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Naturally, then, politicians — Republicans in particular — are determined to scrap what works and promote what doesn’t. And that brings me to Mitt Romney’s latest really bad idea, unveiled on Veterans Day: to partially privatize the Veterans Health Administration (V.H.A.).
What Mr. Romney and everyone else should know is that the V.H.A. is a huge policy success story, which offers important lessons for future health reform.
Many people still have an image of veterans’ health care based on the terrible state of the system two decades ago. Under the Clinton administration, however, the V.H.A. was overhauled, and achieved a remarkable combination of rising quality and successful cost control. Multiple surveys have found the V.H.A. providing better care than most Americans receive, even as the agency has held cost increases well below those facing Medicare and private insurers. Furthermore, the V.H.A. has led the way in cost-saving innovation, especially the use of electronic medical records.
What’s behind this success? Crucially, the V.H.A. is an integrated system, which provides health care as well as paying for it. So it’s free from the perverse incentives created when doctors and hospitals profit from expensive tests and procedures, whether or not those procedures actually make medical sense. And because V.H.A. patients are in it for the long term, the agency has a stronger incentive to invest in prevention than private insurers, many of whose customers move on after a few years.
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And yes, this is “socialized medicine†— although some private systems, like Kaiser Permanente, share many of the V.H.A.’s virtues. But it works — and suggests what it will take to solve the troubles of U.S. health care more broadly.
Yet Mr. Romney believes that giving veterans vouchers to spend on private insurance would somehow yield better results. Why?
And the international evidence accords with U.S. experience. The most efficient health care systems are integrated systems like the V.H.A.; next best are single-payer systems like Medicare; the more privatized the system, the worse it performs.
Idiot-child goes on to claim that Republicans reject evidence, when he himself is rejecting evidence. He claims that the motivation is blind partisanship, when it is his own blind partisanship that tells him "fuck the veterans, so long as we can declare that we have socialized medicine in the form of the VA and lie and claim that it's a wonderful success."
Nothing Paul Krugman has ever said has ever been correct. NOTHING. Not one single thing. EVER. The guy is a hypocritical moron of the highest order, and deserves as much derision as the entirety of the universe can heap upon him.
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