Tuesday, June 3, 2014

Don't Believe the Hype

With all the recent sturm und drang about how the Obama Administration is failing our vets, and the way this issue is being exploited by the right to indict "government-run healthcare" in general,  I thought I'd pass along this reasonable assessment (with data to back it up) of the Veterans Administration healthcare system by Phillip Longman:
Over the next several days, I plan to make a series of posts here at Political Animal that I hope will be helpful to those covering the story, or for those who are just trying to get the full context for forming an opinion.
Today, let’s just start by scrutinizing the now almost universal assumption that there is a “systemic” problem at VA hospitals with excessive wait times. Even progressives, including the likes of Jon Stewart and Bill Maher, seem predisposed to believe this for their different reasons. Some voices, like my former colleague Brian Beutler of The New Republic, even speculate that the scandal may ultimately bounce in a way that harms the Republicans more than it does the Democrats.
But before we go there, can we get clear on just what the underlying reality is? There is, to be sure, a systemic backlog of vets of all ages trying to establish eligibility for VA health care. This is due to absurd laws passed by Congress, which reflect on all us, that make veterans essentially prove that they are “worthy” of VA treatment (about which more later). But this backlog often gets confused with the entirely separate issue of whether those who get into system face wait times that are longer than what Americans enrolled in non-VA health care plans generally must endure.
Longman quickly identifies the initial choke-point in the ability of veterans to obtain medical care, one that has nothing to do with the actual socialized healthcare system run by the VA. Basically, in order to access VA health care, veterans have to "prove" they are entitled to that care - that their ailment was a result of their service, for instance. These regulations were mandated by Congress, not the VA or the Obama Administration, and only Congress can pass laws to loosen those restrictions or make the process the Veterans must undergo to receive care less burdensome.

Longman then moves on to a discussion of waiting times at VA facilities, the root of the current scandal. He detail how, although most VA hospitals are actually underutilized because of the passing of large numbers of WWII, Korean War, and Viet Nam War veterans, due to recent population shifts from the north to the sun-belt states, there are some hospitals that are over utilized and have longer wait times (hence the problems in the Phoenix area that have been getting all that press).

After putting the numbers in perspective, Longman critiques the critics calling for privatizing the VA (and all other government-administered healthcare) by noting that the Veterans' organizations themselves do not want the VA privatized, and generally rate the quality of care they receive higher than that provided in the private sector.

Longman finishes with the promise to investigate the question that most media outlets seem to be doing their best not to ask at all:
. . . the key question to ask when confronting the real deficiencies of the VA is “compared to what?” Once that context is established, it becomes clear that VA as a whole continues to outperform the rest of the American health system, making its true lessons extremely important to learn. 
I look forward to reading the rest of the pieces in this series.

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