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With its shameful backlog and secret waiting lists at some of its facilities, the Veterans Health Administration is facing an urgent crisis. But the only reform certain to make things worse would be to privatize the system of 1,700 VA facilities that serve 8.76 million American vets. Despite its troubles, studies consistently show that VA health care is very popular, delivers quality service and costs less than private sector alternatives. Nevertheless, the usual suspects on the right like John Fund and Charles Krauthammer are predictably calling for its replacement by a voucher program.

Appearing on Fox News on Monday, Krauthammer declared, ""Well, if you would suggest that we go to a voucher system, where everybody will get a voucher for treatment in any hospital he or she chooses, and I were a vet, I would choose that," adding, "I would rather go to Georgetown University Hospital than to a VA." If that formulation sounds familiar, it should. During the 2012 presidential campaign, GOP nominee Mitt Romney floated the same trial balloon, which just about every veterans' group in the nation quickly shot down:

"Sometimes you wonder if there would be some way to introduce some private-sector competition, somebody else that could come in and say, you know, that each soldier gets X thousand dollars attributed to them, and then they can choose whether they want to go in the government system or in a private system with the money that follows them," said Romney. "Like what happens with schools in Florida, where people have a voucher that goes with them. Who knows?"
Actually, many people know exactly what would happen, among them (as ThinkProgress noted) AMVETS, Disabled American Veterans, Paralyzed Veterans of America, and the Veterans of Foreign Wars. Sending millions of older, sicker Americans—many of them requiring specialized care for rare and complex health problems—into the waiting arms of private insurers, private doctors and private pharmaceutical firms is a recipe for chaos and de facto rationing on a grand scale. As the nonpartisan Congressional Budget Office (CBO) concluded its assessment of Paul Ryan's premium support proposals for Medicare, the result would be a dramatic shift of health care costs onto patients.

Please read below the fold for more on this story.

As the RAND Corporation explained in 2012 ("'Socialized' or Not, We Can Learn from the VA"), the VA system delivers care as good or better than its private sector counterparts, all while doing a much better job of controlling costs for American taxpayers.

RAND's study, led by Dr. Steven Asch, found that the VA system delivered higher-quality care than the national sample of private hospitals on all measures except acute care (on which the two samples performed comparably). In nearly every other respect, VA patients received consistently better care across the board, including screening, diagnosis, treatment, and access to follow-up...

Among chronic care patients, VA patients received about 70 percent of recommended care, compared with about 60 percent in the national sample. For preventive care, the difference was greater: VA patients received 65 percent of recommended care, while patients in the national sample received recommended preventive care roughly 45 percent of the time...

After adjusting for a changing case mix as younger veterans return from Iraq and Afghanistan, the CBO calculated that the VA's average health care cost per enrollee grew by roughly 1.7% from 1999 to 2005, an annual growth rate of 0.3%. During the same time period, Medicare's per capita costs grew by 29.4 %, an annual growth rate of 4.4 %. In the private insurance market, premiums for family coverage jumped by more than 70% (PDF), according to the Kaiser Family Foundation.

Sadly, it wasn't always this way. The turnaround at the VA isn't merely, as Paul Krugman explained, "one of the great policy success stories of the past two decades." Writing in the Washington Monthly, Steve Benen highlighted the 2005 findings of Phillip Longman in "The Best Care Anywhere":
As Longman explained at the time, "Who do you think receives higher-quality health care? Medicare patients who are free to pick their own doctors and specialists? Or aging veterans stuck in those presumably filthy VA hospitals with their antiquated equipment, uncaring administrators, and incompetent staff? An answer came in 2003, when the prestigious New England Journal of Medicine published a study that compared veterans health facilities on 11 measures of quality with fee-for-service Medicare. On all 11 measures, the quality of care in veterans facilities proved to be 'significantly better.' ... The Annals of Internal Medicine recently published a study that compared veterans health facilities with commercial managed-care systems in their treatment of diabetes patients. In seven out of seven measures of quality, the VA provided better care."
In June 2010, Elizabeth McGlynn, associate director of Rand Health, a division of the Rand Corp., concurred with the assessment that "it's hard to top veterans' health care."
"You're much better off in the VA than in a lot of the rest of the U.S. health-care system," she said. "You've got a fighting chance there's going to be some organized, thoughtful, evidence-based response to dealing effectively with the health problem that somebody brings to them."

The combination of its information system and support tools, routine performance reporting and financial incentives for managers who hit quality targets gives it an edge, said McGlynn, who co-authored a comparative study published in the Annals of Internal Medicine in 2004 that found the VA outperformed its community health-care counterparts by 20 percentage points in preventive care. It also performed significantly better on chronic disease care and in overall quality.

Just as telling, a June 2011 study by Amal Trivedi and Regina Grebla published in the journal Medical Care found that the VA delivered much better results for elderly patients than private sector Medicare Advantage (MA) plans:
Among persons aged 65 years or older, the VA health-care system significantly outperformed private-sector MA plans and delivered care that was less variable by site, geographic region, and socioeconomic status.
Back in 2006, the Defense Department reported that "VA Outranks Private Sector in Health Care Patient Satisfaction." President Bush's VA Secretary R. James Nicholson called the findings of the annual American Customer Satisfaction Index, "the greatest story never told."
Veterans who recently used VA services and were interviewed for the 2005 ACSI survey gave the VA's inpatient care a rating of 83 on a 100-point scale -- compared to a 73 rating for the private-sector health care industry. Veterans gave the VA a rating of 80 for outpatient care, five percentage points higher than the 75 rating for private-sector outpatient care and 9 percent higher than the average satisfaction rating for all federal services.

"Although VA has received many wonderful endorsements recently, the support of our veterans -- the people who know us best -- is the highest praise," Nicholson said.

As the Washington Post noted last month, "The American Customer Satisfaction Index for 2013 shows that the VA health network, which serves more than 8 million veterans, achieved marks equal to or better than those in the private sector." (The latest ACSI report is available here.)

At the end of the day, the fiasco at VA could not come at a worse time. While Congress is wrangling over the size of the defense budget, the total costs of the wars in Iraq and Afghanistan could reach up to $6 trillion once veterans' pensions and health care are factored in. Over the next 10 years, the Veterans Administration will need more money, not less. And redirecting those resources to the private sector as Mitt Romney, Charles Krauthammer and the conservative commentariat urge can have only one outcome. As Krugman summed it up in 2011:

You know what voucherization would mean in practice: the vouchers would be inadequate, and become more so over time, so that veterans who don't make enough money to top them up would fail to receive essential care. Patriotism!
It's no wonder the Veterans of Foreign Wars tersely responded to Mitt Romney's proposal by simply declaring, "The VFW doesn't support privatization of veterans' health care."

Originally posted to Jon Perr on Tue May 20, 2014 at 12:48 PM PDT.

Also republished by Daily Kos.

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Comment Preferences

  •  It seems to me that (2+ / 0-)
    Recommended by:
    Sylv, Lily O Lady

    Senators McCain and Graham and Sherrod Brown and Elizabeth Warren should get  together  and draft a bill  appropriating $1B immediately  to fix the VA systems and bring them into the 21st century so that the computers for the DOD can talk to the puters of the VA and we can get the system moving again.

    Senators routinely spout the  "support the troops" meme.. It is time  fo rthem to put their money where their mouth is and  any Senator that does not co-sponser the  bill should be shamed for NOT supporting the troops.

    •  Would McCain Make a Move Against (0+ / 0-)


      We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

      by Gooserock on Tue May 20, 2014 at 01:26:10 PM PDT

      [ Parent ]

    •  My VA healthcare is computerized (10+ / 0-)

      I have VA as my ACA on top of Medicare, and Medicaid.
      I can go to, log in and talk to my doctors.
      My doctors give me incredibly good care, have saved my life a couple of times.

      The VA provides a level of walk in ambulatory care that can include things like CAT scans, X Rays, ultrasounds, phlebotomy, biopsies, colonoscopies, specialists for optometry, audiology, podietry, and if necessary for a surgery they don't perform they can plop you in an ambulance and have you in an ICU in another state getting prepped for surgery same day.

      Do not mess with my VA healthcare.

      I will allow some states may have more problems than others but I can also tell you that the VA follow up is in my experience above and beyond in every way.

      "la vida no vale nada un lugar solita" "The Limits of Control Jim Jarmusch

      by rktect on Wed May 21, 2014 at 07:45:11 PM PDT

      [ Parent ]

      •  VA - isn't that like a Single Payer system? (7+ / 0-)

        Granted, qualifying for the program is not for the faint of heart...

        "No special skill, no standard attitude, no technology, and no organization - no matter how valuable - can safely replace thought itself."

        by xaxnar on Wed May 21, 2014 at 07:50:53 PM PDT

        [ Parent ]

        •  Bingo! That's what all the fuss is about, (9+ / 0-)

          proving that the VA, i.e. single payer health, doesn't work.

          And it doesn't, if we chronically underfund it, especially if we give mid level managers bonuses for lying that they're meeting impossible (within funding/staffing realities) targets.

          This much larger than a veterans issue.

          War beats down, and sows with salt, the hearts and minds of soldiers." Brecht

          by DaNang65 on Wed May 21, 2014 at 08:20:55 PM PDT

          [ Parent ]

        •  Indeed it's Single Payer. (3+ / 0-)
          Recommended by:
          HM2Viking, OhioNatureMom, xaxnar

          That's why the FLICKING Rethugs would wish to voucherize/profitize it.

          Meh. GOP/TPers.
          Meh. Private VA healthcare.

          Ugh. --UB.

          The Republican Party is run by the KOCH BROTHERS.

          by unclebucky on Wed May 21, 2014 at 09:06:52 PM PDT

          [ Parent ]

        •  It's better than just Single Payer, it's like NHS (2+ / 0-)
          Recommended by:
          dksbook, OhioNatureMom

          The distinction is that in a Single Payer system the providers may be private hospitals or private Doctors, but in a NHS system, such as that in England, the providers are employees of the publicly owned and operated NHS. This difference means a Single Payer system still has private profit entities billing for services, with all the attendant overhead costs and profit motives.

          Given the animus corporatists have for anything like a National Health Service (NHS), it's not surprising that corporatists are systematically working to underfund the VA Health Service, while screaming for its destruction.

          Carbon dioxide in the atmosphere is now 401.25 ppm. That is "Climate Cluster Chaos". (hat tip to JeffW for CCC)

          by Zinman on Wed May 21, 2014 at 09:53:05 PM PDT

          [ Parent ]

        •  Yes, it is a single payer system (2+ / 0-)
          Recommended by:
          OhioNatureMom, xaxnar

          If all healthcare could be more like the VA, universal, comprehensive, single payer, it would save more American lives every year than were lost to 9/11, Katrina, Iraq, and Afghanistan combined. It would save half as many lives every year as are lost to gun fail.

          Most healthcare in this country is either universal, like community health centers, or comprehensive like Hospitals, but generally not both like the VA.

          Most healthcare in this country could easily be single payer, why do we need insurance companies taking 20% profits to be the middleman between you and your doctor?

          Now the thing about the VA and the ACA healthcare is they save a huge amount of money by emphasizing regular checkups and preventative care as a much less expensive alternative than going to hospital emergency rooms to get therapeutic care.

          First off its not a bad idea to see a doctor for 15 minutes once or twice a year and have them ask you where it hurts; have a nurse take your vital signs, lecture you about diet and exercise, give you your flue shots, see to it you get an X Ray, ultrasound, CAT scan, phlebotomy, colonoscopy, mammogram and checkup for whatever ails you.

          Do that and  things like diabetes, high cholesterol and blood pressure that cause heart attacks, can be controlled by medication.

          Most importantly that quick scan may mean the early identification of a stage 1 cancer. Stage 1 cancers are a lot easier to treat than stage 3 or 4 cancers and that just makes all the difference in the world.

          Every time that happens it saves a few hundred thousand dollars by substituting preventative care for expensive radiation and chemo therapy.

          For vets the VA is a place where people who care about you can give you  some counseling about drug and alcohol abuse that cause things like cirrhosis of the liver and kidney disease.

          Bottom line a healthier population is a dammed good investment.

          "la vida no vale nada un lugar solita" "The Limits of Control Jim Jarmusch

          by rktect on Thu May 22, 2014 at 02:27:57 AM PDT

          [ Parent ]

        •  It's a socialized system (at least in part) (1+ / 0-)
          Recommended by:

          The VA owns and operates its own facilities.  That's a socialized system, not just single payer.

          •  so much the better (0+ / 0-)

            Socialism is "from each according to their abilities, to each according to their needs" The 1% don't make three hundred times what everybody else makes for doing nothing but own stuff, and there is no poverty, no war, and no religion too.

            Imagine that.

            "la vida no vale nada un lugar solita" "The Limits of Control Jim Jarmusch

            by rktect on Fri May 23, 2014 at 09:09:29 PM PDT

            [ Parent ]

  •  Shrink the VA (4+ / 0-)

    Enroll veterans in Medicare immediately, vets would have Zero co-pay, Zero out of pocket, Zero premium. And yes, vet spouses and children would be included in their coverage. The least we can do for their service. All VA hospitals would be turned into non-profits run in a similar setup as the post office. The VA would be shrunk down to only dealing with military specific things mostly research related but also with a staff of specialists to support and advise doctors and facilities treating vets for service unique issues. Such as missing limbs, traumatic brain injury, chemical exposure, PTSD. Otherwise, the vets could go to any doctor, clinic, hospital, or whatever for their healthcare needs and just submit their claims to medicare. The Defense Department would simply have a line item in their budget to pay the premiums into medicare for every vet.

    At least that is my basic idea.

    The nine most terrifying words in the english language . . . "I'm George Bush, we're here to liberate your country"

    by TiredOfGOPLies on Tue May 20, 2014 at 02:04:19 PM PDT

    •  Retired military go off TRICARE and onto (1+ / 0-)
      Recommended by:

      Medicare at age 65. So you're talking about those veterans who have less than 20 years of service with the military.

      "The object of persecution is persecution. The object of torture is torture. The object of power is power. Now do you begin to understand me?" ~Orwell, "1984"

      by Lily O Lady on Tue May 20, 2014 at 02:36:44 PM PDT

      [ Parent ]

    •  Any doctor or clinic could not identify (1+ / 0-)
      Recommended by:

      with combat trauma....  I am totally against private VA ..Vets need a working VA Healthcare system.  Private cannot do for vets what the VA can and it's caregivers.  There is a whole lot more to health of the vet than medicine and primary care.  A whole lot more !

      They provide special mode of transportation
      They provide social services
      They provide workshops
      They provide financial counseling
      They provide much that a walk in clinic cannot do.

      Just how much Koch do Right Wingers want in their life? . United Veterans of America

      by Vetwife on Tue May 20, 2014 at 03:13:44 PM PDT

      [ Parent ]

      •  Please change what I suggested (0+ / 0-)

        I do not want to privatize VA, medicare is not private. I just want to shrink the VA down so it can absolutely focus on the very things you are talking about and let medicare handle all of the rest. We do not need two healthcare bureaucracies and we are seeing and have been seeing what a mess the VA is. Financial Counseling is not healthcare, that would stay in the VA. Medicare doesn't help with transportation for those who need it? Well if they they don't they should, for everyone. Workshops, what kind of workshops? Workshops can stay in the VA. The majority of healthcare that veterans access is not service specific/related. Get the VA out of dealing with the routine stuff so they focus on the service related stuff. That is what I am suggesting. I am not suggesting privatizing the VA and I do not appreciate your implying that I was.

        The nine most terrifying words in the english language . . . "I'm George Bush, we're here to liberate your country"

        by TiredOfGOPLies on Tue May 20, 2014 at 04:01:07 PM PDT

        [ Parent ]

        •  Medicare does not provide special mode as (0+ / 0-)

          far as I know,  Medicare also only pays 80 percent and the VA pays 100 percent.  Workshop therapy sessions of PTSD.
          Some veterans opt out of Part B because of the extra money and do qualify for 100 percent with no co pay.  No deductible.
          There has to be a healthcare in place to qualify for things like clothes reimbursement for SMC.. Special medical compensation for aid and attendance including a clothing allowance for those in wheelchairs.   This is all based on physical and medical evaluations inside the VA system.
          Medicare works fine and is in place now on an emergency fee basis such as heart stents, and emergency care.  The VA encourages people to go to outside facilities in emergencies and they DO have a choice now if they want to be seen privately and the VA pays through Fee basis.  One cannot separate the treatment of some of the issues you said I was referring to without the speciality of VA Healthcare.  Medicare works in many instances but the VA specializes in physical therapy and vision, dental  and so many other things that have to be referred by a VA medical doctor to even get glasses... There is also dental for many at enrolled.. Medicare IMO is not the answer.

          One cannot separate physical from mental either.  I am sorry if you were offended but I deal with this stuff every single day.

          Just how much Koch do Right Wingers want in their life? . United Veterans of America

          by Vetwife on Tue May 20, 2014 at 05:33:10 PM PDT

          [ Parent ]

        •  the point is (0+ / 0-)

          Vets get better health care by having everything under one roof. Part of the reason that vet outcomes are better is that health information systems are fully integrated.

          Workshops are patient education.

          Financial counselling is a mental health services.

          Vocational rehabilitation is part of mental health.

          Veterans have much higher rates of chronic illness including diabetes, chronic pain, hypertension.  While it is true that these could be managed in a private clinic their individual outcomes would be worse.

        •  Medicate isn't healthcare, it's insurance (0+ / 0-)

          Keep in mind, the VA provides healthcare - they run hospitals staffed with doctors that take care of people. Medicare doesn't provide healthcare, it is an insurance plan.

          So if you "shrink" the VA, then they're not providing healthcare any more.

          As for "what a mess the VA is", keep in perspective that the VA has better medical outcomes, higher patient satisfaction, and lower costs than private insurance. So while it's not perfect - the VA could use better funding, which Republicans keep fillibustering - making it more like Medicare, or worse, private healthcare, would simply waste money and decrease actual healthcare.

          Keep in mind that for "the routine stuff" it's a lot faster, and more efficient, to walk into a VA center and have the doctor check you out than to do the same in a private hospital. No paperwork, no insurance claims, no months of billing and negotiations. Nice and simple.

          If you want to help things, get the Republicans to stop fillibustering VA funding so that they can increase capacity and reduce waiting times.

          And if you really want to improve things for everyone, we could expand the VA to cover everyone. Then we could save $trillions a year that's being wasted on insurance companies, not to mention saving the lives of people who die due to lack of healthcare.

      •  Another reason not to privatize VA Care. (4+ / 0-)
        Recommended by:
        Vetwife, Aquarius40, JrCrone, unclebucky

        From its sisters Medicare and Medicaid. The private system is not designed to perform uniform care on all people in this time slot, and doesn't. Not just for insurance and billing, but for any reason any particular hospital or doctor sees fit, with there often not being another alternative in the community where the need for service arises.  Even Medicare can be flat out rejected by hospitals and doctors, here and there and over there, and the guy in the tie. . . .

        VA does not have that problem, and the part about the reliability and non turning away of people seeking service is an important part of what VA gives to those battered in the effort to protect us all. I remember when my father was in a VA hospital at the end of his life, after he had a stroke in the garage and I found him there. What we did NOT ever worry about as to him was whether he would be well and properly cared for and respected, and he didn't worry about that either. One of the reasons we had moved to the town I grew up in was that he could get VA care there if he had another heart attack. And he did.

        •  Spot on ! (0+ / 0-)

          Just how much Koch do Right Wingers want in their life? . United Veterans of America

          by Vetwife on Wed May 21, 2014 at 05:39:05 AM PDT

          [ Parent ]

        •  We tried this before (1+ / 0-)
          Recommended by:

          funny how soon some forget

          The Bush administration's push for privatization of WRAMC "may be responsible for the 'deplorable' outpatient care for soldiers," Ron Brynaert reported March 3, 2007, for The Raw Story. A "five-year, $120 million contract" was awarded to IAP Worldwide Services, Inc., a "firm run by" Al Neffgen, a former senior official at Halliburton, "a multi-national corporation where Vice President Dick Cheney once served as CEO."

          "Before the contract, over 300 federal employees provided facilities management services at Walter Reed," according to Rep. Henry A. Waxman (D-Calif.), "but that number dropped to less than 60 the day before IAP took over. ... 'Yet instead of hiring additional personnel, IAP apparently replaced the remaining 60 federal employees with only 50 IAP personnel,'" Waxman wrote in a March 2, 2007, letter to Maj. Gen. Weightman.

          Some people have short memories

          by lenzy1000 on Wed May 21, 2014 at 08:57:43 PM PDT

          [ Parent ]

    •  no (1+ / 0-)
      Recommended by:

      Your proposal would drive up costs. Veterans Health care is complex. A friend of mine was recently diagnosed with diabefes. His va providers got his arc down from 13.5 to 6.3 in 6 months. His quality of care was superior to a private sector provider.

      He would have received much worse care at higher cost from a private clinic.

    •  Why do that? (0+ / 0-)

      So what's the advantage in doing that?

      Keep in mind that when comparing the VA, Medicare and private insurance/healthcare, the VA is the most efficient and has the highest patient satisfaction and best medical outcomes.

      Of course, Medicare is more efficient and more effective than private insurance plans, which are a complete disaster, but it still has the waste and complexity associated with forcing patients to deal with individual, profit-driven healthcare providers and insurance.

      So, if anything, we should be shifting people from private insurance and Medicare onto a VA-like system, since it's better for them and costs less.

      Like any organization run by human beings, there are issues with the VA. But those issues are small compared to what's going on with the insurance companies. The only reason that there's an attempt to spin the VA's into a "crisis" is that some politicians are trying to make healthcare in the US more wasteful because that added waste could become $billions in profits for insurance companies.

      So let's see some push back, and start talking about the people screwed by insurance companies, and how much better people are at the VA?

  •  As a VA healthcare patient.... (4+ / 0-)
    Recommended by:
    tardis10, Lily O Lady, Vetwife, Jon Perr

    Look, we can always criticize the VA. It has suffered a chronic case of underfunding for decades. There are definitely aspects of Veteran care that could improve.

    That said.....In my particular case, I have received truly life changing care at VA Hospitals all over the country over a period of 18 years. I am literally alive because the unique care I got as a vet. Vets have a different medical profile than the population at large. we have been exposed to War, to to the amazingly poor environmental exposures that one suffers on bases at home and abroad, to social stigmas when discharged.

    The military is a aberrant social structure. Its focus is not on defense. The Military exists to kill, to hold what is not theirs, to bully, to destroy. It is an instrument of blunt force to be used as a last resort, though we have asked it to deploy at times when last resorts aren't even explored. As an aberrant institution, it can and does produce victims both within its ranks and against it's intended foes. That the VA exists at all is somewhat of a miracle.

    At any rate, the VA made me a better person along the way. I received compassion I did not expect from my fellow vets and the VA staff. I have complicated diagnoses that would probably not been understood in the general healthcare 'system'. And I receive wonderful care from the nurses, and specialists I have been referred to while at the VA.

    What is to be done with the current issues? Well, more investment in the infrastructure of the VA would bring benefits, higher pay and respect for primary care providers would bring real improvement. I have rarely seen the same primary care provider year to year, and this is both disconcerting and disabling to my situation. I have to be my own advocate way too much. I have been impressed with the Nurse practitioners specifically, but again a bit more continuity of care in the primary care arena would bring inherent benefits of long term memory.

    The VA computer system may not be attachable to the DOD, but it works great for the patients receiving care. All their records are digitized and available to what ever clinic, care provider, or hospital. Most of my care is in the Northwest, but I have been treated for emergent iritis, something that has to be treated quickly, in Richmond, VA. They had all my history and doctor contacts within a minute of my arrival, and I was treated and medicated within an hour by informed doctors who did just the right thing.

    A few days later as I was traveling home I stupidly misplaced my medication. I was near Martinsburg, W. VA. I went to the VA there. They had my records right away and gave me enough medication to get home with. Up and down in less than an hour. X-rays and MRI's that I had taken in Palo Alto are available to my doctors in Portland with a few key strokes. My entire medical history with the VA is available, my meds, my treatments and diagnoses, my allergies, the successes and failures of my treatments, all there when needed.

    Yes there are things that need improvement, but there are also things that are demonstrably better than civilian healthcare.

    What the VA needs is more money pure and simple, and a commitment by the Congress to make what is bad good and what is good better. The VA needs better management, but what huge organization doesn't? And of course, the VA needs better leadership. Shinseki is okay, but not what is needed right now. We need a kickass, take absolutely no shit Secretary, and a board of directors, that would be Congress, that doesn't have their heads so far up their collective asses.

    Single payer IS the answer.

    by oofer on Tue May 20, 2014 at 02:17:51 PM PDT

    •  I suspect that this whole VA "scandal" is (2+ / 0-)
      Recommended by:
      Vetwife, oofer

      just part of the GOP ongoing effort to shrink government down small enough so it can be drowned in the bathtub, as per Grover Norquist, who never served a single day in the military.

      "The object of persecution is persecution. The object of torture is torture. The object of power is power. Now do you begin to understand me?" ~Orwell, "1984"

      by Lily O Lady on Tue May 20, 2014 at 02:40:03 PM PDT

      [ Parent ]

  •  But, but, but what about that "shortage of DRs" (0+ / 0-)

    at private facilities conservatives keep whining about when bashing ACA?

    My Karma just ran over your Dogma

    by FoundingFatherDAR on Tue May 20, 2014 at 02:35:37 PM PDT

  •  The VA problem can be fixed.. Private anything (2+ / 0-)
    Recommended by:
    Jon Perr, oofer

    is MOST of the problem.. They have been contracting things out and not following up.   Vets need other vets and in private hospitals one does not get the luxury of having a doc or psych counselor used to combat trauma,  The VA has that and this thing ...the majority of the whole problem is when too many wars happened with too little funding and contracting out with no oversight.
    I suggest since congress does nothing anyway.. Every congressperson should have a duty ( they are supposed to anyway) assign their VA staff to completely oversee the backlogs, and make it a top priority.   The VA has great healthcare when funded and not overwhelmed or privatized...   They need to throw more than money but money is definately a factor.. but see where it goes and oversee these private contractors..... BIG PROBLEM.
    Forget privatization.  

    Just how much Koch do Right Wingers want in their life? . United Veterans of America

    by Vetwife on Tue May 20, 2014 at 03:08:47 PM PDT

  •  Absolutely NO to privatization (2+ / 0-)
    Recommended by:
    Jon Perr, Vetwife

    I know there are problems at the VA, but they are nothing that more funding can't solve.  

    I experienced VA healthcare through my husband.  The care he received was excellent, the medical staff and caregivers were kind and caring, and I never will forget the social worker apologizing to me that we'd have to pay something towards his care after we married and my income was taken into account.  My jaw dropped!   I told her it was a privilege to give something back to an organization that had helped him so much.  

    The VA does so much good, and treats our vets with such respect.  They don't get that kind of care in the private sector.  

  •  the VA has great health care... (0+ / 0-)

    the problem is the VA does not let you get it.  This is a problem of leadership.  They have had five (and more) years to fix the problems, and they have only made them worse.  Of course this recent "scandal" (murder of Vets really by denying them access to health care) was an attempt to make the numbers look good, like there was improvement.

    The Sectary of the VA needs to be fired, and held responsible for the harm his people have caused.

    Stupid question hour starts now and ends in five minutes.

    by DrillSgtK on Tue May 20, 2014 at 05:04:39 PM PDT

    •  The GOP needs to be fired (1+ / 0-)
      Recommended by:

      No funding from the right wing assholes in Congress.

      Yeah, they sure do love OUR country.

      I would tell you the only word in the English language that has all the vowels in order but, that would be facetious.

      by roninkai on Wed May 21, 2014 at 08:32:15 PM PDT

      [ Parent ]

    •  If the problem is lack of funding... (0+ / 0-)

      If the problem is that the VA is underfunded so that it doesn't have enough capacity to keep up with demand, don't blame the head of the VA. The VA documented demand and required funding, and it was the Republicans who fillibustered in order to make sure that the VA was underfunded.

      It's part of their ideology. They don't want people to be able to rely on the government, so when a part of the government works well, like the VA, they have to screw it up, and then create the perception of a crisis so that they can "fix" it.

      But keep in mind, their "fix" would make things worse, because "privatizing" would just make the VA more like private insurance, which is much more expensive and much less effective. But I think that's their goal - the more waste they can inject into the system, the more opportunity for profit. That's why private insurance costs went up 70% over the same years the VA costs went up less than 3%, even though the VA provides better, faster medical services. But to a private insurance company CEO, that 67% that VA costs didn't go up is a lost opportunity to make a fortune.

      So do you care more about the patients and taxpayers, or the CEO?

  •  Corporations do horrible things. (3+ / 0-)

    They kill people all the time due to malfeasance.

    But you rarely hear liberals blame the private-sector when things like that happen.

    At most, they'll go after a particular company or maybe an industry group, such as Wall Street.

    Whenever government malfeasance leads to a tragedy, the Conservatives are all over it as another reason government doesn't work. They do that so often that people generally believe it government is more incompetent than the private sector, without anything really to back up that belief other than a few isolated examples.

    Liberals have to get better at that.

  •  VA hospital associated w/ academic medical centers (1+ / 0-)
    Recommended by:

    Many, if not most, of the large VA medical centers are affiliated with neighboring academic medical centers.  Many of the VA physicians are faculty at these medical schools.  They are highly specialized and very capable of dealing with patients with multiple complex problems which is common place in the VA system.  Its not surprising healthcare quality is high at the VA.'
    Unfortunately, its also people like Jack Jacobs (ret colonel and military analyst on NBC/ MSNBC) calling for replacing the VA with a voucher system.  No one is pushing back forcefully in the media against this line of thinking.

    •  I have only one problem with Obama (0+ / 0-)

      and that he is too nuanced about all the crap the republicans throw.  He needs to push back harder and with facts.   He can fire and replace and overhaul and spit in the republicans faces rather than take their crap.  I would use that bully appears to be gathering dust.

      Just how much Koch do Right Wingers want in their life? . United Veterans of America

      by Vetwife on Wed May 21, 2014 at 05:47:10 AM PDT

      [ Parent ]

  •  TiredofGOPlies (0+ / 0-)

    hit it right on the head. Vets to Medicare and shrink the it racist to refer to CK as a Nazi?

  •  What again is Krauthammer supposed to be? (1+ / 0-)
    Recommended by:

    Oh right - prize winning brilliant conservative columnist, writer, physician - and a mean-spirited professional mugwump.

    "No special skill, no standard attitude, no technology, and no organization - no matter how valuable - can safely replace thought itself."

    by xaxnar on Wed May 21, 2014 at 07:49:16 PM PDT

  •  Voucherization requires a healthcare plan (1+ / 0-)
    Recommended by:

    It is easy for Republicans to say they want to privatize the VA, but the devil is in the details.

    Disrupting the healthcare system of 8 million veterans is not going to be popular and they will face a backlash.

    I predict it will be a gain for the Democrats if Republicans actually attempt this.  It will be like Bush trying to privatize Social Security all over again.

  •  Obama is a privatizer (0+ / 0-)

    He's done more than any other president to privatize public services. He's devastated public schools, Head Start, and now the VA. He tried to initiate the process for privatizing Social Security.  

    He's already working to get a bill passed in congress to make it easier to fire VA administrators. Dismantling due process is a guaranteed union busting tactic.
    Make no mistake, Obama will do to the VA what a republican could not get away with doing. It's one of his Nixon goes to China moments.

  •  What's next? (1+ / 0-)
    Recommended by:

    An all mercenary army instead of an all volunteer army?

    Privatizing is a cruel scam designed to extract MAXIMUM PROFITS from taxpayers without any viable returns.

    I would tell you the only word in the English language that has all the vowels in order but, that would be facetious.

    by roninkai on Wed May 21, 2014 at 08:30:34 PM PDT

  •  i cant image the va privatized (2+ / 0-)
    Recommended by:
    HM2Viking, OhioNatureMom

    It just seems so...wrong. But then again the VA has been a major part of my life since I could remember. My father has been a nurse/hiv counselor/teacher for the VA for 30 years, he has loved every minute of it. A great environment to work in, everyone in the VA health care system seems to genuinely care about vets and their families. I volunteered there during my 4 years of high school doing a variety of jobs my favorite of which was just sitting down with the vets in the icu and hospice care and talking to them. I never heard one veteran say one negative thing about the care they received. Maybe a complaint or two about not being able to smoke but that's about it. Now my husband is a patient at the VA as well as an employee. Its been great for his health and our families' finances. If the VA is privatized, everyone, patients and employees will suffer. The private sector cannot and will not match the LIVING WAGES and benefits being a federal employee brings.

  •  VOUCHER? (2+ / 0-)
    Recommended by:
    OhioNatureMom, jts327

    You sonnuvabitch republican war boys broke these men and women.

    GODDAMMIT you fix them or take care of them.


    Ugh. --UB.

    The Republican Party is run by the KOCH BROTHERS.

    by unclebucky on Wed May 21, 2014 at 09:05:07 PM PDT

  •  This whole thing has a contrived odor about it (3+ / 0-)
    Recommended by:
    unclebucky, OhioNatureMom, sweatyb

    Maybe it's the cynic in me, but since NBC started covering this "breaking scandal" a few weeks ago, I've had this gut feeling that the story is being purposely fanned to counter the successes of the ACA and continue to cast the Obama Administration in a negative light (which of course benefits the GOP).  Feeds right into the "long waiting list" meme of "government-run" health care.  And because our veterans are victims, the moral outrage is even more pronounced.

    On tonight's NBC Nightly News, we had the spectacle of NBC showing video clips of various news outlets' coverage of the story as evidence of how the "growing scandal" is getting more and more media coverage and attention from...gasp...the media, and has become a rapidly growing scandal.

    Yup, maybe it's just the cynic in me.

  •  JUST REMEMBER... (2+ / 0-)
    Recommended by:
    certainot, OhioNatureMom

    Almost every service that the Rethugs have succeeded in underfunding or scuttling in some way has then been criticized for underperforming.

    Amazing that. All for tax reductions for the 1%.

    Ugh. --UB.

    The Republican Party is run by the KOCH BROTHERS.

    by unclebucky on Wed May 21, 2014 at 09:11:34 PM PDT

  •  privatizing it is a major RW meme now, all the (1+ / 0-)
    Recommended by:
    Back of Bourke

    radio gods are using  it as an eg of how single payer doesn't work. fire the secretary NOW NOW NOW!!!!

    and it will probably happen because the left doesn't have an answer to that big buzz machine and because they don't know what the gods are repeating many reps and media hacks actually believe there's an outraged public calling for the firing instead of the usual same old dumbass teabagger dittoheads

    this is pititful

    This is a list of 76 universities for Rush Limbaugh that endorse global warming denial, racism, sexism, and GOP lies by broadcasting sports on over 170 Limbaugh radio stations.

    by certainot on Wed May 21, 2014 at 09:18:09 PM PDT

  •  What is that clip? Specifically, what source, it (0+ / 0-)

    Isn't You Tube and is giving my browser grief, so I'd like to know just what is embedded there.

    That, in its essence, is fascism--ownership of government by an individual, by a group, or by any other controlling private power. -- Franklin D. Roosevelt --

    by enhydra lutris on Wed May 21, 2014 at 09:26:44 PM PDT

  •  war profiteering at its most vulgar. (0+ / 0-)

    privatize means profitize.
    insurers making a profit off soldiers?...nice idea, mccain.

    I am tired of laughing at the irony of their stupidity.

    by stagemom on Wed May 21, 2014 at 09:26:59 PM PDT

  •  Shock Doctrine. Privatize, strip and loot. (0+ / 0-)

    It's all part of the right-wing conspiracy.

  •  And that be worse exactly how? (0+ / 0-)

    "... a recipe for chaos and de facto rationing on a grand scale"

    I get your drift about private corp concerns, but really, the status quo is absolutely revolting.

  •  the chances of this really happening (0+ / 0-)

    Are close to zero.

    The Legion and VFW. Always respond with a resounding no in response to these proposals.

    Privatized service especially are more expensive. The real problem is that primary clinics are often. Built and services contracted out at higher cost.

    Additionally va has statutory missions to educate health care providers, conduct research and provide health care.

    Plus VETERANS like the system.

    I am very proud that I had the privilege of providing care for over 5 years to vets.

  •  LOL ! I'm A Prophet ... maybe or just lucky (1+ / 0-)
    Recommended by:
    Back of Bourke

    I posted this on another news site five days ago here:

    WSOC obama VA story

    . your are going love this ...

    Posted by Windsong01 at 10:22 a.m. May. 17, 2014
    Right out of the American Oligarchy ALEC play-book ...

    First this ...CBS NEWS February 27, 2014
    "A $21 billion bill to greatly expand aid and other programs to veterans went down in the Senate Thursday, falling victim to election year fights over spending and how much power the minority party should have."


    Then the lower ranking tea party deep plants within the system are ask to throw themselves on to sword for the cause by causing as much havoc from within as they can and then reporting it to the GOP and the press but not using proper channels.

    So soon you can expect the call for probes and investigations followed by the all to predictable call to turn over VA Services to "Privatized Hospitals " that are under the stewardship of Mitt Romney's Blain Cap investment Hospital Corporations of America.

    You should really study ALEC and infiltrate tea party meetings, they work together much like Hitler and the SS of old Germany did during the Nazi rise to power..

  •  Why not privatize? (0+ / 0-)

    I regularly read on DK that the ACA exchange system is the greatest thing since sliced bread.   Is that true or not?  If it is, then is it not cruel to deny our veterans access to it?  Give the vets a voucher and let them enjoy the wonderfulness of the ACA exchanges.

    •  VA > ACA exchanges > private insurance (0+ / 0-)

      The ACA exchanges are clearly better than people dealing with private insurers without an exchange (i.e. no place to cleanly compare competing offers, no standards).

      But the VA is clearly superior to private insurance. It's much more efficient because it's simpler. The VA runs hospitals and hires doctors who provide healthcare. In private healthcare there are numerous layers of insurance companies introducing delays and waste. That's why VA costs per patient are lower, and growing at 0.5% percent a year, while private insurance costs are higher and growing 10x faster.

      The result is that the VA provides the best care, at the lowest cost. But if you can't get access to the VA, and don't quality for Medicare, the exchanges are more efficient than buying private insurance without the exchange.

      •  I understand your point. (0+ / 0-)

        I'm a single payer advocate and not a big fan of the ACA.  I particularly hate that the ACA has turned millions of liberals into uncritical cheerleaders for the private for-profit insurance industry.   All that liberal cheerleading provides some pretty good ammunition for people on the right who want to do stuff like privatize veteran's care.   It's not actually feasible to argue that ACA is super awesome and in the same breath argue that privatizing VA care is horrible, but I'm sure people here will try.

    •  you do? (0+ / 0-)
      I regularly read on DK
      Stop trolling.
  •  The structural problem of the VA... (0+ / 0-) that it's a national network to provide comprehensive care to a very narrow demographic.  In heavily populated parts of the country it's an efficient model, but in much of the country it's not.  

    It's not the side effects of the cocaine/I'm thinking that it must be love

    by Rich in PA on Thu May 22, 2014 at 03:36:54 AM PDT

    •  Yes, but in total it's much more efficient (1+ / 0-)
      Recommended by:

      Somewhat true, but...

      1) Most of the population lives in 'heavily populated parts of the country'.
      2) The same factor affects private healthcare. If you live in a major city you can get anything you need. If you live in a rural area, you likely have to go to a major city to get anything specialized.

  •  I'm a retired Army officer (1+ / 0-)
    Recommended by:

    A Vietnam combat vet, I have had Type 2 Diabetes resulting from exposure to Agent Orange for 15 years and arteriosclerosis, despite exercising almost every day.

    So I have had a lot of experience with the VA. Aside from having to wait for appointments a little longer than I would like on occasion, I am very pleased with the treatment I receive at the VA facilities in Palo Alto and Menlo Park. Many of the doctors come from Stanford and the staff are caring and knowledgeable.

    The worst thing that could happen would be privatization of the VA. I liken it to the difference between health insurance coming from for profit companies versus single payer or medicare.

  •  Vouchers = less money (0+ / 0-)

    Problems vouchers might address:
    - overuse by patients
    - overspending by the government
    - lack of choice in provider

    So which problem are these Republican mouthpieces seeking to rectify?

    A voucher system will not address the chronic underfunding of the VA. It does not address the huge surge in VA demand after the wars in Iraq and Afghanistan (thanks Dubya!). It does not address the special care needs our veterans have. It will not decrease patient wait times for vets or provide them with better outcomes.

    They are being disingenuous (aka, lying). Once again, they're using a headline-level understanding of an issue to drive their partisan agenda. They might as well propose replacing the VA with tax cuts for the rich.

  •  Privatize the VA (0+ / 0-)

    The strategy is always the same.  Defund the agency so it can't function then demand it be privatized.  

    This is the true conspiracy.

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