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.
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