Wednesday, August 12, 2015

Eliminate VA Bottlenecks: Put Veterans on Medicare




Veterans Administration medical facilities recently have been under intense criticism for concealing how long patients must wait to see doctors and receive treatment.  A number of veterans may have died while waiting to see a VA doctor. 

Veterans Affairs Secretary  Eric Shinseki recently testified about the situation before the Senate Veterans’ Affairs committee.  He was not warmly received.  Several senators suggested that he ought to resign or be fired.

Unfortunately the problems with VA medical care will provide ammunition to politicians who oppose replacing Obamacare with a simple single-payer system, “Medicare for all.”  
Although the Affordable Care Act made no changes to veterans’ medical benefits,  critics of Obamacare have already seized the opportunity to charge that “government-run health care doesn’t work---just ask a veteran.”   

Of course the problems with veterans’ benefits do not prove that “government health care” doesn’t work.  Medicare,  for example, is a government program and it works quite well, with none of the problems afflicting Veterans’ Administration facilities, or,  for that matter,  Obamacare. 

A key difference between Medicare, on the one hand,  and veterans’ benefits and Obamacare on the other hand,  is that Medicare patients can go to virtually any doctor or hospital in the country, most of which are not operated by the federal government.   The VA has only limited facilities,  not always conveniently located,  and insurance policies sold under Obamacare often severely restrict the doctors and hospitals people can go to. 

Firing Secretary Shinseki would not solve the problems with VA medical facilities, which go much deeper than current complaints might suggest.  A major reform is needed here, and the simplest approach would be to privatize or close all VA facilities and put veterans on Medicare without regard to their age.  Like all other Medicare patients,  veterans could then choose freely among doctors and hospitals and not have to wait for appointments any longer than anybody else.  Money saved by closing VA facilities could be moved to the Medicare Trust Fund;  perhaps part of the savings could be used to provide supplemental insurance to veterans if that is needed to duplicate the coverage they had under the VA. 

The United States is unique in the industrialized world in having completely separate medical insurance systems for veterans,  retired people,  employed people,  the unemployed,  and for native Americans.  Other countries have single-payer systems covering everybody, systems which have worked quite well and which hold administrative costs down to a bare minimum.

Let’s treat the current criticisms of VA medical facilities not just as a problem,  but as an opportunity.   Moving all veterans into Medicare would eliminate one of these separate systems and would be a step in the right direction towards eliminating all of them and providing Medicare for all.

No comments:

Post a Comment

Comments are e-mailed to me. I will post excerpts from those I think will most interest readers.