health care

The Veterans Health Administration Really Does Offer 'Lessons' in 'Socialized Medicine'

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Mollenborg / Foter

Just a couple of years ago, Paul Krugman pointed to the Veterans Health Administration (VHA) as a "huge policy success story, which offers important lessons for future health reform." He gloated, "yes, this is 'socialized medicine.'"

Similarly, a letter touted by Physicians for a National Health Program trumpeted "the success of 22 wealthy countries and our own Department of Veterans Affairs, which use single-payer systems to provide better care for more people at far less cost."

How could a bloated government bureaucracy achieve such low-cost success? As we found out recently, it's by quietly sticking veterans on a waiting list and putting off their treatment for months—sometimes until the patients are far too dead to need much in the way of expensive care. Which is to say, calling it a "success" is stretching the meaning of the word beyond recognition.

And, while the White House insists it learned from press reports about the secret waiting lists, Press Secretary Jay Carney acknowledges that the administration long knew about "the backlog and disability claims" that have accumulated in the VHA.

This should surprise nobody. Canada's government-run single-payer health system has long suffered waiting times for care. The country's Fraser Institute estimates "the national median waiting time from specialist appointment to treatment increased from 9.3 weeks in 2010 to 9.5 weeks in 2011."

Likewise, once famously social democratic Sweden has seen a rise in private health coverage in parallel to the state system because of long delays to receive care. "It's quicker to get a colleague back to work if you have an operation in two weeks' time rather than having to wait for a year," privately insured Anna Norlander told Sveriges Radio

An article in The Local noted that "visitors are sometimes surprised to learn about year-long waiting times for cancer patients."

Britain's single-payer National Health Service (NHS) is up front about wait times for care, with the organization's website promising, "you have the legal right to start your NHS consultant-led treatment within a maximum of 18 weeks from referral." Last year, the Daily Telegraph reported that "waiting lists, which have hovered around 2.5 million patients in recent years, reached 2.88 million in June, the highest level since May 2008."

Why the common delays across single-payer health systems?

Christopher S. Penn / Foter

It's like that sign you see in car repair shops owned by wiseasses: "Fast. Good. Cheap. Pick Any Two."

Advanced medical care costs a lot of money. Delivering it quickly costs more. To the increasingly limited extent that it's allowed, American private medicine recognizes the compromises that have to be made and offers a variety of coverage at different price points—that is, you have some choice in which two you get. The British NHS also recognizes the need to compromise—and there goes "fast." (The NHS is known for holding back on "good," too, when further cost controls are needed.)

The VHA has tried to pretend that compromises don't have to be made; that it can, somehow, deliver care to everybody without worrying about cost. But it faces the same lack of infinite resources as everybody else. If the VHA won't charge more for quick access to better care, fast will have to give. So we end up with secret waiting lists.

The VHA also often compromises on the good part, denying that illnesses exist, or that they're military-related and therefore its responsibility.

So the VA really is a good example of a single-payer, socialized health system. Just not in the way that fans of that approach mean.

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  1. Everyone understands that the more middlemen get in between the seller and the buyer, the more costs go up. But progs can’t seem to get that this also happens in healthcare when the government gets between the provider and the patient. And government is by far the worst middle man to have.

    1. Progtards constantly made the claim that all insurance industry profits were waste that could be eliminated by efficient, government run health care. Except that the profits made by the insurance industry was FAR less than the total spent on “improper payments” through medicare…. so….

      1. the ratio is ~

        12-14bn in annual profit /versus 50-70bn in federal HC spending ‘losses’

        or

        ~4-5X ‘worse’.

        The negative magnitude of the impact is likely heightened by at least 2 things

        Profits are carefully and strictly measured, and then dispersed according to where they may serve the greatest further economic interests of stakeholders (dividends, cost-saving measures, reinvestment, debt reduction, etc)

        Federal losses, by contrast, are unmeasured/hidden/funged, and generally retained outside whatever system originated them. ‘Bleeding’, you could call it. or ‘spoilage’/breakage. A writeoff.

      2. Progtards constantly made the claim that all insurance industry profits were waste…

        Sounds like the communists; they always maintained that all profits were waste. Or theft.

    2. Telling a progressive that his ideological policies are retarded is like telling one of Napoleon’s cannon men that cannonballs hurt people, he doesn’t give a shit he’s got to go to Russia somehow.

    3. For them it’s a moral issue. Profiting off of sick people is immoral, thus health insurance corporate profits are immoral.

      They would rather people die in an inefficient government run system than allow rich people to profit off of a more efficient system.

      1. Profiting off of sick people is immoral, thus health insurance corporate profits are immoral.

        Making 6 figures and retiring w/ a pension worth millions as a govt employee, off sick people, is just fine tho. They’ve earned it w/ the ‘good’ that they do.

        1. They’re not capitalists, so it’s OK.

      2. The really sad part is that they don’t realize that it’s the government that props up those obscene corporate profits. Without government’s collusion, corporations’ “obscene profits” would be eaten by competitors.

        1. Right, Rich… and since you and I don’t vote to re-elect those “government leaders” on average, about 95% of the time, who’s to blame?

      3. Oh, you mean like Rick Scott, gov of FL, who ran one of the largest for-profit medical companies in the world – with many of his executives indicted for FRAUD and the company paying the largest fines in history!

        Assuming that “rich people” have efficient systems would be like assuming Madoff has financial responsibility or that Priests are the best babysitters for young children.

        Be Real.

        No system is perfect. But I know a lot of vets who claim the VA system is pretty decent compared to the predatory “regular” system.

        1. “Be real” so are you a vet? Have you ever had to use the VA? My father in law had to go to your local VA in Jamaca Plain because the one here in NH doesn’t do surgery. No one spoke English, a two hour out patient procedure took all day and they fucked it up. He ended up using supplemental ins. to have it done right here in NH. Me thinks you’re full of shit craiginmass. Wait a few weeks and you will here about 10’s of thousands of vets with similar stories now that the cats out of the bag dumbass.

  2. This story can’t be a surprise to any Veteran who has ever been to a VA Hospital. They have always sucked.

    1. Yeah, I’ve been down to mine like one time.
      One visit and it became clear it was nothing more than a jobs program for the incompetent.

      1. Seemed like a great place to work up the nerve to commit suicide.

    2. They have always sucked.

      Yes, pretty much. I remember hearing about VA hospital scandals on the radio news back in the 1950s when I was a little kid.

  3. Please get out of the way and allow a free market in medical services and health insurance to develop, thanks.

    1. I liked your old motto more.

      1. That’s the formal and full platform of Libertatism.

        1. Does that make you a libertator?

      2. “No, fuck you, cut spending”?

        1. Yes. The platform, which is seventy pages long, just says that over and over again.

          1. And the “Fuck off, slaver” Amendment, right?

            1. Yes. Added to the end of each clause, for clarification purposes.

  4. The most dishonest thing about Krugman’s VA comments is that he says the only reason care delays occur is because the VA is underfunded.

    But in any other context, he’d use the VA’s cost per member as an example of how much more “efficient” single-payer care is.

    So which is it, Krugabe?

    You can’t damn the budget and then turn around and use it as your argument.

    1. Sure he can. His audience has no interest in facts, consequences, or doing the right thing.

    2. Appeals to emotion don’t have to be logically consistent. They just have to feel right.

    3. Adjusted for inflation the VA spends astronomically more today than it did even after World War II, when we had nearly a million wounded veterans to care for.

      Krugman’s claim that the VA is underfunded is, like nearly everything he says, a flat out lie.

      1. Just like everything else that’s ridiculously overfunded and expensive–“NOT ENOUGH MONEY. MORE.”

      2. He’s mastered stirring economic facts with personal ideology, it is what get’s you Nobels, until someone calls you out on it.

        1. The economics Nobel is awarded decades after the fact, and thus usually goes to people whose best work is long behind them.

          We had an economics laureate on our faculty when I went to school. He didn’t teach any classes, and the students in his department (qualtitative empirical models of the economy) considered his theories and his econometrics hopelessly ouut of date, but having his name on the masthead was good marketing nonetheless.

          1. “quantitative”. A qualitative model would be interesting, but not very useful.

      3. My partner interned at a VA facility for a few months. Said it was the laziest bunch of health care workers he has ever seen. 8-5, didn’t care if someone had been waiting all day to be seen or even if they had a scheduled appointment. Extremely inefficient record systems, people with jobs that shouldn’t even exist. Waste, laziness, indifference, exactly what I would expect from a govt run hospital…

        1. My wife interned at the VA in Dallas and said the same thing. The nurses were obese layabouts who just sat around and chatted all day and who would get personally offended if you tried to make them work. Meanwhile, the place was deserted on Friday afternoons because all the staff ducked out early.

          1. So it’s like every other government office.

            1. Yes.

            2. Yes – and any sick Veterans who wander in are treated like they are trespassing.

          2. Sounds like the VA in Houston.

    4. The most dishonest thing about Krugman’s VA comments is that he says the only reason care delays occur is because the VA is underfunded

      Which is a load of shit. $143 billion went to the VA last year; $52 billion of that was for medical expenses.

      Furthermore, Medicare and Medicaid serve as the same “government-run healthcare” example–and they collectively cost over $1 trillion a year now.

  5. This should be trumpeted from the rooftops.

    Bottom line for me is – will this be repealed, or will there be a bi-partisan (trigger word!) effort to “make it work” somehow.

    As long as there is a national health care system like this, insurance companies will prefer it to private solutions out of self-interest. Unless doctors and consumers start complaining enough and causing enough of a dungstorm to pressure more private-based options i.e. forming non-employer-based collective insurance groups.

  6. or will there be a bi-partisan (trigger word!) effort to “make it work” somehow.

    Every time I hear the term “bipartisan consensus” my ass starts to hurt.

  7. My friend broke his back in the Air Force on duty. Is he using the VA? Fuck no. He hates the VA. That should tell you something.

    1. I will beg on a street corner, sell a cornea or work for OFA before I would resort to the VA.

    2. I would die in a gutter in Detroit, before going to the VA. At least that way I would have some dignity.

  8. Please get out of the way and allow a free market in medical services and health insurance to develop, thanks.

    Sounds like a scam, to me.

    1. It’s true. Invisible hands and participants in the free market secretly benefit.

      1. You don’t know where those hands have been!

        1. In your markets, killing your gov’ments.

  9. As a Canadian with a mother, sister and girlfriend as nurses trust me single payer does not work. Basic economics and, for me, personal experience shows this; all the Canadian socialists say in response to the Frazier Inst’s stats is that a) they’re “big bad conservatives with a bias” or b) at least everyone can get medical help (I had no idea 3 week later Lazuras coverage was included)

  10. When the VA can be spun as a success, it is relevant to debate over socialized medicine. When the failure is too big to ignore, it is irrelevant. It’s just like a hot day being evidence of global warming, but a cold day just showing weather is not climate.

    And, before he gets here, hey Weigel.

    1. I think Dipshit must be on a chapter deadline on his stupid-ass prog rock book or something; he hasn’t been around here much the last few days.

      1. he’s probably in rehab recovering from his meltdown over the last few days.

  11. How could a bloated government bureaucracy achieve such low-cost success? As we found out recently, it’s by quietly sticking veterans on a waiting list and putting off their treatment for months

    Statistics were just as much a fantasy in their original version as in their rectified version. A great deal of the time you were expected to make them up out of your head. For example, the Ministry of Plenty’s forecast had estimated the output of boots for the quarter at 145 million pairs. The actual output was given as sixty-two millions. Winston, however, in rewriting the forecast, marked the figure down to fifty-seven millions, so as to allow for the usual claim that the quota had been overfulfilled. In any case, sixty-two millions was no nearer the truth than fifty-seven millions, or than 145 millions. Very likely no boots had been produced at all. Likelier still, nobody knew how many had been produced, much less cared.
    — George Orwell, 1984

  12. until the patients are far too dead

    I don’t think 2chili has disappointed me yet.

  13. Just a couple of years ago, Paul Krugman pointed to the Veterans Health Administration (VHA) as a “huge policy success story, which offers important lessons for future health reform.”

    Well, I’ll make Dr. Krugman and Physicians for a National Health Program a deal. I’ll be happy to support a law allowing them to use the VA Hospitals AND ONLY THE VA HOSPITALS for all their future medical care needs! I’ll help pony up the price tag. But they’ve got to restrict themselves to that particular care. Let’s see them put their money where their mouths are.

    1. Nah, he won’t for the same reason he will fly all over the world to fight climate change at expensive resorts. It isn’t enough of a crisis to expect him to sacrifice personally.

      1. What are you talking about, Johnny? Dr. Krugman assures us that, without the cost and drag of profiteers and wreckers, the VA procvides brilliant medical care more efficiently than any decrepit old private system. Dr. Krugman and Physicians for a National Health Program should be absolutely begging to take me up on my generous offer.

  14. Here’s the thing about single payer:

    The set of people actually receiving health care is smaller than the set of people anticipating a future need for health care, in most demographic situations.

    And the set of people who encounter the worst features of the rationed health care system is a subset of the second set.

    What single payer deals with the best is the first set of people’s neurotic anxiety.

    “How will I pay for health care in the future?” is a source of fear for millions of people. “Will I die if I have to wait 16 weeks to see an oncologist?” is a source of fear for thousands of people.

    That is why we shouldn’t let “democracy” have anything to do with property relations or economics. Because that ends up favoring policies that ameliorate the neurotic anxieties of large groups, at the expense of the real concerns of small groups.

    1. Aw, crap. I reversed my sets.

      And me with no edit button.

      Sorry, gang.

      1. Because that ends up favoring policies that ameliorate the neurotic anxieties of large groups,

        The feelz of the many outweigh the needs of the few.

  15. Hey, the ‘sign-ups’ weren’t as screwed as O-care!

  16. Where the hell is the reports that blame the tea party and republicans for this?

    The left wing media’s spin machine is late on this one.

    Maybe they are just looking for a fake scandal angle first….awaiting their marching orders from Carney.

    1. I wonder if it’ll be the “Obama could have done something if the obstrukkktionist republicans hadn’t stopped him”, like anyone would vote against appropriating more funding for the VA.

      *Of course, if the bill was to force the pentagon to allocate more funds there, it would be killed by neocons of both parties.

    2. Corning|5.20.14 @ 2:16PM|#
      “Where the hell is the reports that blame the tea party and republicans for this?”

      Shreek will be here soon telling us it’s Bush’s fault and Obo just hasn’t had time yet to fix it.
      But he is angry at it!

      1. Will he be posting that he has proof that Romney killed Christopher Stevens?

      2. Shreek will be here soon

        Shrike gets his Obama scandal marching orders from Bill Maher. That will take longer then soon.

        When is Maher’s next show?

  17. RangerUp Presents:

    The Wizard of VA

    You will like it. it involves cartoon animals that curse frequently.

    I know my audience here.

    1. The Wicked Witch of Westboro is pretty classic =


      “God Hates Queers
      America Protects Queers
      Veterans Protect America
      Therefore by the Transitive Property of Batshit-Crazy
      God Hates You!!!
      DIEEEEE!!!!!

  18. When I began reading about public policy nearly 50 years ago, I soon encountered revealing articles about the NHS in the UK. Waiting lists, and people dying while on waiting lists. Spartan service in many hospitals (and a much better quality of service in hospitals whose clientele was mainly educated and upper middle class). The best and latest American drugs not covered. It was acknowledged that the NHS refused certain treatments outright. For instance, the taxpayer stopped paying for kidney dialysis when one turned 65.

    A relative of mine moved her career to Germany. She told me that about 25% of Germans have private health insurance and use that insurance to buy a higher quality of health care in the private sector.

    The day will come when all people on Medicaid will be allowed to use VA hospitals. State & local governments will failing private hospitals, and run them along the lines of today’s county hospitals. Doctors in these hospitals will work on annual salaries. There will be “free” health care for all comers, with waiting lists etc. All households earning 80K/year will purchase private insurance, and use private hospitals. The American future is Germany. And I can assure you that scandal will be endemic in the American public hospitals of the future. Taxes will go up, quality and overall satisfaction will not. All that socialised medicine can deliver is health care with a zero out of pocket cost. Cheap, but neither Fast nor Good.

    1. Please explain why Germany spends 1/2 per capita what we do – and they have better results by most all measurements.

      Anecdotes are cute. But if we talk economics, their systems is way ahead of ours.

      The brits measures as good or better than ours – but not as good as Germany. Again, at about 60% of the price we pay.

      So are you saying we will have better care at lower prices in the future? That’s the German and Swiss way.

      1. We have nearly 5,10 times the population of many European nations. Federal, state, AND local levels spend an enormous amount of money to cater to individuals who pay no separate taxes to support education or healthcare (other than medicare). The quality of our healthcare is better, and more expensive.

        Do you think poor Mexican in America can just march into Germany and receive a buffet of a healthcare? What, paying almost 8 bucks a gallon of gas, fighting through their residency requirements, and finding a job in someplace where German isn’t spoken? Europe, now you can’t find xenophobia there (snicker).

        You can’t simply copy and paste any system abroad and hope that it works in a country like America, which is used to a certain flexible, piecemeal approach that caters to different groups and is less likely to accept built in cost to pay for things. Let’s say the price of gas went up to 8 bucks a gallon to pay for healthcare and education – that ain’t gonna fly here.

  19. Start working at home with Google. It’s a great work at home opportunity. Just work for few hours. I earn up to $500 a week. I can’t believe how easy it was once I tried it out. http://www.Fox81.com

  20. “Fast. Good. Cheap. Pick Any Two.”

    What if I only need it half-fast?

  21. You know what never gets brought up in these conversations?

    All of the free places that you can get excellent care like St. Judes Childrens Center.

    Seriously, they will pay for your travel costs, a place for you and your family to stay while you’re there, and even give you a food card. All from charity from private organizations.

    Why doesn’t Krugman bring these up? There is nothing you can possibly say bad about these places except that .gov doesn’t have a hand in it. Go figure.

    1. Can they do that with 10’s of millions of vets, uninsured, etc?

      Or are they limited?

      I’d guess the second.

      1. They’re limited, all goods are. That’s one of the main reasons you can guarantee everybody everything.

        But back to your point, no, St. Judes can’t fix the VA problem. That’s something that I argue with a lot of progressives about. They want me to come up with solutions to the problems they created.

        I guess if I had to come up with a solution with the present system, I would give each veteran some money to either buy insurance or purchase healthcare directly.

        I haven’t run the numbers, but if you divided the amount they spend now, by the veterans with the most urgent need, you could probably do a lot better than they are doing now.

        1. Ah, so progressives – the very same ones protesting the wars day in and day out – CREATED all the soldiers who need trillions in health care???

          Wow.

          1. Odd that they would be protesting…since nearly all the wars fought by this country in the previous century took place under Democrat and Progressive administrations.

          2. Come on Craig, don’t be so “My team”.

            When I say progressives, I really meant pro-gov people. Yes, Conservatives are just as bad.

            But to say progs don’t support wars is also blatantly false.

            1. I must live in a different world. You see, I have hundreds of friends who belong to anti-war groups, protest in the streets, help vets with non-violent ways to make a living, etc.

              “My” progressives don’t support wars. Or, if we want to be accurate, the right wing in this country supports them about 90/10 and the left wing maybe 25/75.

              That’s a big big difference and one any honest libertarian would give credence to.

              How many big anti-war protests have you been to? How much money do you donate to anti-war causes?

              I’ve been to a lot of protests (that’s how we petition the government), including some with over 1/2 million people. Mark my words…they were not conservatives or right wingers there.

              1. You are completely missing my point. You turned in support govt to now supporting wars.

                If you look back, my point was that progressives (or pro-gov people, whatever term you want to use) ask my for solutions to problems that they created, such as education, high public union pay and pensions, govt debt, etc.

                Why do you get into such a we/us thing?

                As far as supporting war, yeah, you may not support it yourself, but you’d never call BO out on the stuff he’s done, will you.

                And yes, GB was horrible.

              2. craiginmass….A Republican hates war, but thinks it is needed sometimes. He votes for someone whom he thinks, thinks like him. An anti-war protestor, such as yourself hates war, and thinks it is never needed. He votes for someone in a party that starts as many wars as the hated Republicans starts. He votes for a president who sends drones to countries which we are not at war with, and kills families, and declares victory! He votes for politicians who think war is good, provided it is their war, and provided it looks good in the polls.

                Can you not see your incredible hypocrisy? And, attending a protest? Wow! A big one, to boot! Progressive morals at work.

        2. My 85 y.o. mother (everyone’s a vet in my extended family) receives care from the VA in Seattle and everything’s referred to private care there. Works well, for now. Meanwhile all the VA in Loma Linda, Ca., and Fresno, Ca., have managed to do is deny care until I turned up inoperable and terminal as a result. Should’a gone north.

          1. My sympathies to you, man. The VA is real good at putting people off. And why wouldn’t they be? Their employees draw the same salary every two weeks regardless of how many patients they see or treat. They don’t have any incentive to work harder, and due to the public sector employee unions it’s damn near impossible to fire any of them.

          2. Take care, Briny.

      2. And my point was that Krugman brings up the VA as a good example of healthcare being provided when its obviously not. In my opinion, that makes him a hack.

        I don’t think anybody, however, could say anything negative about St. Judes and similar places, but because it doesn’t fit their agenda, it doesn’t get brought up.

        1. The thing about St. Judes is that their donations dry up if they don’t do a good job. That isn’t true of the funding for government run institutions.

  22. To bring just a bit of reality into this conversation – and one that libertarians hopefully agree with:

    We cannot afford the TRUE COST of sending our best, brightest and youngest to constants conflicts and then promising them we will spend anything and everything it takes to try and heal them for the rest of their lives!

    I saw a story on the tube about ONE Iraq Vet. He was blinded and also have TBI and PTSD. It showed his family in PA…poor folks from a rural area. They are sunk. There is no amount of care or money that the government can provide that will allow them to live a decent life.

    That’s 1 person. Now – multiple it by the many millions of Vietnam, Iraq and Afghanistan war vets.

    It’s one more “cost of war” what we don’t hear about in the regular budget. Sure, the VA does a decent job…according to the Vietnam vets I know. But they are trying to accomplish the impossible.

    Add up the trillions spend on the war, the money we will spend trying to fix the vets…and then add the cost to society and our economy of the loss or productivity and “happiness” caused by all of this.

    I’d say the true cost is incalculable.

    If you wanna blame it on the neo-cons who cheer for war (still – I hear it regularly), go ahead-a certain amount of truth to that. LBJ is just as guilty.

    I hope this is what libertarians agree on. If you can’t afford the true cost, then don’t start the conflicts….

    Until they land in Atlantic City, I’m not picking up a gun. The cost is too high.

    1. Craig, I totally agree with you and I don’t want to speak for everybody else, but I would say yes, going to foreign places with our guns is not something I support.

      I will admit, that initially I supported the Iraq war. Now, I don’t understand what I was thinking then.

      If I had my druthers, there would be no Army, Air Force, etc…

      1. The problem with realizing now that you shouldn’t have support it – is that it’s water over the dam.

        The money is spent. The harm is done.

        You’ve learned a lot because now you know how easy it is to convince people to do massive wrong! Also, you probably realize how much the private sectors benefits from war. I know a LOT of people who did very good business for those years…and they are not makers of weapons. Just about anything and everything does well because of the trillions being spent (borrowed money).

        But the bills comes due.

        Getting back to this article – war is always exciting to profiteers….I can only imagine if folks such as Romney and Bill Frist and Rick Scott (all big medical profiteers) were given the purse strings to even more taxpayers money – that is, they’d make money on the way to war, during the war and then after the war….all from the public coffers.

        Philosophy is a fine thing. But when I look at the situation of that blind vet and his family (x10,000), it’s hard to think of fiction writers (Rand) and other such authors…

        1. I agree Craig, it’s a tough situation and I can’t say I know the answers.

          I gave you what I would do, but I’m curious as to what suggestions you have.

          Also, and I tread here lightly, but it could be said that some of these soldiers knew what they were getting into. When I read that book by the sniper, Chris Kyle, it made me sick to my stomach. He grandstands how killing people is so awesome, but he leaves the details as to why to other people.

          I have to say, when I heard he was shot and killed by a fellow navy dude, I felt justice was served.

          1. First, to address the sniper – a recent (good) book on psychopaths makes the point that every modern society needs some. Not to say we need as many as we have – but we need some. And, these folks were generally not born as snipers….although they may have been born with tendencies that allow that. I had employees who were special forces and marines and they told me if ordered to kill their own mothers..they would do it.

            Training. That’s really a micro issue, though.

            My suggestion is very simple and very clear. There is nothing wrong with VA which can’t be fixed or improved.

            The problem is in the quantity of clients. You have to fix problems closer to the root. It’s too late once we have tens of millions of citizens who need care due to decisions made decades ago.

            1. The guy totally enjoyed killing people. He bragged about shooting somebody that was making faces at him.

              He broke into people’s homes, kicked them out, and then stole their stuff. Why do we need that?

            2. You still haven’t provided an actual suggestion on what you would do to help the current situation.

              You totally dogged me for saying it’s water under the bridge, but you’re doing the same thing.

              1. Well, fixing the current situation – as-is, would require more money, more resources and more oversight.

                But the American people and our representatives can’t do that.

                Asking me to put humpty dumpty back together again would be like yelling at me to fix the vet who took a direct hit from an RPG. At that point, there is no answer worth discussing.

                The human condition – above most animals – is that we have the ability to foresee and plan. That’s what took us out of Africa – the ability to store water and food at certain locations so we could forge on.

                Yet today you ask “What would you do if stranded 500 miles from food and water?”.

                Our ancestors knew better. We should too.

                1. Very difficult to unmake an omelet.

  23. When you don’t understand that prices and profits aren’t immoral artifacts of humanity’s exploitative past, but information regarding where human effort is most valued by people, you’re not going to understand why getting rid of the price system always results in a subpar and usually pitiful product. That simple realization is why a fourteen-year-old child could be a better economist than half the Nobel-ish Laureates of the past generation.

    I’d like to see a whole series of articles on this point, dredging up salient writings by everyone from Hayek to Mises to Rand to beat the dead economic horse of socialism until the world denounces nationalized medicine or I feel better, whichever comes first.

    1. You are correct. It’s called a feedback and it allows systems to self correct.

      It can be applied to most any system, from very complicated to very simple.

      When you kill feedback, the system will usually self destruct.

    2. This is very simplistic. Take a sick billionaire and tell him it’s 500 million for a heart operation to make him good as new and he will value the price.

      Take an average person and give them the same price and it’s a death sentence.

      No one is saying to get rid of the price system. It works within the proper bounds of regulation. I’ve sold on ebay and amazon from day one. The systems are simplistic – but they work because:

      1. You are told of the new and average price of the item beforehand. In larger schemes, this would be called “disclosure” or “regulation”.
      2. You are bound by the big corporations lawyers and agreements – I just had a perfectly good camera returned to me before it even arrived at it’s destination. That’s big-time “regulation”.
      3. Reversibility – any and all transactions can be charged back days, weeks and even months after they happen. In fact, my bank told me even a certified check can be reversed months later – again, this is heavy “regulation”.

      You’d be wrong to think that even 2% of liberals and progressive advocate the type of socialism y’ll rally against! You made up your own enemy and are shadow boxing!

      All the libs I know work hard – many are in business and many write, invent, manufacture, build, etc….and they work within the “free market” to whatever extent.

      The difference is that they don’t build churches to it and pray to it. They understand that regulated markets work best in our complex world.

      1. Every regulation, almost by definition, has a cost.

        Let me ask you this, I get cut, should I have to go to an ER or clinic just to get stitches.

        If there is a person that is trained to give stitches and has a business just to do that and would charge $40 to do so, why I can’t go there instead.

        No insurance, little cost, very efficient, however, because of regulations, that would never happen in todays world.

        Every regulation has a cost to it and if you can’t admit that some/most are un-necessary and that things self regulate, well, then you are being dishonest.

  24. I’ve had military care which is basically socialized care and here’s what I’ve seen.

    Emergency care is pretty good, and it’s comforting to know it’s covered.

    Even though it’s pretty good they still have to outsource to civilians when they don’t have experts.

    Non-emergency care is pretty bad. It’s common to joke about going to get vitamin “M” (Motrin) because it’s what you get for everything. I’ve had headaches daily for five years. They tell me it’s allergies, when the prescription doesn’t work I get a new one. There is no drive to actually solve problems. They come up with a diagnosis and you’re out the door. If it was a civilian there would be a price for failing to come up with some solution or theory by losing business but since it’s military I have no choice. I will see the same doctor.

    My wife was in the military and they couldn’t figure out why she had abdominal pains so they kicked her out and gave here separation pay. For another 6 years military doctors couldn’t figure it out and decided it was psychological. We went through the long process (almost a year) of getting approved to see a civilian expert in abdominal pain. In one appointment he figured out the issue and a cure. She has been pain free for 4 years. Maybe that’s a success since the military paid but it seems to me if the military or socialized care was the only choice these experts would not exist.

    1. People take advantage of the “free” care. Many go to appointments over nothing, build retirement by cataloging non-existent problems, and use physical and mental causes to avoid work or get medically separated and collect retirement. Basically, anyone willing to take the time can gain military retirement with no penalty because appointments are free. People do take advantage.

      The system is inefficient. Let’s not forget the military essentially only services relatively young healthy people and their families. The price should be lower. After seeing my doctor I sat for another 30 minutes as he entered information from a long psychological questionaire (unrelated, the questionaire is now required at every appointment for apparently any reason). He said he was required to enter the information himself. It would seem that using a highly paid doctor for data entry a HS kid could do would not only raise costs but reduce the amount of people he can see.

  25. Advanced medical care costs a lot of money. Delivering it quickly costs more.

    The sad thing is that this need not be the case. If we made the government fuck off and quit trying to kill us under the avalanche of regulations, normal market forces would cut those costs drastically over time.

    -jcr

  26. I retire from the Army on 1 Oct, because my choice to retire was made only a few month ago. I don’t have enough time for the Benifits on Discharge program, so I will retire and then begin my evals for disability. I am expecting to wait a year before I recieve any disability compensation

  27. Ask Stefan Molyneux about the wonderful Canadian system. Almost killed him.

    1. Can you compare that to the Cuban System?
      The Somalian System?

      Or, your perfect idea of the libertarian system (a real world example)?

      Many here seem to use a standard of perfection – as if anything short means we must cast off the lessons of 600 years of (enlightenment) history. That’s not the way the real world functions – in the real world, you must weigh things in a comparative sense and then come to a logical and “reasoned” conclusion based on choices.

      Anyone can be a critic. The question is whether you can do better.

      1. Craig, simple question, can you at least cede that the govt run VA system is very crappy?

  28. Here are a few huge savings that would help bring the cost of medical care down such that Fast and Good are more likely in more situations.

    1. Anyone on the dole: vets, seniors, welfare recipients, don’t first get to see a doctor. They first get to see a nurse. All the dog bites, tetanus shots, ear cleanings, ankle sprains, etc are not treated by a person with 12 years of medical training, but by someone with 5.

    2. If you are on the dole, you can’t sue, unless for egregious reasons. And, the amount you can sue for is actual losses, and a prescribed amount for pain and suffering. This reduces the amount you must pay doctors.

    3. Then offer a low-cost, no frills, nurse first, can’t sue, generic drugs, government run health care insurance plan. Make it a basic plan that doesn’t include chiropractic, dentists, eyeglasses, and so on. This should provide a valid lower cost alternative to the overly expensive private systems, which should cause competitive pressure on the privates to offer a similar plan. They’ll do it better. Overall, costs should come down.

    4. Offer incentives for staying in shape, not being obese, not smoking, no illegal drug use, and for not using the system, in the form of reduced premiums in the government run cheap system. If you don’t see a doctor in the previous year, your premiums are 25% less. If you’re not obese, stay in shape, etc., give similar savings.

    Unless you bring the costs down nothing really is changing.

    1. Overall I agree that we need to bring costs down. but I have couple comments:

      1. Most Vets and seniors are not on the “dole”, Seniors paid into medicare for the last 50 years so that when they retired they would have health insurance. As for Vets, part of the agreed upon compensation package for risking their lives for this country was that they would have any injuries incurred as a result taken care of. The VA is doing a terrible job of this, but is very cheap.

      2. “you can’t sue, unless for egregious reasons” What is egregious? Any stats for how many suits are for frivolous reasons? Caps on damages could bring down costs, but aren’t lawsuits the free market answer to civil infractions?

      All of your responses only apply to the the demand side of things, what we also need to do is increase supply. That would help everyone. More doctors, less student debt for the doctors, more hospitals, and more competition.

      1. People being initially treated by nurses, not doctors, increases supply.

        I didn’t mean to denigrate vets by the use of the word ‘dole’, and it did I realize. I just meant anyone the government pays for.

        My Dad, by the way, was a 100% disabled 2nd world war vet. I grew up with the whole mess of problems associated with that, including alcoholism, etc. So, I’m sympathetic to vets.

  29. If the government offered a really simple, stripped down version of health care, available to everyone, this would be attractive to a lot of people. It would then cause a competitive reaction by the privates, and they too would offer this.

    We need a ‘health care’ system, not a disease and drug selling system, which is what we have now. PSAs over ten years extolling the virtues of health and staying in shape would do a lot towards cutting health costs.

    At least half of health costs are self-inflicted. Probably more. Yeah, we all have some time bombs ticking in us, but most health problems occur because we didn’t look after ourselves. There is a huge savings waiting to happen if we can sell this to the public. It works. But, it takes time. It worked with smoking and drunk driving, and in Canada it worked with getting in shape. But, it takes about 10 years or more, depending upon the issue.

  30. VA hospitals are similar to Britain’s National Health Service:

    “Telling harsh truths about the NHS is a bitter but necessary pill” http://www.telegraph.co.uk/hea…..-pill.html

  31. The people who faked waiting times, like that monster in Phoenix, should be headed to prison.

    But to say that this “proves” that socialized medicine doesn’t work is a stretch. It proves that the VA is broken.

    US health care costs are 8k per capita and the OECD countries are below 5k per capita (in some cases well below). This is pre-Obamacare.

    Here is a study of wait times for care:

    Germany took the top stop on the list with 76 per cent of patients being able to see their doctors same-day or next-day, followed by New Zealand at 72 per cent and Switzerland at 69 per cent.

    The U.S. ranked second last in the same category, with 48 per cent of those polled south of the border saying they could get a same-day or next-day appointment.

    Read more: http://www.ctvnews.ca/health/c…..z32SDmY1rP

    Not too impressive.

    The US did better with elective surgery wait time at 92% satisfaction. But Germany did better at 94% satisfacation.
    http://getbetterhealth.com/wai…..2010.02.02

    Some of these systems like Switzerland are private and some like Germany’s are public. Both work.

    Sweden is also having good luck experimenting with more privatized care.

    The bottom line is that in a magazine called reason, you would hope for articles that assess what works and leave it at that.

  32. …that in a magazine called reason,…

    Drink?

  33. First comment, why not close the VA hospitals and have taxpayers just foot the bill for care at private facilities? The rates have already been established for Medicare. It surely would be less expensive than the bloated mess that the VA has been revealed to be.

    Second comment: Is the whole VA system a fraud, designed to fail? I was seeking a vet’s widow’s benefit and told the wait would be 8-12 months. But a call to my congressman got results in two weeks. Wonderful? HELL NO! Is this not a form of vote buying? You must kneel before your “elected representative” to secure that which was earned, often at the ultimate cost? Everybody has a low opinion of congress EXCEPT of their own congressman who provides such services. If your congressman and mine would fix the system, that obeisance would not be required. How about conveying this idea far and wide, and just maybe this phony “help” would give way to fair and equal service for all who have born the battle.

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