegal aliens. They do not know about our expensive Medicaid program, which helps people who cannot afford health insurance. And our very very expensive Medicare program, which provides health care to the elderly – including prescription drugs. I get the feeling that foreign critics of American health care are getting their views from amateur documentaries produced by uneducated Hollywood propagandists, or maybe from TV shows on the Comedy Channel. They certainly are not getting their information from peer-reviewed studies by credentialed scholars from top universities, like the ones cited above.

I have literally spoken to Canadians who think that people in the USA without insurance do not get treatment and just die in the streets from stab wounds. They don’t know about the emergency room rule, or about charity care, or about Medicaid and Medicare. There is a lot of ignorance up there – wilful ignorance, in some cases. And keep in mind that the average Canadian household is paying over $11,000 a year for this substandard health care! They are paying more for less, and that’s not surprising since a large chunk of the taxes that are collected for health care go to overpaid unionized bureaucrats. Naturally, when their left-wing politicians need treatment, the first place they go is to the United States, where they pay out of pocket for the better health care. But that doesn’t stop them from denouncing American health care when they are talking to voters.

Higher infant mortality rates?

One of the other common arguments you hear from uninformed people outside the USA is the higher infant mortality rates argument.

Here’s an article by Stanford University professor Scott Atlas to explain why the argument fails.

Excerpt:

Virtually every national and international agency involved in statistical assessments of health status, health care, and economic development uses the infant-mortality rate — the number of infants per 1,000 live births who die before reaching the age of one — as a fundamental indicator. America’s high infant-mortality rate has been repeatedly put forth as evidence “proving” the substandard performance of the U.S. health-care system.

[…]n a 2008 study, Joy Lawn estimated that a full three-fourths of the world’s neonatal deaths are counted only through highly unreliable five-yearly retrospective household surveys, instead of being reported at the time by hospitals and health-care professionals, as in the United States. Moreover, the most premature babies — those with the highest likelihood of dying — are the least likely to be recorded in infant and neonatal mortality statistics in other countries. Compounding that difficulty, in other countries the underreporting is greatest for deaths that occur very soon after birth.

[…]The United States strictly adheres to the WHO definition of live birth (any infant “irrespective of the duration of the pregnancy, which . . . breathes or shows any other evidence of life . . . whether or not the umbilical cord has been cut or the placenta is attached”) and uses a strictly implemented linked birth and infant-death data set. On the contrary, many other nations, including highly developed countries in Western Europe, use far less strict definitions, all of which underreport the live births of more fragile infants who soon die. As a consequence, they falsely report more favorable neonatal- and infant-mortality rates.

[…]Neonatal deaths are mainly associated with prematurity and low birth weight. Therefore the fact that the percentage of preterm births in the U.S. is far higher than that in all other OECD countries — 65 percent higher than in Britain, and more than double the rate in Ireland, Finland, and Greece — further undermines the validity of neonatal-mortality comparisons.

You can listen to a podcast with Dr. Atlas here, from the Library of Economics web site.

If you want to read more about how American health care compares with health care in socialized systems, read this article by Stanford University professor of medicine Dr. Scott Atlas. And you can get his book “In Excellent Health: Setting the Record Straight on America’s Health Care” from Amazon.

New study: NHS patients are 45 percent more likely to die than US health care patients

Wes sent me this article from the UK Telegraph.

Excerpt:

Patients are 45% more likely to die in NHS hospitals than in US ones, according to figures revealing how badly England’s health service compares with those of other countries.

Previously unpublished data collated by Professor Sir Brian Jarman over more than 10 years found NHS mortality rates were among the worst of those in seven developed countries.

A patient in England was five times as likely to die of pneumonia and twice as likely to die of septicaemia compared to similar patients in the US, the leading country in the study, the data suggested.

The elderly were found to be particularly at risk in English hospitals compared with those in the other countries.

The figures showed that the situation had improved since 2004, when the death rate in English hospitals was 58% higher than that in the best performing country.

But NHS institutions still lagged behind in the most recent data, from 2012, despite reforms of the health service and increased funding.

Of the other six countries studied, only the US was named because of the sensitivity of the data.

Prof Sir Brian, who adjusted the data to take account of differences in the countries’ health services, did not initially release his figures because he was so shocked by them he at first assumed there must be a flaw in his methodology.

There was, however, “no means of denying the results,” he said.

“I expected us to do well and was very surprised when we didn’t,” the Imperial College London medic told Channel 4 News.

“If you go to the States, doctors can talk about problems, nurses can raise problems and listen to patient complaints.

“We have a system whereby for written hospital complaints only one in 375 is actually formally investigated. That is absolutely appalling.”

Previously, I had posted a summary of a book by Scott Atlas, a medical doctor at the Hoover Institute at Stanford University. In that article, he laid out the reasons why the U.S. healthcare system was the best in the world.

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