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Tuesday, October 25, 2016

The unofficial end of summer, Labor Day, may serve as a bookend to a scandal that exploded around the unofficial start, Memorial Day. We speak of the very long wait times to see primary care providers at veterans hospitals and, more seriously, the doctoring of records by some hospital administrators to hide that reality.

Back in May, this writer erred in underestimating the wrongdoing at hospitals run by the Department of Veterans Affairs. She’d been swayed by friends who had nothing but praise for their VA hospital experiences — and independent studies by the likes of RAND showing higher patient satisfaction in VA hospitals than in privately run ones.

Also, the blast of outrage bore all the signs of another right-wing attack against “evil” government and, with it, a call to privatize another of its services.

The media, meanwhile, were facing the news desert of a quiet, long weekend. So what perfect timing — especially over a holiday honoring those who served — to flog the accusation that the government was killing veterans by the thousands.

That incendiary charge has thus far proved to be unfounded. The VA inspector general’s office has been investigating the deaths of veterans waiting for primary care appointments. So far, it’s failed to find evidence of veterans dying because they were on those lists.

The inspector general did uncover some worms, however: Hospital administrators were faking data about those delays. Punishment is being meted out.

At the bottom of this emotional story sits a very plain vanilla villain: the nationwide shortage of primary care medical professionals. This scarcity plagues the entire American health care system, government-run and private alike.

In a highly market-based system such as ours, providers go where the money is. That would be the more lucrative medical specialties — and in hospital settings rather than doctors’ offices.

In most other countries (though not Canada), patients have shorter waits to see primary care providers. Reliance on expensive specialists to treat conditions that a family doctor could handle helps explain why America spends so much more on health care than do other rich countries.

The reason we know more about the waits at the VA than the ones in the private sector is governments require that such records be kept. The private system does not.

A $16 billion fix for the VA’s primary-care problem was signed this month by President Obama. Thousands of such doctors, nurses and other health care professionals are being hired. Most of the money, however, will pay for veterans on long waiting lists — or who live more than 40 miles from a VA facility — to see private providers.

Thus, conservatives got some of what they wanted and some of what they didn’t. In their plus column, the system is now somewhat more privatized. In the minus column, conservatives had to approve spending these billions — and after they had blocked a vote in February to spend large sums on some of the same things.

A handful of Republicans refused to vote for the bill, insisting that the entire VA system needs a multiple bypass.

“We need structural changes,” said Rep. Jack Kingston, a Georgia Republican, “a purge of those who made this mess, and more choices for our veterans.” “More choices” is code for privatization.

Turns out government can’t promise good health care to the growing numbers of veterans — whether through public or private facilities — without spending a lot of money. That’s the way it goes.

All is quiet now on the VA hospital front. But where are the two-inch headlines noting that the three-inch headlines about murdering veterans were way off? Don’t even bother answering.

Follow Froma Harrop on Twitter @FromaHarrop. She can be reached at [email protected] To find out more about Froma Harrop and read features by other Creators writers and cartoonists, visit the Creators Web page at

AFP Photo/Brendan Smialowski

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  • dtgraham

    “In most other countries (though not Canada), patients have shorter waits to see primary care providers.” Utter frickin’ nonsense. There are always a plethora of walk-in clinics in any Canadian city or town to fill in the gap if you’re not able to see your family physician in the time that you feel you should. These clinics are always staffed by medical doctors and, although appointments can’t be made, the wait time is never more than an hour or so at the worst of times. Although I’ve always had a family doctor, I’ve still been to a number of them in my lifetime out of convenience and this has always been my experience. An MD can obviously do a lot for you on the spot. They can write prescriptions and make referral appointments to any specialist that they feel you should see. You can see a medical doctor for free any day of the week in any Canadian town or city. He/she may not be your family doctor, but they certainly qualify as “primary care providers.” Trust me Froma, you have no idea what you’re talking about.

    There have been some serious factual errors in National Memo articles lately, and this is another one.

    • TZToronto

      Agreed. I’ve been to walk-in clinics in Toronto, too, and the doctors there are quite capable of diagnosing and treating typical health issues. If they can’t handle something (they are not ERs), they can refer you to a facility that can handle the problem. . . . and if it’s really serious, you get seen right away at the ER. I have a family doctor, too, but he’s not there on weekends. The walk-in clinic(s) are open on weekends and after hours, too.

  • Dominick Vila

    I spent many years in Spain and England, and I have close relatives in those countries and in Sweden. I never noticed the long lines this article refers to, or any evidence of inadequate medical care during my stay in Europe. In fact, the opposite is true, and we have to go no further than the last Olympics, when the British people highlighted their healthcare system as one of its greatest achievements to understand how important and satisfying it is for them. Does that mean that there is no room for improvement? Of course not, there are always better ways to get things done. The difference is that while our approach to progress is to dismantle what is being done to improve our old ways of dong things, others simply improve things that are not working as efficiently and effectively as they would like.
    I remembering reading articles in the Washington Post 25 or 30 years ago, when I lived and worked in Maryland, about inefficiencies in the VA system. Needless to say, those articles were influenced by what journalists saw at some of the largest VA facilities in the country: the Bethesda Naval Hospital and Walter Reed. The saddest part of this issue is that it is not new, and that little has been done to correct the problems that afflict our VA system. The problems appear to be influenced, mostly, by inadequate funding and cultural matters. The easiest solution, in my opinion, is to merge the VA system with MEDICARE, with one exception: the new VA section of MEDICARE must cover ALL costs. Contrary to what we hear from the right wing, both Social Security and MEDICARE work very well and are cost effective. There is no reason for not expanding the scope of those social programs, and taking advantage of a well designed infrastructure, to improve healthcare areas that are not working as efficiently as they should. Considering how critical the VA system is to our veterans, it should be one of our top priorities and something that should enjoy pragmatic and patriotic bipartisanship.

    • dtgraham

      The false and misleading information from the right on the ACA and other health care systems is bad enough, but when a journalist who supports us can’t get it right… The winger media will have a conniption fit and go into apoplexy when Vermont starts it’s single payer system for everyone.

      There has been a long history of underfunding the VA by Republicans (who else). These are war veterans who need much more care on average than the ordinary citizen in a single payer system, and the cuts have really hurt. The GOP are in an impossible position ideologically. They claim to be the ‘support the troops’ party but if they make the VA system work properly, then what does that say about their private market health care philosophy? They don’t intend to make it work properly. You can tell by both their actions and, now, their words. “More choices”, “structural changes”. They used to at least fake it.

      • Dominick Vila

        Their idea of healthcare system that works properly starts and ends with a system that allows healthcare providers and the insurance industry to rip off the government, and by default the electorate. If it excludes some of our most vulnerable citizens from getting the medical services they need, so be it. For the GOP, impacting 47% of Americans is the least of their concerns, when the achievement of their narrow goals produce a bounty for those who don’t need our help to enjoy everything that money can buy.

  • ScotDog

    Wrong about Canada again. Is it a optimal system no, but it’s getting better and those waits you heard about were from a labour dispute 20+ years ago by doctors against the conservative government’s restrictions that kept health costs down. Sound familiar, people who took an oath to help others broke that oath to try and get more money. Capitalism at it’s ugliest.

  • ps0rjl

    All the promises made to us veterans about free healthcare when we were in were just so much pie in the sky. The truth is the VA system was screwed up 45 years ago when I got out of the marines and it is still screwed up. One of the biggest problems is that they have failed to automate veterans healthcare but that is just one problem. I’ve never gone to the VA but when I retired I thought I would see about getting free blood pressure medicine. Yeah that was a joke. I don’t have any combat injuries and I am not indigent so I am so far down on their list that I will never be allowed to use the system.

  • coalgateOps

    Obama lied on June 28, 2012 when he claimed that Americans who already have health insurance would be able to keep it.