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Tags: Obamacare | VA | healthcare

VA Scandals: Harbinger of Things to Come

Kevin R. Campbell, M.D. By Wednesday, 24 June 2015 04:25 PM EDT Current | Bio | Archive

Opponents of the Affordable Care Act (ACA, also known as Obamacare) have long argued that the U.S. Department of Veterans Affairs (VA) healthcare system was a homegrown example of problems inherent in a government-managed healthcare system. The troubled history of the VA and the recent scandals and controversies can teach us much as we make decisions about the future.

The VA system has its origin in 1921, when Congress consolidated three federal agencies — the Bureau of War Risk Insurance, the Public Health Service, and the Federal Board of Vocational Education — into a new entity called the Veterans’ Bureau.

In 1930, the Veterans Administration was created under President Herbert Hoover in response to a need to take care of those who had served in the First World War, and the agency continued to grow substantially following World War II.

The goal of the system was to provide care and benefits to those who had served our country and sacrificed so much to preserve our freedom. But the VA System as a whole has fallen far short of serving those who have served.

The Veterans Administration has had issues for years. Both Republican and Democratic administrations have had problems with quality of care, cleanliness, access to care, and more.

In the last year, however, scandal after scandal has erupted and exposed troubling, deep-seated issues within the VA. Long waits for care persist, and veterans continue to receive less than the care that they deserve.

While the leadership of the VA system has changed, there has been little meaningful change in the quality of service.

If our government has not been able to manage a healthcare system for a small portion of its citizens (heroes, for that matter) how on earth could they manage a system that covers all Americans?

The VA system provides endless examples of unfortunate and uncomfortable truths about government-run healthcare programs, as well as what we can expect from Obamacare in the years to come.

The most disturbing of these issues have been illustrated include unaccountable bureaucracy, long waiting lists, and rationed care. A quick look at only one recent controversy within the VA system sheds light on the impact of government-controlled healthcare on patient care, and ultimately, on patient outcomes.

This week, details are emerging (after an investigation by the “Arizona Republic”) about a plan to ration care for veterans who need treatment for the chronic liver disease hepatitis C. New, drugs have proven to cure 75 to 95 percent of those treated. But these drugs come with a very high price tag.

The VA system has begun a system of prioritization for treatment, as the funding for the therapy for has simply run out. Because the VA is underfunded, the only solution is to use money from the controversial and nonfunctioning Veterans Choice Act to outsource veterans to treatment in private institutions.

Furthermore, the VA and its employees must ultimately decide who is treated and who is not — even given the opportunity for access to the potentially curative therapy. Decisions about who will receive care are relegated to regional teams of VA medical experts required to follow a mandated protocol for granting access to care.

According to records obtained by the “Arizona Republic,” nearly 150,000 veterans have been outsourced. Only the sickest patients will be referred for therapy.

Those who are more stable or those determined to have less than a year to live will not be treated.

The “Arizona Republic” further reports that physicians within the VA System have been vocal in their criticism of this move — hundreds signed a letter to VA Secretary Robert McDonald, calling any action other than treatment of all eligible veterans unacceptable.

We must look carefully at the VA system, and act quickly in order to protect our veterans. It is clear that there are many talented and compassionate physicians within the VA who want to provide the best care for their patients — if the government will only allow them to do so.

We cannot afford to allow the government to manage a national healthcare system unless we are willing to accept the consequences that we are now seeing in the VA. If Congress doesn’t modify or repeal Obamacare, I expect that we will see rationing of care, long lines and access difficulties among all ACA enrollees within the next five years.

If government can’t run a healthcare system to care for 25 million veterans, how can we expect them to manage a system covering the entire population of the U.S.?

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Opponents of Obamacare have long argued that the VA healthcare system was a homegrown example of problems inherent in a government-managed healthcare system.
Obamacare, VA, healthcare
Wednesday, 24 June 2015 04:25 PM
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