VA's Job Can Not Be Done by the (Inferior) U.S. Private Medical System
Good editorial at the NYT on why the VA Health System is not inferior to the for profit U.S. health care system, focusing on the research which the VA conducts and then gives away (making no profit on innovations such as nicotine patches and shingles vaccines)--innovations which benefit us all.
https://www.nytimes.com/2018/11/10/opinion/sunday/veterans-department-health-hospitals.html
I want to take this one step further. The VA is not just good for all of us. The VA is good for veterans.
The VA is good for veterans on Medicare who can not afford their medications. At the VA, all medications come with the same low copay whether they are a $4 generic or a $10,000 course of the state of the art medication that you (the veteran) need for your fatal/rare condition. In other words, the VA does not discriminate against those who are sick. The VA also supplies hearing aids without a $4000 co-payment. It offers glasses, durable medical goods, home repairs and other supplies aimed at preventing falls, strokes, illness. The VA is not like the for profit system--it does not make money every time grandpa falls and breaks a hip. So, the VA tries to prevent the fall, prevent the osteoporosis, stop the smoking, control the diabetes.
And now, I am going to take this one step further still. The for profit system absolutely can not fulfill the VA's other purpose which is to keep the men and women in our nation's military reserves health and ready for active military duty if an emergency such as Pearl Harbor occurs. Every combat veteran is entitled to five years of free care at the VA. That means five years with no out of pocket for check ups, medications, tests, smoking cessation programs, gynecology and obstetric care, orthopedic care, mental health care. Imagine what would happen if our combat veterans--the ones who will be vital to our national security if we are attacked--were thrown into the for profit health care system. More than likely, they would have no health insurance. And if they did have insurance, it would be high deductible and it would not cover preventive services and it would have no incentive to invest in disease prevention. Since most young men do not visit a doctor for check ups, veterans would quickly fall prey to the same preventable diseases that have rendered non veterans obese and unhealthy.
The for profit health care system makes money from treating disease. The for profit health care system has no incentive to prevent disease. The for profit health insurance system makes money from writing insurance policies for the healthy, and when the healthy become sick and lose their jobs (and their employer sponsored insurance) they go on Medicare disability or Medicaid or a county funded program, meaning that the for profit insurance system has no incentive to prevent disease. Quite the opposite. In an ideal (for profit) system, those who get sick will get so sick that they can no longer work--and no longer have insurance.
The VA, on the other hand, makes a commitment to take care of veterans from military discharge to the grave. That is why the VA invests in disease prevention insurance. The VA is the closest thing we have in this country to a single payer, cradle to grave system like that in Canada or Western Europe. It is streamlined. It is efficient. And the for profit sector hates it for pioneering research in disease prevention and research that debunks medical claims--like claims that lumbar surgery is 100% effective at relieving pain. The private sector will give a morbidity obese man with uncontrolled diabetes who smokes two new knees--knees doomed to become infected or fail or lead to complications such as chronic deep venous thrombosis. The VA will give that same man bariatric surgery so he can lose weight, diabetes control, smoking cessation--and then, when that is all done, if his knees still hurt, they will give him new knees. Knees that are much more likely to work.
In time of emergency, the United States can quickly increase the size of its military forces by calling upon members of the reserves and those who have recently served. But what good is that fighting force if over half its members are no longer healthy? The U.S. for profit health care system has terrible statistics when it comes to health and disease prevention. If the job of the VA is farmed out to the for profit sector, then national security is threatened.
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