Coburn Claims “VA Is Not Up to the Level of Health Care of the Rest of the Country,” Ignoring Clear Evidence of Its Quality
Tom Coburn (R-OK)
On CSPAN this morning, Senator Tom Coburn made the case against a government-run insurance plan on the strange grounds that a government-run health care delivery system would be ineffective. Specifically, he claims that “the VA is not up to the level of care of the rest of the country.” In reality, as Phillip Longman has detailed it’s true that VA Health Care is not of the same quality as health care elsewhere—it’s better:
— “An answer came in 2003, when the prestigious New England Journal of Medicine published a study that compared veterans health facilities on 11 measures of quality with fee-for-service Medicare. On all 11 measures, the quality of care in veterans facilities proved to be ’significantly better.’”
— “The Annals of Internal Medicine recently published a study that compared veterans health facilities with commercial managed-care systems in their treatment of diabetes patients. In seven out of seven measures of quality, the VA provided better care.”
— “Winning NCQA’s seal of approval is the gold standard in the health-care industry. And who do you suppose this year’s winner is: Johns Hopkins? Mayo Clinic? Massachusetts General? Nope. In every single category, the VHA system outperforms the highest rated non-VHA hospitals.”
One can go on like this. It is, obviously, possible for a government-run health delivery system to perform poorly. But it’s also possible for a government-run delivery system to deliver excellent quality. And in the United States, the VHA appears to be the highest performing major system of providers that exists. The National Health Service in the United Kingdom, to take another example, delivers a standard of care that’s somewhat worse than what Americans receive but drastically cheaper. So you can understand the NHS as delivering a more efficient, albeit not-fantastic in absolute terms, product than the American private sector.
But be all that as it may, creating a government-administered health insurance option is a totally different animal from creating a government-run health provider system. Medicare is an example of a public insurance option operating in the United States. So whatever you make of the VHA, it doesn’t prove much one way or the other. It would be nice if Senators who go on television to talk about important issues would show some mastery of what the basic facts are.
27 Responses to “Coburn Claims “VA Is Not Up to the Level of Health Care of the Rest of the Country,” Ignoring Clear Evidence of Its Quality”
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June 10th, 2009 at 9:48 am
It would be nice if Senators who go on television to talk about important issues would show some mastery of what the basic facts are.
MY,
Are you kidding? We are talking about Republicans. Facts don’t matter to them. If it did, they’d be even more irrelevant than they are now.
June 10th, 2009 at 9:56 am
The Annals of Internal Medicine study referred to is here. Very sporting of the Annals to make these articles readily and freely available.
June 10th, 2009 at 10:02 am
The whole point about Repubs saying non-factual stuff is found just two columns ago:
http://yglesias.thinkprogress.org/archives/2009/06/the-bad-news-about-correcting-myths.php
Its almost impossible to break the myth once it gets ingrained.
June 10th, 2009 at 10:08 am
So the big question of the day: Is Tom Coburn stupid, or a liar?
June 10th, 2009 at 10:16 am
It seems pretty clear that conservatives are perfectly content to make things up when the facts are inconvenient for them.
June 10th, 2009 at 10:23 am
IIRC Coburn is a M.D., making this ignorance particularly notable.
June 10th, 2009 at 10:28 am
Unfortunately, this lie can and will work because people think that Walter Reed is administered by the VA. Absent that misconception, the VA would be Exhibit A in every public push for health reform.
June 10th, 2009 at 10:35 am
A more accurate comparison would be to Medicare. But a more demagogic comparison requires comparison to government-run health care. So that much is understandable. No, Dr. Coburn displays he’s an ignorant idiot (yet again) by dissing the VA system, not by making a popular dishonest rhetorical gambit against a public insurance option. What, he couldn’t just go after Britain’s NHS again?
June 10th, 2009 at 10:35 am
Doctors! I know a retired physician who tells of sitting in the doctors’ locker room at the hospital, watching surgeons openly walk up and down the ailes, peeling off $100 and $50 dollar bills to pay for referrals. Surgeon: “Let’s see, you sent me 2 knees and 1 hip last month.” One, two, three, the hundred dollar bills are peeled off into the general practitioner’s hand. Nobody blew the whistle.
June 10th, 2009 at 10:39 am
Here’s a thought: let’s let the market decide.
Open the VA to everyone and see if people agree or disagree with Coburn’s assessment.
June 10th, 2009 at 10:42 am
[...] This is closer to the mark than Oklahoma Senator Tom Coburn’s insistence that a public plan would be like the Veterans Health Administration, which he (also falsely!) claimed would be bad. Advocates of a public plan are proposing something [...]
June 10th, 2009 at 10:43 am
I think it’s straight-up misinformation, not ignorance. Coburn probably knows the truth (although he’s always been a tad weird, given his thing about a lesbian epidemic in Oklahoma’s high school bathrooms), but doesn’t want to believe it’s true.
June 10th, 2009 at 11:13 am
Coburn is more than a tad weird. He’s legendarily one of the dumbest and least well-informed Senators, regularly leading institutional surveys of ‘Who’s The Dumbest….’.
June 10th, 2009 at 12:49 pm
My husband works in the VA and I can tell you that the vets are given every device out there to help them heal….however…the quality of care falls short in many areas because private practice is much more lucrative and once hired it is VERY difficult to weed out those that are performing poorly.
So there is definitely a trade off for government run health care….better equipment to facilitate healing, but not necessarily the best quality of care.
June 10th, 2009 at 1:38 pm
Im finishing my PhD in psych, and there isn’t a single colleague I know that doesn’t want to work at the VA. They actually provide health and mental health care of high quality and are efficient and modern. The amazing thing about his statement is his lie implies we are providing substandard health care to our veterans. Why would you want to be saying such a thing anyway? I know, convenient lie to be backtracked on at later date.
June 10th, 2009 at 1:58 pm
One, two, three, the hundred dollar bills are peeled off into the general practitioner’s hand.
That’s crazy, I thought the typical coin of the realm for medical referrals were free trips to the beach house or expensive Christmas gifts, much harder for the Feds to prove Medicare fraud that way.
As for Coburn, checking his bio, I see he did his residency in the mid-80s. Most residency programs (being federally subsidized) involve rotating through VA hospitals, so I have no doubt he’s speaking from personal experience, I’ve talked about Longman’s “Best Care Anywhere” with couple of doctors who trained in VA hospitals during the 70’s and 80’s. Both of them were surprised, their experience was of decrepit facilities, substandard care and slacker staff doctors only there because they couldn’t hack it in private practice.
That the VA now rates so highly is a testament to the reforms that Ken Kizer began when he was VHA chief in the 1990’s. But its not surprising that physicians who did their residencies in the old system tend to discount whatever the Annals of Internal Medicine has to say about the VA today.
June 10th, 2009 at 3:26 pm
Is Tom Coburn trying to distract attention from the ongoing investigation into the human corpses found buried under his house? And come to think of it, has anyone seen his wife lately?
(This is fun – no wonder the GOP do it all the time!)
June 10th, 2009 at 3:54 pm
My roommate had his cancer treated by the VA, and they did excellent work. They couldn’t prevent him from dying, but nobody could at that point. But his care was as good as you’d get at any hospital. The only downside I saw about the VA is that the hospitals are pretty crowded these days. But that’s not the VA’s fault. It’s the fault of those who thought invading Iraq was a good idea. In Denver, the first thing you see coming in is the amputee ward. And that ward is doing a lot of business these days. All I could think when I would walk by was “man, those are young kids, they’ll have no legs for a long time.” And then I’d think: “these VA hospitals need more money. The people they treat deserve the best.”
June 10th, 2009 at 5:40 pm
Im finishing my PhD in psych, and there isn’t a single colleague I know that doesn’t want to work at the VA.
Not least because spending five years at the VA usually allows people with psych doctorates to write off their tuition loans. And a psych doctorate usually makes you overqualified (and underpaid) in public mental health unless there’s some way to offset the cost of getting that degree.
PTSD among Iraq vets is going to be the gift that keeps giving, and the VA will be at the sharp end of dealing with it.
June 10th, 2009 at 8:24 pm
Oklahoma legislators are an odd lot.
On the one hand, Tom Coburn may be the dumbest human being ever to serve in Congress.
On the other hand, he might not even be the dumbest human being currently representing Oklahoma in Congress.
Oklahoma GOP: a Mobius Strip of stupidity.
June 10th, 2009 at 9:26 pm
MY “So whatever you make of the VHA, it doesn’t prove much one way or the other.”
The VHA proves everything. It is a shining example of the possibility that the government institutions and bureaucracies, when properly led and staffed, can far outstrip the private sector in levels of fairness and efficiency.
June 11th, 2009 at 1:12 am
From being there: The VA provides disabled veterans for use by university medical schools. The doctors are freeloaders who cannot make it in private and many are barred from working in private due to imcompetence where they lost their state medical licenses. The VA is federal and welcomes these low life and pays them a low wage. The VA also sub-contracts out certain private doctors who do evaluations of disabled veterans even when the disdability is not in their field. The public just doesn’t know how negative the VA medical system really is in 2009. When a VA doctor screws up a veteran and that veteran dies, its kept quiet and the death is blamed on the veterans illness. Of course none of this can be proved as the VA is federal and what happens on federal property remains on federal property.
June 11th, 2009 at 2:37 am
I am in private practice and fit hearing aids. As a hearing-care professional, I know that every hearing loss is unique and the have to be taken on a case by case basis. I evaluate their hearing on th edya of the exam, select the instuments that will best fit their loss and make recomendations. Of the patients that I have seen that went to the VA first very few are satisfied. They tell me stories of waiting for 1 year to get their initial appointment, getting tested and then all patients are fit with the same hearing aids. The VA sets up a contrct to fit a certain hearing aid and they fit all patients in my area with the same aids no matter what the test results show they need. They then have to wait 3 months for their next appointment. And if they have a problem that comes between scheduled service(like a broken hearing aid) they have to wait 2-3 months just to be seen… On the contrary, my patients recieve a comprehensive follow up program in which they are seen until they are satisfied with the settings of the instruments(usually 2-4 times in 1 month). We then see our patients every 3 months and ANY time in between in which they may have trouble. All they have to do is call and set an appointment.. And guess what, They are not charged for their follow up appointments, unlike the VA! So be very, very careful when you think that Government can run things better than someone who has to worry about actually pleasing their clientele to Survive! I bet that the guy who actually has a horse in the race will care more than the government agency that will be open no matter what.
June 11th, 2009 at 5:31 am
If you think the VA is an outstanding example of health care, I propose you simply set up a survey along these lines. Ask all the Agent Orange and Desert Storm veterans what they think. Ask them what their opinion of the great VA health care system and it’s extensive equipment for repairing their health issues is like. Ask those same veterans would they prefer the VA or private specialist Dr.’s to help them with their issues.
The VA health care system is very good in some areas and extremely lacking in others. The VA COULD be a great health care system if politics were kept out of the system. To bad when the government messes something up it tends to never see the light of day. Currently there are over 100,000 veterans with health issues related to Desert Storm alone. I wonder how many of them would prefer private health care specialists if they could afford them.
June 11th, 2009 at 5:42 am
I had to deal with the VA for my father. And I promise you I never had a bigger nightmare. They treated him for non-exhisting problems and nearly killed him. I finally got him to go to a non-VA doctor, and he was properly diagnoised. Unfortunatly by that time his cancer was so advanced he couldn’t be saved. But he recieved the best care available. And we never had to wait hours to be seen by a Dr. that couldn’t even speak English. What a joke the VA is! Ask a vet, and learn the truth!
June 11th, 2009 at 8:50 am
Please note that the study cited that found the quality of care in veterans facilities to be “significantly better” than commercial managed-care systems was funded by a Veterans Affairs Health Services Research and Development grant. If I were looking to honestly prove that the “VHA appears to be the highest performing major system of providers that exists” I’d hesitate to use VHA financed research.
June 15th, 2009 at 5:10 pm
[...] Administration health care system is the most effective health care system available, not just on results but on cost efficiency as well: Or consider this measure of the VA’s medical efficiency. Veterans [...]