A Washington Times op-ed:
Do we want the government employees who run the troubled Walter Reed Army Medical Center to be in charge of our entire health-care system? Or, would you like the people who deliver our mail to also deliver health-care services? How would you like the people who run the motor vehicles department, the government education system, foreign intelligence and other government agencies to also run our health-care system? After all, they are not motivated by the quest for profits, and that might mean they’re truly wonderful, selfless, caring people.As for me, I would choose profit-driven people to provide my health-care services, people with motives like those who deliver goods to my supermarket, deliver my overnight mail, produce my computer and software programs, assemble my car and produce a host of other goods and services I use.
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{ 10 comments }
In the televised congressional hearings,I thought they stated the care was outsourced to a private firm,who couldn’t handle the job. This combined with the medicare part D mess,make me feel, after 30 years of practice; that the insurance system in this country is responsible for much of the problems in medicine today.
Would you want the head of your local ripoff HMO to run our system? Oh that’s right, he is.
The Post Office delivers my mail on time. In fact, I get my meds from the VA delivered to me via the Post Office, always on time and within a day or two of my refilling my scripts online on my computer. Man, it sucks not having to drive 45 minutes and wait on line at CVS and pay monopoly rents for a drug they often don’t have in stock. But hey, four legs goooood, two legs baaaaaad. Free market goooood, government baaaaad. The problems at Walter Reed were clearly the result of failure to outsource *all* its services to Halliburton in a timely manner. By only partially outsourcing, Walter Reed forced Halliburton to fail because we all know the free market can’t work its magic while there’s even an iota of government interference.
We all know, as a result of the divine revelation granted to Saint Ayn, that the government can’t do anything right, so let’s just stick with the failed, corrupt and barbaric system we have because there is no possible better alternative. If there was, the market would have invented it by now (pg 41, verse 3, Libertarian Little not-so Red Book). All that stuff you hear about Europe is propaganda from communists and doctor-bashers and some fat guy in a baseball cap who obviously can’t follow his doctor’s orders. And I do mean orders.
The problems at Walter Reed are endemic to the VA. If you have never worked in one you do not understand the culture of incompetence (physicians) and laziness (staff, especially nurses) that pervades it from top to bottom. It’s a nightmare.
If you don’t understand that Walter Reed isn’t part of the VA, you probably ought not to be commenting about it either.
Evan:
Why did you assume the poster was confusing the military medical system with the V.A? I have worked in both, and there is truth to his observation.
We have profit-driven people selling health care insurance, and it’s debatable whether this is good or not. One might argue that they are trying to make “your” health care dollar go farther, but they’re also there to generate a profit for their shareholders with your health care dollar.
Of course they are not in the same system; the fact that they aren’t and yet have the same problems goes to show that it is something pervasive in all US-government run healthcare.
So let’s follow that road down. The survival rate from battle injuries has increased something like 4 fold over injuries sustained in Viet Nam. That was accomplished by our existing military medical system, of which Walter Reed AMC is part. So, just like all human systems, the military medical system has some good things and some bad things. The VA does as well. I have also worked in both. I have also worked in the private sector.
There are problems everywhere. So glib denunciations without offering solutions to problems are the easiest, and most lame statements to make.
The military medical system is outstanding at treating battle injuries, and I would argue it is far superior to any other system on earth in doing that. Yet it’s run by the same government that runs the post office. But Kevin never highlights that fact. That should tell us a lot.
Evan:
The military medical system, inasmuch as it is successful in treating battle injuries is the vicarious beneficiary of changes in technology and practices acquired in civilian trauma management. The survival rate is the result of improvements in vehicle and body armor, in field management using civilian-acquired techniques and in the practice of rapid evacuation of wounded to high-level trauma hospital facilities. Those are civilian-developed practices. The sad fact is that the military operates no significant trauma centers except its in-theater hospital at Balad. All of the military trauma experts get their specialty training in trauma at places like Ben Taub, Washington Hospital Center and other major trauma centers in U.S. cities.
Management of traumatic battle injuries is of necessity a military practice; they are usually the only functioning organization in a battle theater. But that skill set is obtained in civilian training centers. And it isn’t just true in the US; the same applies to other countries with military medivac and treatment systems, particularly Israel.
I don’t see where for-profit medical systems have any special claim here. Most care of this type is provided by neither government hospitals nor by for-profit hospitals but by non-profit private hospitals owned by trusts and foundations or universities.
And the post office, or more properly the United States Postal Service, is of course a semi-independent government corporation charged with among other things, meeting its own expenses. That is why first-class rates go up not by decision of Congress but by the Postal Rate Commission, and that is why your mailbox is and will remain a landing spot for so much unsolicited commercial advertising and credit card offers.
The observation that the V.A. (civilian, government) and the military (civilian, military and non-military government) medical systems have similar problems in staff behavior and motivation while true is neither here nor there. And it is hardly an argument for turning those systems over to private contractors.
The article in the Washington Times states that 13,000 deaths occurred in France during a prolonged heat wave, and that this was due to France’s failed healthcare system. Wrong. The deaths were due to a multitude of factors – poor social services available to the elderly during August, when most French are on vacation, the lack of air conditioning, persons who are isolated from family and neighbors. It is not the case that the French healthcare system does is unable to train people to treat dehydration.
The same thing happens here in the US during heat waves in large cities – the elderly who live isolated in older homes with no air-conditioning succumb to the heat. Our healthcare system, no matter its flaws, is not responsible for these deaths.
Re the problems at Walter Reed: I caught about 15 minutes of the Congressional hearing on the problems there. The biggest factor is that in 2000, before the Iraq war, the Army made the decisioin to privatize the workforce there, approx. 400 persons. Within 2 years, half of those persons had left the medical center, seriously compromising the care that could be delivered with the large increase in the number of soldiers with war injuries.
The problems at Walter Reed are, unfortunately, due to the collision of two events – the war and the privatization of the workforce – occuring at the same time. I am not so certain that the problems are due mainly to incompetance or lack of services.
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