James Taranto of The Wall Street Journal, demonstrating what they say about a broken watch, is right on one point. His column carries the subheading of “Not long ago, the left raved about the VA.” While this is widely true about the left, there was at least one exception (myself). A few years back, many on the left were exclaiming about the quality of the VA system based upon quality evaluations. Evaluations of quality in health care currently has many limitations, and was downright primitive a few years back. I pointed out several times, such as here, that the indications being looked at were not a valid means of determining quality health care.
Now we are learning that there is an even more serious problem beyond the fallacy of accepting computerized data as truly indicating quality health care. If the allegations we are now hearing are true, there is also the danger that information entered into computer systems might not even be accurate.
Suddenly, with the recent revelations about the VA, the line from the left has changed to (more accurately) saying that The Veterans Affairs Scandal Was Decades in the Making.
Of course this doesn’t mean that that the right is correct in their interpretation of this scandal. Many are using this to attack the idea behind the Affordable Care Act. We are comparing two entirely different ideas here. The VA is a rare case of government actually providing health care while the ACA involves using private insurance (or in some cases Medicaid) to pay for private medical care. The ACA became necessary in order to provide necessary regulations to curb the abuses of the insurance industry, along with providing support for those who could not afford health care coverage.
If government has problems in providing health care, as with the VA system, the problems in the private insurance industry have been far worse. In the past most areas had one or a very small number of insurance plans dominating a market. Thanks to the Affordable Care Act, we are having more insurance companies planning to enter many markets, which should lower prices. In the past, private insurance companies found it to be more profitable to deny coverage to many people with medical problems, including finding ways to terminate coverage should a policy holder develop a serious (and expensive) medical problem. Here is a report of just one example of an insurance company targeting women with breast cancer for recission of policies.
Obamacare provides needed reforms to encourage more market competition and eliminate this type of abuse from the insurance industry. It is an example of where government action is necessary and beneficial. We also have an example in providing coverage for medical care where government does a better job than the market. People on Medicare have a choice of the government program, which pays private physicians to provide medical care, or Medicare Advantage plans in which private companies handle the payment instead of the government. It costs from 13 to 19 percent less to over the same Medicare population under the government plan than with private insurance plans. The added money going to the private Medicare Advantage plans primarily goes towards increased profits for the insurance companies. Medicare might also be a better, and more cost effective, model to care for Veterans as opposed to the government attempting to maintain a parallel health system.
The lesson of the VA might be to question having the government actually provide health care, although Republicans certainly share the blame here considering their long history of opposing funding which Democrats have backed for the VA. Regardless of whether this is true, this has no bearing as to the benefits of the Affordable Care Act along with government programs such as Medicare which handle health care payments as opposed to directly providing health care.
Originally posted at Liberal Values