Tuesday, August 26, 2014
The unofficial end of summer, Labor Day, may serve as a bookend to a scandal that exploded around the unofficial start, Memorial Day. We speak of the very long wait times to see primary care providers at veterans hospitals and, more seriously, the doctoring of records by some hospital administrators to hide that reality.
Back in May, this writer erred in underestimating the wrongdoing at hospitals run by the Department of Veterans Affairs. She'd been swayed by friends who had nothing but praise for their VA hospital experiences -- and independent studies by the likes of RAND showing higher patient satisfaction in VA hospitals than in privately run ones.
Also, the blast of outrage bore all the signs of another right-wing attack against "evil" government and, with it, a call to privatize another of its services.
The media, meanwhile, were facing the news desert of a quiet, long weekend. So what perfect timing -- especially over a holiday honoring those who served -- to flog the accusation that the government was killing veterans by the thousands.
That incendiary charge has thus far proved to be unfounded. The VA inspector general's office has been investigating the deaths of veterans waiting for primary care appointments. So far, it's failed to find evidence of veterans dying because they were on those lists.
The inspector general did uncover some worms, however: Hospital administrators were faking data about those delays. Punishment is being meted.
At the bottom of this emotional story sits a very plain vanilla villain: the nationwide shortage of primary care medical professionals. This scarcity plagues the entire American health care system, government-run and private alike.
In a highly market-based system such as ours, providers go where the money is. That would be the more lucrative medical specialties -- and in hospital settings rather than doctors' offices.
In most other countries (though not Canada), patients have shorter waits to see primary care providers. Reliance on expensive specialists to treat conditions that a family doctor could handle helps explain why America spends so much more on health care than do other rich countries.
The reason we know more about the waits at the VA than the ones in the private sector is governments require that such records be kept. The private system does not.
A $16 billion fix for the VA's primary-care problem was signed this month by President Obama. Thousands of such doctors, nurses and other health care professionals are being hired. Most of the money, however, will pay for veterans on long waiting lists -- or who live more than 40 miles from a VA facility -- to see private providers.
Thus, conservatives got some of what they wanted and some of what they didn't. In their plus column, the system is now somewhat more privatized. In the minus column, conservatives had to approve spending these billions -- and after they had blocked a vote in February to spend large sums on some of the same things.
A handful of Republicans refused to vote for the bill, insisting that the entire VA system needs a multiple bypass.
"We need structural changes," said Rep. Jack Kingston, a Georgia Republican, "a purge of those who made this mess, and more choices for our veterans." "More choices" is code for privatization.
Turns out government can't promise good health care to the growing numbers of veterans -- whether through public or private facilities -- without spending a lot of money. That's the way it goes.
All is quiet now on the VA hospital front. But where are the 2-inch headlines noting that the 3-inch headlines about murdering veterans were way off? Don't even bother answering.
Follow Froma Harrop on Twitter @FromaHarrop. She can be reached at email@example.com. To find out more about Froma Harrop and read features by other Creators writers and cartoonists, visit the Creators Web page at www.creators.com.
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