40 U.S. Veterans die in Phoenix waiting to see a doctor

Interesting that folks like Paul Krugman and other defenders of the government Affordable Care Act point to the veterans’ health system as a prototype of the best health care in the United States. Krugman, writing a while back, said “The V.H.A. is a huge policy success story, which offers important lessons for future health reform.” But Krugman and others tend to ignore the failures of the same system. From CNN a few days ago was this item: 

“At least 40 U.S. veterans died waiting for appointments at the Phoenix Veterans Affairs Health Care system, many of whom were placed on a secret waiting list. The secret list was part of an elaborate scheme designed by Veterans Affairs managers in Phoenix who were trying to hide that 1,400 to 1,600 sick veterans were forced to wait months to see a doctor, according to a recently retired top VA doctor and several high-level sources. For six months, CNN has been reporting on extended delays in health care appointments suffered by veterans across the country and who died while waiting for appointments and care.”

We will never know if any of those 40 veterans would have lived if they had seen a doctor in a more timely manner but I would think that the odds are that some of them could have survived.

I am just pointing out what has happened in a long running U.S. government-run health care system where the data is available. Also, a large number of us have pointed to the government-run health care systems in Europe where similar problems have been reported.

I am sure that 40 dead is just a drop in the bucket and they may have died anyway but what will happen when the ACA kicks in full force? Will there be deaths because of wait time? It may be only a very small percentage of the people wanting to see a doctor, as it is with the Veterans Health Administration but what if one of those in that very, very small percentage is your father or mother, or your husband or wife, or your son or daughter?

Just asking?

Jerry

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Abolishing private property rights

Ever hear of Armen A. Alchian? One of the best econ thinkers on Price Theory and his 100 birthday was yesterday. Wish he were still around to impart more wisdom to us.

Dr. Alchian said: "The worst outcome by far occurs when property rights really are abolished." 

This is a well proven theory known as the “Tragedy of the Commons”. A political economist at Oxford University, William Forster Lloyd, explained this theory in 1832. Looking around England he found that common, not privately owned, pastures were devastated and of little economic value while privately held land was not. Lloyd's answer was that each user of the common was guided by self-interest. When the carrying capacity of the commons was fully reached the owner of a herd would ask "Should I add another animal to my herd?" and because the person owned the animal and not the pasture, adding an animal would be a gain for him while the loss would be “communized” among all the various herd owners using the pasture. In this privatized gain would exceed the herdsman's share of the commonized loss.

Now property rights not only have to do with the private ownership of pastures, property rights has to do with the private ownership of the product of your hands and mind.

Now if you consider the ACA (Affordable Care Act) you will see that the Tragedy of the Commons may be applied. The commons in this case is medical service. A limited number of care providers [doctors, nurses, etc.] and an expanding number of people demanding care that may or may not be necessary but is free. I may have a cold or an upset stomach and so go to the doctor, so the demand will exceed the carrying capacity of the health system.

Jerry

At last - something good to report about the Affordable Care Act

I have to say that today I found one good thing to come from the ACA. You ask, Jerry what could that be? Well, I read that "Retail" health clinics are increasing in number where in the past they had reached a point of stagnation. Now, if you don't know, a retail health clinics is one that, in general, is open seven days a week, doesn't require an appointment, accept more types of insurance than doctors and charge about 30% to 40% less for similar services. The reason for the increasing numbers is that the small business people who are opening them are betting that the ACA will bring longer waits and higher prices at the doctors' offices and will drive a money making percentage of patients to their door. Just economics. If there is a need for a product then someone will come along and attempt to fill that need.

This could be a great idea and the reason that I think so is that the AMA is against it. Their position is that "such facilities don’t provide the continuity of care" and "they are detrimental to the concept of a 'medical home,' where patients have a personal physician who knows them well and coordinates all their care."

And if that does not keep people from using these new clinics then they say, “Some pediatric practices say they won’t see you if you go to a retail clinic,”

Well, if the "competency card" does not work then you can always play the "fear card"...

Jerry