VA A Preview of Single-Payer Politics

Published March 24, 2015

It’s been a while since I’ve heard single-payer advocates tout the VA as “proof” that government-run health care works. I’m guessing the recent scandals may have something to do with that, but those will likely fade from memory soon and we’ll once again be hearing about the VA and the promise it holds as a model for the U.S. health care system.

And they’re right, just not in the ways they think.

One of the things that will happen when the government directly controls health care delivery is that medicine will be heavily influenced by politics. An AP story this morning drove that home to me:

VA says it will relax 40-mile rule for private medical care

Responding to pressure from Congress and veterans groups, the Department of Veterans Affairs is relaxing a rule that makes it hard for some veterans in rural areas to prove they live at least 40 miles from a VA health site.

The change comes amid complaints from lawmakers and advocates who say the VA’s current policy has prevented thousands of veterans from taking advantage of a new law intended to allow veterans in remote areas to gain access to federally paid medical care from local doctors.

The VA said it will now measure the 40-mile trip by driving miles as calculated by Google maps or other sites, rather than as the crow flies, as currently interpreted. The rule change is expected to roughly double the number of eligible veterans…

The first five words are key: “Responding to pressure from Congress…” Veterans are fortunate that they are a relatively influential interest group, and Congress will indeed respond to their needs. But imagine the health needs of a less influential or sympathetic group were being ignored by the bureaucracy of a single-payer system- what then? Under single-payer, the short answer is, “tough luck.”

That’s not a health care system anyone should want, yet some do.

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