Editorial: Bill continues giving veterans health care choice

Trump signs VA Choice bill. (AP pix)

With a deadline rapidly approaching, two weeks ago President Trump signed a bill sponsored by Nevada Sen. Dean Heller that appropriates $2.1 billion to extend a program that provides veterans with an opportunity to seek health care outside the backlogged, and too often distant, Department of Veterans Affairs hospitals.

Senate Bill 114, VA Choice and Quality Employment Act of 2017, passed both the Senate and the House without a single nay vote.

Trump said at the bill signing ceremony, “This bill will ensure that veterans continue to have the ability to see the doctor of their choice — so important — and don’t have to wait or travel long distances for care. And during the campaign, I kept talking about it. People — these great, incredible veterans — our finest — they’re waiting in line for seven days, nine days, fourteen days, for ailments that could be fixed quickly, and they end up dying of things that could be taken care of very, very routinely.”

The president used the occasion to personally praise Heller, Sen. Johnny Isakson of Georgia and Congressman Phil Roe of Tennessee for shepherding the bill through a passage.

Trump also noted that the bill authorizes new community-based outpatient clinics and improves the VA’s ability to hire quality employees through improved recruitment and training.

Sen. Heller noted that the funding for the Choice Program will continue to give the 300,000 veterans living in Nevada access to services that the VA cannot provide – such as chemotherapy and certain life-saving surgeries.

“I applaud the president for signing my bill to ensure Nevada’s veterans can continue using the Veterans Choice program,” said Heller. “Nevada’s warriors have fought and served their country selflessly, and they should not be forced to jump through hoops when it comes to accessing the care and benefits they’ve earned.”

He cited as examples a Navy veteran from Lovelock named Wendell, who used the Choice Program to get a neck surgery so that he could still walk and an Air Force pilot from Battle Mountain named John who had cancer removed from his neck.

“The program also allows veterans living in rural areas to receive care near their homes,” Heller said. “Without funding for the program, rural veterans, like those in Ely, Elko, Winnemucca, and Tonopah, would have to drive hundreds of miles to get care. The Choice program allowed an Army veteran from Ely to access mental health services nearby as opposed to traveling over 200 miles to Salt Lake City, Utah, or forgoing the care entirely.”

We applaud this modest step toward privatization of our veterans’ health care.

A version of this editorial appeared this week in some of the Battle Born Media newspapers — The Ely Times, the Mesquite Local News, the Mineral County Independent-News, the Eureka Sentinel,  Sparks Tribune and the Lincoln County Record.

Editorial: Past time to abolish VA health system and give vets vouchers

This past week the Department of Veterans Affairs reluctantly released to USA Today quality of care rankings — one to five stars with one being the poorest and five the best — for its 146 VA medical centers. The VA health facilities in Las Vegas and Reno warranted only two stars each, placing them solidly in the bottom third in the rankings.

At about the same time the agency also released Inspector General reports on wait time manipulation at facilities in eight states, including one for the mental health division of the VA Southern Nevada Healthcare System in Las Vegas.

The IG has been looking into wait time manipulation for the past couple of years after it was learned a number of VA medical centers lied about how long veterans were delayed in receiving medical care.

North Las Vegas VA Medical Center

North Las Vegas VA Medical Center

In 2014 it was revealed that the VA hospital in Phoenix was claiming veterans waited an average of 24 days for their first primary care appointment, when the average was actually 115 days. There were 1,400 vets on the official waiting list, but another 1,700 who were not even included on that list. Some died waiting to be seen by a doctor.

A subsequent audit found 64 percent of VA facilities had tampered with waiting lists.

The recent report on the Las Vegas waiting list said the inspection was launched following a complaint by a former VA mental health staffer who said he and others were directed by their boss to schedule the next available mental health appointment date as a vet’s desired appointment date, even when that was untrue.

He said he was told to do this “so the numbers looked good” and it appeared there was no waiting.

The IG interviewed 11 VA employees and reviewed emails. Though many staffers denied being pressured to manipulate the wait times, most admitted the methodology of recording desired appointments had this effect.

The report said of one staffer: “He stated that he was told the only acceptable wait time for appointments was zero days. He said he was told by a lead MSA (medical support assistant) to cancel appointments for veterans with wait times and reschedule them using the next available appointment date as the veterans’ desired date so that the wait times appeared to be zero. … He said this was done to make the wait times appear shorter than what they actually were.”Still another staffer said she was handed a list of 50 patients by her boss and told the appointments had been scheduled improperly. The wait times varied from 45 to 60 days. She was told the patients agreed to the appointment date, so the appointment date should be recorded as the desired date, making the wait time zero.

The report concluded, “The investigation determined that some MSAs were not scheduling appointments correctly because of confusion over the scheduling directive, incorrect information from coworkers, and incorrect information received during previous training. Several of the MSAs interviewed indicated that they were directed by supervisors to manipulate scheduling data.”Though the report was referred to the VA’s Office of Accountability Review back in February, there was no indication any disciplinary action was taken.

The local VA released a statement to the Las Vegas newspaper saying, “The VA Office of Accountability reviewed the … findings and concluded there were no accountability issues that warranted action and that revised training addressed the scheduling deficiencies discovered.”The problem is that the VA health system is socialized medicine, pure and simple. A bureaucracy, like any other organism, has at its base the objective of self-preservation, not the objective to provide quality service. No matter who President-elect Trump may appoint to head the agency, it will fail, as it has done so over and over again over the decades.

Nevada has had more than its share of VA woes. The VA Medical Center in North Las Vegas cost $1 billion to build — twice what a private hospital costs — and took four years longer than scheduled. It opened with too small of an emergency room and no ambulance drop-off ramp.

For rural vets it is too long a drive to Reno or Las Vegas.It is time to dismantle the VA health care system and give veterans vouchers to use at whatever doctor or hospital they wish.

A version of this editorial appeared this week in some of the Battle Born Media newspapers — The Ely Times, the Mesquite Local News, the Mineral County Independent-News, the Eureka Sentinel,  Sparks Tribune and the Lincoln County Record.

UPDATE: Some newspaper editorials are so persuasive that they get considered even before they are published. In a meeting this week the president-elect was asked about the possibility of veterans being given an option allowing them to go to any hospital of their choice.

VA providing classic example of just how socialized medicine doesn’t work

Obama signs the Veterans’ Access, Choice, and Accountability Act of 2014, at Fort Belvoir, Va., Aug. 7, 2014. The bill was intended to provide the Department of Veterans Affairs the resources to improve access and quality of care for veterans. (White House photo)

Thank goodness that after World War II the government did not open a bunch of Veterans’ colleges but instead provided the GI Bill to finance higher education for veterans.

Healthcare is another matter altogether.

In the summer of 2014 after learning of veterans dying while waiting to see a Veterans Affairs health system doctor, Congress doled out $16 billion to solve the problem. VA officials had been manipulating the waiting lists to make them look like vets were waiting less time to see a doctor than was actually happening.

A year later, The Associated Press reported that the number of veterans waiting more than 30 or 60 days for non-emergency care has largely stayed flat, while the number of medical appointments that take longer than 90 days to complete had nearly doubled.

In March the Government Accountability Office reported that it studied 180 veterans newly enrolled in the VA health system. Sixty of that 180 had not yet seen a health provider and “nearly half were unable to access primary care because VA medical center staff did not schedule appointments for these veterans in accordance with VHA policy. The 120 newly enrolled veterans in GAO’s review who were seen by providers waited from 22 days to 71 days from their requests that VA contact them to schedule appointments to when they were seen, according to GAO’s analysis.”

The analysis found that the system lacks a comprehensive scheduling policy and data weaknesses. In addition there were ongoing scheduling errors.

Nothing seems to change. A VA report in September found nearly 900,000 listed as “pending” for health care, but Social Security records listed 300,000 of those as deceased.

“This will not and cannot be the end of our effort,” Obama said when he ceremoniously signed the bill providing the $16 billion in additional VA funding. “And even as we focus on the urgent reforms we need at the VA right now, particularly around wait lists and the health care system, we can’t lose sight of our long-term goals for our service members and our veterans.”

As Investor’s Business Daily noted in an editorial: “In the meantime, however, the ongoing scandal at the VA should serve as a warning to anyone who thinks socialized medicine is a good idea.”

The bureaucracy is impenetrable.





Congress’ fix for the VA will only make things worse

What to do about a corrupt Veterans Affairs health care system?

Why, give them more money, of course, which is precisely what Congress did. The House passed H.R. 3230 on a voice vote and a Senate version passed 97-3.

The CBO estimates the bill will cost about $54 billion a year, but the estimate could be low because it is unknown how many veterans will take advantage of its low-cost coverage.

“The magnitude of those budgetary effects is highly uncertain,” the CBO admits. “A significant number of veterans could receive new and expanded health care benefits under the House bill. How many would ultimately receive those benefits and the resulting costs will depend on a number of factors that are very difficult to predict.”

Where will the money come from? Nobody knows.

If the VA is inundated with more veterans seeking inexpensive coverage, how long will wait times be and how quickly will the cover-up begin?

Throwing more money at a broken system is not the answer.

A Wall Street Journal editorial points out:

“What neither bill does is address the fundamental problem of excessive demand, which stems from the VA’s guarantee of virtually universal care at little to no out-of-pocket costs. This would involve increased cost-sharing, but that would mean reforming a government program through free-market incentives. Democrats oppose this, and Republicans are afraid to propose it.”

Congress often makes things worse when it tries to fix things.

Newspaper column: Close VA hospitals and give veterans vouchers for private care

So, Veterans Affairs Secretary Eric Shinseki resigned this past week as a result of the scandal over veterans dying while waiting to receive treatment at a Phoenix VA hospital.

Nevada Sen. Dean Heller’s strongly worded call for his ouster surely tipped the scales. “The Department of Veterans Affairs Inspector General’s report provides a very disturbing view of what has been confirmed as a systemic problem at the VA. …” Heller said. “It is time for a leadership change at the VA at the highest level,” as reported in this week’s newspaper column in The Ely Times and the Elko Daily Free Press and Mesquite Local News.

The inspector general report indeed called the VA’s problems “systemic.”

North Las Vegas VA Medical Center

The problem is not just systemic, it is endemic and pandemic.

You may keelhaul the captain of a sinking rust bucket, but you are still aboard a sinking rust bucket.

The problem lies not in who is heading this system, it is the system itself — pure socialized medicine. It is a bureaucracy that like any other organism has at its base the objective of self-preservation. No matter who you put in charge it will fail eventually, as it has done so over and over again between brief periods of improvement after one crisis or another.

The inspector general found that the Phoenix VA hospital staff lied about its waiting list, claiming veterans waited on average 24 days for their first primary care appointment, when the average was 115 days. There were 1,400 vets on the official waiting list, but another 1,700 had been excluded from the list.

A subsequent audit issued on the day Shinseki resigned revealed that 64 percent of 216 VA facilities reviewed had tampered with waiting lists.

A year ago, Obama was warned by the House Veteran Affairs Committee about “management failures, deception and lack of accountability permeating VA’s health-care system.”

In 1945 the head of the VA hospital system resigned after a series of news reports about shoddy treatment.

In 1976 an investigation of a Denver VA hospital found some veterans’ surgical dressings were rarely changed.

In 1986 the inspector general found 93 VA physicians had sanctions against their medical licenses, including suspensions and revocations.

In 2007 a commission reported “delays and gaps in treatment and services.”

Today the bureaucrats are still cooking the books in order to make themselves eligible for “awards and salary increases.”

Be thankful that when FDR signed the GI Bill in 1944 he did not create a system of veterans’ colleges or we’d have colleges as bollixed as the VA hospitals.

Read the entire column at Ely or Elko or Mesquite.

VA provides an example of how the bureaucrats will handle ObamaCare

Let’s see, Harry Reid and crew hand the Department of Veterans Affairs $300 million in additional funding so it can reduce the backlog of disability claims. Then, Harry praises VA Secretary Eric Shinseki for doing a “wonderful job” when the claims backlog drops more than 2,000 claims per day.

So, how did they manage to become so much more efficient? The Las Vegas Review-Journal reports in the penultimate graph of a story in today’s paper:

“Concerned Veterans for America notes, however, that the VA’s reported progress in reducing the backlog is a mirage because claims processors rushed to deny claims with little review. The result: a backlog in appeals.”

Voila, fewer claims backlogged.

So, how will the bureaucrats respond when too few younger Americans sign up for ObamaCare and the older and sicker people who do begin to drive the costs of the program far beyond what was anticipated?

Death panels!

As Investor’s Business Daily points out in an editorial that Canada’s Supreme Court has ruled a government board, not family or doctors, has the ultimate power to pull the plug:

“Lost in the discussion of defunding ObamaCare and the failed effort in Congress is the fact that failure means the government’s ability to defund your life through the ObamaCare’s Independent Payment Advisory Board (IPAB) remains. IPAB is regarded by many, starting with former Alaska Gov. Sarah Palin, as a death panel whose decisions based on cost effectiveness would result in health care rationing.”

Howard Dean, a physician, former screaming presidential candidate and head of the Democratic National Committee, wrote in The Wall Street Journal this past summer:

“The IPAB is essentially a health-care rationing body. By setting doctor reimbursement rates for Medicare and determining which procedures and drugs will be covered and at what price, the IPAB will be able to stop certain treatments its members do not favor by simply setting rates to levels where no doctor or hospital will perform them.

“There does have to be control of costs in our health-care system. However, rate setting — the essential mechanism of the IPAB — has a 40-year track record of failure. What ends up happening in these schemes (which many states including my home state of Vermont have implemented with virtually no long-term effect on costs) is that patients and physicians get aggravated because bureaucrats in either the private or public sector are making medical decisions without knowing the patients. Most important, once again, these kinds of schemes do not control costs. The medical system simply becomes more bureaucratic.”

Do you think, when the money runs out, the IPAB will do what the bureaucrats at the VA did — deny, deny, deny?