Vouchers for veterans and other bad ideas

Vouchers for veterans and other bad ideas

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U.S. health care is remarkably diverse. In terms of how care is paid for and delivered, many of us effectively live in Canada, some live in Switzerland, some live in Britain, and some live in the unregulated market of conservative dreams. One result of this diversity is that we have plenty of home-grown evidence about what works and what doesn't.

Naturally, then, politicians — Republicans in particular — are determined to scrap what works and promote what doesn't. And that brings me to Mitt Romney's latest really bad idea, unveiled on Veterans Day: to partially privatize the Veterans Health Administration.

What Romney and everyone else should know is that the VHA is a huge policy success story, which offers important lessons for future health care reform.

Many people still have an image of veterans' health care based on the terrible state of the system two decades ago. Under the Clinton administration, however, the VHA was overhauled, and it achieved a remarkable combination of rising quality and successful cost control. Multiple surveys have found the VHA providing better care than most Americans receive, even as the agency has held cost increases well below those facing Medicare and private insurers. Furthermore, the VHA has led the way in cost-saving innovation, especially the use of electronic medical records.

What's behind this success? Crucially, the VHA is an integrated system, which provides health care as well as paying for it. So it's free from the perverse incentives created when doctors and hospitals profit from expensive tests and procedures, whether or not those procedures actually make medical sense. And because VHA patients are in it for the long term, the agency has a stronger incentive to invest in prevention than private insurers, many of whose customers move on after a few years.

And yes, this is 'socialized medicine"

Read more: http://www.stltoday.com/lifestyles/relationships-and-special-occasions/columns/miss-manners/vouchers-for-veterans-and-other-bad-ideas/article_8c30a823-94bd-5d25-a2b7-7827e5b0743d.html#ixzz1dnG1zgEQ