Universal care? First, prove feds can care for 8 million veterans

By Ray Nothstine

Individuals and groups terrified of nationalized healthcare like to point to examples of government dysfunction, such as Medicaid, to stoke fears of what a government-managed plan would look like in the United States.

Proponents of socialized medicine, meanwhile, frequently offer their own example to demonstrate a more positive potential of government healthcare: the medical system operated by the Veterans Administration (VA). It’s time to take a closer look at this supposed model of effective healthcare.

The VA manages the largest U.S. healthcare system, with more than 1,400 medical facilities. It’s true that veterans treated at VA hospitals generally receive quality care. Yet this fact overlooks major drawbacks, such as backlogged claims, rationing of treatment, and waiting periods for appointments.

Those who have service-related disabilities are the VA’s primary responsibility. Plans have been made to expand care to veterans who meet income qualifications. Yet cost and rationing are already problems in the VA. Expansion will aggravate rather than mitigate these difficulties.

In an interview, Rep. Gene Taylor (D-Miss) described the problem of using the VA as a model for a bigger public plan. “We [government] can’t pay for the promises we’ve already made on healthcare,” he said, “and it only gets worse for the next 50 years.”

Taylor, who has been an advocate for improving care for veterans and trying to rein in deficit spending in Washington, noted that current public spending accounts for more than half of all healthcare expenditures.

Previously non-survivable battle traumas have created an even greater need for lifetime care of severely wounded veterans from Iraq and Afghanistan. Understandably, the cost for this care can be astronomical.

It’s not uncommon for long-term care of these wounded vets to total many millions of dollars over a lifetime. When the number of mental health patients from the war on terror is added into the mix, the cost for quality care rises higher still. Among the more than 300,000 veterans from the wars in Iraq and Afghanistan currently receiving VA care, one in five received a post traumatic stress disorder diagnosis.

The president and Congress have responded by spending more on care for veterans than ever before. And while some experts agree that VA care has improved from previous decades, the government still must do a much better job at providing safe, timely, and efficient care.

Several VA medical centers are now under review for possibly infecting veterans with HIV, Hepatitis C, and Hepatitis B because of improperly cleaned equipment used for colonoscopies and endoscopies.

In March 2009, CBS Evening News reported that paperwork submitted by veterans had languished unopened, or worse, had been lost or shredded. Jason Scott, who was severely wounded in the war on terror, had his records lost. In the process of completing his MBA degree, he told CBS News that he was waiting to graduate so “I can get a job and get real healthcare.”

Eddie Ryan could be described as the miracle Marine. Shot in the head twice by friendly fire in Iraq, he was brought home to die. Doctors said if he survived he would have to be on life support for the duration of his life and would never recognize anyone. Talk radio hosts across the country called on people to pray for Eddie.

His family credits such prayers for the young Marine’s remarkable recovery. Despite severe brain injuries, Eddie speaks coherently and knows everybody he has ever met. While he is confined to a wheelchair, he is not paralyzed and dreams of taking up running again. Even more courageously, Eddie wants to return to active duty in the Marine Corps.

But Eddie’s family says they have had trouble getting efficient or even adequate care from the government. The VA has cut back some of the therapies he previously received. The Post Star in Glens Falls, N.Y., reports that Eddie’s parents spend about $1,200 a week on Eddie’s care. Fund-raisers help some, but a lot of the money comes out of the family’s pocket.

President Abraham Lincoln spoke of the moral obligation to care for wounded veterans in his second inaugural address: “To care for him who shall have borne the battle and for his widow, and his orphan.” That quote from Lincoln is also the VA motto.

Justice demands that government provide for the medical needs of those who have been injured in the conflicts it enters.

Yet prudence suggests that if government’s competence is strained even to fulfill this obligation, then creating new and ultimately unrealistic responsibilities for government will increase the likelihood and scale of injustice.

Veterans’ healthcare has accomplished amazing feats, and many of the health officials and workers who work in that industry do so because of their desire to serve those who served their country.

But the government must and should do a better job taking care of veterans, especially those wounded in America’s wars.

The government needs to prove it can handle existing obligations before proposing the adoption of any universal government plan.

If it cannot handle the challenge of caring for 8 million veterans, how will a government bureaucracy manage a system dealing with 300 million Americans?

[Ray Nothstine is associate editor at the Acton Institute (www.acton.org) in Grand Rapids, Mich. The Acton Institute’s academic investigations are conducted by Acton Research. The work produced at Acton Research includes the disciplines of philosophy, economics, theology, and history, among others, and it includes the contributions of both in-house research fellows and of invited scholars. The principal goal of Acton Research’s investigations is to seek truth by means of the examination and clarification of ideas.]