Let's be clear: Fixing the VA's culture--important as that is and as much in need of being fixed as it is--won't resolve the disease that's evidencing itself in the chronic symptoms upon which the media has focused its laser. Those symptoms include: long waits to see medical professionals; the deaths of veterans who are forced to endure those long waits just to get a referral; and, systematic coverups that VA employees failed to expose even though whistleblower protections are provided.
The disease at the heart of all these chronic symptoms--what needs to be fixed--is the economic model upon which the VA system is constructed: It's a single-payer system. That is, Congress sets the VA's budget. That budget limits the $$$s VA administrators can direct towards patient care as well as other elements of the system.
A Senior Fellow at the Cato Institute, Michael Tanner, describes the genesis of these chronic symptoms that continue to evidence themselves today in the VA's culture despite the promises of politicians to "clean up the system":
- The number of soldiers returning from the Iraq and Afghanistan wars increased demand for VA services. In the 5 years between 2007 and 2012, that demand rose 13%. Yes, Congress allocated an additional $24B--a 76% increase--during that period. But, the VA still lacked the resources its medical professionals needed if they were to provide all of the care demanded. So, VA personnel made decisions to ration care. Understandable, but with tragic and not so tragic consequences.
- It is estimated that it takes an average of 160 days for veterans to gain access to their defined health benefits. Today, that means the VA has a case-processing backlog of 344k+ claims. Since the pie can't be expanded without additional resources to meet demand, decisions must be made about those cases meriting the highest priority or having the greatest amount of political clout. Then, too, appealing those decisions is estimated to take an additional average wait time of 1,598 days.
While these data might strike some people as extraordinary and perhaps limited solely to the VA, Tanner found similar data among Medicaid patients. They are 600% more to be denied a doctor's appointment than the privately insured. Furthermore, when Medicaid patients finally do get an appointment, they have an average wait time of 42 days before they actually get in to see a doctor. That's 200% longer than the wait time of privately insured individuals.
Note well: All of these symptoms reveal the disease--the essence of a single-payer system. The pie can't expand unless additional resources for infrastructure and the personnel needed to provide for the goods and services demanded are available. Supply must equal demand or inefficiencies result, namely, too much supply or too little supply to meet demand. The VA's chronic disease is the latter.
As Tanner notes, promising access to healthcare in a single-payer system does not mean the system can or will deliver more or even better healthcare. In fact, as the revelations about the VA confirm, the system itself spawns a culture wherein well-intentioned healthcare professionals not only cannot provide medical care for their patients, but those same healthcare professionals also end up creating a diseased organizational culture characterized by mismanagement, corruption, and even neglect of those for whom the VA was created.
Unless Americans focus upon the disease rather than the symptoms of the single-payer system characterizing the VA, it's entirely predictable what kind of healthcare they should expect from Obamacare in a very few, short years. That's why the VA's problems really do matter.
Let the discussion begin...
To read Michael D. Tanner's study, click on the following link:
"How VA Hospitals Are a Government-run Disaster."