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Grant Bosse: VA health care for everyone?

By GRANT BOSSE
August 07. 2017 11:23PM


Should we put the government in charge of our health care? What could go wrong?

Come for the dirty surgical equipment. Stay for the bug-infested operating rooms.

We’ve been hearing about medical mistreatment of our nation’s veterans for over a decade. The Washington Post reported on the deplorable conditions facing wounded soldiers at Walter Reed Medical Center in 2007. We found out that the Department of Veterans Affairs was letting thousands of veterans languish on waiting lists three years ago.

Yet the recent allegations about the Manchester VA Medical Center still managed to shock us. It’s not just that these mistakes of arrogance and neglect happen. It’s that nothing ever seems to change.

VA Secretary Dr. David Shulkin rose through the ranks as a VA doctor, and is both hard-working and well-meaning, like most of his colleagues. He seems to be taking these latest allegations seriously, using new authority recently given him by Congress to fire the top staffers in Manchester. Shulkin has brought in Alfred Montoya from the White River Junction VA to run things while he looks for new administrators.

Hopefully, things will improve. They have to. I remain skeptical that the federal government should be running a segregated chain of hospitals to care for veterans.

I’ve argued for a decade that the VA should concentrate on service-connected medical problems, such as Agent Orange, Post-Traumatic Stress Disorder, and Traumatic Brain Injury. Leave general medicine to private hospitals, as the military does through its Tricare program. The stalled Veterans Choice program was supposed to expand access to private care, but maintains the substandard silos of existing VA hospitals.

Whatever government touches ends up taking longer, costing more, and delivering less than the private sector. Why would we want government to control more of our health care.

Faced with the crumbling wreckage of Obamacare, Democrats are prescribing more Obamacare. They want to pour billions more in taxpayer subsidies into the broken system, as well as cross-subsidize the failing individual market exchanges from the functioning, if already expensive, group market.

Senate Democrats have decided that Medicare isn’t speeding toward the fiscal cliff fast enough. They want to step on the gas pedal by letting people aged 55-64 buy into Medicare.

Bernie Sanders continues to push the envelope by backing Medicare for all. But if everyone is on Medicare, there would be nobody left to subsidize it. We would all go bankrupt together.

When we ask government to pay our medical bills, or our health insurance premiums, we lose control over our health care. This is not a bug that can be corrected by brilliant plan design. This is a central feature of socialized medicine.

In Britain, we saw how little control patients have over their own medical decisions, even when money isn’t the issue. A London hospital blocked the desperate parents of infant Charlie Gard from coming to New York for an experimental procedure.

Britain’s National Health Service is facing a huge funding gap, prompting North Yorkshire hospitals to bar smokers and anyone with a body mass index of 30 or above from most surgeries for up to a year. Hospitals across England have stopped offering in-vitro fertilization as too costly to justify.

It’s not quite a Death Panel, but they’re getting there.

When we decouple prices from heath care decisions, patients and doctors make irrational decisions. Costs skyrocket. Insurance companies and government officials step in to make those decisions for us. We end up with both higher costs and fewer choices.

Whether we let government run its own hospitals, like the VA system, or simply pay the bills, through Medicare and the Obamacare exchanges, we cede control over our health care decisions.

When government tries to control health care costs, we’ve seen just how costly its decisions can be.

Grant Bosse is the editorial page editor of the New Hampshire Union Leader and Sunday News.


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