Dont you think our military veterans deserve decent health care? I certainly do. Thats why I like Mitt Romneys idea of setting the veterans free. Give them the opportunity to choose private health care alternatives to the Veterans Health Administration (V.H.A.) a system that too often fails them.
Why cant we do for veterans what we do for seniors? About one in every four Medicare beneficiaries is not actually in Medicare. They have enrolled instead in private health insurance plans operated by such entities as Aetna United Health Care Cigna etc. Why cant we give people who risked their lives for the rest of us similar options?
You would think this idea is a no-brainer. But just like the Grinch at Christmas time you can always count on Paul Krugman of The New York Times to argue that being trapped is good free to choose is bad and government medicine is all anyone should ever have or need.
According to Krugman the V.H.A. is providing better care than most Americans receive" and it does so at a lower cost. He doesnt stop there. Here is Krugmans view of health care worldwide:
The most efficient health care systems are integrated systems like the V.H.A.; next best are single-payer systems like Medicare; the more privatized the system the worse it performs.
In other words in the best of worlds we all would be getting veterans care courtesy of the U.S. government! Before you buy that idea try a Google search. I found these unsettling headlines: Vets Not Getting the Care They Need One Million Vets Waiting on VA for Disability Claims Never Event Occurs at VA Hospital Federal Court Challenges VA Mental Care and Veteran Suicides Becoming Epidemic." Did you know that one in every five suicides in the U.S. last year was a veteran? Last May the 9th U.S. Circuit Court of Appeals in San Francisco said that with an average of 18 veterans killing themselves each day the VAs unchecked incompetence has gone on long enough; no more veterans should be compelled to agonize or perish while the government fails to perform its obligations." A Miami Herald investigation (using the Freedom of Information Act) discovered that:- Despite a decade-long effort to treat veterans at all V.H.A. locations nearly 100 local V.H.A. clinics provided virtually no mental health care in 2005; the average veteran with psychiatric troubles gets almost one-third fewer visits with specialists than he would have received a decade ago.
- Mental health care is wildly inconsistent from state to state; in some places veterans get individual psychotherapy sessions while in others they meet mostly for group therapy.
- In some of its medical centers the V.H.A. spends as much as $2000 for outpatient psychiatric treatment for each veteran; in others the outlay is only $500.
Private hospitals tend to have private rooms and lots and lots of plumbing. These features help control infections and make hospitals safer for patients. Because governments can shut down private hospitals that fail cleanliness standards private hospitals also spend a lot on maintenance and housekeeping. Government hospitals tend to do things differently.
An investigation of the Kansas City VA Medical Center revealed that things were so bad that clinicians felt compelled to clean their own areas. Management embarked on a hand washing campaign but with limited success. The review found that many soap dispensers were empty and noted one clinicians hope that one day sinks should actually work. An investigation of a V.H.A. system in Dallas reported that Most patient rooms and bathrooms we inspected were unclean…the rooms had foul odors suggesting that they had not been thoroughly cleaned over a significant period. Outside commentators consistently praise the V.H.A. for keeping patient records electronically. In principle all the doctors in the system should be able to access the same records and practice integrated care rather than the piecemeal approach that often characterizes health care generally. Also the system is doing something else rarely seen: it is publishing outcomes data (mortality rates infection rates and readmission-after-initial-surgery rates) on procedures at its 152 hospitals so vets will have information about the quality of care to expect. But because rationing-by-waiting is endemic throughout the system its not clear what patients can do with this knowledge. Here is the bottom line: The V.H.A. may be good at some things and not at others. Quality and service levels apparently vary around the country. So let the V.H.A. compete in the marketplace against private doctors private hospitals and private insurance instead of trapping veterans in a system that may or may not meet their needs. John C. Goodman is president and founder of the National Center for Policy Analysis a free-market think tank established in 1983. Goodmans ideas on health policy can also be found at his own blog where he provides daily analysis and lively discussion on a wide range of health care topics.
