Like many if not most medical students, I spent some time at the VA hospital attached to the school. I did a thoracic surgery rotation and a psychiatry rotation there, at least. Also worked in their ER, which was inexplicably and redundantly separate from the general hospital's ER a block away.
The joint medical school-VA staff there were wonderful and more practically-minded than the full-time academics and researchers at the med school. They let us do things and procedures which the regular med center would never have let us do, and that was good experience. The patients, mostly WW 2 and Korea vets, but some Vietnam vets (they were still youthful and healthy then) were poor, on the whole, lacking in financial and overall life resources. There were plenty of veterans admitted to the regular medical center too but, at the time, I had no interest in how these systems worked.
Now I understand the the VA is plain old government medicine. Here's Charles Krauthammer, MD:
CHARLES KRAUTHAMMER: If you are non-ideological, if you brought in some experts and say how do you attack the problem right now? You give everybody on the list a voucher to go anywhere they want and they'll get their care within days. And if the budget won't hold it, then you do a separate appropriation. I can't see anybody in Congress who would oppose that. However, as you point out, this administration has been arguing for five years that the government knows best, it should allocate resources, and we won't even think of this.
And for the long-run, I think the question is this -- you know, this was started by Abraham Lincoln after the Civil War and at the time it made sense. But now that the country is so much larger, medicine is so much dispersed in areas of the country where there are other expertise. The budget for the VA is $85 billion a year, the number of patients is 6.5 [million] or so. Do the math. That's almost $10,000 a year per patient.
Why not have each of those vets get a voucher for $10,000 to purchase private insurance and to go anywhere? But of course an administration like this would never even contemplate that. But it is a question. If these problems are systemic and chronic, and they are from the bureaucrat structure of a government-run system, why wouldn't you contemplate voucherizing and privatizing it?
This article is good: Transform The VA Into A Pro-Growth Model For First Rate Health Care. There is no reason for the VA to exist today. It's an obsolete government program and does no favors to American vets.
