People who disagree with the OP are Nazis? That’s fucking classy, pal.
And were there more dead guys from the private system or the VHA?
I’m… not sure how it’s a thing to begin with. Suits upstairs came up with unworkable rules and guidelines wholly abstract and disconnected from the realities in place because saying it should be so naturally makes it so (and noncompliance incurrs penalties, because that makes it all work of course) ; and the guys on the ground found ways to work around those rules while covering their asses.
It’s wrong at every step I suppose, for a given value of wrong ; but I’m not seeing malfeasance is my point.
As for the innefficiency issue, here’s a friendly tip : you want an efficient system ? Pour actual money into it. I know this will come as a blinding shock to middle managers and HR fuckmooks the world over, but in a grand majority of case you can’t *actually *make more with less.
That’s a great point. That’s why they should always include all the dead guys in their surveys, to keep it apples to apples. Those dead guys have the right to be heard too, right?
Or, alternatively, include in the survey those on the wait lists (the real ones, not the fake ones) if we want to get a true measure of how our vets feels about the health system they use.
Didn’t they falsify records, or is every one of the thousand reports I’ve been bombarded with wrong? That falls easily within the boundaries of “malfeasance,” in my book. But I’m a stickler.
Not sure - I’m not really up on the latest details of the “thing”.
But from what I heard, what happened was that there were strict guidelines in place that “Waiting times WILL NOT be longer than 14 days, you peons have been warned” and when actual wait times were actually longer the clerks would simply not log the waiting patient until their appointment were 14 days away (or would reschedule the admistrative appointment to secure a doctor’s appointment until a possible doctor’s appointment was available within 14 days, it’s not 100% clear to me).
Which I suppose does count as falsifying records, again for a given value of falsifying, but whatareyagonnado ? The clerks can’t pull a doctor’s appointment out of their arses, can they ? And if they *had *booked appointments beyond those 14 days against internal rules, they’d have gotten shitcanned for something that was entirely out of their hands. Or do you reckon they did it specifically to hurt veterans ?
The 14 days thing is/was a retarded policy made by people divorced from reality. The low-level employees worked around it, which produced stats that made the upper level managers look good, which explains why even if they knew the lower-level guys were “cooking the books” they were all too happy to let it happen. Fine. Change the policy, solve the problem.
Well, the cooking the books problem. You still need *actual *money and effort to solve the waiting times problem, as I said.
But to use that specific state of affairs as a “SEEEEEE ? THIS IS WHAT PUBLIC COMPANIES DO ! INEFFICIENCY ! COVER UPS ! Woe, woe, woe to socialized healthcare !” as the OP is doing is blithely ignoring that the exact same stupid shit happens every fucking day in private corporations out there. I’m a translator working primarily for management consultants. I’m balls deep in that particular layer of human retardation, though I’m trying to cut down on those contracts because they make me drink a lot.
Don’t get me fucking started.
I don’t have a lot to add to the excellent points that Grim Render and others have already made about what seems to be some sort of superficial attempt to use the recent events at the VA as a sort of blunt instrument to beat up on this nebulous strawman called “socialized medicine”. I think the key points are that there’s a vast difference between “government-run health care” and “government-run health insurance”, and in any case the unfortunate tragedy at the VA completely pales in comparison to the thousands who die every single year from lack of health insurance, or lack of adequate health insurance, or insurance that was declined. Or the thousands more who go bankrupt every year from health care costs, even though most of them thought they were insured. These things simply don’t happen under single-payer, which is universal and unconditional, and ironically is one of the key reasons that the costs are so low, since it’s simple to administrate. It also provides an important means of cost control which the private system lacks.
Regarding that linked report on the alleged “costs” of wait times in Canada, that whole thing is an unmitigated pile of crap for many reasons. Those who are aware that the Fraser Institute is a right-wing think tank which periodically regurgitates bullshit position papers on things like climate change denial and trying to privatize the Canadian health care systems would not be surprised by this. The concept of “wait time” generally applies to lead times for things like non-urgent specialist appointments and routine elective surgery. It’s hard to see how there are “costs” involved in having a dermatologist appointment a month from now instead of tomorrow. Indeed, systemically it’s the opposite: having no wait times for routine non-critical matters implies idle resources and is a major cost driver.
It’s also important to note that all such scheduling is medically triaged and urgent cases are handled expediently, so the scare stories are right-wing fabrications. Likewise, the theory of greater mortality due to wait times for diagnostic tests is an unsubstantiated fabrication; cancer survival rates in Canada vs US are slightly different in both directions depending on type, and survival rates for some types are better in Canada. Also better in Canada is life expectancy in general, quality of life in old age, and the rate of infant mortality. So much for the horror of “socialized medicine”, whatever that is. There’s a reason that even the most conservative governments in Canada don’t dare meddle with the health care system, despite the caterwauling from right-wing loony bins like the Fraser.
Who says they had the option of getting care from a civilian hospital? I have VA coverage, and it’s my sole source of medical treatment because I have no other health insurance and can’t afford any other care.
However, I, personally, have had no problems with being seen for treatment. The only problem that I have encountered was having to wait in the ER for about five hours before being seen, but I understood at the time that they were relying on triage and first come first served for prioritizing care.
In November of 2012, I visited the ER (this was a different time) complaining of shortness of breath. They immediately took me in, monitored me, and admitted me to the hospital. The next morning, they ran tests on me and told me that they needed to run an angiogram on me the following morning. They ran the angiogram and told me that I was going to need an angioplasty to have a stent put into a cardiac artery because it was 95% clogged. But this testing was all done at the Sacramento VA hospital, which did not have the facility to do the angioplasty, so they were going to have me treated at the San Francisco VA hospital. They immediately put me into an ambulance and drove me to San Francisco, where the operating room was set up and waiting for me, and the angioplasty was performed.
Assuming it was a competently run study, there seems to be no reason to believe that they would not have been proportionately represented in the sample.
Well, as I understand it,about 45 000 people die each year in the US waiting for treatment because they have no healthcare. Who would have lived if they had recieved healthcare. So if the 40 deaths reported actually are a fair indication on how more advanced systems in the developed world perform, they perform 10 000 % better.
Thats…a large improvement, to put it mildly.
Of course, the number of people without healthcare is over 4 times as large as the number of VA enrollees, so its “only” about 2000 % better. Still.
And that does not count the numbers that died due to insufficient or faulty care. If the US matched the top performers there, then another 84 000 under-75 people would have survived. Each year.
I mean, thats assuming the VA lost 40 per year. Not in total.
Just a little perspective.
For a given value of falsifying? If a particular area’s list of people waiting over 14 days showed “none” when in fact there were “lots,” and that was a deliberate lie to avoid being discovered–well, that’s a given value of falsifying that could be described as “textbook,” don’t you think?
Did they do it specifically to hurt veterans? I reckon not. The deaths were just a secondary effect, which I’m sure is a great comfort to the vets’ families. Those lists were a monitoring tool, so that if a troubling backlogs occurred, then management could try something crazy, like maybe doing something about it. Instead of doing nothing since everything seemed hunky dory. The people who did that put people’s lives in jeopardy to save their own jobs. “But they might have been fired!” Oh, that’s different then. They’re really heroes now that I think about it, courageously dealing with a difficult circumstance. I hope they end up in jail. And if management turned a blind eye, I hope they end up in jail, too.
Who performed better? The poor bastards on the waiting list who lived? I’m not getting your point. Are you suggesting 40 people dead who might well have lived with treatment is an okay number, relatively speaking?
Assuming I’m a billionaire, there’s no reason to believe I’m not typing this post up from my gold-plated recliner as the Swedish Bikini Team fans me with palm fronds.
Perhaps the point would be that the 40 deaths was a one-time failure in a complex imperfect system that is fixable, whereas tens of thousands of deaths every single year is a systemic entrenched problem in a system so fundamentally broken that it’s not just flagrantly ineffectual, but at the same time also the most expensive in the world.
One observation I’ve read is that there two VA components: 1) bureaucrat administrators who want to cover their ass, and 2) the actual doctors and nurses who want to provide medical care, and their interests are sometimes at odds (I could try to find the cite if asked, but it was just someone’s opinion).
This particular scandal first surfaced in Phoenix, to where the director had been transferred after misrepresenting suicide statistics as the director of the VA hospital in Spokane, IIRC.
I admit my first thought was isn’t this similar to what the Catholic Church has been accused of with doing with pedophile priests—let’s just transfer them instead of addressing the issue.
If that’s the point, it had nothing to do with the exchange to which it was responding, which was about how much love the vets have for that super VHA care, the vets who didn’t die waiting for treatment at least. But don’t let me knock you off your soapbox.
An additional early observation I heard and can believe is, that if gaming the system is going on at one VA location, you can be sure it’s going on at others.
And this is what we’re seeing…
Sure. But to me there’s a difference between massaging numbers into adding up right because if you don’t you’re out the door (with zero indication that the problem you gave up your job to demonstrate is getting fixed, or even getting any attention at all, BTW), and making numbers add up right because you’re dipping into the petty cash. That’s what I meant by “no malfeasance”. What we have here is managerial incompetence, and its effect rolling downhill - but that’s not a crime.
And like it or not that’s what most people would have done in their shoes. Particularly low-level clerks who don’t exactly have the luxury of quitting their job the better to stand on principles. You can’t eat principles. Even moreso when the victims of the path of least resistance are never seen by the cogs in the Machine. You can rage about human nature if you want, but shrug.
The fundamental problem here as I see it was turning a monitoring tool (i.e. alerts when waiting times go higher than 14 days) into a mandatory maximum. “If you can’t perform to those standards wot I made 'em up, I’ll find someone who can !”, that sort of thing. Lots of terrible managers make that mistake. Hell, the voting public makes it all the time.
I still don’t see how any of that’s an argument against socialized healthcare or public medicine as concepts.
This was not incompetence. It was a deliberate act, people cooking data for their own benefit.
I disagree. Putting someone’s life at stake is not justfied by any “poor, lowly worker” jive. That’s bad shit, and I would hope most people wouldn’t do it. And all this “downtrodden worker, cog in the machine” stuff–where are you pulling that from?
I didn’t say it was. But for some reason, this thread keeps drifting there.
Well, to be fair, it started there.