Journalist Charles Lane
Washington Post opinion writer Charles Lane suggested today that “market signals” can do a better job than the Veteran’s Administration in taking care of our nation’s veterans.
Without market signals to help allocate resources, long waits and other patient frustrations are inevitable, no matter how sincerely, or how threateningly, Washington orders their elimination.
Ah yes, market signals. That must be why every hospital in America is clamoring to staff its cardiology department, since heart disease is the leading cause of death in the United States. Cancer is #2, so cancer centers are springing up everywhere, too. There’s a huge market for these services but do they do anything to actually advance medical science? The vast majority of them do not. They are, however, unbelievably profitable for the hospitals that have them.
“Market signals” would say every hospital needs heart and cancer centers, but what about the other diseases that are just as deadly if not as popular? ALS was off the public’s radar until last year’s “Ice Bucket Challenge.” The fad brought in more research money for ALS than ever but will the interest remain? Should we not pursue research and treatment because the “market signals” say it’s not as profitable as cancer? Do you tell your loved one with ALS, “sorry, dear. Our death panels, … er, I mean “Wall Street analysts” … say you should’ve gotten cancer instead.”
Serving in the military is one of the few jobs around where one knows full well that one could be asked to sacrifice one’s life. Military veterans bring to civilian life unique health issues. Veterans make up only 13% of the American population. Are “market signals” enough to provide the care to this group that was promised when these citizens signed on the bottom line?
Even to suggest that veterans’ health care should be partially spun off to the private sector — that, say, former service members should be provided a generous subsidy to purchase health insurance — is to invite a charge of callousness toward those who have sacrificed so much, or to risk being labeled a right-wing ideologue.
We not only ask for military members to put their lives at risk, we pay them poorly for it, too. Over 5,000 active duty military members live on SNAP benefits (food stamps), and base pay is barely above the poverty line. Health benefits are one of the few upsides to a life of constant financial struggle, relocation, and time away from family. If our country is going to ask these sacrifices of our men and women in uniform, it’s our duty to honor our commitment to care for them when their service is done. Through their service to our country, veterans have earned the right to heal their broken bodies. Does it make you “callous” to suggest otherwise? Hell fucking yeah, it does.
As for VA construction, undoubtedly its woes reflect a lack of institutional competency, compared with other federal agencies such as the Army Corps of Engineers, which some reformers believe should take over the job. Yet the root cause would seem to be the insistence on a dedicated system of state-run hospitals in the first place.
Here Lane accuses state-run hospitals yet offers no supporting evidence. I suppose it’s okay if he says it “would seem.”
Let’s talk about state-run hospitals a minute. When our infant son became feverish on vacation to Italy years ago, the state-run hospital patched him up in a caring and professional manner without costing us a dime. I reentered the VA system again after mysterious health issues I suspect are Gulf War Illness became worse. The entire process was unexpectedly smooth, with friendly assistance and efficient care. My appointment was actually on time and I never felt the least bit rushed by my primary care physician. She was happy to listen rather than dismiss me in mere minutes the way civilian doctors do.
You know how efficient “market signal-based” health care is? Market-based health care charges you $30 for an aspirin and $546 for six liters of saltwater. Market-based health care sues poor patients when they can’t afford to pay. It’s a market worth billions of dollars, which means many billions of those dollars go to waste.
Is there waste in the VA? Sure. But any VA waste absolutely pales in comparison to the waste generated by the private health care market. Yes, it’s expensive to care for our veterans. As long as there’s a need for veterans, though, there’s a need to honor our commitments and provide them with the health care they’ve earned, expenses be damned.