New ObamaCare endgame: the VA for all.

PositionYOUR LIFE - Patient Protection and Affordable Care Act

Americans need to take a close look at the VA--and not only because of their concern about poor treatment of our wounded warriors. It is the prototype for ObamaCare, warns Richard Amerling, associate professor of clinical medicine and an academic nephrologist at Beth Israel Medical Center, New York, as well as president of the Association of American Physicians and Surgeons, Tucson, Ariz. "The intent behind ObamaCare is to completely centralize control over health care, and thus turn American health care into one huge Veterans Administration."

While the scandal at the Phoenix, Ariz., VA lifted the curtain on the agency's secret waiting lists--"the VA lies while patients die"--this by no means is a new phenomenon, points out Amerling.

'The nation's single-payer system for veterans long has been greatly overloaded. Congress tried to fix it in 1996 by passing a law requiring that any veteran needing care had to be seen within 30 days. The VA is supposed to have a wonderful electronic medical records system, and the EMR is touted to be the magic formula for efficiency and quality, but the VA gamed the electronic system to hide the waiting lists.

"Readers of the British press will be struck by the similarities between fudging waiting lists at VA hospitals and stacking patients in ambulances outside U.K. hospitals. Finding it impossible to comply with a National Health Service mandate that all patients admitted to an ER be seen within four hours, hospitals kept patients waiting in ambulances outside the emergency room."

Amerling adds that Britain's NHS and our VA system both are administratively top-heavy, command-and-control bureaucracies. All such systems tend to expand, along with their budgets, as administrators hire more and more people to do what those already there cannot--or will not--get done.

There is no competition, and virtually no accountability. Every problem always is someone else's responsibility. Mandates and quotas, rather than incentives, are used to motivate those in the trenches, explains Amerling.

"Physicians working in the VA system, like the NHS, are mostly salaried employees. There are many fine doctors in both systems, but the incentives in place do not reward them for going the extra mile, seeing the additional patient, or doing another procedure if it means going past their shift. Inevitably, these systems create backlogs and lengthening queues for care."

ObamaCare, meanwhile, was designed as Medicaid for all, Amerling...

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