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Posted by on May 23, 2014 in Health | 23 comments

Liberals Were Wrong About The VA, But Conservatives Remain Wrong About Health Care Coverage

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

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Copyright 2014 The Moderate Voice
  • dduck

    The WSJ? “The Wall Street Journal is a biased right wing source”, and worse a repeater of Rep talking points and” made up horror stories”. LOL.

  • the problems in the private insurance industry have been far worse.

    Absolutely, there was the entire death panel meme. I have lost two friends and a cousin because the insurance companies refused to authorize tests that may have identified conditions that might have saved them.
    The real problem with the VA is that Congress has not given the resources although the fact that it has become a bureaucratic boondoggle probably contributed to it.
    I was pretty much forced into a Medicare Advantage plan because most of the doctors and clinics around don’t accept straight Medicare anymore.

  • sheknows

    “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”
    Most are just using it to attack Obama…

    I wrote once before that these problems didn’t exist in a vacuum.
    Inadequacies throughout the entire VA system have been evident for many, many years. I think the Republicans will have to admit their fair share of neglect at the top.
    Each VA had it’s own agenda and I would never expect for any president to know about these ongoing failures, I would expect them to have staffers who do. ..and did…and said nothing.

  • dduck,

    Did you miss the point that Taranto was right on one point, like a broken watch is correct twice a day, but beyond that is wrong on the bigger issue?

  • dduck

    There are so many “points” to miss in the fog of obfuscation that I may have missed that one.
    However, some points are like a clock that is running fast or slow, it is never correct, and that it thinks it is the only clock that tells the correct time is its biggest flaw. (All the other little clocks laughed at its hubris- Unknown.)

  • SteveK

    Thanks dduck, and I mean that.

    The depth and breath of ignorance about the VA System and how it works (and works so well on so many levels) is simply astounding and I have no interest in participating with those who seem to be so gleeful regarding their intentional ignorance.

  • Props to Ron for hinting that all “right wing lies” are not just right wing lies. Sometimes common sense sounds like lies to partisans. I am guessing that about 10% of our conflicts are a result of an actual difference of opinion and 90% are a result of ‘tone of voice.’

    I will continue to separate the ACA failures/successes from the VA failures and successes. However, what we are seeing is an example of systemic issues that plague enormous federal programs. My inclination is to lean toward state run programs.

    You backward peeps will be California in 20-30 years 🙂

    Do some additional lifted research and grow up. You don’t need Congress to get your house in order.

  • Kevin,

    Most right wing lies are right wing lies. We had one minor point in which the conservative columnist is right, while he and his allies are wrong on the big things. Most of the differences between left and right are true differences in opinion, and on top of it differences as to what the facts are. (Of course we know that reality has its liberal bias per Stephen Colbert.)

    The point is that there is a tremendous difference between the VA, which is run by the government, and the ACA in which the government is not running the health care, but instead placing new regulations on insurance companies, changing how insurance is purchased, etc.

    The part which was directly run by the federal government, healthcare.gov, certainly was a mess at first, but at least that appears to have been fixed. Some state run exchanges did better, but some did worse and they are giving them up in some states to use healthcare.gov. Plus the federal government appears to be learning. I read recently that they plan to have limited trials of the computer system for small business before going live nationally. Who knows why they didn’t do this with healthcare.gov.

    Do you really mean to be advocating state run systems in place of the ACA, or was that just a more general statement about state run programs in other areas? While some variation from state to state might work, I have my doubts that things would work smoothly with different health care systems in different states. Plus we know that if left to the states few would get it done, and many would outright oppose it.

  • Ron, I think that what most people don’t recognize is that that there is very little difference between government bureaucracies and private sector bureaucracies. Yes indeed bureaucracies are bureaucracies and made up of people trying to protect their turf and protect their own personal interests. I worked for several very large multinational corporations in my career and it was very frustrating.

  • dduck

    Agree.

  • sheknows

    Agree Ron. One reason may be that these large corporations like Kaiser Permanente and Alegent haven’t got their finger on the pulse of their hospitals. Often, they appoint medical doctors to run them and very often these docs may be great in scrubs, but can’t manage their way out of a paper sack. There is a lot of favors and a lot of politics in these places just like everywhere else..and that causes poor management.
    .

  • Ron,

    This gets to a major problem with conservative economic theory. Many conservatives would point to works such as Bureaucracy by Ludwig von Mises to argue that businesses receive feedback based upon profits and loses which lead to them making the correct decisions (or go out of business to be replaced by other businesses which will make the correct decisions). Lacking such management based upon profits and loses, he claims that all types of government bureaucracies lack the ability to manage their affairs in a rational manner.

    It doesn’t take any great economic studies to tell us that conservatives are wrong on this and in the real world bureaucracies in big business can be and often are as bad as government bureaucracies. Plus in the case of health insurance, the drive for profit led to a business model based upon denying care and dropping sick people. This might lead to higher profits, but shows that having a profit motive doesn’t lead to the best results.

    In many areas the market does do a better job than the government. A for profit shoe industry will probably do better than a government bureaucracy in putting out a wide range of shoes to satisfy consumers. I doubt we would all want to wear government-issued shoes. This doesn’t mean that there aren’t other areas which are handled better by government.

    There are real problems with any large bureaucracy, public or private, which is why I like Medicare as a better model than the VA. While Medicare does have its bureaucratic problems, it handles payment for medical services and the government doesn’t try to get involved with the far vaster matter of actually running a large system of hospitals. Medicare pays the bills and a wide range of individuals and institutions and provide the health care services.

    Getting back to the main topic of the article, conservatives are also wrong when they claim that the problems of the VA apply to the Affordable Care Act. One issue might be that the VA is a huge bureaucracy, but contrary to conservative claims that the ACA is a government take over of health care, the ACA neither creates a bureaucracy on the scale of the VA and does not have the government directly provide health care.

  • The point is that there is a tremendous difference between the VA, which is run by the government, and the ACA in which the government is not running the health care, but instead placing new regulations on insurance companies, changing how insurance is purchased, etc.

    Complete agreement.

  • slamfu

    Good luck getting the GOP base to notice that distinction. That being said, someday the left is going to make a push for single payer. It would greatly increase the strength of their case, and in fact would increase the strength of the overall concept, if the govt can get the VA working properly instead of a caricature of inept govt bureaucracy that is costing people their lives and providing extremely poor service to the rest.

  • slamfu

    Also, forgot to mention that this President is fully empowered to get this fixed. The GOP has tried to paint him as useless while tying his hands. Usually they are rigging the game and misrepresenting the results to confuse voters. In this case, they can and should go buck wild. Its a shame.

  • dduck

    Obama will do squat on ACA. The decades old rotten structure is too established and it would take a set. His speech in 2009 on the VA was nice as are all of his “hopes” and promises campaign gigs. That’s not saying that a Rep president could fix the problems, especially with an obstructionist house of the opposite party.
    Folks, money has destroyed a fairly good system, I’m afraid.

  • I assume you meant to say “do squat on the VA.” Agree it will be hard to do much with an obstructionist House, plus even if the Democrats keep the Senate the Republicans can still block anything by requiring 60 votes.

    dduck, do you at least feel a little more affinity towards Obama now that he is becoming a lame duck?

  • dduck

    No, see the Russians assessment of him.

  • That’s a shame. I thought you ducks might stick together.

  • DA DUCK

    If I am not mistaken that is how dduck is pronounced.

    Just wanted to clear that up.

  • dduck

    Ok, It is Sunday, and there are very few, if any, people on this blog, so I will tell my secret now.
    It is DDuck, which is an amalgam of Donald, Daffy, Dewy, Daisy and Duckman. All of these have attributes and failings that go to make up a total character.

  • I dig the dduck’s stuff.

    The whole enchilada.

    I am on the dduck train.

  • dduck

    Quack.

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