August 16, 2014


It's Time for Real Reform of Veterans' Health Care (Joseph Antos, July 31, 2014, The American)

Overall, the Miller-Sanders bill will probably do some good in waking up the VA and at least temporarily improving access to health care. However, it cannot permanently ensure that the promises of medical benefits made to veterans can be met within limited budget resources without returning to long waiting lists and compromised quality.

We need to decentralize the VA health system and give veterans realistic health plan choices. As much as possible, veterans should receive their care from the broader health system, and not be kept locked up in a system that cannot handle the full caseload.

The VA has gotten away with a long history of failures because its customers have no other choice if they want to obtain promised care without having to make a financial payment. Veterans may be dissatisfied, but they have no effective voice other than through the political process, which has shown only sporadic interest in the ongoing problems with access and quality.

Rather than authorizing private health care on a short-term basis, as the Miller-Sanders bill does, most veterans can be fully integrated into mainstream health care. The private health sector is fully equipped to deal with most of the health needs of former soldiers. The VA should focus its resources on specialized services, including treatment for combat trauma and rehabilitation that is unique to war veterans. Facilities not needed to provide those services should be sold off.

Veterans should be given vouchers to purchase private health insurance, including coverage on the new health insurance exchanges. With more health plan options, veterans can become active consumers who can pick plans that best meet their needs. The principle of informed choice of health plans has been adopted by Obamacare for everyone else. It is time to give that option to veterans.

Except that the poroblem is veterans are extremely satisfied with the VA system, not least because it treats them as if they were special and deserving of a system not available to the rest of the citizenry.

Posted by at August 16, 2014 7:16 AM

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