Letter: VA mess indicts ACA, single-payer
To the editor of THE EAGLE:
In the July 22 letter entitled "Two falsehoods on single-payer," Drs. Lotto and Kaplan, members of Physicians for a National Health Program, made two points. One was that the problems at the Veterans Administration are due to an insufficient budget combined with pay for performance which incentivized supervisory staff to lie about wait times. The VA leadership, testifying before Congress, said it had the budget to handle the claims. The VA medical facilities spending has risen by 193 percent (tripled!) over the years 2000-2013 even though, despite the recent wars, the number of living veterans has decreased.
Further, a decision to use pay for performance has to include audits that verify the data. It was management’s failure to have audits that are the root of the VA problem. A well-run business would not make this mistake. The VA is emblematic of what happens when the government tries to run something better run privately.
Their second point was that "Obamacare is a thoroughly privatized system." That isn’t true either. The two problems with the Affordable Care Act (Obamacare) are that it enables the executive branch to set rules determining what "acceptable" health insurance has to cover, which has increased cost and allowed rule-setting to further a political agenda, and it raised the income threshold for Medicaid. How is this private?
The legislation requires people to buy insurance and provides financial assistance to those who can’t afford it. Medicaid recipients could have just become part of that system, buying insurance through the exchanges and receiving full premium support from the government.
Instead, Obamacare doubled the number of people under Medicaid, which, as the good doctors know, pays pennies on the dollar to care providers. That forces doctors and hospitals to raise the prices on the privately insured.
Studies indicate that prior to the Obamacare 20 percent of the cost of private insurance was effectively compensating the providers for the shortfall from Medicare/aid. Under Obamacare, that compensation will become 40 percent. Why didn’t the Act replace Medicaid instead? Because the goal is to drive the system to single-payer and this inflation will become the motivation.
For those who think that doesn’t sound bad, look again at the VA. It is exactly what single-payer, run not as a business but as a benefit, will look like. Long waits, immigrant doctors, poor management -- ask friends in the UK if this doesn’t describe their system. It is a precise match.
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