Free Health Care For All...

[JimL]

so even though you are rich you opt for inferior health coverage? Right.


First your links don't work. Second, I already know what medicare covers and pays for, but you don't seem to. I was trying to determine if you merely mistyped something or if you are truly ignorant. Giving me a link doesn't answer that question. Which seems to me is your way of dodging the question. Therefore the only conclusion I can come to is you have no idea what medicare covers or costs



But you know they wouldn't do that. Putting the insurance companies out of business would be an economic disaster. Millions of people would be out of work. The stock market would crash.

Yeah, ok Sparko, I knew I shouldn't have wasted my time.

[Sparko]

Yeah, ok Sparko, I knew I shouldn't have wasted my time.

Translation: Sparko has caught me. Better slink off into the shadows.

[carpedm9587]

You have a gift for understatement. Or is that a curse?

You have minimized the scope of the problem with the VA to make it sound minor.

Actually, I said nothing about "minor" or "major." My comments were about the breadth/scope of the problems. Even a problem that only involves 1% of a workforce can have major implications and require remedying. I would say that, if people are dying, that would be a "major problem," even if it is only a fraction of the workforce that is involved.

[carpedm9587]

You have move past fence sitting to full on denial at this point.

Rather than admit the VA is poorly run and mismanaged you take the tact of nitpicking to say "well not all 300K employees are bad!" - which nobody claimed.

Since I do not have evidence that "the VA is poorly run and mismanaged," I do not take that position. Since I have evidence that "aspects of the VA are poorly run and mismanaged, I DO take that position.

When you utter a statement like, "the VA is poorly run and mismanaged," that is an unqualified indictment of the entire organization, Sparko. Perhaps you do not intend it - and perhaps that is not what you think, but that is what the words are saying. The sentence begins with "the VA." It doesn't say "part of the VA," or "some aspects of the VA" or qualify that claim in any way whatsoever. It's a pretty blanket indictment. It is that sort of language to which I object.

This is done continually - and not only here. "The FBI is corrupt." "Government is wasteful." The list goes on. Yes, there is corruption in the FBI. We've certainly seen the stories. But I will not make such a sweeping indictment on evidence that involves a few people. And I will carefully distinguish between "poor decisions," "mistakes," "unanticipated consequences" and outright corruption.

So no - I am not in full blown denial. I am simply (apparently) more careful about my use of language than you are.

[lilpixieofterror]

CP, look at your "carpet bomb." Read the stories and ask yourself, "how many people do these stories identify?" At best, it is a few hundred people involved with the scandals reported. Even if I grant you a few thousand people, which is a stretch, the VA employs over 377 thousand people. Even if 3,000 of them are demonstrably involved, that's 1% of the VA. That leaves 99% good people doing their jobs and helping others.

Sorry, but I'm not going to throw 374 thousand people under the bus because 1% of their colleagues (if that) have been shown to be complicit in inefficiencies and even corruption. You have not presented data that shows the "corruption" or "inefficiency" is in every state, in every hospital, in every administration, etc.

Is there a problem? Yep. Several of them, according to the articles. Do we need better leadership and management? No question about it or argument about it: yes. Does it justify a broadside against the VA and it's people? No. As with most groups, most of it is probably good people doing the best they can for those they serve. They deserve our respect and thanks, until it can be shown that the problem is bigger and more widespread than the smattering of articles/problems that list you sent indicates.

The media loves stories that get eyeballs. Sometimes, real people doing their best get skewered as a consequence. I won't be part of that. I understand Sparko has an issue with that. Frankly, Sparko appears to have an issue with pretty much anything I post, so I have long since tuned out his personal attacks and just try to focus on the arguments in play. I refuse to pig-pile people because it's "politically correct" to do so. Show me evidence that the problem extends beyond a few hundred or few thousand people, and I'll join the "bandwagon." Otherwise, I tend to prefer to give people the benefit of the doubt. Too much harm has been done to good people in the name of politics.

[carpedm9587]

I would think my posts were reasonably clear: sweeping blanket statements that impugn "the VA" generally are simply not substantiated. Go through all of the articles in CP's "carpet bomb" and you come to a total of a few hundred people involved, many of whom are the exact same rank-and-file you reference.

The media like to jump on stories. They want anything that gets eyeballs. Any article about some government agency screwing up is going to get eyeballs. For the anti-government members of the right, it feeds right into their narrative, so they tend to swallow it all hook, line, and sinker and it further affirms "government in general" or "this government agency" is bad. In general, all the articles do is show that this government agency has problems in some areas that need attention. They are important problems. They are critical, even (given that people are dying). What has not been shown is that they are pervasive, or impact more than a small fraction of the people working in that agency.

Sparko's accusations of denial are false: I have never denied that there are problems. I HAVE denied that the evidence shows they extend beyond a small fraction of the agency.

A few years ago, news media could not write enough stories about the IRS investigating Republican-leaning organizations applying for non-profit status. It was a great scandal. I'm sure many people still think in those terms about the IRS. The subsequent investigation that found that the IRS was actually investigating ALL applications with political motivations (Republican and Democrat) was nowhere near as widely reported, because it wasn't "scandalous" and would not get anywhere near as many eyes.

I try to look at the data within the articles, and set aside the "eyeball attracting" hype. And I refuse to jump on the latest "I hate government" bandwagon just because it's the PC thing to do. Give me evidence, and I will agree with the perspective. Give me a lot of media hype, and I'm going to raise an eyebrow and suggest you be a bit more discriminating.

[lilpixieofterror]

I would think my posts were reasonably clear: sweeping blanket statements that impugn "the VA" generally are simply not substantiated. Go through all of the articles in CP's "carpet bomb" and you come to a total of a few hundred people involved, many of whom are the exact same rank-and-file you reference.

The media like to jump on stories. They want anything that gets eyeballs. Any article about some government agency screwing up is going to get eyeballs. For the anti-government members of the right, it feeds right into their narrative, so they tend to swallow it all hook, line, and sinker and it further affirms "government in general" or "this government agency" is bad. In general, all the articles do is show that this government agency has problems in some areas that need attention. They are important problems. They are critical, even (given that people are dying). What has not been shown is that they are pervasive, or impact more than a small fraction of the people working in that agency.

Sparko's accusations of denial are false: I have never denied that there are problems. I HAVE denied that the evidence shows they extend beyond a small fraction of the agency.

A few years ago, news media could not write enough stories about the IRS investigating Republican-leaning organizations applying for non-profit status. It was a great scandal. I'm sure many people still think in those terms about the IRS. The subsequent investigation that found that the IRS was actually investigating ALL applications with political motivations (Republican and Democrat) was nowhere near as widely reported, because it wasn't "scandalous" and would not get anywhere near as many eyes.

I try to look at the data within the articles, and set aside the "eyeball attracting" hype. And I refuse to jump on the latest "I hate government" bandwagon just because it's the PC thing to do. Give me evidence, and I will agree with the perspective. Give me a lot of media hype, and I'm going to raise an eyebrow and suggest you be a bit more discriminating.

[Starlight]

I would think my posts were reasonably clear: sweeping blanket statements that impugn "the VA" generally are simply not substantiated. Go through all of the articles in CP's "carpet bomb" and you come to a total of a few hundred people involved, many of whom are the exact same rank-and-file you reference.

In the UK they do a lot of polling on public satisfaction with their health services, and they found that people who had used the services rated them extremely highly, while people who hadn't used them rated them poorly. They attributed this to media coverage reporting all the rare negative experiences while not reporting the 99.9% non-stories of "another day, another person successfully treated".

I can't find many US polls on the subject, but there's this 2013 survey:

The American Customer Satisfaction Index (ACSI), an independent customer service survey, ranks the Department of Veterans Affairs (VA) customer satisfaction among Veteran patients among the best in the nation and equal to or better than ratings for private sector hospitals...

In 2013, the overall ACSI satisfaction index for VA was 84 for inpatient care and 82 for outpatient care, which compares favorably with the U.S. hospital industry (scores of 80 and 83, respectively). Since 2004, the ACSI survey has consistently shown that Veterans give VA hospitals and clinics a higher customer satisfaction score, on average, than patients give private sector hospitals... One signature finding for 2013 is the continuing high degree of loyalty to VA among Veterans, with a score of 93 percent favorable. This score has remained high (above 90 percent) for the past ten years.

I give the ACSI low marks for my own customer satisfaction of trying to find anything on their website as I look for some more recent numbers. The only ones I can find is that in 2017 the inpatient & outpatient satisfaction was 86% & 83%.


P.S. You may be interested in this excellent analysis I came across recently done last year by a think-tank that looked at healthcare systems in 11 advanced countries and did large surveys and data-collection, and you can click through the various survey questions asked and see graphical breakdowns of responses by country etc. It's interesting that the 3 healthcare systems they rank as overall best (UK, Australia, Netherlands) use 3 quite different funding mechanisms - to put it into US terms: UK is basically a "VA for all" model, Australia is a "medicare for all" model, and the Netherlands is an Obamacare marketplace model.

[carpedm9587]

If it's a few hundred, it's not "the VA," it's a fraction of the VA that needs attention and correction.

At not point did I say anything otherwise. Indeed, I pointed out several times that even small numbers can create "critical" problems. You appear to be agreeing with me.

[carpedm9587]

In the UK they do a lot of polling on public satisfaction with their health services, and they found that people who had used the services rated them extremely highly, while people who hadn't used them rated them poorly. They attributed this to media coverage reporting all the rare negative experiences while not reporting the 99.9% non-stories of "another day, another person successfully treated".

I can't find many US polls on the subject, but there's this 2013 survey:

The American Customer Satisfaction Index (ACSI), an independent customer service survey, ranks the Department of Veterans Affairs (VA) customer satisfaction among Veteran patients among the best in the nation and equal to or better than ratings for private sector hospitals...

In 2013, the overall ACSI satisfaction index for VA was 84 for inpatient care and 82 for outpatient care, which compares favorably with the U.S. hospital industry (scores of 80 and 83, respectively). Since 2004, the ACSI survey has consistently shown that Veterans give VA hospitals and clinics a higher customer satisfaction score, on average, than patients give private sector hospitals... One signature finding for 2013 is the continuing high degree of loyalty to VA among Veterans, with a score of 93 percent favorable. This score has remained high (above 90 percent) for the past ten years.

I give the ACSI low marks for my own customer satisfaction of trying to find anything on their website as I look for some more recent numbers. The only ones I can find is that in 2017 the inpatient & outpatient satisfaction was 86% & 83%.


P.S. You may be interested in this excellent analysis I came across recently done last year by a think-tank that looked at healthcare systems in 11 advanced countries and did large surveys and data-collection, and you can click through the various survey questions asked and see graphical breakdowns of responses by country etc. It's interesting that the 3 healthcare systems they rank as overall best (UK, Australia, Netherlands) use 3 quite different funding mechanisms - to put it into US terms: UK is basically a "VA for all" model, Australia is a "medicare for all" model, and the Netherlands is an Obamacare marketplace model.

Thanks for the links. Interesting reads, and perfectly consistent with human nature.

[lilpixieofterror]

If it's a few hundred, it's not "the VA," it's a fraction of the VA that needs attention and correction.

At not point did I say anything otherwise. Indeed, I pointed out several times that even small numbers can create "critical" problems. You appear to be agreeing with me.

[Sparko]

In the UK they do a lot of polling on public satisfaction with their health services, and they found that people who had used the services rated them extremely highly, while people who hadn't used them rated them poorly. They attributed this to media coverage reporting all the rare negative experiences while not reporting the 99.9% non-stories of "another day, another person successfully treated".

I can't find many US polls on the subject, but there's this 2013 survey:

The American Customer Satisfaction Index (ACSI), an independent customer service survey, ranks the Department of Veterans Affairs (VA) customer satisfaction among Veteran patients among the best in the nation and equal to or better than ratings for private sector hospitals...

In 2013, the overall ACSI satisfaction index for VA was 84 for inpatient care and 82 for outpatient care, which compares favorably with the U.S. hospital industry (scores of 80 and 83, respectively). Since 2004, the ACSI survey has consistently shown that Veterans give VA hospitals and clinics a higher customer satisfaction score, on average, than patients give private sector hospitals... One signature finding for 2013 is the continuing high degree of loyalty to VA among Veterans, with a score of 93 percent favorable. This score has remained high (above 90 percent) for the past ten years.

I give the ACSI low marks for my own customer satisfaction of trying to find anything on their website as I look for some more recent numbers. The only ones I can find is that in 2017 the inpatient & outpatient satisfaction was 86% & 83%.


P.S. You may be interested in this excellent analysis I came across recently done last year by a think-tank that looked at healthcare systems in 11 advanced countries and did large surveys and data-collection, and you can click through the various survey questions asked and see graphical breakdowns of responses by country etc. It's interesting that the 3 healthcare systems they rank as overall best (UK, Australia, Netherlands) use 3 quite different funding mechanisms - to put it into US terms: UK is basically a "VA for all" model, Australia is a "medicare for all" model, and the Netherlands is an Obamacare marketplace model.

VA touts patient satisfaction, but its findings are questionablehttps://www.azcentral.com/story/news...able/91491528/

[carpedm9587]

That appears to be a personal opinion I don't agree with. It's something like saying, "it's not how a business treats the majority of it's customers that makes it good, it's how it treats the difficult ones." As a business owner, I would never use that metric to evaluate my business.

Actually, I have acknowledged that there have been several critical incidents that need attention. Perhaps you missed that part of my posts. I still do not see justification for impugning "the VA" when the problem is specific elements within the VA, and the vast majority of the VA appears to be serving its constituents reasonably well. The negative always gets more attention and news cycles. You have to look past the media hype.

[lilpixieofterror]

That appears to be a personal opinion I don't agree with. It's something like saying, "it's not how a business treats the majority of it's customers that makes it good, it's how it treats the difficult ones." As a business owner, I would never use that metric to evaluate my business.

Actually, I have acknowledged that there have been several critical incidents that need attention. Perhaps you missed that part of my posts. I still do not see justification for impugning "the VA" when the problem is specific elements within the VA, and the vast majority of the VA appears to be serving its constituents reasonably well. The negative always gets more attention and news cycles. You have to look past the media hype.

The vast majority of any failed business are not terrible people either.

[carpedm9587]

Is your business about saving lives?

No.

I actually agree with this, and it doesn't change my observation: impugning "the VA" in general because on aspect of it is broken and needs fixing is simply not just. First of all, the rest of the VA appears to be working reasonably well (no better or worse than the rest of the U.S. healthcare system). And even for critical cases, a few articles about a few incidents in a few locations does not translate to all critical care situations in all venues. No data has even been provided that demonstrates that the problems are any better/worse than in the regular healthcare system for critical care situations.

My objection stands: general statements like "the VA is X" are simply not warranted, just, or defensible.

The vast majority of any failed business are not terrible people either.

Agreed.