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Paul Krugman vs. Reality: The VA Hospitals

Written by Gary North on June 10, 2014

This is reality: a report by the VA, as summarized by the Washington Post.

The Department of Veterans Affairs on Monday shed light on the depth of the VA scheduling scandal and substantiated claims that rank-and-file employees were directed to manipulate records.

The agency said more than 57,000 new patients have waited at least 90 days for their first appointments and that about 13 percent of VA schedulers indicated they were told to falsify appointment-request dates to give the impression that wait times were shorter than they really were.

The information comes from the agency’s internal audit of 731 VA medical centers, which the VA released Monday.

The report said that complicated scheduling practices created confusion among clerks and supervisors, contributing to the problems. It also said the VA’s goal of providing an initial appointment within 14 days of a request was unattainable because of the growing demand for care among veterans.

Here is the assessment by Nobel Prize winning Keynesian economist, Paul Krugman. He offered this assessment in 2011. The article was “Vouchers for Veterans,” in which he attacked a variant of Milton Friedman’s voucher plan for government-run schools, but applied to medicine. (The public has never adopted Friedman’s voucher idea for government-supplied services.) Krugman prefers socialized, government-run medical care. He likes his socialism straight, not some sugar-coated “Let’s make coercion workable” version from Friedman. This appeared in the New York Times.

What Mr. Romney and everyone else should know is that the V.H.A. is a huge policy success story, which offers important lessons for future health reform.

Many people still have an image of veterans’ health care based on the terrible state of the system two decades ago. Under the Clinton administration, however, the V.H.A. was overhauled, and achieved a remarkable combination of rising quality and successful cost control. Multiple surveys have found the V.H.A. providing better care than most Americans receive, even as the agency has held cost increases well below those facing Medicare and private insurers. Furthermore, the V.H.A. has led the way in cost-saving innovation, especially the use of electronic medical records.

What’s behind this success? Crucially, the V.H.A. is an integrated system, which provides health care as well as paying for it. So it’s free from the perverse incentives created when doctors and hospitals profit from expensive tests and procedures, whether or not those procedures actually make medical sense. And because V.H.A. patients are in it for the long term, the agency has a stronger incentive to invest in prevention than private insurers, many of whose customers move on after a few years.

And yes, this is “socialized medicine” — although some private systems, like Kaiser Permanente, share many of the V.H.A.’s virtues. But it works — and suggests what it will take to solve the troubles of U.S. health care more broadly.

In the choice between Nobel Prize-winner Milton Friedman’s voucher system and Nobel Prize-winner Paul Krugman’s socialist medicine, count me out. I prefer Nobel Prize-losing economist Murray Rothbard’s assessment in 1994, the year before he died.

We have to remember a crucial point about government as against business operations on the market. Businesses are always eager for consumers to buy their product or service. On the free market, the consumer is king or queen and the “providers” are always trying to make profits and gain customers by serving them well. But when government operates a service, the consumer is transmuted into a pain-in-the-neck, a “wasteful” user-up of scarce social resources. Whereas the free market is a peaceful cooperative place where everyone benefits and no one loses, when government supplies the product or service, every consumer is treated as using a resource only at the expense of his fellow men. The “public service” arena, and not the free market, is the dog-eat-dog jungle.

Want proof? The VA hospitals are the poster child.

Continue Reading on www.nytimes.com

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15 thoughts on “Paul Krugman vs. Reality: The VA Hospitals

  1. Buckeye Libertarian says:

    Like I commented when this story was posted on this blog on 03 June, Krugman is the Baghdad Bob of Washington D.C.

  2. peleus212 says:

    Based on what I have been reading it is still the poster child for how the ACA will be setup in the hospitals, the wait lists, the fudging of numbers and the blatent mis information that will be sent out. So the folks while dying while waiting will be happy to know how efficient the system is. Or so it would seem and they would have us to believe

  3. Roy S. Mallmann says:

    This is going to be a preview of Obamacare and I think everybody knows it. It can't help but be like that as government workers are never every held accountable for anything as all the recent events in this administration have shown. It is kind of hard for the liberals to deny reality though. I just thank God, that I am on Medicare, handled through a private contractor.

  4. Sad, but no fix for the VA! Not going to happen under obama! obama doesn't fix, just lies for destruction purposes! obama is on a mission to have new world order and it does not include America! obama is America's enemy!

  5. One has to wonder if the awarding of the Nobel Prize to Mr. Krugman is as deserving as the Nobel Peace Prize given to Obama.


  7. And the poster boy for educated idiots !

  8. You make a very important point ? We really do live in massive illusions and all are created by PRAVAD/MSM as control mechanisms. Check out my site . I imagine you will enjoy ! Like minds anb all .

  9. You may be sure that the overly vaunted and frequently wrong, Mr. Krugman, will not be subjected to the vagaries of Obamacare. That is for us little people. The elite and self important fools, somehow avoid the little bumps in the road that afflict most of society. I suspect that heavy inbreeding makes them what they are. See my blog at http://cranky-conservative.blogspot.com

  10. David in MA says:

    I wonder if the problem areas had been reported if correcting them would have prevented expansion…and, who is actually responsible for this, the person or persons who gave the directive to cook the books? THAT or THOSE people need to be sued criminally AND civilly and if found guilty___ JAILED! Seems these types of problems follow democrats, why?
    Whatever it is, it shows socialized medicine (socialized anything) does not work, never has and never will, been proven time and time again.
    P.S. I do not like Obama.

  11. The reason there is "no funding left" to pay for veterans' healthcare is here. Prepare to be shocked by how much these whining bureaucrats make for putting vets on "wait lists" (where they die waiting for treatment).

    And then there's the head of the VA Hospital in Phoenix, who said openly to subordinates that "we should just shoot old veterans in the head, because it costs too much to take care of them!"

    I hope every patriotic young man or woman considering a "career" in the military takes these revelations to heart before entering into that contract some recruiter has lied about to get you to sign. This is what awaits you, when you are of no more use to the US regime.

  12. I think you make a category error when you refer to folks like Krugster as 'educated idiots'.

    Krugman is a smart guy: to my way of thinking it makes no sense to try to advance an argument that relies on rejecting that proposition.

    What's important is that Krugster responds to incentives – precisely as the core of economic theory tells us. And the incentive structure that he faces is tilted as a result of government intervention in, and control over, the formal academic market for ideas.

    Put it this way: if someone approached you and said "We like you – we think you're a good fit for our organisation. We can guarantee you seven figures, and the prestige and profile that come along with that. We can open up all sorts of doors – from speaking gigs at Davos, to an endowed chair at the best educational institutions on the planet. Seriously – that's something we can do for anybody we want to do it for. All we're looking for from your perspective, is that you … "

    Well-paid-for-minimal-productivity, low-stress gig as an economic commentator do not exist unless you are prepared to be a .gov polemicist: that's just the way things are (although there are periodic bursts of funding for anti-.gov research of decent quality – but they don't last very long before they attract professional bullshít-artists looking for the easy money in board and management positions).

    Krugman's panegyrics in favour of his paymasters are simply a reminder of Upton Sinclair's aphorism:

    "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!"

    Half the battle that advocates of voluntaryism face, is that the State indoctrinates people to believe that the net benefits of anarchy are less than the net benefits of the State: in fact the State takes advantage of loss-aversion and 'anchoring' and availability heuristics, by promulgating the notion that the net benefits of anarchy are negative.

    And since less than 1% of the entire OECD adult population is capable of "assessing truth values" and "evaluating competing claims when they involve subtle rhetorical clues", there is little prospect of advancing the ball by trying to change the Mass Mind (because the Mass Mind is pretty retarded: the median adult in the OECD does not have the "minimum level [of literacy or numeracy] required to cope with everyday life").

    See that paragraph above? That's a distillation of the results of the latest research into "Adult Competency" that the OECD finished in 2013: the surveys covered 166,000 people in 33 countries with a combined adult population of about 735 million – equal to about 16% of the entire planet's adults, and all of the world's most advanced economies.

    When you consider that the metrics for India and China (where most of the rest of the world's adult live) will almost certainly be worse than OECD statistics, it's worrisome.

    Take a look (and be horrified) –

    OECD (2013), OECD Skills Outlook 2013: First Results from the Survey Of Adults Skills,
    (link: http://skills.oecd.org/documents/OECD_Skills_Outl… )


    OECD, "The OECD Programme for the International Assessment of Adult Competencies (PIAAC)", 2010

    Rammstedt et al (2013) PIAAC 2012: Overview of the Main Results (link – http://www.gesis.org/fileadmin/piaac/Downloadbere… )

  13. You seem to be assuming that Krugster's job is to be 'right', RLOwen.

    It's not – no more than Bill Kristol's job is to be 'right', or Henry Kissinger's, or John Roberts, Samuel Alito or Antonin Scalia. Or Yoo, Addington, Gonzales. Or Blair, Sarkozy, Hollande, Gillard, Howard, Rudd, Cameron, or Netanyahu. Or Keller, Rusbridger, Murdoch, Packer.

    Their jobs – individually and collectively, is not to be 'right'. It is to advance the interests of their class. And they arre doing an absolutely splendid job: why, the vast bulk of the human livestock will accept without question that all those people abovementioned are âssholes, and yet actively ridicule anybody who says that the system cannot be reformed by must be done away with entirely…

  14. I was in the VA healthcare system for 13 years after the war. When I married, my wife got me on her insurance at work and I've been there since. I believe I owe my life to my wife and private medical insurance. For nearly six years I've told folks if they want to know what government healthcare is like, spend a day or two at the nearest Veteran's Administration medical center.