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If you think the private healthcare system is immoral, you should take a look at the 100% government ran healthcare system that is the VA. You literally couldn'

If you think the private healthcare system is immoral, you should take a look at the 100% government ran healthcare system that is the VA. You literally couldn't make up worse things than their administration has been caught doing with little or to consequence. If the VA is the best the US government can do, with some of the most sympathetic citizens, then it is incapable of doing better than our private system.

e40 9y ago
This is one of the straw men that is often brought up. There are a million reasons why the VA is messed up, most of which have NOTHING to do with healthcare. Congress has underfunded our troops for decades, related to healthcare and not. Something as simple as body armor is often purchased with personal money. A woman that works for me is high up in the Marines and I hear stories that disgust me. I do not know how Congress gets away with this. The stories are out there, but the American people seem to not give a you know what. Please don't conflate the problems of the VA with Universal Healthcare.
- RangerScience 9y ago
  I haven't heard these stories and would like to. Where can I find more?
  - e40 9y ago
    Here's one https://www.military.com/daily-news/2016/02/26/lacking-basic-gear-special-operators-stuck-buying-own-equipment.html https://www.military.com/daily-news/2016/02/26/lacking-basic... Do a search for "us troops buying own". You'll find lots.
- imglorp 9y ago
  I'm curious why there are more than one public health system. There's the VA, the IHS (Indian Health Services), and of course medicare/medicaid. Why are these not all the same system? It's not like we're different species.... edit, If this is a benefits/paperwork thing, then shouldn't that be separate from the care provider network?
  - Hozzle 9y ago
    Fun fact: Those systems cost more tax money than most other developed nations spend on full UHC. Either per person or as a per cent of GDP.
  - e40 9y ago
    It's the nature of the beast, in the US, I think. I believe if there were a Universal system, all of the others would go away. That would be a good thing.
fergie 9y ago
"If you think the private healthcare system is immoral, you should take a look at the 100% government ran healthcare system that is the VA" Or you could actually read the linked Economist article
SideburnsOfDoom 9y ago
But other countries can do this. So the hard question then is, why is the US government so uniquely bad at doing things that it doesn't want to do?
- knz 9y ago
  Is the issue the US government? Or the lobbying to protect special interest groups?
  - SideburnsOfDoom 9y ago
    From a far enough distance, they look like interconnected parts of the same system.
monocasa 9y ago
The VA was a good system not too long ago, but the past couple decades has seen it get extremely underfunded in a starve the beast strategy. It used to be a black eye in the Republican's view of healthcare, but they sure fixed that.
- Hozzle 9y ago
  The VA is much the same as all the other US healthcare setups. A system with the controls taken off, trying to operate in a jungle of different systems and bureaucracies. IN most nations with a VA-style (Beveridge) setup, there is great media interest in the least failing or hint of scandal. And they mean politicians lose a lot of votes. The VA hasn't enjoyed that feedback system until recently.
- rukittenme 9y ago
  What makes you think universal healthcare would be any different? If you recognize the VA's failings, and you blame Republicans for it, what's to stop them from doing it to every "good" idea you have? If a few motivated politicians can ruin the lives of millions those politicians shouldn't have that power in the first place.
  - Sangermaine 9y ago
    >What makes you think universal healthcare would be any different? Because America isn't the entire world and there are many places where socialized healthcare of various forms have been very successfully implemented for a long time. The idea peddled by conservatives in America that the only options for socialized healthcare are inevitable failure or tyranny is simply, demonstrably nonsense. It's exactly this kind of parochial, limited mindset that needs to change.
    - rukittenme 9y ago
      Oh yes. Everyone who disagrees with me has a limited mindset. You could have used your open mind to read about a European (within this comment thread) who is having trouble with "the right" in his country: > This is a principal reason why the US was crossed off my list of countries where I would work and live. I fight against the privatization that is occurring within healthcare in my native country, Iceland. We used to have the Scandinavian model but decades of attacks from the right-wing Independence Party has broken our healthcare system. The next phase described by Chomsky is handing it over to private capital since people are outraged that it doesn't work anymore. I'm sickened by the development and feel a little like an old man screaming at the desert wind. It's exactly your kind of Utopian mindset that needs to change. Please read the news of countries other than the US. You might be surprised at the amount of controversy that surrounds universal healthcare systems.
Pharylon 9y ago
The VA has gotten a lot of bad headlines, but I work with a vet who absolutely loved the VA. He brags about the quality and speed of his healthcare all the time. This is in Charlotte, NC. Different offices might be different.
- mter 9y ago
  The thing with the VA isn't that it's all bad. It's that the percentage of completely inept people seems higher than in a normal hospital. Normal hospitals don't have multiple scandals of reusing insulin pens on different people, reusing colonoscopy bags, killing people, paralyzing people and periodically losing all of our records. A lot of veterans who are covered by the VA are like me. Technically covered because of service connected disabilities, but I will never use it.
  - dnomad 9y ago
    Again, this is not true. Read the studies comparing VA care to private care. You're actually better off going to a VA hospital than most private hospitals.
    - mter 9y ago
      I've been to a VA hospital. My brother/dad/uncle have been to the same VA hospital. Our experiences have all been poor. If you were told that you'd get an appointment some time in the future and they sent you a notice randomly in the mail a few months later, you probably wouldn't be happy with the service. If your doctor was over an hour late, you wouldn't be happy. If you had a friend that was paralyzed after a spinal tap (my dad's buddy) then you probably wouldn't hold the VA in high regard. You are the first veteran I've ever met who had good experiences at the VA and who doesn't know anyone that has been crippled by the VA.
      - Clubber 9y ago
        >If your doctor was over an hour late, you wouldn't be happy. Doctors aren't on time in privatized offices either. It's always a long wait for me. But you're right about the not being happy about it. >If you had a friend that was paralyzed after a spinal tap (my dad's buddy) then you probably wouldn't hold the VA in high regard. Yes, but that happens in private hospitals as well. They aren't all that great in the US either. >f you were told that you'd get an appointment some time in the future and they sent you a notice randomly in the mail a few months later, you probably wouldn't be happy with the service. Ya that sucks. Private industry has solved the scheduling problem with DSS and template based schedules. My uncle didn't have a good experience with the VA either. He had dementia and the nurse questioned him about it and he said "I have diabetes," which he did, but he didn't know what was going on. The nurse of course said, "we don't treat diabetes," or something like that and sent him away. All the while his sister was telling her about the dementia, she just didn't want to hear it. I could tell you horror stories about private hospitals too and how after being admitted, they shipped him to a nursing home an hour away wearing nothing but a gown in winter. No calls, no nothing. I guess the bottom line is right now, the US sucks at healthcare, period. I'm sure being a highly politicized wedge issue doesn't help matters much. (The VA, universal healthcare, skyrocketing costs in the private industry, etc).
simonbarker87 9y ago
The point isn’t really to compare it to the current best that the US governmeny can do. With the US’s historic view on universal/“free at the point of access” health care it is hardly surprising that the VA is a mess. What you should compare it to is the best that other governments have done, in which case there are many examples of excellent universal healthcare from public insurance based all the way through to the UK’s NHS - which does an excellent job despite below inflation budget increases and endless media hyped scandals.
Symmetry 9y ago
The VA is far from perfect and is really noticeably worse than many other country's nationalized health systems. But it's not obviously worse than private health insurance in the US and generally veterans are as happy with their health care as other people. I think the VA example tends to dispel the notion that single payer would save that much money but it works about as well as other approaches, of which the US has way too many.
- chimeracoder 9y ago
  > The VA is far from perfect and is really noticeably worse than many other country's nationalized health systems. But it's not obviously worse than private health insurance in the US and generally veterans are as happy with their health care as other people If you want to convince people to support a single-payer system, this is quite possibly the worst argument you could use. Any veteran or anybody who has had any experience whatsoever with the VA will instantly assume you don't know what you're talking about. The VA is, on the whole, atrocitous. There are a couple of regions which do relatively well, because the system is federated, but on the whole, it's almost universally considered to be a disaster, even by people who are supportive of the program's existence. If you want to convince people that a single-payer system wouldn't end up like the VA, start by acknowledging the problems with the VA, not denying them.
  - dnomad 9y ago
    > The VA is, on the whole, atrocitous. There are a couple of regions which do relatively well, because the system is federated, but on the whole, it's almost universally considered to be a disaster, even by people who are supportive of the program's existence. Yeah, this is bullshit. The VA and its effectiveness has been studied quite a bit. Its quality has been found to generally exceed the quality of private hospitals. The media and conservatives paint this idea that the VA is "atrocious" but it has no basis in reality. The scientific evidence for universal healthcare is overwhelming. The only "controversy" -- exactly like the "controversy" around climate change -- exists within people who have carefully decided to ignore the evidence and buy into the propaganda. The problem here is not the VA. The problem here is that many Americans have abandoned reality.
lg 9y ago
no reason why single-payer means government-run hospitals
Fomite 9y ago
For a large number of different outcomes, the VA is superior to private care. It has a disproportionate footprint because "The VA does something bad!" is national news, while "SmallSizeMidwestCity Memorial does something bad!" isn't. It's not perfect, by any means, and struggles with cost constraints (veterans are sympathetic, but sympathetic doesn't mean well supported), but many of its quality outcomes are superior. See, for example, https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2618816 https://jamanetwork.com/journals/jamainternalmedicine/articl...
- maxsilver 9y ago
  Your getting downvoted for this, and I have no idea why. Have other folks actually stepped inside a VA facility? Many of them are old/outdated/underfunded it's true. But some of them truly do offer superior care to a typical private hospital (in staff, facilities, and outcomes). The VA system could use significant improvement, absolutely. But if the fear-mongering 'worst case scenario' is that everyone gets VA levels of healthcare, that's still a huge win for all of America. That's a great baseline standard to start with, that no one should ever fear falling below. If an uninsured American is critically injured, the options today are "A: Die" or "B: Bankruptcy". Having a new option "C: Universal VA-levels of healthcare" would be a win for literally every American, even for Americans who are lucky enough to already have great private insurance and who would never need/use this option themselves.
  - mter 9y ago
    > But some of them truly do offer superior care to a typical private hospital Which ones? Because that has not been my experience at the hawaii facility. From my appointment time being written down on a piece of paper then they send me my actual appointment date a few months later to the doctor being an hour+ late, my personal experiences have been subpar. Add in how doctors/nurses at multiple hospitals do comically incompetent things like reusing insulin pens/colonoscopy bags/not washing equipment, the general sense of incompetence when they lose my records every few years, or talking to my buddies who got out and ended up working at the VA and have told me that they'll never get treated there, and I do not have the same sense of "superior care" that you're talking about. If I want hep C, I'll go to the VA. If I want medical care, I'll go anywhere else or just not go to a doctor.
sykh 9y ago
The people on TRICARE don’t seek to leave the system, do they? That’s a government run healthcare system. Do Medicare recipients seek to leave it? That’s a government run healthcare system. Universal healthcare can be implemented poorly but it doesn’t have to be. It can be done right. There are lots of examples of this.
- creaghpatr 9y ago
  >Do Medicare recipients seek to leave it? No, because it's free, but 1/3 of Medicare recipients opt to receive their coverage through private insurers that typically add on additional coverage, an indicator that Medicare alone is not enough for a large segment of the population, or that they prefer a private insurer even with government subsidization. https://www.kff.org/medicare/fact-sheet/medicare-advantage/ https://www.kff.org/medicare/fact-sheet/medicare-advantage/
  - sykh 9y ago
    Excellent. We are in agreement that the American government can and does provide a health insurance program that covers lots of people and has the property that people don’t seek to leave it. Perhaps the idea that everyone be covered in such a system is not so far fetched.
    - chimeracoder 9y ago
      > We are in agreement that the American government can and does provide a health insurance program that covers lots of people and has the property that people don’t seek to leave it. People literally are leaving it, to the fullest extent that they legally can. It's not a small number, either. About 40% of Medicare patients aren't on the government-run system at all, and that number has consistently grown over the years.
      - Clubber 9y ago
        They supplement it, I don't believe they are leaving it, unless they are wealthy and can afford to pay out of pocket because they want to use a doctor that is not participating in the medicare program. Do you have a cite?
Sangermaine 9y ago
>If the VA is the best the US government can do Who said it was?
chiefalchemist 9y ago
> "If the VA is the best the US government can do..." It's not the best Uncle Sam can do. It's the best it wants to do. It's the (minimal) "best" is has to do. Sure there's plenty of verbal grandstanding - by both politicians, the public, and the private sector (e.g., NFL) - about supporting the vets and their families, but actions speak louder than words. (Verbally) supporting the vets is good branding. It's that simple. That's all it takes. Put another way, if the US brought back the draft and the armed forces made up a wider cross-section of society (i.e. poor, rich and in between) priorities would change. Actions would speak louder than the words.
dnomad 9y ago
This is a lie. By virtually every measure the VA is the most cost effective and best quality care that Americans can get. * The VA is very cost effective. It is much cheaper than any private sector health plan or Medicare. Instead of buying into the propaganda go straight to the source [1] and look at the actual facts. * The VA enjoys very strong customer satisfaction. You wouldn't know this because the media and conservatives work together to denigrate the VA every chance they get but you should actually talk to people on the VA plan. Surveys of actual VA customers [2] indicates they're quite happy with their free, comprehensive government healthcare. (Shocker.) * Study [3] after study [4] has shown that VA hospitals are better than private, profit-driven hospitals. Most Americans would kill for VA coverage. It far exceeds anything they will ever receive unless they make it to the 1%. And this is why it's so very important to keep spreading this lie that the VA is this gross, evil system where all the patients are just waiting to die and ignored by incompetent and indifferent government bureaucrats. And this is the real problem. You can't have real discussions about health care in America because, frankly, most Americans don't live in the real world. They've been led to believe objective nonsense and you simply can't build anything off such a foundation. [1] https://www.cbo.gov/publication/49763 https://www.cbo.gov/publication/49763 [2] https://www.va.gov/opa/pressrel/pressrelease.cfm?id=2537 https://www.va.gov/opa/pressrel/pressrelease.cfm?id=2537 [3] https://link.springer.com/article/10.1007/s11606-016-3775-2 https://link.springer.com/article/10.1007/s11606-016-3775-2 [4]https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2618816?redirect=true https://jamanetwork.com/journals/jamainternalmedicine/articl...
ajross 9y ago
> You literally couldn't make up worse things than their administration has been caught doing with little or to consequence. I literally could. The scandals you're referring to basically come down to them having been cooking books about care records. Bad, but not exactly in the realm of "literally nothing worse" hyperbole. In fact the VA tends to produce health care outcomes that are well within the range of US citizens in the same income bracket (which is to say, not great relative to the rest of hte industrialized world, but not bad) at a cost that is much less than that of private insurance. Really, you could do a lot worse. The criticism of the VA tends to be very similar to the criticism of the NHS in the UK. It's valid as far as it goes, but... neither UK citizens nor US vets are suffering serious catastrophes here. They're getting care and living decent, healthy lives by any reasonable standard. Literally.
- XorNot 9y ago
  Also the problems with the VA generally stem from the reality that US politicians "support the troops" right up until they're home and maybe not so enthusiastic about the war anymore.

e40 9y ago

This is one of the straw men that is often brought up. There are a million reasons why the VA is messed up, most of which have NOTHING to do with healthcare. Congress has underfunded our troops for decades, related to healthcare and not. Something as simple as body armor is often purchased with personal money. A woman that works for me is high up in the Marines and I hear stories that disgust me. I do not know how Congress gets away with this. The stories are out there, but the American people seem to not give a you know what. Please don't conflate the problems of the VA with Universal Healthcare.

RangerScience 9y ago
I haven't heard these stories and would like to. Where can I find more?
- e40 9y ago
  Here's one https://www.military.com/daily-news/2016/02/26/lacking-basic-gear-special-operators-stuck-buying-own-equipment.html https://www.military.com/daily-news/2016/02/26/lacking-basic... Do a search for "us troops buying own". You'll find lots.
imglorp 9y ago
I'm curious why there are more than one public health system. There's the VA, the IHS (Indian Health Services), and of course medicare/medicaid. Why are these not all the same system? It's not like we're different species.... edit, If this is a benefits/paperwork thing, then shouldn't that be separate from the care provider network?
- Hozzle 9y ago
  Fun fact: Those systems cost more tax money than most other developed nations spend on full UHC. Either per person or as a per cent of GDP.
- e40 9y ago
  It's the nature of the beast, in the US, I think. I believe if there were a Universal system, all of the others would go away. That would be a good thing.

fergie 9y ago

"If you think the private healthcare system is immoral, you should take a look at the 100% government ran healthcare system that is the VA" Or you could actually read the linked Economist article

SideburnsOfDoom 9y ago

But other countries can do this. So the hard question then is, why is the US government so uniquely bad at doing things that it doesn't want to do?

knz 9y ago
Is the issue the US government? Or the lobbying to protect special interest groups?
- SideburnsOfDoom 9y ago
  From a far enough distance, they look like interconnected parts of the same system.

monocasa 9y ago

The VA was a good system not too long ago, but the past couple decades has seen it get extremely underfunded in a starve the beast strategy. It used to be a black eye in the Republican's view of healthcare, but they sure fixed that.

Hozzle 9y ago
The VA is much the same as all the other US healthcare setups. A system with the controls taken off, trying to operate in a jungle of different systems and bureaucracies. IN most nations with a VA-style (Beveridge) setup, there is great media interest in the least failing or hint of scandal. And they mean politicians lose a lot of votes. The VA hasn't enjoyed that feedback system until recently.
rukittenme 9y ago
What makes you think universal healthcare would be any different? If you recognize the VA's failings, and you blame Republicans for it, what's to stop them from doing it to every "good" idea you have? If a few motivated politicians can ruin the lives of millions those politicians shouldn't have that power in the first place.
- Sangermaine 9y ago
  >What makes you think universal healthcare would be any different? Because America isn't the entire world and there are many places where socialized healthcare of various forms have been very successfully implemented for a long time. The idea peddled by conservatives in America that the only options for socialized healthcare are inevitable failure or tyranny is simply, demonstrably nonsense. It's exactly this kind of parochial, limited mindset that needs to change.
  - rukittenme 9y ago
    Oh yes. Everyone who disagrees with me has a limited mindset. You could have used your open mind to read about a European (within this comment thread) who is having trouble with "the right" in his country: > This is a principal reason why the US was crossed off my list of countries where I would work and live. I fight against the privatization that is occurring within healthcare in my native country, Iceland. We used to have the Scandinavian model but decades of attacks from the right-wing Independence Party has broken our healthcare system. The next phase described by Chomsky is handing it over to private capital since people are outraged that it doesn't work anymore. I'm sickened by the development and feel a little like an old man screaming at the desert wind. It's exactly your kind of Utopian mindset that needs to change. Please read the news of countries other than the US. You might be surprised at the amount of controversy that surrounds universal healthcare systems.

Pharylon 9y ago

The VA has gotten a lot of bad headlines, but I work with a vet who absolutely loved the VA. He brags about the quality and speed of his healthcare all the time. This is in Charlotte, NC. Different offices might be different.

mter 9y ago
The thing with the VA isn't that it's all bad. It's that the percentage of completely inept people seems higher than in a normal hospital. Normal hospitals don't have multiple scandals of reusing insulin pens on different people, reusing colonoscopy bags, killing people, paralyzing people and periodically losing all of our records. A lot of veterans who are covered by the VA are like me. Technically covered because of service connected disabilities, but I will never use it.
- dnomad 9y ago
  Again, this is not true. Read the studies comparing VA care to private care. You're actually better off going to a VA hospital than most private hospitals.
  - mter 9y ago
    I've been to a VA hospital. My brother/dad/uncle have been to the same VA hospital. Our experiences have all been poor. If you were told that you'd get an appointment some time in the future and they sent you a notice randomly in the mail a few months later, you probably wouldn't be happy with the service. If your doctor was over an hour late, you wouldn't be happy. If you had a friend that was paralyzed after a spinal tap (my dad's buddy) then you probably wouldn't hold the VA in high regard. You are the first veteran I've ever met who had good experiences at the VA and who doesn't know anyone that has been crippled by the VA.
    - Clubber 9y ago
      >If your doctor was over an hour late, you wouldn't be happy. Doctors aren't on time in privatized offices either. It's always a long wait for me. But you're right about the not being happy about it. >If you had a friend that was paralyzed after a spinal tap (my dad's buddy) then you probably wouldn't hold the VA in high regard. Yes, but that happens in private hospitals as well. They aren't all that great in the US either. >f you were told that you'd get an appointment some time in the future and they sent you a notice randomly in the mail a few months later, you probably wouldn't be happy with the service. Ya that sucks. Private industry has solved the scheduling problem with DSS and template based schedules. My uncle didn't have a good experience with the VA either. He had dementia and the nurse questioned him about it and he said "I have diabetes," which he did, but he didn't know what was going on. The nurse of course said, "we don't treat diabetes," or something like that and sent him away. All the while his sister was telling her about the dementia, she just didn't want to hear it. I could tell you horror stories about private hospitals too and how after being admitted, they shipped him to a nursing home an hour away wearing nothing but a gown in winter. No calls, no nothing. I guess the bottom line is right now, the US sucks at healthcare, period. I'm sure being a highly politicized wedge issue doesn't help matters much. (The VA, universal healthcare, skyrocketing costs in the private industry, etc).

simonbarker87 9y ago

The point isn’t really to compare it to the current best that the US governmeny can do. With the US’s historic view on universal/“free at the point of access” health care it is hardly surprising that the VA is a mess. What you should compare it to is the best that other governments have done, in which case there are many examples of excellent universal healthcare from public insurance based all the way through to the UK’s NHS - which does an excellent job despite below inflation budget increases and endless media hyped scandals.

Symmetry 9y ago

The VA is far from perfect and is really noticeably worse than many other country's nationalized health systems. But it's not obviously worse than private health insurance in the US and generally veterans are as happy with their health care as other people. I think the VA example tends to dispel the notion that single payer would save that much money but it works about as well as other approaches, of which the US has way too many.

chimeracoder 9y ago
> The VA is far from perfect and is really noticeably worse than many other country's nationalized health systems. But it's not obviously worse than private health insurance in the US and generally veterans are as happy with their health care as other people If you want to convince people to support a single-payer system, this is quite possibly the worst argument you could use. Any veteran or anybody who has had any experience whatsoever with the VA will instantly assume you don't know what you're talking about. The VA is, on the whole, atrocitous. There are a couple of regions which do relatively well, because the system is federated, but on the whole, it's almost universally considered to be a disaster, even by people who are supportive of the program's existence. If you want to convince people that a single-payer system wouldn't end up like the VA, start by acknowledging the problems with the VA, not denying them.
- dnomad 9y ago
  > The VA is, on the whole, atrocitous. There are a couple of regions which do relatively well, because the system is federated, but on the whole, it's almost universally considered to be a disaster, even by people who are supportive of the program's existence. Yeah, this is bullshit. The VA and its effectiveness has been studied quite a bit. Its quality has been found to generally exceed the quality of private hospitals. The media and conservatives paint this idea that the VA is "atrocious" but it has no basis in reality. The scientific evidence for universal healthcare is overwhelming. The only "controversy" -- exactly like the "controversy" around climate change -- exists within people who have carefully decided to ignore the evidence and buy into the propaganda. The problem here is not the VA. The problem here is that many Americans have abandoned reality.

lg 9y ago

no reason why single-payer means government-run hospitals

Fomite 9y ago

For a large number of different outcomes, the VA is superior to private care. It has a disproportionate footprint because "The VA does something bad!" is national news, while "SmallSizeMidwestCity Memorial does something bad!" isn't. It's not perfect, by any means, and struggles with cost constraints (veterans are sympathetic, but sympathetic doesn't mean well supported), but many of its quality outcomes are superior. See, for example, https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2618816 https://jamanetwork.com/journals/jamainternalmedicine/articl...

maxsilver 9y ago
Your getting downvoted for this, and I have no idea why. Have other folks actually stepped inside a VA facility? Many of them are old/outdated/underfunded it's true. But some of them truly do offer superior care to a typical private hospital (in staff, facilities, and outcomes). The VA system could use significant improvement, absolutely. But if the fear-mongering 'worst case scenario' is that everyone gets VA levels of healthcare, that's still a huge win for all of America. That's a great baseline standard to start with, that no one should ever fear falling below. If an uninsured American is critically injured, the options today are "A: Die" or "B: Bankruptcy". Having a new option "C: Universal VA-levels of healthcare" would be a win for literally every American, even for Americans who are lucky enough to already have great private insurance and who would never need/use this option themselves.
- mter 9y ago
  > But some of them truly do offer superior care to a typical private hospital Which ones? Because that has not been my experience at the hawaii facility. From my appointment time being written down on a piece of paper then they send me my actual appointment date a few months later to the doctor being an hour+ late, my personal experiences have been subpar. Add in how doctors/nurses at multiple hospitals do comically incompetent things like reusing insulin pens/colonoscopy bags/not washing equipment, the general sense of incompetence when they lose my records every few years, or talking to my buddies who got out and ended up working at the VA and have told me that they'll never get treated there, and I do not have the same sense of "superior care" that you're talking about. If I want hep C, I'll go to the VA. If I want medical care, I'll go anywhere else or just not go to a doctor.

sykh 9y ago

The people on TRICARE don’t seek to leave the system, do they? That’s a government run healthcare system. Do Medicare recipients seek to leave it? That’s a government run healthcare system. Universal healthcare can be implemented poorly but it doesn’t have to be. It can be done right. There are lots of examples of this.

creaghpatr 9y ago
>Do Medicare recipients seek to leave it? No, because it's free, but 1/3 of Medicare recipients opt to receive their coverage through private insurers that typically add on additional coverage, an indicator that Medicare alone is not enough for a large segment of the population, or that they prefer a private insurer even with government subsidization. https://www.kff.org/medicare/fact-sheet/medicare-advantage/ https://www.kff.org/medicare/fact-sheet/medicare-advantage/
- sykh 9y ago
  Excellent. We are in agreement that the American government can and does provide a health insurance program that covers lots of people and has the property that people don’t seek to leave it. Perhaps the idea that everyone be covered in such a system is not so far fetched.
  - chimeracoder 9y ago
    > We are in agreement that the American government can and does provide a health insurance program that covers lots of people and has the property that people don’t seek to leave it. People literally are leaving it, to the fullest extent that they legally can. It's not a small number, either. About 40% of Medicare patients aren't on the government-run system at all, and that number has consistently grown over the years.
    - Clubber 9y ago
      They supplement it, I don't believe they are leaving it, unless they are wealthy and can afford to pay out of pocket because they want to use a doctor that is not participating in the medicare program. Do you have a cite?

Sangermaine 9y ago

>If the VA is the best the US government can do Who said it was?

chiefalchemist 9y ago

> "If the VA is the best the US government can do..." It's not the best Uncle Sam can do. It's the best it wants to do. It's the (minimal) "best" is has to do. Sure there's plenty of verbal grandstanding - by both politicians, the public, and the private sector (e.g., NFL) - about supporting the vets and their families, but actions speak louder than words. (Verbally) supporting the vets is good branding. It's that simple. That's all it takes. Put another way, if the US brought back the draft and the armed forces made up a wider cross-section of society (i.e. poor, rich and in between) priorities would change. Actions would speak louder than the words.

dnomad 9y ago

This is a lie. By virtually every measure the VA is the most cost effective and best quality care that Americans can get. * The VA is very cost effective. It is much cheaper than any private sector health plan or Medicare. Instead of buying into the propaganda go straight to the source [1] and look at the actual facts. * The VA enjoys very strong customer satisfaction. You wouldn't know this because the media and conservatives work together to denigrate the VA every chance they get but you should actually talk to people on the VA plan. Surveys of actual VA customers [2] indicates they're quite happy with their free, comprehensive government healthcare. (Shocker.) * Study [3] after study [4] has shown that VA hospitals are better than private, profit-driven hospitals. Most Americans would kill for VA coverage. It far exceeds anything they will ever receive unless they make it to the 1%. And this is why it's so very important to keep spreading this lie that the VA is this gross, evil system where all the patients are just waiting to die and ignored by incompetent and indifferent government bureaucrats. And this is the real problem. You can't have real discussions about health care in America because, frankly, most Americans don't live in the real world. They've been led to believe objective nonsense and you simply can't build anything off such a foundation. [1] https://www.cbo.gov/publication/49763 https://www.cbo.gov/publication/49763 [2] https://www.va.gov/opa/pressrel/pressrelease.cfm?id=2537 https://www.va.gov/opa/pressrel/pressrelease.cfm?id=2537 [3] https://link.springer.com/article/10.1007/s11606-016-3775-2 https://link.springer.com/article/10.1007/s11606-016-3775-2 [4]https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2618816?redirect=true https://jamanetwork.com/journals/jamainternalmedicine/articl...

ajross 9y ago

> You literally couldn't make up worse things than their administration has been caught doing with little or to consequence. I literally could. The scandals you're referring to basically come down to them having been cooking books about care records. Bad, but not exactly in the realm of "literally nothing worse" hyperbole. In fact the VA tends to produce health care outcomes that are well within the range of US citizens in the same income bracket (which is to say, not great relative to the rest of hte industrialized world, but not bad) at a cost that is much less than that of private insurance. Really, you could do a lot worse. The criticism of the VA tends to be very similar to the criticism of the NHS in the UK. It's valid as far as it goes, but... neither UK citizens nor US vets are suffering serious catastrophes here. They're getting care and living decent, healthy lives by any reasonable standard. Literally.

XorNot 9y ago
Also the problems with the VA generally stem from the reality that US politicians "support the troops" right up until they're home and maybe not so enthusiastic about the war anymore.