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Monday, November 14, 2011

Paul Krugman: Vouchers for Veterans

Why is the Veteran's Health Administration "in the crosshairs" of Republicans? Is it because it's an example of socialized medicine that works?:

Vouchers for Veterans, by Paul Krugman, Commentary, NY Times: American 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. ...
And that brings me to Mitt Romney’s latest really bad idea, unveiled on Veterans Day: to partially privatize the Veterans Health Administration (V.H.A.). What Mr. Romney and everyone else should know is that the V.H.A. is a huge policy success story, which offers important lessons for future health reform. ... Multiple surveys have found the V.H.A. 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 V.H.A. has led the way in cost-saving innovation...
And yes, this is “socialized medicine” — although some private systems, like Kaiser Permanente, share many of the V.H.A.’s virtues. But it works — and suggests what it will take to solve the troubles of U.S. health care more broadly.
Yet Mr. Romney believes that giving veterans vouchers to spend on private insurance would somehow yield better results. Why? Well, Republicans have a thing about vouchers. ... The claim, always, is ... that “private sector competition” would lower costs.
But we have a lot of evidence about how private-sector competition in health insurance works, and it’s not favorable. The individual insurance market ... has huge administrative costs and has no demonstrated ability to reduce other costs. ... And the international evidence accords with U.S. experience. ...
So what lies behind the Republican obsession with privatization and voucherization? Ideology, of course. It’s literally a fundamental article of faith in the G.O.P. that the private sector is always better than the government, and no amount of evidence can shake that credo.
In fact, it’s hard to avoid the sense that Republicans are especially eager to dismantle government programs that act as living demonstrations that their ideology is wrong. Bloated military budgets don’t bother them much — Mr. Romney has pledged to reverse President Obama’s defense cuts, despite the fact that no such cuts have actually taken place. But successful programs like veterans’ health, Social Security and Medicare are in the crosshairs.
Which brings me to a final thought: maybe all this amounts to a case for Rick Perry. Any Republican would, if elected president, set out to undermine precisely those government programs that work best. But Mr. Perry might not remember which programs he was supposed to destroy.

    Posted by on Monday, November 14, 2011 at 12:24 AM in Economics, Health Care, Market Failure, Politics | Permalink  Comments (32)


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