Fail. Next time bring fact. Or at least some reason to doubt the study.
Of course they live longer, they’re so cold they practically live in suspended animation!
I haven’t really read much into this, but I’ve got a question. If the record keeping was accurate (instead of waiting until 14 days before an appointment to put it in the books), would it have made any difference for these patients? Would they have been seen any sooner? Again, I could be way off as I don’t know a lot about this story…
OK, let’s try it that way : what’s the benefit, exactly ?
First, ITR, what is it you want to debate here? Are you trying to analyze the problems the VHA seems to have in order to find a way to fix them? Or are you trying to use this as an excuse to bash the ACA?
:dubious:
And then there’s this (bolding mine):
Which is it? Can the system get fixed, or is the only recourse to leave the country? :dubious:
Fail fail. I essentially asked if the survey included those on the real waiting list, at least those who hadn’t yet shuffled off this mortal coil. Your answer was a form of, “Well, it must have, if the survey was sound.” So, you would logically expect that a survey conducted by an independent entity on satisfaction with inpatient and outpatient care would have polled people yet to receive that care, including “customers” from a list that was secret and not public. Okee-dokee.
Your cite notes the vets’ satisfaction with inpatient and outpatient care, which I’m not questioning. I would speculate that the survey went to those who recently received care, which is how customer satisfaction surveys typically work. But I don’t know that for certain, and neither do you.
What I do know is that the VHA hid those on the waiting list, and I am pretty sure they didn’t provide those names to an independent polling entity. So, you asked for my doubt. That’s it. I have no reason to doubt that the survey accurately reflects the satisfaction of those surveyed. I do wonder (1) how they would have surveyed people who weren’t publicly acknowledged as waiting for care,and (2) why people yet to receive care would be surveyed for their opinion on inpatient and outpatient service. You may, of course, interpret the survey’s results however you’d like, especially since your cite includes Eric Shinseki’s assurance that “Our nation’s veterans deserve the best care, and the ACSI survey results help us better understand how veterans feel about their overall care experience at the VA.” If he says so, that’s good enough for me.
Didn’t you already cite it? Nobody gets any heat or gets fired–or anything bad that might occur when the public learns of the shitty service–if nobody knows about it. Seriously, it was in your post, and it’s pretty obvious. The investigation is underway (Obama has top men on it), but this aspects seems self-evident. If the allegation is true, the motive is pretty obvious. “When I lie about the bad performance, nobody gives me any shit. So I lied.”
Exactly. Which bring us to my actual point. Firing people who fail to meet a monitoring metric : good management ?
The OPs original point was that this is a bad thing that happens in “socialized systems”. Whatever he means by that. I pointed out that he had not supported this in any way, nor provided any evidence on whether what happened here was better or worse than what happened in other systems.
So I thought your comment about counting the dead was a good opportunity to do a bit of the OPs work for him and check that. Which system has the biggest number of dead guys due to lack of health care?
Unsurprisingly, that turns out to be the system that leaves a large fraction of its population with no healthcare, or insufficient healthcare. By a very, very, very large margin.
So if these numbers are indeed, as the OP posits, something that can be expected from a “socialized system”, then whatever that is, it is a massive improvement on the present setup.
Now the sad fact is that things this sometimes happens in every system. These are systems that employ hundreds of thousands of people, doing millions of complex things each year. Human error will happen sometimes. What makes this case stand out is that it does not seem to have been human error, but deliberate.
However, it is like crime. While we may rage about a particularily nasty crime, we do not realistically expect a totally crime-free society. The measure of the system is how much effort it expends to prevent things like this and how successful it is at that.
Total absence is unfortunatly not an option.
That was your point. Um, okay. I thought the exchange was over whether or not records were falsified and if that was “malfeasance.” You can excuse it for whatever root cause you’d like, but what doesn’t change is that people falsified records, an indirect result of that decision is that some people might be alive today if they hadn’t, and they did so deliberately and to serve their own interests. Those poor, downtrodden, mismanaged workers (by the way, where exactly are you pulling the details of your back story?) don’t get a pass.
Okay, got it. It was in response to my post, so it seemed a non sequitur. To me, this is not an indictment of socialized medicine. It is a very specific scandal, triggered by deliberate bad behavior, and management not competent enough to have dealt with it early and properly.
You miss my point. I’m not *excusing *fuck all. The higher level brain trust that is at the root of the policy of cooking the books should absolutely get fired for that. But then again, that’s a no-brainer, and a no-debate.
But it is also, and much more, important to understand the underlying cause of the falsifications and to fix that. Otherwise it’s just going to happen again for the exact same reason, and the only thing learned here will be “hide your shit better next time”. Grok ?
Well, Stratocaster, the point is that the list was secret. Therefore, it seems reasonable to assume that the surveyors would have no way of avoiding those on the list. And they made it onto the list by having been assessed and referred, so we can assume even in your scenario that they had been seen within some length of time, not necessarily any longer or shorter than the average VA patron. In any event, I introduced the caveat with “assuming”.
At that point, you have the option to introduce a competing study, or to investigate the methodology such that you can poke holes in it.
Or you can insinuate with no apparent basis that the study must be flawed, adding a generous helping of snark.
But that doesn’t add any value, really, and doesn’t win points in a debate.
What list? Are you asserting they surveyed all veterans? Or only those who received service, including some who had been on a waiting list? The latter makes more sense, if we assume that vets cycle through the waiting lists at roughly a steady rate (so at any given point, a survey would capture a normal subset of previously waiting guys). Do you actually know how the survey was structured and conducted? Because if you don’t, then you (like me) are speculating. The difference is that I never said I was doing otherwise.
But we’re exerting too much energy on this. I believe the the survey is accurate relative to those surveyed. I have no reason to believe otherwise. It’s plausible to me that the number with excessive waits could be in the survey and are so diluted by everyone else, they don’t move the meter. But the ones currently waiting, I would assume are not included. But none of that changes the fact that people may not have died had the records not been falsified, of course. I don’t give a shit if the VHA gets 4 stars from all the people who actually lived to tell about it, not as it relates to this scandal.
Where are you getting your back story about the “higher level brain trust”? And your point earlier most certainly was at least in part a minimization of this falsification, which you said was only a falsification “for a given value,” not as bad as stealing petty cash for example, no malfeasance you could detect. Call it whatever you’d like, sounds like making excuses to me.
Fair enough. Certainly the VA hasn’t given us much reason to give them a benefit of a doubt. I just wonder how much the failure to fund the VA adequately created this mess, at least indirectly. I doubt that’s a question that will lend itself to an easy answer, especially when the answer is pursued through House and Senate hearings through partisan lenses.
With regard to this aspect the reactions won’t be too nuanced. I’ve read that VA funding has increased enormously while the number of vets has decreased, for what that’s worth. I am weary with the standard “well, this probably wouldn’t have happened if the Republicans hadn’t stopped us from spending more money” talking point from some. Everyone will offer their own partisan flavor of, “Our vets deserve better than this…” followed by some idiotic non sequitur that disavows any accountability except for the other guy. I’d like to see some real data / analysis. Not that it excuses what occurred.
Between this and the “why are you guys talking about socialized healthcare ?! 
” bit earlier… Have you read the OP ? 'Cause that’s a definite plus when you participate in a thread. Pro tip.
Yeah, that was a real pro move ignoring everything in my post after the first sentence. Just like magic, no one will notice you have no answer for it. You, sir, are a true master, and I bow before your superior debating skills.
We don’t know enough to assess the statement that 40 people died while waiting for care. Waiting is not all that straightforward to define, as discussed in this useful Fraser Institute report on queuing in Canada.
As the report makes clear, judging all single payer systems on the basis of the Canadian example is unfair as Canada’s system is one of the worst-plagued by wait times, partly because of the total absence of copays and because of a fee-for-service orientation as opposed to an outcomes orientation. Japan has a successful government-run health system without significant wait times.