Friday, March 16, 2018

Allow veterans to choose their healthcare

After sending our men and women to fight for our defense or interests abroad where they face the barrel of a gun or travel along bomb-strewn roads as a course of their daily duties, it only makes sense that upon their return we give our warriors some sort of benefit since most of them are paid little for the risks they take. It isn’t unreasonable to say that we should offer publicly-funded healthcare to our veterans. They deserve it and it should be our responsibility to maintain and improve the health of the bodies and minds that were scarified for us.

But, the current way of doing things – clinics and hospitals maintained by Veterans Affairs (VA) – shouldn’t be the only way. By following that path, we’ve achieved the cruelest of ironies: After they have survived wars and occupations overseas the health system that was meant to protect our veterans at home could ultimately end up being the very thing that kills them.

For a glaring example, look at the track record of the Buffalo VA Medical Center.
In 2013, a routine inspection discovered more than 700 vets could have been exposed to HIV or hepatitis from reused insulin pens. Hospital staff did not follow the necessary protocol and failed to dispose of the one-time use pens, which in turn created a health risk similar to that of sharing a syringe.

In 2017, in excess of 500 veterans were potentially exposed to those diseases and more after improperly cleaned colonoscopy equipment was inserted into their bodies. Not surprisingly, Buffalo’s officials didn’t learn from a 2009 crisis of the same that put 10,000 patients from VA hospitals in the south at risk.

Then there was last week’s headline: A report issued by the VA’s Inspector General gave an account of a 2016 tragedy during which a man suffered cardiac arrest and rather than try to resuscitate him the staff decided instead to declare him deceased. The details of the incident weren’t reported to higher-ups until almost a year later.

Were all of this to happen in the private sector, doctors, nurses, and hospitals would lose their employment and their licenses. Facilities would close, some people might even be jailed. Not in the VA system. It is, after all, a federal bureaucracy. When crises happen in the VA very few heads roll, some guilty parties keep their jobs or are “reassigned”, and reforms are slow to come if they do at all. The VA has no reason or will to change because it’s a monopoly. They have a captive audience and there is no competition.

One of the greatest aspects of free markets and free choice is competition…the dueling participants (individuals or organizations) will always aspire to offer and/or acquire the best, most diverse and most effective products or services possible. Without that motivation, limitations and suspect quality rule the day.

We need to allow our vets some of that freedom (after all, didn’t they fight for freedom?) and give them the ability to choose the care they want, from who they want, and from where they want. They shouldn’t be limited to a single source. Let them get their care from a place of their choosing, be it a VA medical center, Kalieda, Catholic Health or any number of specialists and clinics.

The best way to achieve this is through some sort of voucher system whereby veterans would receive government-funded insurance or their providers would receive publicly-paid reimbursement. It’s a simple concept that would allow the vets to escape the ills of the VA system while pursuing care at some of America’s best facilities.

It’s been tried, but poorly. In 2014, in response to 35 vets who died while waiting for care at the Phoenix VA, the Veterans Choice Act was introduced. That was a misnomer for most of the $2 billion bill was spent on building 26 new VA facilities and hiring more doctors and nurses. Only a relatively small portion of the bill granted vouchers and, even then, a vet had to live more than 40 miles from the nearest clinic to utilize the benefit.           

A truly effective voucher system would not be dissimilar to Medicaid, through which recipients receive stellar care and benefits that far rival what most privately-insured individuals get. If that Cadillac insurance system can work so well for non-contributors, why shouldn’t something similar – or better – work for those who did contribute to the greatness of our nation?  

Simply put, choice and safety are two things that we can - and should - offer our veterans. What we do now affords neither. It’s time for a change…why expose them to ongoing health scares – on domestic soil, no less -- after everything they’ve done for us? 

From the 19 March 2018 Greater Niagara Newspapers and Batavia Daily News

No comments: