Scandal-ridden VA hospitals are template for Obamacare

If you still think Obamacare is wonderful, you should pay attention to the daily scandalous news about the criminally-run Veterans Administration hospital system.

Why?

Because VA hospitals, being a “single-payer” government-owned and government-run healthcare system, are the model for the ultimate objective of  Obamacare.

doctors against obamacareNew Obamacare Endgame: the VA for All

By Richard Amerling, M.D.
American Association of Physicians and Surgeons (AAPS)
May 26, 2014

Scandal at the Phoenix Veterans Administration lifted the curtain of secrecy on the VA’s secret waiting lists. The VA lies while patients die.

This is by no means a new phenomenon. The nation’s single-payer system for veterans has long been greatly overloaded. Congress tried to fix it in 1996 by passing a law requiring that any veteran needing care had to be seen within 30 days.

The VA is supposed to have a wonderful electronic medical records system, and the EMR is supposed to be the magic formula for efficiency and quality. The VA gamed the electronic system to hide the waiting lists.

Readers of the British press will be struck by the similarities between fudging waiting lists at VA hospitals and stacking patients in ambulances outside UK hospitals. Finding it impossible to comply with a National Health Service mandate that all patients admitted to an emergency room be seen within four hours, ho spitals kept patients waiting in ambulances outside the ER!

Britain’s NHS and our VA system are both administratively top-heavy, command-and-control bureaucracies. All such systems tend to expand, along with their budgets, as administrators hire more and more people to do what they were supposed to be doing. There is no competition, and virtually no accountability. Every problem is always someone else’s responsibility. Mandates and quotas, rather than incentives, are used to motivate those in the trenches.

Physicians working in the VA system, like the NHS, are mostly salaried employees. There are many fine doctors in both systems, but the incentives in place do not reward them for going the extra mile, seeing the additional patient, or doing another procedure if it means going past their shift. Inevitably, these systems create backlogs and lengthening queues for care.

Americans need to take a close look at the VA—and not only because of their concern about poor treatment of our wounded warriors. It is the prototype for Obamacare. The intent behind Obamacare is to completely centralize control over health care, and thus turn American health care into one huge Veterans’ Administration.

In 2011 I wrote that Obamacare was designed as Medicaid for all. Medicaid expansion is a key component of the law. If Congress wanted to expand coverage to the ten million or so individuals who fall through the cracks of the private/public health system, this could have been accomplished easily by offering them Medicaid or Medicare. These creaky systems could be made to work better simply by eliminating the price controls on physicians and allowing them to balance bill patients for the difference between payment and the cost of providing service. But expanding coverage was not the goal.

The stated goal of government central planners, and of many medical elites, is to abolish traditional fee-for-service medicine. They wrongly blame FFS for out of control health care spending. This is absurd on its face. FFS medicine pre-dates the massive health spending inflation that was largely brought on by Medicare and Medicaid, and the domination by third-party payers. The lack of price transparency and the removal of most disincentives to utilization of health services are what led to the incredible over-spending on health care that we’ve seen since the ‘60s. FFS is the only way to insure the prompt delivery of needed care.

But what central planners want is for all physicians to be salaried employees of either the government or of large hospital systems. Then planners could centrally control care through “payment-for-performance” algorithms built into electronic records. The promptness and quality of care will suffer.

Obamacare is already becoming like the VA. A kidney transplant patient suddenly developed blurred vision. This alarming symptom could signal a brain tumor or other serious diagnosis. I would have arranged for an MRI to be done the same day. Her new Obamacare plan, however, offered a specialist appointment two weeks hence.

The shameful backlog in our VA system could be remedied overnight by either giving veterans vouchers for care in the private, FFS system, or by building incentives into the VA payment structure. Ah, but this would require an acknowledgment that their top-down system has failed.


Richard Amerling, MD is an Associate Professor of Clinical Medicine and a renowned academic nephrologist at the Beth Israel Medical Center in New York City. Dr. Amerling studied medicine at the Catholic University of Louvain in Belgium, graduating cum laude in 1981. He completed a medical residency at the New York Hospital Queens and a nephrology fellowship at the Hospital of the University of Pennsylvania. He has written and lectured extensively on health care issues and is President-elect of the Association of American Physicians and Surgeons. Dr. Amerling is the author of the Physicians’ Declaration of Independence.

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~Eowyn

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0 responses to “Scandal-ridden VA hospitals are template for Obamacare

  1. Reblogged this on Dead Citizen's Rights Society.

     
  2. There are only two ways Obamacare will come to an end, and neither involves the ballot box, as the repubes have now indicated they are not going to repeal it.

    1) The American people hit the streets and demand it’s repeal…

    -or-

    2) The country collapses under the weight of its rapidly expanding entitlement programs.

    My money is on the latter.

    -Dave

     
  3. Troops on active duty are frequently fed antidepressants, psychotropics, various injections, etc., without real evaluation and monitoring. This leads to a higher death rate by suicide than by combat, and the conditions continue when back home. The mental problems are more due to medication than combat, for a majority of the troubled never saw combat, and some have never been near a combat zone. Who doesn’t know that Gen. Shinseki is a fall guy? Do we really need this? How many good Americans does the NWO want to have killed for their objective of global tyranny over a population reduced by 5 billion or more?

     
  4. DAH!

     
  5. And now it is the private sector that will have to be utilized until/if these issues can be resolved. Integrated health care systems–offering both care and coverage/services–do not work. They may be able to manipulate data to show good health outcomes, but in reality when both top-heavy administrators and health care staff are on government salaries…need I say more. I’ve heard nightmare stories from my friends who work for the VA–they say the standard of care is so bad it makes them cry at night. And this IS a model of how Obamacare will work, welcome to less access, longer wait times for specialty care, and poorer health outcomes. Not to mention that care providers will be following cost saving care protocols that do not leave doctors room for creativity in treating the condition. God Bless those Vetarans.

     

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