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I picked the VA because it's an attempt at a thoroughly integrated system in a way that Medicare and Medicaid are not. It's not irrational for people to look a
by Kalium 5y ago
I picked the VA because it's an attempt at a thoroughly integrated system in a way that Medicare and Medicaid are not.
It's not irrational for people to look at the risk of making a worse system and judge for themselves if they think it's a risk worth taking. Examining a worst case that's within the scope of possible outcomes is a reasonable part of a good-faith process.
- freeone3000 5y agoBut a thoroughly integrated system isn't necessary. One proposal is to simply allow every American to enroll in Medicare, keeping the remainder of the system the same. It's the most expensive option, but since people on Medicare like Medicare, it might be the best next step for user acceptance.
- Kalium 5y agoI agree! That said, the person I responded to was to my reading optimizing for getting away from the private health care apparatus as much as possible. Medicare For All does not accomplish that.
- r00fus 5y agoYes, the VA is more akin to the UK's NHS (socialized costs/medicine) than a single-payer system like Medicare (socialized insurance/private doctors). The VA was under-budget even before the two wars started in 2002/2003. Then the ruined bodies and psyches rolled in, and VA wasn't given additional funding to handle the aftermath. It's pretty clear how that ends up. The wars above cost $Trillions but the aftermath costs a few more Trillions that VA and other agencies didn't have.
- dragonwriter 5y agoVA efficiency is driven way down by the fact that it is an integrated system that covers a very small, diffusely distributed segment of the population, which is the worst possible case for an integrated (in your sense of having dedicated staff and facilities) system.