The VA As A Model For Good Government

A piece by Kevin Drum reminds me of what will probably be the enduring lesson of the Bush years – people who don’t believe in government do a crappy job when they try to run it. You can look practically anywhere in government today and find the same story – managing the occupation of Iraq, science, women’s health, disaster management. Officials in environmental and corporate oversight always seem to have long histories as lobbyists and short to nonexistent experience in management. Nominating Harriet Miers to The Supreme Court is about the most clear-cut and undeniable show of contempt for government institutions imaginable. They simply don’t care enough about the job, even initiatives that they like, to make sure that it gets done right.

Kevin reminds us that for decades the VA hospital network served as the poster boy for conservative arguments that government managed health care doesn’t work. Then, in the 90’s, that changed. The Clinton administration set out to prove the skeptics wrong. Rather than throwing money at the problem they simply cleaned up its management, as documented in this Washington Monthly story. By the Clinton-Bush handoff in 2001 the VA had become a model organization.

The lesson here is fairly simple. People who use our present circumstances to argue that government can’t manage its way out of a paper bag are either fooling you or fooling themselves. Of course government breaks down when it’s run by people who don’t care to do the job right. Contrary to the bill of goods that ideological partisans want to sell you, that is far from an argument that government shouldn’t take the lead in fixing problems. Rather it is a rock-solid case for putting people in charge who care about doing the job right and have a decent sense of how to go about it.

Remorseful Bush supporters should reflect on this point to avoid making the same mistake twice. To use my own example, in 2000 election I could have gone several ways. Al Gore’s rock solid eco credentials had my vote, but not so much the rest of the Democratic field. I would have thought hard about voting McCain. For me the one non-starter was candidate Bush, for reasons that should be extremely important today – his history of escaping responsibility betrayed a deep sense of entitlement and a near total lack of personal responsibility. His business history showed a near total lack of either management skill or good judgment, depending on whether his investments were doomed from the start. The campaign’s dishonest tax cut salesmanship implied a deep faith in ideology over facts.

These details matter. It is these character flaws, and not personality trivia like Bush’s genial breeziness that overwhelmed the race coverage, that have inexorably driven America to our current state. The substantive details of the president’s character, and through his leadership the entire administration, explain why the government is no longer capable of handling a hurricane, a war or the care of its own veterans. This is a recurring problem for Republicans and right-leaning moderates whose chosen leaders have an ingrown bias against the idea of government solving problems. Ideological opposition to the idea of government makes it that much harder to internalize the mechanics of how to do it right.

I wrote off George Bush in 1999 because of his disastrous management history as much as his ideological rigidity. For me the choice was easy. It will be harder work for the folks who respond to the siren song of a candidate’s ideological reliability to recognize in advance that he will wreck the country and hang around their neck like a lead albatross for years or decades to come.

***Update***

More, from the leftwing hacks as BusinessWeek.

***Update 2***

via Steve Benen:

Stacy Beardsley, a soldier’s wife released this week from the hospital after a grueling surgery, watched two men in pressed military uniforms walk steadily to her front door. ‘Tell me he’s just hurt,’ the Indiana woman told the pair, according to family friend Marilyn Piersdorf. ‘Well, they couldn’t tell her that,’ Piersdorf said. Her husband, Army Sgt. William ‘B.J.’ Beardsley, who recently lived in Coon Rapids, died Monday in Diwaniyah, Iraq, 80 miles south of Baghdad, after a roadside bomb went off near his vehicle. The 25-year-old soldier had re-enlisted, in part, for the health insurance to cover his wife’s medical bills. He died the day she left the hospital.

The greatest healthcare on Earth.

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90 replies
  1. 1
    ThymeZone says:

    Bush was right when he said this stuff was “hard work.”

    What he didn’t mention was that he and his pals don’t bother to actually do it.

  2. 2
    Pb says:

    Also… guess who had The Best Medical Care In The U.S., according to BusinessWeek

  3. 3
    cd6 says:

    Personnally, I enjoyed Darrell’s suggestion that many troops, if given the choice, would opt out of going to a government run hospital which specifically focused on the needs of wounded veterans and soldiers and generally provides excellent care, and instead would go to Understaffed General Hospital down the street where they are far far less experienced worth with veterans’ and their main problems, such as post traumatic stress, because all the other veterans go to the VA.

    I see no fault in that logic, whatsover.

    Too bad you socialist moonbat are too busy pushing your own anti-Bush agenda to see it.

  4. 4
    Jackmormon says:

    people who don’t believe in government do a crappy job when they try to run it

    Jesus Christ.

    Okay, I guess it needed to be proven for some people.

  5. 5
    jenniebee says:

    It doesn’t help that the VA must worry about getting shortchanged by Washington. President George W. Bush wants to hold down costs by raising eligibility requirements for vets. So far, Congress has rebuffed him. That doesn’t mean Capitol Hill is always on the VA’s side, though. Kizer, the turnaround’s architect, was forced out in 1999 when Congress refused to reconfirm him after he closed hospitals in key districts. Dr. Dennis S. O’Leary, president of the Joint Commission on Accreditation of Healthcare Organizations, praises Nicholson and Perlin for sticking with Kizer’s reforms. But he warns that “the most common reason hospitals go into the tank is a change in leadership.” Since the VA is as affected by politics as any other federal entity, that will always be a concern, he says.

    Is that an argument for or against nationalizing health care?

  6. 6
    Tim F. says:

    Is that an argument for or against nationalizing health care?

    It’s an argument for electing competent managers.

  7. 7
    Tsulagi says:

    It’s an argument for electing competent managers.

    Damn, I was going to say essentially the same then refreshed and saw you beat me to it.

    Obvious answer.

  8. 8
    Otto Man says:

    More evidence for the old saying — Republicans are the ones who campaign on complaints that government doesn’t work, and then get elected and prove it.

  9. 9
    demimondian says:

    And Democrats are the ones who get elected on the platform that the government can work better than their opponents claim — and just barely justify that claim while in office.

  10. 10
    dreggas says:

    demimondian Says:

    And Democrats are the ones who get elected on the platform that the government can work better than their opponents claim—and just barely justify that claim while in office.

    Thanks not only to their own diversity but also due in large part to the minority party who’s slogan is “Can’t”.

  11. 11
    Darrell says:

    I’ve read that the waiting lists to see doctors and specialists in the VA system, although backlog been reduced 20% under the Bush administration, it’s my understanding that the wait times in the VA system are significantly longer than with private care systems. That BW article doesn’t spell out their metrics for how they determined that the VA is “best”.

  12. 12
    dreggas says:

    Darrell Says:

    I’ve read that the waiting lists to see doctors and specialists in the VA system, although backlog been reduced 20% under the Bush administration, it’s my understanding that the wait times in the VA system are significantly longer than with private care systems. That BW article doesn’t spell out their metrics for how they determined that the VA is “best”.

    Don’t know where you have read this but I know my father, a vet, is getting the best care he’s ever had through the VA and there’s no “wait”, he gets all of his healthcare taken care of promptly and is healthier now than he was when he had insurance through his work.

    Of course wait times would increase significantly in areas seeing a large influx of war casualties…

  13. 13
    Darrell says:

    From July 1999 under the “expert” and oh so caring management of the Clinton administration:

    However, the waiting times to schedule primary care and specialty care appointments have increased since the beginning of fiscal year 1999. VA’s guidelines state that new patients wanting routine care and specialty care patients should receive appointments within 30 days. VA is not consistently meeting these timeliness standards.

    Why Clinton’s “miracle” management looks good on paper

    July 1999:

    During the last decade, hospital use by the Veterans’ Health Administration’s (VHA) has dropped about 58 percent, or by 28,000 patients a day

    When you have such a drastic reduction of patients, that would explain much of the improvement being attributed to Clinton’s management ‘genius’

    And after all, Bush wants veterans to die in the streets.

  14. 14
    chopper says:

    And after all, Bush wants veterans to die in the streets.

    well, you’ve got one thing right at least.

  15. 15
    dreggas says:

    Of course Darrell you conveniently ignore the fact that it was a Republican Congress controlling the purse strings when Clinton was in office.

    But that is besides the point, if the VA experienced an influx of patients that extended wait times, or had a shitty managerial and back office staff so to speak then this would be one of many reasons that the VA experienced problems. You also neglect to mention that over time and as what qualifies a person for VA care has changed. This occurred with the The Veterans’ Health Care Eligibility Reform Act of 1996 that is mentioned in your first quote. This changed what made a vet eligible to receive care to include any vet with a “medical need” meaning…any vet. This of course would lead to an influx in the system.

  16. 16
    Newport 9 says:

    It’s an argument for electing competent managers.

    It’s an argument for having the media point out which managers you’d like to have a beer with are incompetent.

  17. 17
    Darrell says:

    The idea that hulking government bureaucracies can ever work as good or better than their private counterparts if “only the right management” was in control.. that’s the same kind of crap we heard from leftists who told us that communism would work, if it was just implemented in the “right” way. Bullshit. Large govt bureaucracies run by politicians and political appointees spending other people’s money, are never going to be as efficient as private industry. Why do you think UPS and FedEX run circles around the USPS?

    One aspect of Clinton’s “model” VA organization worth noting, is that the VA, as a large government entity, has almost entirely insulated itself from lawsuits due to malpractice. You libs willing to give the same protections to private hospitals?

    Bush model VA organization?:

    (Washington, DC) Newly released data from the U.S. Department of Veterans Affairs indicates the agency has dramatically improved its performance in seeing new veterans. In the first part of 2006, nearly 18,000 veterans had to wait thirty days or longer to see a VA doctor for the first time. By October, that number had dropped to less than 4,000.

    Even with these improvements, in which the VA has less backlog now than under Clinton, even though there were fewer coming through the system under Clinton’s watch, we still have this:

    There are over 7 million veterans enrolled in VA health care, and VA officials report that 96 percent are able to see a primary care doctor within 30 days. The number slips only slightly for specialty care doctors. VA reports that 94 percent of enrolled veterans are able to see a specialty care physician within 30 days.

    First of all, 30 days can be a damn long wait depending on their suffering, but 6% can’t see a specialty doctor even within 30 days under the government system? I’ve never heard of such a wait for people with private medical insurance. Hell, anything more than a one week wait for an important doctor’s visit is considered long when using private doctors.

    But then again, we’re talking about the ‘miracle’ of government run healthcare

  18. 18

    What this country need is a political system that gives most Americans all the government they need, want and are willing to pay for, while at the same time giving Republicans the kind of government they deserve.

  19. 19
    chopper says:

    that’s the same kind of crap we heard from leftists who told us that communism would work, if it was just implemented in the “right” way.

    i’d prefer the nazi comparison. smooth. strong. why are leftists so much like hitler, i ask you?

    Large govt bureaucracies run by politicians and political appointees spending other people’s money, are never going to be as efficient as private industry. Why do you think UPS and FedEX run circles around the USPS?

    y’know, i asked the UPS guy if he could deliver a letter for me for under 40 cents. he laughed out loud. hand to god.

  20. 20
    Darrell says:

    dreggas Says:

    Of course Darrell you conveniently ignore the fact that it was a Republican Congress controlling the purse strings when Clinton was in office.

    Oh, of course, you and TimF and rest of the libs get to give credit to Clinton for any positive changes (ignorning that Republicans were in conrol of the House during these reforms), but blame Republicans for all the bad things that happened during that time. That’s great. And so honest.

    TimF’s and your arguments are so easy to slap down because you are pure partisan hacks who mindlessly parrot leftwingnut talking points and link to others rather than thinking for yourselves. When somone looks under the hood of the details of Clinton’s “model” organization, and then examines numbers more closely and it turns out things aren’t as claimed, well, those problems are all blamed on the Republican congress. All things good = result of Clinton’s stellar management skills. All things bad = result of Republicans in Congress at the time.

  21. 21
    Lee says:

    Already, ‘Darrell’ has more words than everyone else combined. OK, guys, lets just stop responding to this Darrell. His purpose is to disrupt normative conversation here, and nothing more. You are not arguing with someone who can be convinced, or even someone who believes in anything beyond what he is told to do. In fact, I tend to believe that ‘Darrell’ is not one man, as ‘his’ writing style changes day to day, but rather that ‘he’ is a team of men and women who are disseminating bull, dishonest arguments and disinformation in order to keep us from having a real conversation that might get anything done. The “unsupported argument” comments earlier today are only the latest example of these inconsistencies in ‘his’ style. In other words, ‘he’ is getting paid to rile us up, so lets be sure he goes out of business. This site represents the possible left-right nexus that status-quo types might be assumed to fear the most, so I am not surprised by this behavior, but we have to stop playing into it.

    It is worth remembering that being on a mission to kill any useful conversation is rather like being on a mission to kill any cute puppy you find. Indeed, it is worse, for a society could survive without cute puppy dogs, but I don’t think it can without a national conversation. This is indeed exactly what Jesus was talking about when he warned against “Sowing the Wind”. This is my message to you, team ‘Darrell’, deep in the bowels of the AEI or wherever you are. Whirlwinds are indiscriminate when they grow, and if you think you can hide from what you are creating you are wrong. I don’t know about where you are, but the wind is howling outside ‘round here.

  22. 22
    chopper says:

    TimF’s and your arguments are so easy to slap down because you are pure partisan hacks who mindlessly parrot leftwingnut talking points and link to others rather than thinking for yourselves.

    i’d say the irony meter is off the charts, but darrell busted it about a month ago.

  23. 23
    Darrell says:

    y’know, i asked the UPS guy if he could deliver a letter for me for under 40 cents. he laughed out loud. hand to god.

    No surprise you are too ignorant to know why he was laughing. It’s against the law for any organization but the USPS to deliver First class mail to private mailboxes.

  24. 24
    Darrell says:

    Lee Says:

    Already, ‘Darrell’ has more words than everyone else combined. OK, guys, lets just stop responding to this Darrell. His purpose is to disrupt normative conversation here, and nothing more

    Not true. I’ve made a number of solid points which are backed with citations that stand unrefuted. If you’re unable to refute them, then STFU instead of whining like a little bitch because I make you feel stupid.

  25. 25
    ThymeZone says:

    I tend to believe that ‘Darrell’ is not one man, as ‘his’ writing style changes day to day, but rather that ‘he’ is a team of men and women

    This is a possiblity which has been discussed here for at least two years now, and has been spoken to on another thread just today here at BJ. It’s a real possibility, and one which not only makes sense, it answers a lot of questions about a lot of things that have happened here in those two years.

    The question to me is not whether we are going to respond to Darrell, because somebody always will. The question is whether those of us on the mailing list decide to boycott the blog and find out whether John and Tim really care about their commenters, or just enjoy fucking with us for their own benefit … because that’s what it is beginning to look like.

    I’m not ready to say that I totally advocate the boycott just yet, but I think it should be on the table.

    Something tells me these guys are just looking for an excuse to take this thing out in a blaze of glory, so, let’s have one, is my thinking.

    Which makes BJ at this point basically a much better and more successful version of Scrutator, and that’s a worthy accomplishment.

  26. 26
    Darrell says:

    This is a possiblity which has been discussed here for at least two years now, and has been spoken to on another thread just today here at BJ.

    This is what happens every time. The liberal argument gets shredded to pieces and like clockwork, filth like TZ then come in to drag the thread into sh*t with nothing but 100% pure personal attacks.

  27. 27
    ThymeZone says:

    Like I said on the other thread, the presence of Darrell here is long past the “open comments” issue, and long past any other reasonable imperatives. Now it’s just an insult to the people who support this blog and a constant drag on every thread, a constant reminder that this thing can never climb beyond the dumb rhetoric of the right wing noise machine.

    It’s honestly one of the weirdest things I’ve ever seen at this point. It stopped making sense a long time ago, unless you allow for the “team persona” solution and just say well, it’s all been a very drawn out practical joke.

  28. 28
    RSA says:

    And after all, Bush wants veterans to die in the streets of Baghdad.

    Fixed.

  29. 29
    Tim F. says:

    Oh, of course, you and TimF and rest of the libs get to give credit to Clinton for any positive changes (ignorning that Republicans were in conrol of the House during these reforms), but blame Republicans for all the bad things that happened during that time.

    Congress sets the budget. The Executive branch performs management. Since the budget didn’t increase, we can pretty much write Congress out of the equation.

    Simple point. I have a hard time taking you seriously when you’re either too dense to see it or not honest enought to acknowledge it.

  30. 30
    cd6 says:

    filth like TZ then come in to drag the thread into sh*t with nothing but 100% pure personal attacks.

    Your complaint that TZ uses nothing but personal attacks would carry a lot more weight if you hadn’t called him “filth” in the same goddamned sentence

  31. 31
    ThymeZone says:

    Your complaint that TZ uses nothing but personal attacks would carry a lot more weight if you hadn’t called him “filth” in the same goddamned sentence

    Irony is not just dead, it’s extinct. It’s buried under ten thousand feet of igneous rock.

  32. 32
    Darrell says:

    Since the budget didn’t increase, we can pretty much write Congress out of the equation.

    Talk about dishonesty, the budget did increase, even though during the 1990’s

    During the last decade, hospital use by the Veterans’ Health Administration’s (VHA) has dropped about 58 percent, or by 28,000 patients a day

    Next strawman Tim

  33. 33
    Darrell says:

    Congress sets the budget. The Executive branch performs management.

    Not exactly

    The House Committee on Veterans’ Affairs reviews veterans’ programs, examines current laws, and reports bills and amendments to strengthen existing laws concerning veterans and the Department of Veterans Affairs (VA), such as for health care, disability compensation, GI bill education and job training, home loan guarantees, life insurance policies, and a nationwide system of veterans’ cemeteries

  34. 34
    chopper says:

    No surprise you are too ignorant to know why he was laughing. It’s against the law for any organization but the USPS to deliver First class mail to private mailboxes

    uh, he was laughing because UPS could never deliver letters that cheap. so he said.

  35. 35
    Darrell says:

    Like I said, you guys are partisan hacks. That’s what makes it so easy to swat down your “arguments”

  36. 36
    TR says:

    STFU instead of whining like a little bitch because I make you feel stupid.

    We all feel dumber for having listened to you. There’s a difference.

  37. 37
    chopper says:

    Like I said, you guys are partisan hacks

    jesus, i finally fixed the irony meter and you had to go blow it up again.

  38. 38
    Tim F. says:

    the budget did increase, even though during the 1990’s

    Let me be more clear then. The budget has not meaningfully increased since the late 1990s, even though VA treatment continued improving throughout that time.

    And spare me the links to Congressional oversight. Congress has oversight over practically every corner of the federal government. They hold hearings, issue subpoenas, write reports and so on just like every other oversight panel. Having a panel overseeing the military and controlling funding doesn’t put Congress in charge of the military. If you want to have a point, show where Congress wrote meaningful legislation that impacted management of the VA.

  39. 39
    dreggas says:

    There should be a medal for trying to educate idiots…

  40. 40
    Darrell says:

    The budget has not meaningfully increased since the late 1990s, even though VA treatment continued improving throughout that time.

    No surprise you are too ignorant to know that the VA budget has skyrocketed since the late 1990’s, almost doubling. Incredible, but typical of your base of “knowledge”.

    And spare me the links to Congressional oversight.

    More willfull ignorance. Congress is not just involved in oversight Tim.

    The Committee on Veterans’ Affairs is the authorizing Committee for the Department of Veterans Affairs. The Committee recommends legislation expanding, curtailing, or fine-tuning existing laws relating to veterans’ benefits. The Committee also has oversight responsibility, which means monitoring and evaluating the operations of the DVA. If the Committee finds the that DVA is not administering laws as Congress intended, then it is “corrected” through the a hearing process and legislation.

  41. 41
    TR says:

    Darrell clearly knows more in his basement than all of the academics, reporters and government watchdog groups out there.

    Please, Darrell, your country needs you — ride to Washington and show the world your brilliance.

  42. 42
    Tim F. says:

    Like I said, you guys are partisan hacks.

    Coming from someone with your credibility Darrell, I will take that as the highest of compliments. I have almost never seen you answer somebody without misrepresenting their point in in a hackish attempt to make them appear mentally ill. Let’s take an example from this thread:

    The idea that hulking government bureaucracies can ever work as good or better than their private counterparts if “only the right management” was in control.

    Tell me, who was arguing that government could work better than private practice? Nobody that I know. My point was that government did work better. Dreggas and others, myself included, know many who are getting better care through the VA than they ever had before. But that wasn’t convenient for you so you had to twist the point to make it fit your hackish mentality.

    The point is Darrell, you do this on every thread. You are physically incapable of understanding what somebody is actually trying to tell you. I don’t think you can emotionally handle the idea that somebody who disagrees with you is also a sane person with a reasonable point of view. People don’t speak, they “parrot.” They whinge, scream, wail mindlessly, etc. You inhabit a small world that only has room for sane people who agree with you. I couldn’t possibly illustrate it better than yesterday’s display against OCSteve. For the life of me I can’t figure out why I should bother when the words in your head have so little to do with the words that I actually wrote.

  43. 43
    Darrell says:

    TR Says:

    Darrell clearly knows more in his basement than all of the academics, reporters and government watchdog groups out there.

    What the hell are you talking about?

  44. 44
    jg says:

    Darrell, ever heard of Leo Strauss?

  45. 45
    dreggas says:

    Please, Darrell, your country needs you—ride to Washington and show the world your brilliance.

    Or at least joing the military…they’ve lowered the bar enough even he could get in.

  46. 46
    ThymeZone says:

    Speaking of why this blog lowers itself to the level of Darrell ….

    It’s time for the almost-monthly membership drive for the Lefty Mailing List. Grab the email address evident at my url in the first album text, and email me, we’ll hook you up. You don’t even have to be a real lefty, you just have to agree to be talked to like one sometimes. And have a thick skin and a crude sense of humor.

  47. 47
    Tim F. says:

    Congress is not just involved in oversight Tim.

    …and then you show that Congress exerts its normal oversight. Hearings, recommendations, reports and then legislation. That is how oversight works, bro. Show me the work product.

  48. 48
    Darrell says:

    My point was that government did work better.

    And you didn’t substantiate that point worth a damn.. which is why after just a little digging, it turns out that wait list to see doctors at the VA under Clinton was still a big problem, even though the Veterans’ Health Administration’s (VHA) has dropped about 58 percent. So no, government health care is most definitely not “working better” if waitlists to see a doctor is any measure

    So when this is pointed out, you respond with asinine ignorant points about how the mean Rebublican congress didn’t authorize enough money, and when I prove that was a load of shit, you up the ante even more, falsely claiming that the VA budget hasn’t “meaninfully increased” since the late 1990’s and downplaying Congress’ role in managing Veterans affairs. So having been proven wrong on multiple claims, you now decide to get personal.

    Hey, it’s all you’ve got left.

  49. 49
    ThymeZone says:

    Hey, it’s all you’ve got left.

    Quixotic, you are.

  50. 50
    Tim F. says:

    No surprise you are too ignorant to know that the VA budget has skyrocketed since the late 1990’s

    Thank you for correcting me – after looking it up again I was right the first time. During the entire Clinton administration the budget increased incrementally by roughly 30%, total. Under Bush the budget has increased dramatically. Of course, the number of wounded veterans has also increased dramatically so anything less would be a slap in the face.

    Let’s get back to the point. The Republican Congress changed little about the VA’s budget during the Clinton years. Baby step increases. The quality of care increased dramatically by the end of his term. You can belabor that point for as long as it pleases you but it’s only one datum among hundreds to show that the quality of management was the primary reason for the change. Do yourself a favor and read the original article. You’re not just arguing against some naked budget statistic, you’re fighting a sea of widely reported information showing that quality management can make public care into the best available anywhere.

  51. 51
    Jake says:

    Now I see why Darrell calls this place an echo chamber.

    Clever.

  52. 52
    Tim F. says:

    it turns out that wait list to see doctors at the VA under Clinton was still a big problem

    Are you aware that you have an obsessive focus with wait lists? Truth. Would you describe those as wait lists for emergent care, critical voluntary surgery or lower-priority surgery? Makes a difference. Americans who can’t afford excellent coverage would give an arm and a leg to get on a wait list for low-priority surgery. An arm and a leg, ha. I slay myself.

    Then you can comment on the thousands of other ways that a hospital can serve a patient – reducing medical errors, increasing efficiency, guaranteeing the quality of care. An incompetent ophthalmologist almost cost me the sight in my right eye. Preventative care. Reliable access to care for people who might not be able to afford insurance otherwise. In your view, bums. It’s amazing how hospital care means more than you can measure with a single poorly-defined statistic.

  53. 53
    RSA says:

    To pursue this point even further off-topic: From the Senate Democratic Policy Committee, in 2004:

    Bush Rhetoric: “We’re getting the job done. We’ve reduced the large backlog of disability claims by about a third.” (Address to VFW Convention)

    Reality: In the VA’s most recent report on the claims backlog, there were 325,497 total disability claims pending (Monday Morning Report, September 27-October 2, 2004). When President Bush was inaugurated, the VA reported only 278,334 cases pending – 47,000 fewer than today. (Monday Morning Report, January 16-19, 2001)

    Of course, as Tim F. points out, wait lists are a red herring, in the sense that they’re only a small part of the picture (and not even entirely within the picture).

  54. 54
    Tim F. says:

    To be fair RSA, I think that our two wars throw any Bush-Clinton comparisons out the window. Given the major influx of wounded it seems like wartime to peacetime comparisons are an apples-to-oranges situation.

  55. 55
    Darrell says:

    Thank you for correcting me – after looking it up again I was right the first time

    No you weren’t. You were wrong..you were proven wrong on the facts.

    The Republican Congress changed little about the VA’s budget during the Clinton years

    Hang on, the VA budget under Clinton increased percentage wise and dollarwise more under the Republican congress than the increases under the previous Democratically controlled congress.. and those increases came at a time in which the number of VA hospital patients had dropped 58% percent. Plummetting number of patients, yet significant increases to the VA budget. It would help if you would forthrightly acknowledge these fact, which directly contradict your earlier statements.

  56. 56

    […] Balloon Juice: . . . people who don’t believe in government do a crappy job when they try to run it. You can look practically anywhere in government today and find the same story – managing the occupation of Iraq, science, women’s health, disaster management. Officials in environmental and corporate oversight always seem to have long histories as lobbyists and short to nonexistent experience in management. Nominating Harriet Miers to The Supreme Court is about the most clear-cut and undeniable show of contempt for government institutions imaginable. They simply don’t care enough about the job, even initiatives that they like, to make sure that it gets done right. […]

  57. 57
    Darrell says:

    Are you aware that you have an obsessive focus with wait lists?

    I think most Americans would agree that the time one has to wait to see a doctor is a damn important measure of the quality of medical care. If a healthcare system routinely forces its patients to wait a month or more on average to see a doctor or specialist, that is a big problem.

    The article you posted on how great the VA hospital treatment is, ignored these wait time numbers. I also pointed out that neither they nor you EVER defined the metrics for how to measure the quality of VA hospital treatment.. which means nothing more than they “feel” the VA system is the best. Because if you can’t even define the metrics for comparison, then you don’t have sh*t, do you? Just subjective claims.

  58. 58
    Darrell says:

    Dishonest moonbat comparing apples to Toyotas

    Bush Rhetoric: “We’re getting the job done. We’ve reduced the large backlog of disability claims by about a third.” (Address to VFW Convention)

    Reality: In the VA’s most recent report on the claims backlog, there were 325,497 total disability claims pending (Monday Morning Report, September 27-October 2, 2004). When President Bush was inaugurated, the VA reported only 278,334 cases pending – 47,000 fewer than today. (Monday Morning Report, January 16-19, 2001)

    Ah yes, willfully ignore the war in Afgahistan and Iraq to twist the numbers. Fact is, under Bush’s “inept” management, VA backlog has been reduced 20% during wartime, when there is an influx of new patients to be treated.

  59. 59
    Tsulagi says:

    Or at least joing the military…they’ve lowered the bar enough even he could get in.

    I don’t know if they’ve lowered the bar down yet to trained hamsters. Still, that begs the question: Why do you hate the existing troops?

    However, it is a funny visual of him in Basic standing in front of a drill peering up at him through his oversized, thick BCGs. Then after his drill tells him he’s the stupidest fucker on the planet, he replies “How dishonest of you.” I’d bring the popcorn to see that.

  60. 60
    RSA says:

    Ah yes, willfully ignore the war in Afgahistan and Iraq to twist the numbers.

    You’re the moron who keeps bringing up reductions in backlogs and increases in funding without the context that there’s a war on. Take the 83% increase in funding to the VA. What relationship does that have to the cost of treating wounded soldiers? You haven’t said. Is that a lot more than the average increase in health care costs (plus inflation) over the period of the increase? You haven’t said.

  61. 61
    mrmobi says:

    Hey Gruppenfuhrer Darrell:

    If the administration is doing so well running the VA, how come Army Secretary Francis J. Harvey has resigned in the wake of the Walter Reed hospital scandal?

    Could it be that accountability is finally beginning to rear its beautiful head?

    I’ve been in business 34 years, and I’ve never seen a more incompetent bunch of nitwits than this administration. Many deserve jail, and I sincerely hope that includes the Vice President.

  62. 62
    Darrell says:

    You’re the moron who keeps bringing up reductions in backlogs and increases in funding without the context that there’s a war on.

    Except that with a war on, it’s more of a challenge to manage backlogs with the new influx of wounded soldiers. Yet during this influx, backlogs at the VA have been REDUCED under the “inept” management of President Bush.

  63. 63
    Darrell says:

    If the administration is doing so well running the VA, how come Army Secretary Francis J. Harvey has resigned in the wake of the Walter Reed hospital scandal?

    Because, as John Cole pointed out, he used piss poor judgement in appointing LTG Kiley to run Walter Reed, when Kiley himself appears to have been involved in the hospital mismanagement for years.

    Any other questions?

  64. 64
    jg says:

    Darrell Says:

    I think most Americans would agree

    He’s speaking for most americans again. Lord help us.

  65. 65
    dreggas says:

    Except that with a war on, it’s more of a challenge to manage backlogs with the new influx of wounded soldiers. Yet during this influx, backlogs at the VA have been REDUCED under the “inept” management of President Bush.

    So by your logic, despite the fact that there are backlogged cases now than there were when bush was inaugerated he has reduced the number of back-logged cases?

  66. 66
    BARRASSO says:

    Hooray for privatization that totally is the awsomest mostest best way to go!! The memorandum “describes how the Army’s decision to privatize support services at Walter Reed Army Medical Center was causing an exodus of ‘highly skilled and experienced personnel,’” the committee’s letter states. “According to multiple sources, the decision to privatize support services at Walter Reed led to a precipitous drop in support personnel at Walter Reed.”

    The letter said Walter Reed also awarded a five-year, $120-million contract to IAP Worldwide Services, which is run by Al Neffgen, a former senior Halliburton official.

    Did I also mention once that Darrell is just a pathetic contrarian who just wants to disagree with any position defined as ‘Liberal”

  67. 67
    pacified says:

    To Darrell and health care.

    Apparently, a bunch of paper pushers denying claims back and forth is a “model of efficiency”.

  68. 68
    CJB says:

    So this raises the question. How do you run an effective organization when your management is going to be against you 50 percent of the time.

    That is my main problem with government programs. I know I wouldn’t invest in a company that was managed by drunken monkeys half the time.

  69. 69
    Dreggas says:

    Darrell Says:

    Any other questions?

    What is the average flight velocity of an unladen swallow?

  70. 70
    Darrell says:

    So by your logic, despite the fact that there are backlogged cases now than there were when bush was inaugerated he has reduced the number of back-logged cases?

    There may be more disability claims, but fewer backlogs waiting for medical care. Quite the wait times Bush inherited from Clinton’s “model” VA healthcare system in 2001:

    Of note, is the current network average wait time of 40 days in Primary Care, with wait times in the high demand clinics of Cardiology and Orthopedics at 51 and 54 days, respectively.

    In other words, TimF’s “model” healthcare system resulting from Clinton’s genius management skills had average wait times of 51 fricking days to see a Cardiologist. Average. This is the system TimF touts as the “best”. Partisan hack to his very core, he’ll never admit how full of it he is.

    I can’t find my document detailing the drop in medical care backlog that I had yesterday, but I did find this which serves just as well

    Early in 2006, nearly 18,000 veterans had waited 30 days or longer for an initial visit with a VA doctor. By October, that number had dropped to less than 4,000, according to VA data.

    Out of 7 million Vets in the system. Still not so hot by private medical care standards, but a paragon of efficiency compared to the atrocious VA waiting list situation which Bush inherited. And unlike Clinton who had declining numbers of patients in the VA system (dropped in half in the 90’s), the Bush admin is dealing with a huge influx from Afghanistan and Iraq.

    As I said before, it’s the nature of the beast for government run healthcare to suck compared to private healthcare alternatives, but TimF’s claims about the wonderous nature of VA healthcare under Clinton’s “model system” are delusional.

  71. 71
    Jill says:

    Hey Darrell baby, straight form the ArmyTimes

    “The memorandum “describes how the Army’s decision to privatize support services at Walter Reed Army Medical Center was causing an exodus of ‘highly skilled and experienced personnel,’” the committee’s letter states. “According to multiple sources, the decision to privatize support services at Walter Reed led to a precipitous drop in support personnel at Walter Reed.”

    What were you saying about privatization and Walter Reed?

  72. 72
    Darrell says:

    What were you saying about privatization and Walter Reed?

    Jill, do you ever think for yourself, or just react purely emotionally to news without bothering to understand what really happened?

    Without even reading the story, it’s a near certain guess that the company which won the outsourcing contract, hired Walter Reed employees who used to do the work being subcontracted.. but selectively picking which employees to hire in order to avoid the deadwood which so often pollutes govt. run institutions like WR.

    By picking up these skilled employees, WR doesn’t have to lay them off, or reassign them to other duties. Tell us Jill, with your ever so deep insights, why this development is such a bad thing?

  73. 73
    AkaDad says:

    This going to get interesting.

    The Committee on Oversight and Government Reform has subpoenaed Maj. Gen. George Weightman, who was fired as head of Walter Reed Army Medical Center, after Army officials refused to allow him to testify before the committee Monday.

    Committee Chairman Henry Waxman and subcommittee Chairman John Tierney asked Weightman to testify about an internal memo that showed privatization of services at Walter Reed could put “patient care services at risk of mission failure.”

    http://www.washingtonpost.com/.....00999.html

  74. 74
    Darrell says:

    AkaDad Says:

    This going to get interesting

    Your blockquote doesn’t match your link. Clean out your bong water and try again.

  75. 75
    AkaDad says:

    Oops. Thats from Army Times.

    http://www.armytimes.com/news/.....nsubpoena/

    Clean out your bong water and try again.

    Ha! Thats how much you know, I use champagne instead of water.

  76. 76
    Jan Lewis says:

    I have been reading Balloon Juice for a few months now. I thought it was a fairly congenial, reality-aligned place. But the most prominent commenter here, Darrell, has taught me otherwise. I daresay that’s why he has not been banned. Before I read here, I was quite worried about the course the US is on. The failed wars in Afganistan and Iraq, the incipient war with Iran, the scandalous treatment of outpatients at Walter Reed, the catastrophic decline of public opinion worldwide regarding the US. Darrell has set me straight on all that, and I’m so grateful. It’s good to hear that all is going well, and the only problem in the US today is leftist moonbats. I will certainly sleep easier tonight knowing that. Thanks, Darrell!

  77. 77
    Jan Lewis says:

    I was amused to notice that my comment showed up with the tag “Your comment is awaiting moderation”. You have moderators here? I would never have guessed.

  78. 78
    Darrell says:

    Ha! Thats how much you know, I use champagne instead of water

    Well played… kudos. Regarding the memo, no surprise that someone like Weightman in a position to benefit from a larger bureaucracy would write memos criticizing the outsourcing of a portion of the ’empire’. I’m not making a judgement on the decision either way, I’m just pointing out that Weightman is no neutral observer.. he had a personal interest.

  79. 79
    Jay says:

    By the Clinton-Bush handoff in 2001 the VA had become a model organization.

    What a huge pile of steaming bullshit.

    Are people with any brains at all supposed to believe for any reason this was because of Bill Clinton? My father was in and out of a veteran’s hospital for 18 months. The entire ordeal was disgraceful and wouldn’t have changed at all were Bob Dole not running for President in 1996 and the GOP controlled Congress.

    In another classic Clinton maneuver, he signed a bill that greatly expanded money spent on VA hospitals and the care they provided. The biggest change however came as a result of threats from the GOP about cutting their direct funding and providing money to vets to use at any hospital of their choice. THAT woke those idiots up in the VA and THAT is a major reason why many of the changes took place. You want a government organization to start performing better? Threaten their funding.

    So it’s a freaking joke to say that it was a ‘model’ organization in 2001 and that somehow BC deserves any of the credit. It still had a host of problems though things started getting better, but ONLY if the families of those receiving care were diligent and always on the case of the people working for the VA. That hasn’t changed.

    So please, let’s put aside this crackpot notion that everything was puppy dogs and ice cream until January 21, 2001. That’s just crap.

  80. 80
    chopper says:

    Are you aware that you have an obsessive focus with wait lists? Truth. Would you describe those as wait lists for emergent care, critical voluntary surgery or lower-priority surgery? Makes a difference. Americans who can’t afford excellent coverage would give an arm and a leg to get on a wait list for low-priority surgery. An arm and a leg, ha. I slay myself.

    funny thing is, wait lists are a terrible metric for quality of care. wait lists are par for the course in private care as well. hell, try to get a hip replaced in a week and see how well that works.

    i have private insurance and about the only specialist i can see w/in 2 weeks or more of needing one is a dentist.

  81. 81
    The Other Steve says:

    If you think Government is bad.

    You should try working in private industry. Our managers are totally incapable of making decisions. We still don’t have a budget and the fiscal year started in January.

  82. 82
    The Other Steve says:

    Are people with any brains at all supposed to believe for any reason this was because of Bill Clinton? My father was in and out of a veteran’s hospital for 18 months. The entire ordeal was disgraceful and wouldn’t have changed at all were Bob Dole not running for President in 1996 and the GOP controlled Congress.

    Seee!!!! It’s all Bill Clinton’s fault!!!!!

    wAAAAHAHAHAAAAAAAAAA!

  83. 83
    Darrell says:

    funny thing is, wait lists are a terrible metric for quality of care. wait lists are par for the course in private care as well. hell, try to get a hip replaced in a week and see how well that works.

    Do you have anything to back up that assertion? Or is this more extreme ignorance on your part, just like your post office vs DHL embarrassment upthread?

    I have never once heard of wait times to be a problem in private medical care here in the US. Not once. Please cite these wait list problems in private care, because I’ve never heard of such thing, unlike in Canada where wait times for hip replacement often take a year or more.

  84. 84
    Darrell says:

    i have private insurance and about the only specialist i can see w/in 2 weeks or more of needing one is a dentist.

    I call bullshit. Give us the insurance carrier name, because I think you’re full of it.

  85. 85
    chopper says:

    Do you have anything to back up that assertion? Or is this more extreme ignorance on your part, just like your post office vs DHL embarrassment upthread?

    what embarassment? first off, it’s UPS, dumbass (talk about embarassment, you can’t even get three fscking letters right), second, as i explained, my UPS carrier explained it was b/c they could never deliver letters that cheap.

    does your head whistle in a crosswind or something? were you born this stupid, or did you have to work at it?

  86. 86

    “People Who Don’t Believe in Government Do a Bad Job of Running It”:

    I’ve heard this refrain over and over, with regard to FEMA, the V.A., and other examples of government incompetence that happen to occur in the Bush Administration. Via commenter Justin,

  87. 87
    theo says:

    I work at a top tertiary care hospital, and my insurer requires me to use the hospital and its related clinics whenever possible.

    If I wanted to see (for example) a dermatologist, I would need to call on April 1 between 9 and 12 AM. They might then have an appointment available sometime around May 15.

    If I wanted to see them any sooner than that, I would have to tell them I have skin cancer.

    But yeah, waiting lists are never a problem in private healthcare.

  88. 88
    Linus Bern says:

    I must admit that I don’t really understand the argument that private companies can deliver services like health care better and cheaper than the public sector. I don’t know what the margins are like in healthcare, but in retail the usual mark-up for profit is 50% of the retail price. A public sector provider would have to be wasteing half of their budget to inefficiency before they were less cost-effective than the private sector. And as far as quality goes, the bottom line in business is maximizing profit, which is fine if you are buying a widget, not so good if you have cancer.

    I’m sure all kinds of examples can be made to point out waste and inefficiency in the public sector, can you think of one that even comes close to the kind of excesses of incompetence and corruption of Haliburton in Iraq?

  89. 89

    […] Republicans often claim that our government is bad at solving problems. So, we probably shouldn’t be surprised when they take it upon themselves to prove it. A recent post at Balloon Juice takes a look down this road, tying it in to the recent problems at Walter Reed: The lesson here is fairly simple. People who use our present circumstances to argue that government can’t manage its way out of a paper bag are either fooling you or fooling themselves. Of course government breaks down when it’s run by people who don’t care to do the job right. Contrary to the bill of goods that ideological partisans want to sell you, that is far from an argument that government shouldn’t take the lead in fixing problems. Rather it is a rock-solid case for putting people in charge who care about doing the job right and have a decent sense of how to go about it. […]

  90. 90

    Well, this thread was actually quite interesting..until some guy named Darrell barged in and started a process of converting it into an orgy of ad hominems and vituperation.
    Congratulations Darrell. You proved that anybody can pretty much destroy a discussion thread if they are enough of a horse’s ass.
    I now understand why I gave up trying to hold debates with folks like you not long after 9/11. You appear to have limited interest in polite, respectful debate. Your main objectives appear to be to get under people’s skin, and have the last word. You’re the sort of guy who would have been ruled out of order at my high school debating society and probably asked to leave the meeting.
    Be gone with you!

Trackbacks & Pingbacks

  1. […] Republicans often claim that our government is bad at solving problems. So, we probably shouldn’t be surprised when they take it upon themselves to prove it. A recent post at Balloon Juice takes a look down this road, tying it in to the recent problems at Walter Reed: The lesson here is fairly simple. People who use our present circumstances to argue that government can’t manage its way out of a paper bag are either fooling you or fooling themselves. Of course government breaks down when it’s run by people who don’t care to do the job right. Contrary to the bill of goods that ideological partisans want to sell you, that is far from an argument that government shouldn’t take the lead in fixing problems. Rather it is a rock-solid case for putting people in charge who care about doing the job right and have a decent sense of how to go about it. […]

  2. “People Who Don’t Believe in Government Do a Bad Job of Running It”:

    I’ve heard this refrain over and over, with regard to FEMA, the V.A., and other examples of government incompetence that happen to occur in the Bush Administration. Via commenter Justin,

  3. […] Balloon Juice: . . . people who don’t believe in government do a crappy job when they try to run it. You can look practically anywhere in government today and find the same story – managing the occupation of Iraq, science, women’s health, disaster management. Officials in environmental and corporate oversight always seem to have long histories as lobbyists and short to nonexistent experience in management. Nominating Harriet Miers to The Supreme Court is about the most clear-cut and undeniable show of contempt for government institutions imaginable. They simply don’t care enough about the job, even initiatives that they like, to make sure that it gets done right. […]

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