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Single payer: Why the VA scandal is a three-fer for the political class

I rarely quote the Fiscal Times, since it's the house organ of Pete Peterson, who wants to destroy Social Security, but in this case I'm breaking my rule:

The ongoing scandal at the Veterans Affairs Department has forced the idea of government-managed health care into the spotlight, with opponents pointing to the VA’s failures as an example of what could happen if the country were to adopt government run health care or a single payer insurance policy on a larger scale.

For years, liberals in support of single-payer have pointed to the VA as a model for what a larger system could look like. New York Times’ columnist Paul Krugman called the Veterans Affairs Department’s “success story one of the best-kept secrets in the American policy debate.” Krugman wrote in 2006, “The secret of its success is the fact that it's a universal, integrated system.”

[Allow me a moment to disinfect. There.] See what the legacy parties are doing here?

1) Both Republicans and Democrats get to point at the VA as an example of the horror of single payer. (Never mind single payer in Canada, which Canadians prefer, or government health care in Mexico, which Hispanics prefer).

2) In addition, the Republicans get to bash the Democrats -- especially the Demon King, Paul Krugman -- for their supposed support of single payer (support that's never been translated into actual legislation, unsurprisingly, given that both the administration and the career "progressives" who run interference for it have resolutely oppose single payer since at least 2009).

3) And the Democrats get to dole out some rent to the rentiers:

The Obama administration says it will allow more veterans to obtain health care at private hospitals and clinics in an effort to improve their treatment.

Veterans Affairs Secretary Eric Shinseki also said VA facilities are enhancing capacity of their clinics so veterans can get care sooner. In cases where officials cannot expand capacity at VA centers, the Department of Veterans Affairs is "increasing the care we acquire in the community through non-VA care," Shinseki said.

I believe, though I can't prove right now, that this is an example of the privatization quadrille:

1) Underfund a government program;

2) Fund a public relations campaign and plant stories in the press about poor service (but never mention the underfunding);

3) Privatize the program;

4) Profit!!!

This simple scheme is working with the NHS in the UK, I believe it's working with the Post Office here, and I'm sure readers can come up with other examples.

No underpants gnomes, these neoliberals!

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Comments

jo6pac's picture
Submitted by jo6pac on

right to me, hell I can see just down the road and around the next bend all vets will have to buy obumercare.

Alexa's picture
Submitted by Alexa on

within the past several months regarding this topic, and regarding the appointment of a Military Commission, which will review and recommend retirement, healthcare and pay "reform" for military members.

I am trying to follow this--could be personally affected (not to mention if they also go after Civil Service employees/retirees).

I'll try to add a link here about the Commission (a little later this week).

IIRC, the Commission recommendations will be announced (conveniently) AFTER the midterm elections--in about February 2015.

It is SO important to highlight the dismantling of (federal) civilian and military retirement systems (and benefits, in general).

Only early and strong mobilization against Commission can "save" our military members from having their benefits eviscerated (as the PtB seem intent on doing to the rest of us).

Please excuse typos/poor syntax.

;-)

Submitted by lambert on

If we can get the personnel on it, maybe we can get a read on.... Well, how far the privatization will go in this round.

Alexa's picture
Submitted by Alexa on

term is over, the entire military (and maybe even Federal Civilian Service) retirement and benefits system will be "near" destroyed.

I'm a bit pushed this evening, but will come back by the weekend or next week to add a bit more about a House bill which Democrats eagerly helped pass (last week), which will being to dismantle the Civil Service Merit System (as we know it).

I am truly sickened by what is beginning to happen to my fellow (formerly, anyway) civilian service "comrades."

I thank my lucky stars everyday that I can file very soon, and presumably escape the proposed retirement cuts to my federal service retirement. [Except of course, the "Chained CPI," which affects ALL federal transfer programs and/or retirements--from Social Security to VA Disability, to SSI, to Social Security Disability, to Civil Service Retirements, to Military Retirements, and on, and on.]

If I can relocate the link to a preliminary Military Commission hearing that I heard a couple of weeks ago (not that anyone but me would listen to it, LOL!), I"ll post it here also.

Actually, they are pretty interesting. I rarely have the luxury of "watching" them, but can listen to them as I go about my day.

I hadn't had a chance to "check out" any of the Commissioners, but am not in the least surprised at your findings. Thanks for following up!

nihil obstet's picture
Submitted by nihil obstet on

The VA is a National Health Service, not single-payer. The Obama administration proposal is to replace it with single-payer; that is, they're not proposing to pay private insurance premiums for veterans, but to pay providers for medical services.

I prefer an NHS to single payer.

Submitted by hipparchia on

i'd rather have an nhs too, but single payer would be good. also, technically, you can probably consider nhs a subset of single payer, or maybe a special kind of single payer..

Submitted by marym on

Obama is privatizing the provider functions of the VA. It’s a step backward from a NHP.

HR 676 in addition to “de-privatizing” the insurance function, also does so for the provider function though less than the VA. HR 676 requires providers to be public (like the VA) or private non-profit.

Submitted by lambert on

My thought was, the governments paying, therefore it's single payer. (Of course, exactly like Medicare, it may be infested with neo-liberal rent-seeking, even if that's not my picture of it.)

However, there is a spectrum of public to private, with single payer's public payment and private delivery distinct from NHS's public payment and public delivery.

So in some ways I obscured how centrist, literally, single payer is, worldwide.

Alexa's picture
Submitted by Alexa on

in our experience (which I posted on extensively here in comments--maybe in a Dromaius post)--there is no comparison between the two systems, really.

Mr A is in one of the higher priority VA categories, but at present, really doesn't use the system.

HOWEVER, the VA System is very much like the "active duty" military medical system which we have used extensively.

Believe that I posted once before that Mr A's neurosurgery (performed by one of the top military neurosurgeons in the entire military system--not the VA System), including the cost of two medevac flights from Alaska to the Lower 48, with me in tow as his "medical assistant," at no cost to us--cost him "out-of-pocket" no more than the loss of, or docking of, his daily food rations allowance for the actual days he was hospitalized, and a sum less than $20 to cover "something" upon discharge.

I don't know, but I truly that most military members would incur far more out-of-pocket expense than this, if they are "farmed out" to the private sector.

This entire exercise is an excuse to destroy the VA System (and probably the active duty medical system that we were in).

***********
Democrats are responsible for this fiasco. Didn't realize this until I heard a veteran call in to C-Span about them overturning the Bush Era ban on Category 8 veterans.

I found a transcript of the late Senator Daniel Akaka (HI) calling for this, in a Congressional testimony in 2007. Then I searched, and found that PBO signed the bill in 2009.

Here's an excerpt:

President Signs Bill To Expand Veterans Benefits

And let me say that I take special pride in this legislation because as a senator I was a proud co-sponsor of this legislation. I served on the Veterans Affairs Committee. In the campaign last year, you all remember, I made a promise to pass it. And today as President, I'm fulfilling that promise and I'm going to sign it into law. (Applause.) . . .

And most of all, for our veterans it will mean better access to the doctors and nurses and the medical care that they need: specialized care for our wounded warriors with post-traumatic stress and traumatic brain injuries, and the staffing to welcome back to the VA those half-million "Priority 8" vets.

According to the Doctor/whistle blower that been all over the place lately (sorry--his name escapes me, right now)--that IS definitely one of the main reasons for the massive failures of the VA System over the past several years.

IOW, the current VA System is trying to provide extensive health care services for 9 million veterans, within a system set up to accommodate approximately 3 million veterans.

Wouldn't surprise me in the least if this isn't another one of the Democratic Party Establishment's "unintended consequences." You think?

Submitted by lambert on

Although of course I'm very willing to believe that it is!

The bold part reads:

... the staffing to welcome back to the VA those half-million "Priority 8" vets....

What's a Category 8 Veteran? I can't even see your dust on this, I'm so far behind.

Are the "staffers" private? (Kinda like Medicare Part D? Privatize part and develop a constituency?

Alexa's picture
Submitted by Alexa on

and that actually, they are the same links that I've posted here previously.

I'm "pretty sure" that the (now retired) VA Physician/Whistleblower that I heard on XM Radio was Dr. Sam Foote. Unfortunately, since I have no way to access podcasts to "doublecheck on this," I'd rather not definitively quote him as the source. Suffice it to say it was a VA doctor.

I came in on the "middle of the conversation." But from what I could make out, the "beef" was that opening up the VA System--Categoy 8 Vets had been banned by the Bush Administration (correctly) out of concern for adequately servicing our actual service-connected disabled veterans--to non-disabled and non-low income veterans--caused a huge "system overload," hence the current scandal and coverup.

There was one more very serious allegation, but I'd rather check it out a bit more (if I can find anything more on it) before expounding on it.

Hope this helps for now.

In addition, according to Dr, Foote, the additional Category 8 vets, along with the millions more disabled veterans returning from Afghanistan and Iraq since PBO signed the 2009 legislation, were among the main reasons that the VA System has become so overloaded and/or overwhelmed--both in monetary, and in physical staff and facility resources.

{Pushed, please excuse typos/syntax.}

Submitted by lambert on

Not only that, but if I understand the Section Stuff, it's that who could have purchased in the private sector were allowed to purchase in VA, overloading it. Just insane.

This is very bad. Wherever you look!