Skip to main content

Because God's most Precious Gifts do usually come in a not very flame retardant brown paper-bag with smoking feces inside, don' t they?

People tell me this guy is supposed to be smart.  That he's a world-renown ex-neuro-surgeon.  That he's the best of the one of the best.  But I don't get it because he just keeps on saying more and more insane, deluded, stupid, nutbaggy, stuff like "Obamacare Is Slavery, in a way", and now this....

"I think what’s happening with the veterans is a gift from God to show us what happens when you take layers and layers of bureaucracy and place them between the patients and the health care provider," Carson said on Fox News, using the veterans hospital backlogs to criticize Obamacare. “And if we can’t get it right, with the relatively small number of veterans, how in the world are you going to do it with the entire population?”
Layers and layers of bureaucracy between the patients and their health care provider? Isn't the VA - The Health Care Provider Itself?  And when he says "relatively small number of veterans" - is he high? As was pointed out by Veterans Affairs Chairman Bernie Sanders on CNN today, it's not anywhere near a "small number of veterans".
"They're treating 6.5 million people a year, 230,000 people every single day. Is there waste in the system? Absolutely," he said. "But at the end of the day, when you have 2 million new veterans coming into the system, some with very difficult and complicated problems, I do think we have to take a hard look and see if we have the resources."
VA doesn't just treat recent veterans, they treat all the living veterans we still have.  

If fact, President Obama and General Shinseki have already begun to expand access to private care for veterans to help relieve the pressure and speed access to care that has been held up for so long. They're only facing one hurdle with that - Funding.

Veterans Affairs Secretary Eric Shinseki also said VA facilities are enhancing capacity of their clinics so veterans can get care sooner. In cases where officials cannot expand capacity at VA centers, the Department of Veterans Affairs is "increasing the care we acquire in the community through non-VA care," Shinseki said.


The VA spent about $4.8 billion last year on medical care at non-VA hospitals and clinics, spokeswoman Victoria Dillon said. That amounts to about 10 percent of health care costs for the Veterans Health Administration, the agency's health care arm.

It was not clear how much the new initiative would cost, Dillon said

Yes, it's not clear, because as it turns out - the cost and effectiveness of care provided by the VA and generally far cheaper and more productive than private U.S. care.

As a 2012 study from the Rand Corporation Shows.

First there's the quality issue.

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.

Asch and his team also found that VA patients were more likely to receive recommended care than patients in the national sample. VA patients received about two-thirds of the care recommended by national standards, compared with about half in the national sample. Among chronic care patients, VA patients received about 70 percent of recommended care, compared with about 60 percent in the national sample.

Then there's cost.
"Government health care" is often characterized as wasteful and inefficient. But here too the VA's experience suggests otherwise. In 2007, the nonpartisan Congressional Budget Office (CBO) released a report (PDF) that concluded that the VA is doing a much better job of controlling health care costs than the private sector. 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
And even this report was honest and fair enough to point out the existing problems VA faced, but they weren't because of "Bureaucracy".
Every health system has its faults, and the VA is no exception. In recent years, it has been challenged by severe budgetary constraints and a surge in demand, as large numbers of injured and ill veterans return from the wars in Iraq and Afghanistan. Its Vietnam-era veterans are aging rapidly and the agency must contend with growing case complexity. When a system as big as the VA falls short, anecdotes about shortcomings get more play than reams of data.
Yes, anecdotes do get more play.

This backlog problem is one that plagued President Bush, it's one the President Obama and General Shinseki were both aware of and were working on, but the real problem hasn't been "layers of bureaucracy" - it's been funding and resources.

Just as they voted to slash State Dept. Security Budget then cry-a-Mississippi-River over the so-called lack of security at Benghazi (even though two different CIA-Military Security Teams responded two the Benghazi attack and managed to rescue and transport all the survivors to Tripoli that same day), it was the GOP who went out of their way to slash VA funds which could have been used to alleviate this backlog.

You don't have to trust me on this - just look at how the Washington Times Reported it in February.

Democrats’ plans to expand education and health benefits for veterans died in the Senate on Thursday after Republicans blocked the bill for not having a funding source and thus busting the budget all sides agreed to just two months ago.

Sen. Bernard Sanders, Vermont independent and chairman of the Veterans Affairs Committee, vowed to try again later. But without finding substantial spending cuts elsewhere, it’s unclear he’ll have any better luck.

“I don’t know why we have a Congress, why we pass laws that say we’re only going to spend so much money and then we waltz in a few weeks later and spend billions more than we agreed to and, oh, we’ll just waive the budget we just passed,” said Sen. Jeff Sessions of Alabama, who led the Republican resistance.

Two Republicans did vote with 54 Democrats, but that left them still four votes shy of the 60 needed to waive the budget and advance the bill.

The 367-page bill would have expanded education benefits for survivors and new veterans, worked to reduce the Veterans Affairs claims backlog and opened VA care to more veterans. It was paid for primarily through war money that will not be spent as troops pull out of Afghanistan, which Republicans say is a gimmick.

Yes, that's right - there was a bill on the table - this year - to specifically "Reduce the VA claims backlog" that 54 Democrats voted FOR and all but two Republicans Voted Against and Blocked.  It "Lost" 56 to 44.  Isn't that something?

Those who'd like to blame President Obama or General Shinseki have to realize that ultimately there's little that either of them can do without adequate FUNDING.  Just as there wasn't that much that President Bush could do about it for the same reason.  

These VA problems are not the fault of Obamacare and Bureaucracies - because all of the Bureaucracy involved in administering ObamaCare are in fact PRIVATE - this situation is the fault of the deliberately obstructionist Cut crazed GOP Cult that thinks spending for Wars on the Government Credit Card is just fine, but using that same card to spend on Veterans who fight those wars for us isn't.

The fact is that the additional $21 Billion proposed by Democrats would have gone a lot farther to provide care than adding to the $4.8 Billion they already spend on Non-VA Private care.  But of course, you'll never convince of GOPer of that no matter how many Rand studies you toss at them.

More from the Times...

“If you happen to meet a veteran who is trying to get by on $28,000, $30,000, $35,000 a year and you notice that the teeth in his mouth are rotting I want you to go up to that veteran and have the courage, the honesty to tell him that you believe the United States of America does not have the money to take care of his needs,” Mr. Sanders said. “But explain to him why you may have voted for more than $100 billion in tax breaks for the wealthiest.”
Well, apparently someone somewhere believes that those $100 Billion in tax breaks are going to magically trickle-down to the veterans.  Only they haven't.  And they won't.


Your Email has been sent.
You must add at least one tag to this diary before publishing it.

Add keywords that describe this diary. Separate multiple keywords with commas.
Tagging tips - Search For Tags - Browse For Tags


More Tagging tips:

A tag is a way to search for this diary. If someone is searching for "Barack Obama," is this a diary they'd be trying to find?

Use a person's full name, without any title. Senator Obama may become President Obama, and Michelle Obama might run for office.

If your diary covers an election or elected official, use election tags, which are generally the state abbreviation followed by the office. CA-01 is the first district House seat. CA-Sen covers both senate races. NY-GOV covers the New York governor's race.

Tags do not compound: that is, "education reform" is a completely different tag from "education". A tag like "reform" alone is probably not meaningful.

Consider if one or more of these tags fits your diary: Civil Rights, Community, Congress, Culture, Economy, Education, Elections, Energy, Environment, Health Care, International, Labor, Law, Media, Meta, National Security, Science, Transportation, or White House. If your diary is specific to a state, consider adding the state (California, Texas, etc). Keep in mind, though, that there are many wonderful and important diaries that don't fit in any of these tags. Don't worry if yours doesn't.

You can add a private note to this diary when hotlisting it:
Are you sure you want to remove this diary from your hotlist?
Are you sure you want to remove your recommendation? You can only recommend a diary once, so you will not be able to re-recommend it afterwards.
Rescue this diary, and add a note:
Are you sure you want to remove this diary from Rescue?
Choose where to republish this diary. The diary will be added to the queue for that group. Publish it from the queue to make it appear.

You must be a member of a group to use this feature.

Add a quick update to your diary without changing the diary itself:
Are you sure you want to remove this diary?
(The diary will be removed from the site and returned to your drafts for further editing.)
(The diary will be removed.)
Are you sure you want to save these changes to the published diary?

Comment Preferences

Subscribe or Donate to support Daily Kos.

Click here for the mobile view of the site