By David McKalip, M.D.
“We are not just going to be waiting for legislation in order to make sure that we’re providing Americans the kind of help that they need. I’ve got a pen, and — and I’ve got a phone…”President Barack Obama to his Cabinet, January 14, 2014.
Veterans are experiencing government induced deaths and suffering in the VA medical system designed to provide medical care to the nation’s 21 million veterans. Despite increasing spending and shrinking Veteran populations, the VA has managed to misallocate funds so that it can’t provide promised care to those who served our nation. A recent VA Audit showed 57,000 Veterans spending more than 90 days on waiting lists for their first appointment. 63,000 not even making the waiting list after requesting an appointment! To cover up the bureaucratic failures, the government created fake waiting lists that has led to Veterans dying before they could get an appointment. This list was only exposed thanks to courage of Patriot Dr. Sam Foote who blew the whistle on this government failure after his internal complaints were ignored. Now the VA has decided to solve this problem the only way it knows how: alter the waiting lists again! It turns out that VA has simply removed the 14 day waiting list goal! No goal – no problem.
“Sadly, our Veterans who already put their lives on the line for our freedom, are wounded and dying again on the frontlines of government run medicine.”
This is how a government run systems –especially government run medicine – always works. When promised services can’t be delivered, the promises merely change. When money is evaporating into an enlarging bureaucracy rather than going to Veterans care, care is rationed by waiting. This is a preview of what is already starting to happen as Obamacare roles out in our new nationalized health care system. Sadly, our Veterans who already put their lives on the line for our freedom, are wounded and dying again on the frontlines of government run medicine. The only question is will their sacrifice create more freedom or more government control of medicine?
As usual Congress has decided the solution to this government created problem is to create more bureaucratic hurdles and throw more money at government ! Both houses are working on bills to create 27 new government run VA Facilities around the country. It would create a “Choice Card” for Veterans who can’t get timely care in the VA or live 40 miles away from a facility. But the Veterans would need approval of the Secretary of the VA to get the care and it would only be allowed if the Secretary determined the VA waiting list time was too long. The bill actually has the audacity to create ANOTHER electronic waiting list! In other words, it would change nearly nothing.
There can be no argument that the VA has lacked funds since the VA budget has gone up 78% since 2008 under the Obama administration. The amount spent in the VA medical care system (different than ACTUAL medical care) has gone up over 100% to $43 billion since 2000 and number of Veterans have gone down by nearly 5 million since 2000 to 21.3 million. While the number of patients receiving medical care in the VA System has gone up by about 2 million since 2000 (to about 5.9million) the amount spent per capita is higher than ever at about $7,300 compared to about $4,500 in 2000. These numbers are provided by the VA’s National Data and statics center and they should be interpreted with caution since much of the money is spent on bureaucracy and not medical care.
The question is: where is the money going? Whenever the government takes money in, a large percent is spent on bureaucracy and not actual services (e.g. patient care) and the VA data center does not provide breakdowns on how much goes to medical care. For instance, VA medical spending (40% of its budget) is up 193% while the number of patients is up only 63%. The money is obviously not going to patient care. Medical cost inflation rose 27% in the VA vs. 13% nationwide and returning Afghan and Iraq vets accounted for only 4% of spending while they are 7% of veterans and receive only $4,800 in spending vs. $8,800 by other Veterans. Clearly the money is being wasted on more administration, more computers, more bureaucracy, unneeded construction and the like. Everything but patient care. This in a system where the Operating rooms routinely shut down at 3 pm so the government employees can get home while Veterans scheduled for surgery must wait again to be re-scheduled (as reported here and experienced by this author, a neurosurgeon)!
The solution to the problem is simple and it is the same solution we should pursue for Medicare and for all health care in America. The Veterans should have access to care outside the VA (outside the government system) in a timely fashion. They should be given a voucher to purchase health insurance outside the VA, see doctors who are private and receive care in private hospitals. The VA system was a reasonable idea in the 50’s in post-WWII America when advanced care was harder to find. But that is no longer true and advanced care is abundant in the private sector. Most of the high cost care is not on war wounds (which can still be cared for just as well in the private sector) but on diseases of aging in VA-enrolled Veterans. In fact there is already a “fee basis program” that allows Veterans to see doctors outside the VA when care is not “feasibly available”. Having Veterans die while waiting for care on a secret waiting lists seems to qualify as care being not “feasibly available”.
At the AMA meeting on June 10, 2014, the Florida delegation to the AMA successfully led an effort to help Veterans gain care outside the VA, (based on a resolution submitted by the Editor of this blog and this author). The AMA called for the only action by the only person that can make a difference now. The AMA passed a resolution calling for “the President of the United States (to) take immediate action to provide timely access to entitled care for eligible veterans utilizing the non-veteran healthcare sector until the VA can provide entitled care in a timely fashion”. It is time for President Obama to use his Pen to and his phone to get the Veterans out of the government cage of the VA system. He should be ashamed that he used his pen to do what he just did: remove the waiting goal of 14 days to help bureaucrats game the system. Instead he should use his phone to call his Cabinet members and senior administrators. The conversation should go like this:
President Obama: “Acting Secretary Gibson. This is the President. I expect that by the end of business today, you will direct every necessary VA department to immediately authorize Veterans to get medical care through the Fee-basis program in the Private Sector”.
Secretary Gibson: “Thank you Mr. President, all we needed was your word and your leadership. Thank you for having the backs of the Veterans. Is there anything else?”
President Obama: “Yes, by the end of this summer I want a report on my desk with your recommendations on how to dismantle the VA system and turn over 95% of all entitled VA medical spending to actual medical care for eligible veterans. Good day.”
THAT would be a TRUE “Fundamental Transformation” of America that the President Obama should have meant in the days before he was elected in 2008. The question is this: will the President keep protecting his beloved and failed big government at the expense of the lives of those who sacrificed their lives so Americans can live in freedom? Mr. President, the ball is in your court.