Viewpoints: 'Bureaucratic Ninja' for the VA; Soap Opera in Virginia; hospital readmissions

Bloomberg: The VA Needs A Bureaucratic Ninja
By pulling out of the running to be the next secretary of Veterans Affairs, Cleveland Clinic head Toby Cosgrove has given the administration a chance to think harder about what the VA needs most right now. Does it need an excellent director of an innovative, medium-scale health-care center? Or does it need somebody who can run an army of middle managers on a tight budget? (Christopher Flavelle, 6/9).

The Wall Street Journal: The VA Conspiracy
Washington would like nothing better than for the Veteran Affairs fuss to evaporate, but the department's fraud and access-to-care scandals continue to effloresce. A new audit reveals that 57,000 new VA patients, or 90% of incoming veterans, stood by for three months or more on their first appointment-;and worse, 13% of administrative schedulers were instructed by their supervisors to falsify wait-time records (6/9).

The New York Times' Taking Note: If Virginia Doesn't Expand Medicaid, Blame This Guy
But what's happening in Virginia right now may rival or even top that level of brazenness, proving yet again that personal ambition and venality often outweigh political principle. As The Washington Post reported today, Republicans in Virginia persuaded a Democratic state senator to give up his seat by engineering job offers for him and his daughter. The loss of that seat puts Republicans in control of the closely divided state Senate, and probably means the end of any hope to expand Medicaid in that state (David Firestone, 6/9). 

The Washington Post: By Resigning, Virginia Lawmaker Phillip Puckett Betrayed His Own People
This summer, hundreds of sick, desperate people will gather daily in the pre-dawn darkness of a Southwestern Virginia parking lot, part of a late July pilgrimage as predictable as the state's tobacco crop. They come with festering cancers, rotting teeth, wheezing lungs and aching joints .... Now, if you're a state senator watching what looks like a refugee camp medical tent, staffed by 800 volunteers who come into your town to perform eye surgery and root canals and remove cysts for about 3,000 of your constituents, who have no health insurance and live on about $14,000 a year, wouldn't you do everything in your power to help them? It seems that [Sen. Phillip P.] Puckett has decided that, no, he's not going to help the people who elected him and who are in dire need of every bit of medical care they can get (Petula Dvorak, 6/9). 

The Virginian-Pilot: Usual Business In Richmond
With the former governor and his wife set to be tried on federal corruption charges, and state lawmakers having tweaked Virginia's porous ethics laws to appease public outcry, it seems only fitting that an effort to break the current budget stalemate would involve allegations of personal, pecuniary interests. Sen. Phil Puckett, a pro-gun, pro-life Democrat from southwestern Virginia, is at the center of a firestorm that raised eyebrows across the commonwealth. He abruptly announced his resignation, effective Monday. ... On Monday, Republican leaders said they intended to move for a quick resolution to the budget stalemate, which has broken down between the chambers over whether to use federal funds to cover private health insurance for lower-income Virginians (6/10). 

Richmond Times-Dispatch: Politics: As The State Turns
Now the capital is deadlocked -; as it has been for months -; over whether to expand Medicaid. The dispute has stalled the state budget, and without a resolution soon many state agencies could shut down. ... Democratic State Sen. Phil Puckett rocked the political establishment on Sunday night by announcing his immediate retirement. That will clear the way for the legislature to appoint his daughter, Martha Ketron, to a six-year term on the state judicial bench .... Puckett's departure tilts the Senate to the GOP, which could call members back into session and ram through a budget without Medicaid expansion, breaking the deadlock. That would force [Gov. Terry] McAuliffe either to declare defeat or to veto the budget and shoulder sole responsibility for the ensuing government shutdown (6/9). 

The New York Times' The Conscience Of A Liberal: Meanwhile, On The Health Front
You still encounter people claiming that Obamacare has been a disaster, that more people have lost insurance than gained it, etc., etc. But the reality is that it has already made a big dent in the number of uninsured; and the quality of insurance has gone up, too, because canceled policies were canceled because they offered little real protection (Paul Krugman, 6/9). 

Cleveland Plain Dealer: Ohio Entrepreneurs Should Learn About New Health Coverage Options
In case you're not already familiar with it, Ohio's marketplace has two branches -; one for individuals, the other for small businesses. ... if you're an employer with fewer than 50 employees looking for a plan for your workers, you've still got time! The small business portal, nicknamed SHOP for Small Business Health Options Program, is open to any employer with fewer than 50 employees and provides year-round enrollment (Grant Lahmann, 6/10). 

The New York Times' Well Blog: Revolving Doors At Hospitals
Everyone on the ward fell hard for the patient in the room at the end of the hall. ... The doctors joked with her, the nurses stroked her head and brought antibiotics and nebulizers right on time, and her private-duty attendant organized her pillows and fed her little snacks. She looked like a million dollars when they sent her home. Two days later she was back in the emergency room, wheezing and choking all over again, her readmission an embarrassment to the professional staff -; and, for the hospital, a big fat fine from Medicare in a new effort to discourage these repeat performances. Cases like hers torture health policy makers, partly because nobody can quite figure out who is to blame (Dr. Abigail Zuger, 6/9). 

The New York Times: Progress On Transgender Rights And Health
Progress on civil rights typically comes in incremental steps that discard old policies for new approaches advancing fair treatment. The Obama administration recently took such a step by reversing a 1981 policy that excluded gender reassignment surgery from coverage under Medicare (6/9).