> -----Original Message----- > From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On > Behalf Of Nick Arnett > Sent: Friday, October 27, 2006 10:58 AM > To: Killer Bs Discussion > Subject: Re: Who REALLY supports the troops > > On 10/27/06, Dan Minette <[EMAIL PROTECTED]> wrote: > > > > > Nick, it's not really that simple. My dad and uncles were vets, and I > > grew > > up with their views of the VA. Ending up in a VA hospital was > considered > > a > > very bad thing at the time. The VA administration was considered as a > > last > > resort. > > > How nice for them that they had a choice.
We're talking about average working class folks in the '60s. Most had some form or other of health insurance. The VA was considered someplace to stay away from, if at all possible. >I suspect you'll find that the > problems they ran into were not caused by the VA wasting money. >More likely it was wasting their time fighting the rules and regulations >that make many vets reluctant to fight for their rights. Well, that's not what they said. They said "I hope I never end up in a VA hospital." Now, I'll admit that's a snapshot, not a national survey. But, don't you think that the vets that I knew wanting to stay away from the VA is meaningful? If not, why not? Also, it appears that you don't believe that Weber's law is valid. Is that true? > > It wasn't that the nation wasn't spending money on the VA. It's been a > hard > > to reform bureaucracy for ~60 years now. Weber's law (a bureaucrat will > > work for his own ends not the ends for which his job was created) has > had > > years to rule. Anyone who tries to cut waste is accused of "attacking > our > > Veterans." > > What sort of reform did you have in mind? In general, I'd have every level of the bureaucracy reviewed by folks who are well respected for their expertise in care. > As a health care provider, the > VA is very efficient, delivering more quality health services per > dollar than any other large health care organization in the United States. > I refer you to Brad DeLong, for example: Actually, you are referring me to Paul Krugman...Brad just posted his column. He is a liberal political columnist. He does have an advanced degree in economics, but he has chosen to be an advocate instead of neutral. That's certainly fine, but I take all columnist columns with a grain of salt. Citing a comment by one side does not constitute proof. > http://delong.typepad.com/sdj/2006/01/paul_krugman_on_1.html. Yet those > brilliant Republicans in Congress can see that they're elminating "waste" > by cutting its budget! In fact, if you look at some of the responses, you will see some interesting counters. First, Dr. Krugman argues that the overhead is close to nil, because all veterans are eligible. But, there appears to be priorities that determine who is served established by intricate bureaucratic rules. <quote> One of the things Krugman says isn't even true: There's one "advantage" the VA has that other government health care systems don't have -- they get to pick their patients, and can limit the number of patients based on their budget. Contrary to popular belief, not every military veteran is in the VA system -- the VA sets eligibility requirements in order to make sure that the number of patients they have is limited to what thay can fit within their budget. In fact, only a minority of former military personnel are in the VA system. Krugman says, the VA is "highly successful in containing costs, yet provides excellent care." True, but the do it by containing their patient load. Krugman also says something that is flat-out false: "Because it covers all veterans, the system doesn't need to employ legions of administrative staff to check patients' coverage ..." On the contrary, it does not cover all veterans, and it does have "legions [pun intended?] of administrative staff to check patients' coverage." They have an entire web site devoted just to eligibility which states, in part "All Veterans are Potentially Eligible" (emphasis mine). There is an eight-level system of "priority" detailed here. It has categories like, "Veterans with service-connected disabilities rated 30% or 40% disabling" (priority 2) and "Veterans who agree to pay specified copay with income and/or net worth above VA Income Threshold and income below the Geographic Means Test Threshold" (priority 7 -- which has FOUR "subpriorities," only two of which are currently in use. Does Paul Krugman really believe they can determine eligibility under such complete rules with fewer administrative staff than it takes1 another health system just to look at someone's ID card and take down their policy number? <end quote> Second, the use of the VA is interesting. Use for outpatient has been going up significantly since the mid-90s, even though the number of vets has gone down...and the number of old vets has gone down even quicker....But, in many facilities, hospital beds are empty. If the VA works so well, why do many/most vets use the VA system for outpatient, but not hospital care? So, we really need to look under the numbers quoted by an advocate. If veterans chose the VA system for maintenance, but chose other hospitals for high cost options, such as long stays in intensive care, then even a very inefficient VA will, on paper, be more cost effective than the most private health care system. > There's a lot of call for reform of the VA... but it is by people who are > sick of Congress and the executive branch taking away more and more of > veterans' rights and services while demanding that they pay a greater > share. How about reforming the incredible delays and denials that vets > face... but that would cost more, not less, since more vets would actually > be able to use the system. > > Those who want to keep the VA costs down are opposed to real reform > because they know that the budget would have to go up if they removed > all the obstacles that prevent or discourage many vets from taking >advantage of the benefits they earned. So, are you arguing that totally free health care should be given to anyone who served anywhere in the military? That program would cost in the hundreds of billions....and would certainly be a great inducement for enlistment. Would this be available only for those who served in war zones, or would someone who served two years in the 'States also qualify? Dan M. _______________________________________________ http://www.mccmedia.com/mailman/listinfo/brin-l
