Veterans Affairs ‘Falsifying Reported Wait-Times’

Veterans Affairs purged thousands of medical tests to 'game' its backlog stats

 Thousands of orders for diagnostic medical tests have been purged en masse by the Department of Veterans Affairs to make it appear its decade-long backlog is being eliminated, according to documents obtained by the Washington Examiner.

About 40,000 appointments were “administratively closed” in Los Angeles, and another 13,000 were cancelled in Dallas in 2012.

That means the patients did not receive the tests or treatment that had been ordered, but rather the orders for the follow-up procedures were simply deleted from the agency’s records.

It is not known how widespread the practice is, or how many veterans hospitals have mass-purged appointment orders to clear their backlogs.

Alas, this feels all too familiar to someone who grew up with Britain’s National Health Service.

Here’s the thing: when one subordinates healthcare to government, one inevitably gets all of the usual government games. A favorite trick: Mrs. Jones needs a hip replacement, so she calls up her local NHS hospital to arrange it; the NHS tells Mrs. Jones that she should call back in a given amount of time, after which she will be treated within 24 or 48 or 72 hours — or however long the government has promised would elapse between “phone call” and “treatment”; Mrs. Jones waits the requisite amount of time, then calls, then gets her appointment; the state then says semi-truthfully that Mrs. Jones was given a hip replacement “quickly” and that the gap between her requesting the treatment and her receiving the treatment was short. Now, did Mrs. Jones actually get her hip replacement “quickly”? Of course not. She waited both the amount of time that the government recorded and the amount of time that it did not. But who cares? All that matters when the government is elected or fired based on its performance running the health system is what the government is able to say about how it is running the health system. So it lies its damn head off.

Via: Washington Examiner

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Obamacare’s Threat of Centralized Control

I don’t like much about Obamacare. But most urgently, I oppose its imposition of anti-American centralized control–in the sense that it is the antithesis of the Founders’ governing philosophy–and hopeless complexity over a huge sector of the American economy, as much about the seizure of raw power as it is about restraining costs.

That’s the NHS model.  No, not in the method of its funding but the flawed presumption that bureaucrats somehow know best, a point made very well in by Theodore Dalyrimple’s interesting article about the NHS, entitled “Universal Mediocrity” (my emphasis):

In obeying directives not because they are right but because they are directives, doctors lose their self-respect, their probity, and their intellectual honesty. Gogolian absurdity can result—with a hint of Kafkaesque menace and Orwellian linguistic dishonesty. When the British government decreed that every patient arriving in the emergency room should be admitted to a hospital ward within four hours if admission was necessary (and that hospitals would face fines if they failed to adhere to the rule), traffic jams of ambulances formed outside one famous hospital, with their patients prevented from entering the emergency rooms until the hospital could comply with the directive. Other hospitals redesignated their corridors as wards so that they could claim that patients on stretchers had been admitted in time. In a centralized system, the setting of targets will encourage organized deception, as well as distortion of effort.
In the United States, after President Obama’s health-care law proposed fining hospitals that readmitted too many patients within 30 days of discharge, editorials in the New England Journal of Medicine pointed out the dangers posed by that rule. They omitted to say that when giant bureaucracies set targets for others to reach, they intend not so much to procure improvement as to impose control.

They say that power corrupts and absolute power corrupts absolutely. We already see some of that. But more primarily, it is also the enemy of excellence and innovation. Deprofessionalizing medicine into a technocracy–already in its early stages–will not make our doctors and hospitals better, but instead, equalize increasingly mediocre results.

Via: First Things

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