The Veterans Administration is the largest federal employer, with more employees even then the Army. The horrific and deadly scandal involving this huge bureaucracy is disturbing on a number of fronts. It has direct effect on the veterans, our heroes who have kept us safe. It has frightening implications for the civilian population because it is likely a window to our future.
A Freedom of Information Act request by a watchdog group found that the Edward Hines VA hospital in Cook County, Illinois paid its staff millions of dollars in bonuses over the last three years. General Shinseki, the former head of the VA, attempted to solve this problem by firing an undersecretary of the Veterans Administration who was already planning to retire. His choice for a replacement was the very administrator who oversaw the Edward Hines VA that paid the bonuses in the first place. It is hard to imagine a tighter circle of incompetence.
Even worse, the Edward Hines VA in 2013 had 4230 employees, including 309 physicians and about 800 nurses. Only 25% of these employees were involved in taking care of the patients. Administration and support staff outnumber caretakers 3 to 1. This brings a whole new meaning to the question, "Is there a doctor in the house?"
It hits close to home. Rep. Paul Broun, a family practice physician, said, "The federal government has promised these veterans that they're going to be taken care of, and it's not just those veterans that are dying in Arizona. We've had three deaths that probably could have been prevented in Decatur, Ga. We've had ... over 5,000 veterans that needed colonoscopies at the Charlie Norwood VA center in Augusta, Ga., that were delayed."
Now we find that incompetence is systemic. Waiting times are beyond all reason and would never be tolerated in the private sector. And the incompetence is sometimes fatal, as care delayed is care denied. The contract with America's military has been broken in a way that is callous and arrogant by an administration that is from the top down inept, ignorant, irresponsible, and just plain stupid. The tepid response of the West Point graduates to the address of their bungler in chief recently is understandable.
How does this affect civilians?
The frustrating and potentially lethal problem in the VA is a window into what government healthcare actually provides. If Obama care stands, this will be the best we have.
Recently someone in the clinic told me that she was proud to say that she had paid her premium for her new Obama care policy. She had no idea what it covered, where she could go if she had a need, what doctors she could see, etc. She also had no idea that she would be forced to pay the deductible up front, virtually making her policy useless, as she will not have the money for a $10,000 episode. Indeed, she did not know what a "deductible" was, as the Obamacare Navigator did not explain that part. She is also not really paying those premiums—the taxpayers are.
Another of our patients purchased an Obamacare policy only to discover that it covered nothing he needed. There were multiple exclusions that specifically excised all the care options he required. He tried to cancel it, only to discover what many have found already: it is extraordinarily difficult to cancel one of these policies. They continue to bill him in excess of $500 per month for a policy he cannot possibly use.
Even if you cast aside the question of whether someone has an Obamacare policy, remember that most physicians are highly unlikely to take Obamacare patients. A survey in New York State found that almost half of physicians there are not participating, and three fourths of the rest are forced to participate by pre-existing insurance contracts.
The Association of American Medical Colleges predicts a shortage of 91,500 physicians by 2020, less than six years from now. The dismal prospect of practicing in the Obamacare environment is not an incentive to spend a fortune and 8 to 10 years preparing for a career that may not exist.
All of this means that the long waiting periods, denial of care, suffering, frustrations of dealing with a bureaucracy, increased morbidity, and increased mortality that plague the VA system now may be only a taste of what American medicine in the private sector will become in the Obama vision.
I watch the VA scandal unfold with deep sorrow. I began my career in healthcare in the VA system in Jackson, Mississippi. We took pride in our work and in the care we gave to our heroes. Apparently, government run healthcare leads to an inevitable decline in quality, efficiency, and even safety. We might look At the VA system as a predictor and wonder with Jack Nicholson's character, "What if this is as good as it gets?"