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.