The ongoing scandal at the Veterans Affairs Department has forced the idea of government-managed health care into the spotlight, with opponents pointing to the VA’s failures as an example of what could happen if the country were to adopt government run health care or a single payer insurance policy on a larger scale.
For years, liberals in support of single-payer have pointed to the VA as a model for what a larger system could look like. New York Times’ columnist Paul Krugman called the Veterans Affairs Department’s “success story one of the best-kept secrets in the American policy debate.” Krugman wrote in 2006, “The secret of its success is the fact that it's a universal, integrated system.”
Now, issues of severe mismanagement have emerged with reports alleging that fudged numbers and long wait times have resulted in the deaths of at least 40 vets who did not receive timely treatment in one Phoenix VA hospital. Reports of suicides possibly linked to neglect and similarly long wait times and management issues are cropping up at other VA facilities across the country. Conservatives and opponents of government-managed care are blaming the large agency.
Larry Kudlow of the Kudlow Report was quick to pounce on the VA scandal as testament to what goes wrong when you adopt socialized medicine. “This VA scandal is a reminder that government-run single-payer health care does not work.” Kudlow said. “The long waits for treatment, with excessive delays resulting in as many as 40 deaths, are a tragically predictable outcome. This is the result of bureaucratic rationing, price controls, inefficiencies and the inevitable cover-ups.”
However, single payer advocates say what’s happening at the VA isn’t relevant to single payer at all, since the VA is completely government-run and in a single- payer system, the delivery of care would remain largely in the private sector’s hands.
In a single payer system—known as Medicare for all—the government would pay doctors and hospital bills. It would be funded through taxes.
Advocates have long said adopting a single payer system is the best solution to curb the country’s swelling health care spending. The Affordable Care Act was intended to address that, but they say it doesn’t go far enough. They point to Canada and Taiwan that have controlled health care spending inflation. One study published in the journal Health Affairs shows that American doctors spend nearly four times as much money interacting with healthcare payers than doctors in Canada.
Last year, Sen. Majority Leader Harry Reid said in an interview with PBS that Obamacare is a “step in the right direction, but we’re far from having something that’s going to work forever.” When asked by a panelist whether he meant that ultimately meant the country would adopt a single-payer system, Reid said, “Yes, yes. Absolutely yes,” according to the Las Vegas Sun.
Of course, a single payer system is highly unlikely to be embraced by a Congress that is still fighting over the ACA. House Republicans have voted at least 50 times to dismantle the law and they’ve made attacking the law one of their primary campaign strategies going into the 2014 midterm elections. Instead, advocates say single-payer is more likely to start at the state level.
Sen. Bernie Sanders, the independent Senator from Vermont and potential 2016 presidential contender, has been a leading advocate of a single-payer health care system for years. Last week, Sanders led a panel discussion on Capitol Hill over the future of single payer, since his home state of Vermont is expected to serve as a single payer guinea pig for other states. In 2011, Vermont passed legislation that would make it the first state to create its own single payer system called Green Mountain Care. It's set to launch in 2017.
The most important thing is to show people that change is possible,” Gerald Friedman, an economics professor from the University of Massachusetts-Amherst, said at the panel discussion. “That’s the role that Vermont has had – showing that it’s possible to get something done.”
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