The current health care debate reminds me of one of the most memorable episodes of the 1960's Sci-Fi series, The Twilight Zone. In this episode, a middle aged librarian, played by Burgess Meredith, stood before an enormous dias while a unformed bureaucrat repeatedly screamed that he was "obsolete!" The term "obsolete" was a code word for euthanasia and/or execution. Former Alaska Governor Sarah Palin’s reference to "death panels" invokes this scene. While not as dramatic as the Twilight Zone setting, the fact is that federal government health care "death panels" have been operating for decades by the Department of Veterans Affairs (VA).
The VA is required to provide free medical care to veterans who suffer from service connected illnesses or disabilities. Unfortunately, the law allows VA bureaucrats, with no medical training or experience, to determine who actually suffers from service connected disabilities. Often these decisions are budget driven. As a result, thousands of veterans die because they are denied access to medical care.
In the VA system, a veteran must first apply to the local Regional Office for benefits. After a six to nine month wait, the veteran may receive a compensation and pension exam, conducted by a VA doctor. Traditionally these exams reject claims or find that they were caused by a pre-existing condition not related to military service. Although the VA is required to assist the veteran in developing a "well grounded" claim, the reality is that little or no assistance is provided. Rejection at this stage is common place.
The veteran may appeal a rejection to the Board of Veterans Appeals (BVA) and appear before a Veterans Law Judge hired by and paid for by the Department of Veterans Affairs. Veterans often wait years for these hearings. Although the system is supposed to be non-adversarial, most veterans and veterans service providers will agree that the burden is on the veteran to convince the BVA to overrule the Regional Office. In most cases, the BVA rules against the veteran or remands the matter back to the Regional Office where it will languish for additional months or years before being rejected again.
A veteran may appeal a decision of the Board of Veterans Appeals to the Court of Appeals for Veterans Claims, a court unique to the VA. Unfortunately this court is limited in its jurisdiction and can generally examine only legal issues. Factual review is extremely limited. Again the pace is excruciatingly slow and a decision by the court will take many months.
For decades the VA refused to allow attorneys to practice before the BVA or the Regional Office. Although volunteers and paid employees of service organizations tried valiantly to represent the veteran, they were not experienced attorneys and in most cases they were competing against VA lawyers who were trained to manipulate the system. It was an unfair fight and the losers were the veterans. Even now, attorneys cannot be compensated until after the Regional Office has rendered their initial decision. A fair question is whether or not attorneys will be able to practice in a public health care system
The Independent Medicare Advisory Council proposed by President Obama and decried by Governor Palin appears to be an extension of the VA system. Expanding the VA death bureaucracy to encompass all Americans in a public option plan would effectively result in "pulling the plug on Granny." In the VA system, many veterans die before their case can be fully adjudicated. The same would hold true for Granny and her progeny in a public option system.
If you want to measure the effectiveness of this public option plan take a close look at the VA. They give veterans a second chance to die for their country. Do you want the same opportunity?
