On CSPAN this morning, Senator Tom Coburn made the case against a government-run insurance plan on the strange grounds that a government-run health care delivery system would be ineffective. Specifically, he claims that “the VA is not up to the level of care of the rest of the country.” In reality, as Phillip Longman has detailed it’s true that VA Health Care is not of the same quality as health care elsewhere—it’s better:
— “An answer came in 2003, when the prestigious New England Journal of Medicine published a study that compared veterans health facilities on 11 measures of quality with fee-for-service Medicare. On all 11 measures, the quality of care in veterans facilities proved to be ‘significantly better.’”
— “The Annals of Internal Medicine recently published a study that compared veterans health facilities with commercial managed-care systems in their treatment of diabetes patients. In seven out of seven measures of quality, the VA provided better care.”
— “Winning NCQA’s seal of approval is the gold standard in the health-care industry. And who do you suppose this year’s winner is: Johns Hopkins? Mayo Clinic? Massachusetts General? Nope. In every single category, the VHA system outperforms the highest rated non-VHA hospitals.”
One can go on like this. It is, obviously, possible for a government-run health delivery system to perform poorly. But it’s also possible for a government-run delivery system to deliver excellent quality. And in the United States, the VHA appears to be the highest performing major system of providers that exists. The National Health Service in the United Kingdom, to take another example, delivers a standard of care that’s somewhat worse than what Americans receive but drastically cheaper. So you can understand the NHS as delivering a more efficient, albeit not-fantastic in absolute terms, product than the American private sector.
But be all that as it may, creating a government-administered health insurance option is a totally different animal from creating a government-run health provider system. Medicare is an example of a public insurance option operating in the United States. So whatever you make of the VHA, it doesn’t prove much one way or the other. It would be nice if Senators who go on television to talk about important issues would show some mastery of what the basic facts are.