If you haven’t been hiding under a rock over the last few weeks, you are probably aware of the ongoing scandal at the Veterans Administration. The basics of the scandal involve lengthy wait-times for veterans’ treatment in some cases resulting in death, manipulation of data on treatment and wait-times among top brass at the VA, and outright fraud perpetrated on veterans and taxpayers alike.
This is not the first time that veterans have been failed (remember the Walter Reed scandal?) by their government when it comes to their health care. Given the Obama Administration’s marquee legislative accomplishment “ObamaCare” and this scandal which has signs of “sticking” in ways that other scandals during this Administration have not, it is worth exploring the parallels and differences between ObamaCare and the VA.
The VA is a classic “single-payer” system. This more closely parallels the British or Canadian models than ObamaCare. Not surprisingly, many of the issues causing the VA scandal (rationing, wait-lists, and inadequate care) are often cited as problems with “single-payer” models. I’m not a huge Sarah Palin plan, but I think she was being generous when she made her “death-panels” comments. The reality is that the system’s own inertia will kill people (as has happened with the VA) not an organized panel.
It is worth noting that the VA serves America’s veterans. Few groups in this country are viewed more favorably by all sectors of society. One would expect that health care for a relatively small number of people who served their nation and are viewed sympathetically by large swaths of the population would be BETTER than any care provided to the population at large.
In terms of differences, there is no question that ObamaCare as designed is NOT single-payer. The law simply places additional regulations onto our “third-party-payment” system in which Americans’ health care is paid for by someone else whether that be insurance companies or (increasingly) other taxpayers through government programs like Medicaid. However, many believe that ObamaCare is intended to move America down the path to “single-payer.” None other than Senate Majority Leader Harry Reid Reid has said that he sees a national single-payer health system as the natural next step for health care in America. Reid said the nation had to “work its way past” insurance-based health care.
Reid and conservative Sen. Tom Coburn don’t agree on much, but they do agree that ObamaCare is a significant step towards “single-payer.”
So far, Republicans seem content to concentrate their ire on the individuals involved in the scandal (Obama, Shinseki, a few rogue bureaucrats), when the problem is the incentives (or lack-thereof) of the “single-payer” system itself. Of course, Republicans have played a tremendous role in creating the VA and I doubt they have the interest in or ability to really reform the system so it works, so I doubt we’ll see much discussion of the systematic problems inherent in the VA model.