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Wednesday, June 24, 2015

Makes no sense...PO day 366

There was quite a hullabaloo about a year ago when it was revealed how long veterans were having to wait for medical care at VA clinics and hospitals around the country. I think I recall that there were congressional hearings to get at the root of the problem. It was all over the news but as a normal human being I don't remember the outcome since it did not really impact me personally. I do remember there were pledges and promises to do a better job serving our veterans.

So fast forward to the present. Waitlists for appointments have grown longer, not shorter. The number of veterans on a waitlist longer than one month is up fifty percent from last year. The agency has a $3 billion ($3,000,000,000!) budget shortfall and they are looking for ways to cut costs. The excuse for the increased wait for an appointment  is that by increasing the agency's capacity to treat patients it was overwhelmed by the increased demand by new patients seeking care. So said VA Deputy Secretary Sloan D. Gibson.

The budget shortfall is a major concern and ways to reduce costs are being considered. The VA plans to ask congress to allow them to shift funds between departments to keep operations going. They are considering furloughs, hiring freezes and other ways (not explained) to deal with the funding gap. Most surprising is a plan to outsource medical care for the 180,000 veterans with hepatitis C. The cost of caring for these patients has increased significantly because of effective but expensive new drugs. One proposal suggests rationing new treatments so that patients who have less than a year to live or if they are in a persistent vegetative state or suffer from dementia would be ineligible for treatment. 

To me this is a perfect example of a government run health care program. Expand the coverage to encompass more people and then cut service to the neediest or sickest to save money. Is this the future of Medicare? Will the only way to fund the Affordable Health Care Act be to cut services for the most costly Medicare patients? Already emergency rooms are overwhelmed with people who previously did not have health care insurance. The idea was that they would not have to use the ER as their primary care physician but the opposite has occurred.  So far reductions in the cost of medical care have come at the expense of physicians and hospital reimbursements, not in reduced demand on the most expensive source for routine care, the ER. Will the only way to continue to fund the ACA 
(Obama care) be to limit care to the oldest and sickest patients?

That would seem to be the VA's approach.




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