American Elephants


The VA Scandal Is Caused By the Perverse Incentives of Socialized Medicine. by The Elephant's Child

About-The-Department-of-Veterans-Affairs-resized-6001

Memorial Day just calls more attention to the scandal of the Veterans Administration hospital system. Democrats are in panic mode. This is a bad one. Nancy Pelosi is trying to blame it all on Bush, the usual fall-back position. She would have it that it is all the enormous influx of young veterans wounded in Bush’s wars. Nice try, but that’s not the case. It isn’t the young guys that are dying of inattention, despite their sometimes grievous wounds, they are younger and healthier. The problem is socialized medicine.

The reason Democrats are attracted to government-run health care is that the left is always focused on intent, not results. They believe in government by experts, the best and brightest, and ever more experts to get it right — in other words, in big government. Their intent is what matters. If the results aren’t right, they will fiddle and tweak until they get it fixed.  But they intend a bright and shining success.

When you guarantee beneficiaries free treatment which is open-ended in terms of cost, more patients are apt to seek treatment for less important reasons. They have no idea of the cost—they are guaranteed care. For the government, the patients are now their responsibility and the incentive is entirely to cut costs.

Doctors and nurses may well be wonderful, and choosing to work with veterans indicates a caring intent, when they could probably do as well or better in the private sector. But for the bureaucratic staff, the incentive is to force the medical staff to cover more patients in less time, to prescribe cheaper medicines, to do less costly procedures. Success at bringing down costs results in bigger bonuses and career advancement for the bureaucrats.Some are represented by unions. The incentives for unions are to gain bigger bonuses, better retirement, and better pay, not better care for vets.  Which results in long wait lists, hidden because they are embarrassing and certainly not resulting in career advancement— or exactly what we’ve got.

Democrats don’t really understand what all the fuss is about, because they are focused on their intent. The results can be tweaked to prevent such problems.

You can see  the intent of ObamaCare being tweaked daily by the president, as he issues executive orders and rewrites the law to overcome problems. But we have had added the United States Preventative Services Task Force (USPSTF) which issues decisions on what preventative services will and will not be covered and for whom they are indicated. Got that? You don’t get to decide, it will be decided for you by a new agency filled with unaccountable bureaucrats.

The Independent Payment Advisory Board (IPAB) is tasked with cutting Medicare costs either through a reduction of services or by cutting the payments to providers. They simply don’t understand that they cannot cut payments to providers below a certain point or there will be few or only poorly qualified providers.

Whether with Medicare, Veterans Care or Medicaid, Obama and his advisers were particularly concerned with the higher costs of health care for older people. Statistically, the biggest expenses for health care are in their final years. If you can cut back on those expenses, and old people have fewer worthwhile life years ahead of them, then you are more apt to meet your budget.

And again, whenever care is free at the point of service, the more care people will demand. I wrote this in an earlier post, but this is what Obama said:

Obama did say that people might be better off taking a pain pill than getting surgery. He also said “the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out there.” Excuse me, but isn’t that what health care is for?

department-of-veterans-affairs-va-headquarters-in-washington-dc-photo



Memorial Day: War and Remembrance by The Elephant's Child

6th-maine

The first Memorial Day, which they then called Decoration Day, was celebrated May 30, 1868. The date in May was selected because flowers were in bloom then, and the day was set aside to decorate graves and to remember the fallen. The numbers were appalling. The national population in 1860 was about 31.4 million. The Civil War dead, both Union and Confederate, are now roughly estimated at 750,000, and possibly even more. Memorial Day became an official national holiday in 1971.

Memorial Day now remembers the fallen from all our wars. Robert Samuelson “lists the war dead from the “Historical Statistics of the United States (Millennial Edition)”by conflicts as follows” the Revolutionary War, 4,435; the War of 1812, 2,260; the Mexican War, 13,283; the Spanish-American War, 2,446; World War I, 116,516; World War II, 405,399; the Korean War, 36,576; the Vietnam War, 58,200; the Persian Gulf War, 382. And the Pentagon reports 6,809 deaths in the wars in Iraq and Afghanistan and related combat zones as of May 22.” Mr. Samuelson has a fine column about the surrender at Appomattox to Ulysses S. Grant.

The Civil War, for all its horrors was represented by the world’s first true war photographers, with a relatively new technology recording the bloodiest conflict in U.S. history. Here’s a slide show of Matthew Brady’s photos as well as others. Here is another from the Library of Congress. They are a good accompaniment to Victor Davis Hanson’s brilliant lecture on War.

The photo is of the 6th Maine regiment.



Victor Davis Hanson:. Why War? by The Elephant's Child
May 26, 2014, 1:37 pm
Filed under: Politics

Especially right and necessary for Memorial Day, Victor Davis Hanson talks about War. Why do we have wars? What makes men start wars? How do you end a war? How can we avoid war? Is war simply natural to the human condition? Is there no hope? He spans the entire history of the wars of civilization and shows how the study of the history of war  can be a torch to light our way through the darkness.  Absolutely brilliant. It’s 20 minutes long and worth every minute.

Reposted from the same time last year.




Follow

Get every new post delivered to your Inbox.

Join 6,712 other followers

%d bloggers like this: