C.Y.A.

SEARCH BLOG: GOVERNMENT HEALTH CARE

I have written a couple of times about the issue of government provided... as opposed to funded... health care at Veterans Administration facilities. The issues there as well as at Walter Reed army hospital revolve around the mind-numbing, Soviet-like process required to obtain outpatient care. What I have written can be boiled down to just a few things:

• The health care professionals are doing the best they can with what they have as resources
• The budget process comes before the health care demand levels
• The health care professionals are not responsible for the budget process or the level of resources available to them

Now the government has taken action at one of their government-provided health care facilities:

The commander of Walter Reed Army Medical Center was fired yesterday after the Army said it had lost trust and confidence in his leadership in the wake of a scandal over outpatient treatment of wounded troops at the Northwest Washington hospital complex.

By Steve Vogel and William Branigin

Washington Post Staff Writers
Friday, March 2, 2007; Page A01

And exactly what did that action accomplish:

• The army general takes a bullet for the politicians who provide the funding
• The politicians, like Sen. Charles Schumer, get to stand up and take credit for taking care of our soldiers while really only taking care of their publicity shots
  
• There is a flurry of highly visible activity
  
• The budget process stays the same
• The health care process stays the same
• Everyone waits until the dust settles
• The soldiers still have the same problem
  

Of course, this is the same process that takes place in the V.A. The staffs are understaffed; the patients just have to have patience; the budget is whatever the politicians decide. While there is not much that can be done inside the military except C.Y.A., the V.A. can do this (from my last post):

I have argued on other discussion forums that the VA could be improved by providing eligible veterans with a "VA Health Card" that allowed them to seek treatment from any available hospital, clinic, or family doctor for minor or emergency needs. If longer term care is needed, the veteran would receive that at a VA facility if it is within a reasonable distance (to be defined) or continue receiving treatment locally.

This would accomplish two things:

• Provide quicker care for the veteran while reducing the workload at the VA for short term care
  
• Ensure the veteran receives long term care for chronic problems while focusing VA resources toward ensuring long term care is available.

The problem continues to be that VA health care is budget based rather than demand based. Private sector health care systems compete for patients by improving their systems to raise demand. They are limited by the constraints of insurance coverage and the requirement to provide emergency care for those without insurance. Bad systems eventually fail and get replaced by better ones.

With government-provided health care, you get what the government decides is appropriate in the manner it decides is appropriate.

Or, the VA can cover theirs... just like the army and the politicians... and wait for the public interest to be focused elsewhere. I know, how about focusing on the increase in hot air around Washington a.k.a. "global warming?"

By the way, it wasn't the general's fault. He didn't get the time, the money, or the staff to do what was necessary; but he did get the shaft.