Mitt Romney floated the idea of partially privatizing the veterans health care system during a roundtable discussion with vets in South Carolina on Veterans Day, saying, “When you work in the private sector and you have a competitor, you know if I don’t treat this customer right, they’re going to leave me and go somewhere else, so I’d better treat them right”:
“Sometimes you wonder if there would be some way to introduce some private-sector competition, somebody else that could come in and say, you know, that each soldier gets X thousand dollars attributed to them, and then they can choose whether they want to go in the government system or in a private system with the money that follows them,” said Romney. “Like what happens with schools in Florida, where people have a voucher that goes with them. Who knows?”
Sen. John McCain (R-AZ) introduced a similar proposal during the 2008 presidential campaign, but veterans groups panned the initiative, which would have given veterans “the option to use a simple plastic card to receive timely and accessible care” outside of the VA system. AMVETS, Disabled American Veterans, Paralyzed Veterans of America, and the Veterans of Foreign Wars argued that while veterans should have access to private care, providing “rural veterans greater access to VA-sponsored care exclusively through private providers” would undermine the existing health care system. In their annual report, “The Independent Budget,” the groups argued:
— “The VA’s specialized health-care programs…would suffer irreparable impact by the loss of veterans from those programs.”
— “The VA’s medical and prosthetic research program…would lose focus and purpose were service-connected and other enrolled veterans no longer present in VA health care.”
— If veterans turned to private practice, “they would lose the many safeguards built into the VA system through its patient safety program, evidence-based medicine, electronic medical records and bar code medication administration,” resulting in “lower quality of care for those who deserve it most.”
Indeed, the fully integrated veterans’ health care structure of doctors and hospitals provides veterans with benefits that are the envy of the rest of the health care system. A study by the RAND Corporation found that “VA patients were more likely to receive recommended care” and “received consistently better care across the board, including screening, diagnosis, treatment and follow up. Rather than taking veterans out of a system that consistently delivers “higher quality of care,” Romney should expand its services and improve access.
The RAND study concludes, “if other health care providers followed the VA’s lead, it would be a major step toward improving the quality of care across the U.S. health care system.” And Paul Krugman writes today, “the V.H.A. is a huge policy success story, which offers important lessons for future health reform.”