The U.S. Department of Veterans Affairs medical system—touted by some advocates of reform as a model for how government-run health care could work—in fact exposes deep flaws in the government-run health care model, policy experts say.
Edmund Haislmaier, a health care policy analyst at The Heritage Foundation in Washington, DC, notes the VA provides only limited care and already refuses treatment to some of America’s veterans.
“The VA does not have the capacity to handle all of America’s uninsured,” Haislmaier said. “The system provides good care, but it limits care, and it helps those it cannot assist get their needed care elsewhere.”
Diana Furchtgott-Roth, a senior fellow at the Hudson Institute, agrees, saying such a system would unnecessarily limit people’s choices and cost more than it should.
“The uninsured should have a choice of plans,” Furchtgott-Roth said. “When poor people need food, we don’t give them groceries, we give them food stamps to use at whatever store they choose. Some might find the VA perfect, but others might want a catastrophic health plan at lower cost.”
Joseph Antos, a health care specialist at the American Enterprise Institute in Washington, DC, says the VA has serious capacity and service issues it would have to resolve if tasked with providing health care coverage to the uninsured.
“The VA’s specialty is treatment of people with war injuries,” Antos said. “There, they provide superior care—[but] not too many of the uninsured have shotgun wounds. The VA medical system simply does not have the capacity to treat all of the uninsured. Short of the VA system buying up, and also building, many hospitals and hiring most of the doctors in America, it cannot do this.”
Haislmaier says if the VA health system were tasked with taking care of the uninsured, it would inevitably have to start rationing medical treatment.
“It would be just like the British National Health Service, and rationing would then exist. This option is essentially building a British National Health Service kind of approach,” Haislmaier said. Such an expansion, he says, “would require huge amounts of time and money, making this option completely implausible.”
Furchtgott-Roth says while the VA system has in general provided good care, it has no reason to ensure taxpayers’ health care dollars are spent wisely. That’s true of other government-run plans, she says.
“A government-run system like the VA does not give an incentive to contain costs, as would a catastrophic health insurance plan and an HSA,” Furchtgott-Roth said. “Inevitably, costs would rise.”
Thomas Cheplick ([email protected]) writes from Massachusetts.