Privatize the VA? Pay more for less.

free-vector-veterans-administration_089530_Veterans_Administration

Should the US privatize the Veterans Administration hospitals and clinics?  Let’s put the assumptions in the question on the table:

  • Bureaucracy is bad
  • US health care is good
  • The US is in continuous war
  • Treating the wounded is too expensive

This blog is about healthcare, not geopolitics, yet the temptation to see war as a disease is difficult ignore.  Let’s not go there.  Instead, compare the VA system with the proposed replacement.

VA Healthcare Private US Healthcare
  • Lower drug prices due to negotiation by the system
  • Expertise with PTSD, alcoholism, tobaccoism, drug addiction, low income, amputations and poor literacy.
  • Group sessions with people having a military background
  • Funding is always in doubt
  • Managed as a system, although management is only fair.
  • World healthcare rank is unknown, but is likely better than the US as a whole.
  • High drug prices due to lack of negotiation at the system level
  • Primary care is unequipped to deal with social and psychiatric problems (not in the usual five-minute visit that is profitable)
  • Group treatments with people who might dislike the military.
  • No limits on costs and profits
  • Highly influenced by the biggest lobbying efforts in the US
  • Not managed as a system
  • World healthcare rank is 26th.

Would a veteran actually want private healthcare?  Perhaps veterans living a long distance from a VA facility would choose private care.  But, if VA facilities are close who would want to enter a private system that is hugely expensive, not focused on war injuries, poorly managed, and has low quality ratings?

The real answer to the initial question is that private US healthcare needs to improve tremendously.  If and when that happens then the need for the VA would naturally disappear.  And, by the way, less war would help.

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