Commentary

U.S.-Run Health Care? Ask a Veteran

Continuing problems with government-run health care for military veterans suggests some issues we are likely to face if Congress passes President Barack Obama’s plan for government-run health care.

Like other entitlement programs, government-run health care for veterans has expanded rapidly and struggled amid financial pressures. The Veterans Affairs Department manages the largest U.S. health care system, with more than 1,400 hospitals, clinics and nursing homes. Over the years, it’s gained a reputation for long waiting lists, staff shortages and a wide range of horror stories.

President Obama proposed what he described as the biggest VA budget in 30 years – $93.4 billion – yet March 16, he implicitly acknowledged the funding pressures when he proposed that veterans pay for war-related conditions through their own health insurance plans. Veterans groups protested that the government had always paid for treatment of war-related conditions. Two days later the president dropped the idea.

Why would veterans’ health care be, as the president said, “underresourced”? One reason is that officials are spending other people’s money, so they tend to have ambitious spending objectives. Also, as government grows bigger, the competition for appropriations becomes more intense. By proposing to start new programs and expand old programs, President Obama virtually guarantees that more programs will be underresourced.

In 1994, Dr. Kenneth W. Kizer began serving as the VA’s undersecretary for health and was credited with “the greatest transformation of VA health care since the system was created in 1946.” Kizer fired many incompetent doctors, decentralized decision-making, offered executive contracts with performance compensation, expanded services for chronic conditions and introduced a modern computer system. Following these reforms, veterans’ hospitals were said to offer “the best care anywhere.” After five years, Kizer left the VA.

Meanwhile, pressure to cut corners seemed to have intensified. In 2003, a newspaper report suggested that “problems continue: doctors not doing their jobs; unsupervised residents rotating in and out of the VA, leaving veterans’ medical care postponed; and death rates for open-heart surgery centers that would be unacceptable at any other hospital.”

Four years later, there were disturbing stories about “a vast outpouring of accounts filled with emotion and anger about the mistreatment of wounded outpatients” at Walter Reed Army Medical Center. Although Walter Reed isn’t a VA facility, it became clear that many similar problems occurred at VA facilities.

In February, the VA began notifying about 10,700 veterans in Florida, Georgia and Tennessee that they might have been exposed to HIV or hepatitis because of unsterilized colonscopy equipment.

If this is the kind of care the government provides those who have risked their lives for our country, are the rest of us likely to fare any better if we end up in some kind of national health care plan?

A patient’s best protection is the freedom to opt for another health care plan if one’s current health care plan is cutting corners or becoming too expensive. Yet Obama’s big government-run health care plan would almost certainly drive alternatives out of the marketplace and become a monopoly. This would leave patients at the mercy of Washington officials who have treated veterans badly and might treat the rest of us even worse.

Jim Powell is a Senior Fellow at the Cato Institute.