VA Death Panels

Democrats do not have a basic understanding of economics nor do they care to. That, however, doesn’t change the facts. And the facts are that the law of supply and demand is still with us.

What’s this got to do with American healthcare? Well the plain fact is that when you hype demand without increasing supply you create shortages. Now in a free market economy that would raise the price of the product or service. The price would go up and up and up until enough new producers entered the market to increase the supply to meet demand.

In the case of American healthcare the Obama Administration wants to ignore the laws of economics and have their cake and eat it too.

By making healthcare an entitlement and by covering everything for anybody and by subsidizing those who cannot pay, not only has the Obama Administration made healthcare more expensive but it has increased demand by removing the personal responsibility of the payment of true costs and creating the mirage that healthcare is free – use it as often as you so desire.

On the supply side the Administration is putting the screws to doctors and hospitals limiting what they can charge. Many doctors are dropping out of the healtchcare field which leaves fewer physicians to supply the service. Now when you hype demand like that without increasing the supply you create shortages.

This is where the Democrats lose it. They don’t get the supply-demand workings. The only way they can keep costs from skyrocketing to meet demand is to ration the service. This is the price control method. You force the producers to provide the service at less than market value and at the same time you force the receivers of the service to wait an extra long time so that the demand does not overpower the system. So at the same time you are squashing doctors and their incomes you are also saying to patients that the service is an entitlement provided by the government but we will not let you use it whenever you wish or even whenever you need it because to do so would overload the system.

So once again we have RATIONED CARE. This is where the death panels come in.

Here is how the Obama Administration hyped demand in the VA as explained by VA Under Secretary for Benefits, Allison Hickey:

Claims submitted by Post-9/11 Veterans include more than double the number of conditions claimed by Veterans of the Vietnam era. To put this in perspective, in 2009 (the year Secretary Shinseki assumed office), VA processed claims for 2.7 million individual medical conditions. Last year, that number had grown to over 4 million.

At the same time, Veterans of previous wars are living longer and many have the opportunity to file for benefits for the first time, thanks to decisions made by Secretary Shinseki. These decisions to do right by Veterans were long overdue, and have dramatically increased access for many Veterans who would not otherwise been able to file for benefits. The decision to expand the number of illnesses presumed to be linked with Agent Orange exposure redirected over one third of VBA’s workforce to process 260,000 Agent Orange claims. This grew the backlog, but it was the right decision to make for our Vietnam Veterans who, in some cases, were waiting over 40 years. In fact, Vietnam-era Veterans represent the largest group in the current claims inventory at 37%.

We also liberalized the rules for connecting PTSD to service, as well as adding nine diseases associated with service in the Gulf War to the list of presumptive conditions – again, long overdue. Over the last 4 years, over 940,000 Veterans were added to the compensation rolls — more Veterans than are on Active Duty in the Army and Navy combined today.(1)

So here we have the increased demand but did the extra funding that Obama says he provided the VA hospitals go towards more doctors, nurses, medical equipment and medical facilities? No, much of it went to upgrading buildings, new artwork for the walls, new desks and other infrastructure. So here is what we mean when we say the supply cannot meet the demand. As you see above adding more treatable illnesses and an increase of veterans serving in theaters of war like Afghanistan has led to an increase in demand for VA treatment without an increase in supply of doctors, nurses and treatment facilities to handle the increased demand.

The Administration’s response was to throw more money at the problem which never got to the Vets in need and to issue more stringent rules requiring veterans to be seen by a doctor within a certain time limit. This showcases still more fuzzy Liberal thinking. You can require anybody to do anything but unless you can provide them with the tools and resources to accomplish the standards you have set you are merely whistling Dixie. The response of VA middle management to the increased standards of service was to come up with a scheme to appear that those standards were being met, thereby earning management bonuses, without actually doing so. Hence the hidden lists that created this scandal.

Democrats know they can’t promise the moon and also deliver it. Here is how the situation will be handled by Obamacare:

As part of the Affordable Care Act (ACA-Obamacare), two boards are now in place to administer health benefits under the new plan. One is called the “Independent Payment Advisory Board” (IPAB). The other is the “United States Preventive Services Task Force” (also known as the Mandate Task Force). Together, their missions will result in rationing of care, longer waits for care and possible elimination of care.(2)

The Patient Protection and Affordable Care Act, commonly called Obamacare, called for the establishment of a Patient-Centered Outcomes Research Institute.

The new institute’s purpose is to carry out “comparative clinical effectiveness research,” which is defined in the law as evaluating and comparing “health outcomes” and “clinical effectiveness, risks and benefits” of two or more medical treatments or services.

The purpose of the research is purportedly for the government to determine which treatments work best so that money is not spent on less effective treatments.

Such research was already previously alloted $1.1 billion in Obama’s 2009 “stimulus” package. That legislation first created a Federal Coordinating Council for Comparative Effectiveness Research.

Obamacare now allows for about $3.8 billion in additional funding for effectiveness research, with the establishment of the new Patient-Centered Outcomes Research Institute.

The institute is to be governed by a “board” to assist in identifying research priorities and establishing the research project agenda.

Also weighing in will be an “expert advisory panel” of practicing and research clinicians, patients and experts in scientific and health services research and health services delivery.

Obamacare contains largely unreported text that allows the health secretary to limit any “alternative treatments” of the elderly, disabled or terminally ill if such treatments are not recommended by the new research institute. (3)

Many people scorned Sarah Palin when she declared that Obamacare created death panels. Here is how the DEATH PANELS come in. If you control who receives treatment and who does not you are master of life and death. If healthcare decisions are not an agreement between doctor and patient but rather a bottom line ruling by a political bureaucracy, then your fate is no longer in your own hands.

In the case of the VA by putting off treatment forever you are essentially killing the patient. If you put the patient on a hidden list that delays his treatment so long that he dies of his affliction you have knowingly killed the patient. It is a crime to increase demand without also increasing supply. By deliberately holding down supply and rationing care and creating extra long waiting times for treatment you are responsible for killing the patient – YOU HAVE CREATED DEATH SQUADS.

And this scenario will repeat itself in Obamacare. Give it time.

The scandalous secret waiting lists at Veterans Affairs hospitals are far more widespread than originally thought. The story began in Phoenix, but it soon came to light that facilities in several other states were treating veterans with similar bureaucratic contempt. It’s a disgusting disservice to our veterans, and it’s virtually certain to become normal for all of us as health care becomes rationed under ObamaCare.

The Albuquerque VA hospital evidently is now the eighth facility to place veterans on secret long waiting lists. A whistleblower says the facility has already destroyed records to cover its tracks.

The nationwide death toll is hard to pinpoint. So far, the VA only admits to 23 deaths due to delayed care, but there are allegedly 40 in Phoenix alone and the overall number will grow as more information is discovered. In fact, Dayton Daily News points to VA settlements with the families of veterans who died waiting for treatment: “A database of paid claims by the VA since 2001 includes 167 in which the words ‘delay in treatment’ is used in the description. The VA paid out a total of $36.4 million to settle those claims, either voluntarily or as part of a court action.” So if that’s accurate, it’s 167 deaths and counting.

As unbelievable as it may seem, the Obama administration recycled one of its tried and false defenses — that Barack Obama only just found out about the mess from media reports. White House Propaganda Minister Jay Carney said Monday, “I believe we learned about them through the reports. I’ll double-check if that’s not the case, but that’s when we learned about them.” The White House said the same thing about the IRS scandal, Fast and Furious, eavesdropping on the Associated Press, the unprepared state of Healthcare.gov and so on, and so on.

If it were true that Obama only just found out, how is that a defense? Who is running his administration? Is Obama really just an innocent bystander? The alternative is no better — the White House is lying.

In fact, the administration’s transition team was alerted to the VA’s problems in late 2008, and again in 2013. And in 2007, aspiring president Barack Obama blasted George W. Bush’s Department of Veterans Affairs, saying, “After seven years of an administration that has stretched our military to the breaking point, ignored deplorable conditions at some VA hospitals, and neglected the planning and preparation necessary to care for our returning heroes, America’s veterans deserve a president who will fight for them not just when it’s easy or convenient, but every hour of every day for the next four years.”

As president in 2009 Obama proclaimed to veterans, “We’re going to cut those backlogs, slash those wait times, deliver your benefits soon. I know you’ve heard this for years but the leadership and resources we are providing this time means that we’re going to be able to do it. That is our mission and we’re going to make it happen.”

Fast forward to 2012, when Obama said, “For the first time ever, we’ve made military families and veterans a top priority not just at DOD, not just at the VA, but across the government.” The dozens of Patriots who were willing to give their lives defending their country, but died from negligence instead, beg to differ (4)

Are there lessons in the VA scandal for the rest of us if Obamacare survives and even expands?

You betcha. The first lesson is that as government expands taxpayer subsidies for health care, the demand will always outstrip supply. Here is President Obama in a speech to disabled veterans in August 2013:

The last time I was with you, I pledged to cut the backlog, slash those wait times, deliver your benefits sooner. And I’m going to be honest with you; it has not moved as fast as I wanted. Part of it is all these new veterans in the system who came in — Agent Orange, PTSD. It means a lot more claims, and despite additional resources, it’s resulted in longer waits. And that’s been unacceptable — unacceptable to me, unacceptable to [Department of Veterans Affairs] Secretary [Eric] Shinseki.

A few weeks later, President Obama had to admit that he found the fiasco of the HealthCare.gov website also “unacceptable.” Last week, his aides told reporters he was “madder than hell” over the veteran waiting-list scandal.

There’s a lot to be mad about at the Department of Veterans Affairs. Michael Tanner of the Cato Institute notes that more than 344,000 claims for veterans’ care are backed up and waiting to be processed. It takes an average of 160 days for a veteran to be approved for health benefits, and the VA itself estimates that is has an error rate of at least 9 percent in processing claims. According to VA figures for 2012, as reported by the Washington Post, “a veteran who takes an appeal through all available administrative steps faces an average wait of 1,598 days.” That’s more than four years of waiting.

Obamacare will dramatically expand access to the health-care system at the same time that many surveys show doctors are likely to retire or cut back their hours. It is almost inevitable that we’ll see more waiting-list scandals as the need to ration care grows.

This is the record of many single-payer health-care systems, and both Obama and the Senate majority leader, Harry Reid, have said that establishing a single-payer system is their long-term goal. In 2003, Obama, then an Illinois state senator, told an AFL-CIO conference: “I happen to be a proponent of a single-payer universal health-care program. . . . But as all of you know, we may not get there immediately.” Similarly, Majority Leader Reid told a PBS interview show in Nevada, in October 2013: “What we’ve done with Obamacare is have a step in the right direction, but we’re far from having something that’s going to work forever.” When he was asked by a panelist whether he meant that ultimately the country would need a health-care system that abandoned insurance as the means of accessing it, Reid said: “Yes, yes. Absolutely yes.”

But, if the experience of other countries is any guide, a single-payer health-care plan or even government-managed care brings all kinds of waiting lists with it. In 2012, it was discovered that more than 7,000 patients in just a few Scottish hospitals had been wrongly removed from waiting lists for surgery in order to pretend to meet government targets for treatment. One trick was offering to perform surgery on a date when hospital officials knew a patient would be away on holiday, then dropping the patient from the wait list for “refusing” the date.

Sarah Boyack, a member of the Scottish Parliament, called the figure of 7,000 “astonishing,” given that “an extra five million pounds [$8 million] has been pumped into the NHS [National Health Service] to help cut the waiting list” in the affected hospitals.

Not that NHS patients in hospitals without waiting-list scandals are that much better off. In all of the United Kingdom, NHS patients wait an average of about eight weeks for treatments that require admission to a hospital, four weeks for out-patient treatments, and two weeks for diagnostic tests. While NHS patients have a choice of hospitals, they cannot always choose their specialist.

The situation in Canada, a nation whose government-run health-care system has long been touted by liberal supporters of government in health care, is also dire. Last year, the respected Fraser Institute published a study on Canadian wait times for surgery. Among its finding are these:

In 2013, those requiring orthopaedic surgery were forced to endure waits of more than nine months (39.6 weeks) to receive treatment, while others had to wait for slightly more than four months (17.4 weeks) just to receive an appointment with a neurosurgeon. On the other hand, cancer patients in line for radiation therapy faced the shortest expected wait times for treatment after referral by a general practitioner (3.5 weeks).

Currently, one in 34 Canadians may be in pain, off work, or suffering from depression as they wait their turn for treatment.

The 2013 median waiting time of 18.2 weeks is about three days longer than 2012, and substantially longer than 1993 when it was just 9.3 weeks.

Bacchus Barua, the Fraser Institute’s senior health-policy analyst and the report’s lead author, writes: “Simply putting someone on a list is not the same as providing necessary medical attention in a timely manner.”

The veterans’ hospital scandals now in the news in the United States show just how bad things can get when the pressure of patient demand and waiting lists affects bureaucratic behavior. As many as 40 veterans reportedly died at a Phoenix veterans’ facility because they couldn’t get the care they needed. VA administrators there and at other hospitals apparently covered it up by establishing secret waiting lists and falsifying reports. (5)

(1) Balancing the Record on the Claims Backlog

March 19, 2013 by Allison Hickey , Vantage Point – http://www.blogs.va.gov/VAntage/8995/balancing-the-record-on-the-claims-backlog/

(2) Obamacare: Death Panels, Illinois Review

By Nancy Thorner and Jane Keill – http://illinoisreview.typepad.com/illinoisreview/2012/07/obamacare-1-death-panels.html

(3) More evidence of ‘death panels’ in Obamacare, by Aaron Klein, WND

(4) VA Delays Are an ObamaCare Death Panel Preview

The Patriot Post – http://patriotpost.us/digests/25904

(5) Lessons of the VA Scandal
Lengthy wait times, bureaucratic abuse, rationed care: par for the course in government-run health care.

By John Fund , National Review – http://www.nationalreview.com/article/378233/lessons-va-scandal-john-fund