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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