Saturday, February 25, 2017


      Perhaps because it feels so good when I stop, I again watched C-SPAN’s morning call-in show, Washington Journal, yesterday. The topic, for the first three-quarters of an hour, was the Affordable Care Act. What should be done? Fix it, repeal it, leave it alone. Callers went back and forth for a time, suggesting various fixes and/or alternatives. Then a woman called to announce that “single-payer systems” were the “worst systems in the world.” Her proof? The disaster called the Veteran’s Health Administration, run by the Department of Veteran’s Affairs.

       I’ll leave aside Forbes Magazine’s assessment of the V.A: “There is ample evidence” that outcomes at V.A. hospitals are “at least comparable” to outcomes in private hospitals. A bastion of kick-ass capitalism, Forbes Magazine surely took no pleasure in its analysis of the V.A. But that said, misjudging the V.A. was the least of this caller’s problems.

      Simply put, the Veterans Health Administration (the A.C.A, too) is not a single-payer system. The V.A. is a government-run health care system, like Britain’s National Health Service. The Department’s personnel, including doctors, nurses and administrators, are employed by the government. Its facilities, from hospitals to clinics to scientific labs, are owned by the government. By contrast, in a single-payer system, the government becomes an insurer. Doctors, hospitals etc., acting independently in the private sector, bill the government for the services they perform. Canada’s national system, universally called Medicare by Canadians, is a single-payer system.

      Okay, she made a mistake. Big deal, right? But even if she was correct and the V.A. was a single-payer system and dysfunctional, her reasoning was completely bogus. The V.A. is dysfunctional, therefore single-payer systems don’t work? Gimme a break. You can’t use a single example to prove a universal. Not unless you’ve been effectively brainwashed.

     Brainwashed? Sure enough, a second caller, only a few calls later, made exactly the same point in exactly the same way. Then a third, moments before the segment came to a close.

      The great glory of the American political system is that everyone gets to vote. The great flaw is that everyone gets to vote. In real life, you do the best you can with what you’ve got. And what we’ve got, when you peel away the layers, are human beings. Now what?


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