Wintery Knight

…integrating Christian faith and knowledge in the public square

We have single-payer health care already in the VA system – is it working?

VA health care wait times

VA health care wait times

This is health care policy expert Sally Pipes, writing in Investors Business Daily.

She writes:

new report from the Government Accountability Office has confirmed that the Department of Veterans Affairs can’t take care of those it’s supposed to serve.

The GAO has placed the VA’s health system on the “high risk” list of federal programs that are vulnerable to “fraud, waste, abuse, and mismanagement.” The agency is still struggling to recover from an 8-month-old internal audit that revealed that returning soldiers had to wait more than 90 days for care. Some patients died while waiting.

The GAO’s findings apply far beyond the VA. The agency’s problems — which include long wait-times and out-of-control costs — demonstrate what happens in any government-run, single-payer health care system.

The VA’s failings ought to give pause to the liberal politicians and policy analysts who would love to introduce single-payer health care for all Americans. But they don’t seem to have heeded the GAO report. Within a week of its release, Rep. John Conyers, D-Mich., called for “Medicare for All.”

Champions of socialized medicine used to point to the VA as proof that single-payer worked. In 2011, economist Paul Krugman called it “a huge policy success story, which offers important lessons for future health reform.” In a 2009 debate with me, Princeton professor Uwe Reinhardt said that there’s an example of a single-payer system in the U.S. that works — the VA.

The VA offers lessons about health reform — just not the ones single-payer’s proponents have in mind.

Defenders of government-run health care claim that it will control costs by cutting out middlemen such as insurance companies. The evidence shows otherwise. According to the GAO, the VA budget more than doubled between 2002 and 2013 even as enrollment increased by less than a third.

Single-payer’s “guarantee” of access to high-quality care is a myth, too.

“Despite these substantial budget increases,” the GAO report says, “for more than a decade there have been numerous reports … of VA facilities failing to provide timely health care.”

Over the last decade, more than 63,000 veterans have been unable to get a doctor’s appointment. At least 40 veterans have died because of long waits.

Things aren’t likely to get better anytime soon. The VA has yet to act on more than 100 GAO recommendations for improving care.

Last summer, lawmakers allocated $10 billion to a program intended to reduce wait times by permitting veterans to see private doctors outside the VA system. So far, the agency has only authorized 31,000 vets to seek private care — out of a possible 8.5 million.

That has to change — 88% of veterans say that they want the ability to choose where they receive their care.

However, there is one military person who is getting health care – convicted traitor Bradley Manning. He’s getting sex-change surgery while he is in jail for leaking national security secrets to our enemies. He won’t have to wait at all for his health care. This is what happens when you take money out of your wallet, give it to the government, and then hope that when you get sick, someone in the government will decide that you are worthy of treatment. Which you aren’t, unless they want your vote.

It’s not just the VA health care system – government-run health care doesn’t work in other places:

The United Kingdom’s National Health Service, for instance, is notorious for denying patients everything from certain cancer medications to hip replacements.

The program is also financially unsustainable. According to its own medical director, Bruce Keogh, “if the NHS continues to function as it does now, it’s going to really struggle to cope because the model of delivery and service that we have at the moment is not fit for the future.”

In Canada’s single-payer system, the average wait time between referral from a general practitioner and the actual receipt of treatment by a specialist was more than four months in 2014. That’s nearly double the wait time of two decades ago.

The Canadian system is the one that Democrats want to emulate – but Canada’s rich left-wing politicians come here when they want care. They don’t want to wait in line. Why should we want to wait in line? We need to prefer consumer-driven health care over government-controlled health care.

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Vermont governor cancels single-payer health care because of costs

Reported by the Daily Signal:

Gov. Peter Shumlin announced this week he has called off his plans for single-payer health care in Vermont for 2015, saying “now is not the right time.”

At an unannounced news conference, Shumlin said he received the final modeling for financing single-payer health care on Tuesday and concluded the taxes required to fund a publicly financed system were simply unaffordable.

“As we completed the financing modeling in the last several days, it became clear that the risk of economic shock is too high at this time to offer a plan I can responsibly support for passage in the legislature,” Shumlin said.

“It was clear to me that the taxes required to replace health-care premiums with a publicly financed plan that would best serve Vermont are, in a word, enormous.”

The surprise announcement, which came nearly two weeks ahead of schedule, included details that Green Mountain Care’s new-revenues requirement had ballooned to $2.6 billion — up from prior high estimates of $2.2 billion. The overall cost for Green Mountain Care’s operations and coverage is estimated at $4.3 billion.

According to Shumlin’s financing plan, paying for Green Mountain Care would require a new 11.5 percent payroll tax on all Vermont businesses plus a new sliding-scale income tax of up to 9.5 percent, based on income level and family size.

Under Shumlin’s plan, a family of four with $100,000 of income or more would pay the full 9.5 percent tax. The maximum income tax for any single household would be capped at $27,500.

At the news conference, Shumlin called single-payer “the greatest disappointment of my political life so far,” and he explained why he abandoned his signature policy initiative of the past four years.

Recall that single-payer health care is the holy grail of the left. It is a massive opportunity for vote-buying because it involves mandatory taxation for “health care” which is then doled out to patients as the government sees fit. Money from people who don’t use or need health care (e.g. – young, single men) is taken by mandatory taxation and then used to buy votes of people by making things like contraceptives, breast enlargements, sex changes, IVF, etc. into “health care”.

Canada has a single-payer system. How much does this system cost the average Canadian taxpayer?

CTV News reports on a study published by the Fraser Institute.

It says:

A typical Canadian family with two parents and two kids will pay up to $11,786 for public health care insurance this year, according to a new study from the conservative think tank Fraser Institute.

Using data from Statistics Canada and the Canadian Institute for Health Information, the Fraser Institute study estimated the amount of taxes Canadian families will pay for public health insurance this year. The study also looked at how much the cost of public health insurance has increased over the last decade.

According to the study, Canadian families will pay on average between $3,592 to $11,786 for public health insurance in 2014, depending on the size of their family. For the purposes of their research, the study authors looked at six different family types.

The study found that over the last 10 years, the cost of public health care insurance for the average Canadian family has increased:

  • 1.5 times faster than average income
  • 1.3 times as fast as the cost of housing
  • 1.6 times as fast as clothing costs
  • More than three times as fast as the cost of food

Not only are the costs higher, but the quality is lower when measuring patient outcomes.

We should avoid this system at all costs. Free-market health care is better than government-run health care at keeping costs down. The more we reduce government control of health care, increase competition among health care providers and improve consumer choice, the lower the costs will be.

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NHS appeals decision allowing midwives to conscientiously object to performing abortions

What happens when you let a secular government take over health care provisioning?

Here is a story from the BBC about the state-run health care system in the UK.

Excerpt:

The UK’s highest court will hear legal arguments on whether midwives have a right to refuse to take any part in abortion procedures on moral grounds.

NHS Greater Glasgow and Clyde appealed to the Supreme Court after judges in Scotland said Roman Catholic midwives had a right to conscientious objection.

[…]Five judges in London will hear the case. A ruling is expected next year.

Ms Doogan, from Garrowhill in Glasgow, and Mrs Wood, from Clarkston in East Renfrewshire, were employed as labour ward co-ordinators at the Southern General Hospital in Glasgow.

[…]This landmark case tests the balance between those whose religious beliefs do not allow them to play any part whatsoever in abortion, and the health authorities’ duty under the law to enable women to have an abortion. Many Christian groups back the midwives’ position.

The midwives’ counsel, Gerry Moynihan QC, told the court in the women’s earlier successful appeal that the law was clear that the right to conscientious objection contained in the Abortion Act was intended to apply to the whole team whose involvement was necessary to achieve the procedure.

If the Supreme Court upholds the midwives’ earlier successful appeal, it could set a legal precedent, allowing other midwives who object to abortion to take the same stance.

The Royal College of Midwives and the women’s charity British Pregnancy Advisory Service have both warned that any such ruling could have severe implications for the care of women choosing to terminate their pregnancy.

The BPAS is the largest abortion provider in the UK. I blogged before about their leader, Ann Furedi, who supports sex-selection abortions. I thought then that sex-selection abortions was the worst thing about abortion, but now I see that she would actually force her moral views on other people, compelling them by the power of government to act against their beliefs. There is something deep inside me that just recoils from making a person do something that they think is morally wrong. But I guess pro-abortion people don’t share my concern.

When I blogged before about these two midwives when they won their appeal case, I wrote this:

If the health care system were private, then it would be easy for midwives to find another company to work for that did not violate their consciences. But when the government runs the whole health care system, where are you supposed to go? They are a monopoly and they make the rules. Yet another reasons for Christians to vote for smaller government. In a free market, if you don’t want to buy something from one store, you can go to another store. There is competition. But where are these nurses supposed to go? They are midwives, and the government and the courts make the rules in a government-run health care system.

This is why we need to keep the government OUT of health care. When you work for a government monopoly, and they want you to do something that you don’t want to do, you have two choices – do what they want or leave the country. If the only health care system is government-run, then if you want to practice health care, you have to leave. That seems unfair to me.

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In North Dakota, 35,000 lose their health care plan, but only 30 sign up for Obamacare

I know that Obama talked a lot about wanting to help people without insurance find insurance, but so far all he done is make a lot of people lost their insurance (and more to come in 2014!).

Here’s a story from ABC News.

Excerpt:

More than 35,000 customers in North Dakota face discontinued health coverage because their plans are being scrapped due to new requirements under the Affordable Care Act.

The three major health insurers in North Dakota were asked to report to state regulators their enrollment figures and cancellations resulting from the health reform act, commonly known as Obamacare.

The state’s largest health insurer, Blue Cross Blue Shield of North Dakota, covers about 31,600 members – 17,000 in small groups and 14,600 individuals – whose insurance plans are being discontinued.

That combined figure represents 8 percent of the North Dakota Blues’ 400,000 membership total.

[…]The total number of North Dakota residents who must switch coverage is 35,585, according to the tally by the state Insurance Department.

“You have almost 36,000 North Dakotans who either are or will be losing their health insurance policies, and this is after they and all Americans have been told they will be able to keep their health insurance,” Insurance Commissioner Adam Hamm said Friday.

The premiums are all going up because Obamacare mandates new coverages, which people did not have on their old plans. They didn’t have those coverages because they didn’t need them. For example, people who weren’t addicted to drugs didn’t request treatments for drug addiction. But now we all have to pay for it, whether we use it or not. That makes prices go up!

More:

Under the new requirements, deductibles for individuals or small groups are generally capped at $2,000, with an exception allowing caps of up to $5,000 for individuals and $3,000 for small groups.

Total out-of-pocket expenses now cannot exceed $6,350 for an individual or $12,700 for a family.

Nationally, estimates of the percentage of policies that will be discontinued under the new coverage requirements have ranged from 40 percent to 67 percent, Krystopolski said.

In most cases, plans failed to meet the new requirements because they did not cover maternity care or because the deductibles were too high, she said.

So how many of those 35,585 people that the Democrats kicked out of their insurance plans have found new ones on the Obamacare exchanges?

Almost none:

Besides collecting information on cancellations, Hamm’s office asked the three major health insurers to report the number of enrollments under the new health insurance marketplace provided by the Affordable Care Act.

As of Friday, the three insurers have logged 30 enrollments covering 37 people, a number Hamm called “concerning.”

Remember that these figures only represent the effects of the individual mandate. Things are going to get a lot worse when the employer mandate takes effect in 2014. For those of us with health care through our employers, our day is coming.

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Democrats refuse another offer from Republicans to avoid government shutdown

As expected, the Senate Democrats rejected the compromise on Tuesday.

Last Night, Senate Democrats Voted Along Party Lines To Shut Down The Government Rather Than Agree To Delay Obamacare’s Individual Mandate And Surrender Their Special Insurance Subsidies. “In an extraordinary back-and-forth between the House and Senate that extended late into the night, Democrats beat back attempt after attempt to gut President Barack Obama’s signature health care law. After Senate Democrats rejected the House’s year-long delay of Obamacare and a repeal of the medical device tax on Monday afternoon, Democrats returned to the floor after 9 p.m. to kill another House GOP proposal. The second measure would have kept the government open in exchange for delaying the health care law’s individual mandate and eliminating federal health care contributions for lawmakers and Capitol Hill aides. (Burgess Everett and Manu Raju, “Government Shutdown Update: Senate Rejects House Plan – Again,” Politico, 9/30/13)

According To The Congressional Budget Office, Delaying The Individual Mandate By One Year Would Reduce The Federal Budget Deficit By $35 Billion. “CBO and the staff of the Joint Committee on Taxation (JCT) estimate that enacting H.R. 2668 would reduce federal deficits by roughly $36 billion over the 2014-2018 period and by roughly $35 billion over the 2014-2023 period.” (Cost Estimate Of H.R. 2668: An Act To Delay The Application Of The Individual Health Insurance Mandate, To Delay The Application Of The Employer Health Insurance Mandate, And For Other Purposes, Congressional Budget Office, 9/6/13)

A July Poll Found That 77 Percent Of Registered Voters Support Delaying The Individual Mandate Or Repealing It Entirely. (Morning Consult Poll, 2,076 RV, MOE 2%, 7/24-26/13)

Member of Congress And Their Staff Are Required To Enroll In ObamaCare’s Exchanges. “Sen. Charles Grassley, R-Iowa, then succeeded in adding a measure to Obama’s health care bill three years ago requiring members of Congress and employees in their offices to leave the Federal Employee Health Benefits program and start buying their insurance through the state exchanges that open Tuesday under the Obamacare law.” (Laurie Kellman, “GOP demanded lawmakers pay more for health care,” The Associated Press, 10/1/13)

But OPM Granted Congress The Ability To Provide Subsidies, Which Are Not Available For Other Americans, To Help Purchase Insurance Though The Exchanges. “But the statute means that about 11,000 Members and Congressional staff will lose the generous coverage they now have as part of the Federal Employees Health Benefits Program (FEHBP). Instead they will get the lower-quality, low-choice “Medicaid Plus” of the exchanges. The Members-annual salary: $174,000-and their better paid aides also wouldn’t qualify for ObamaCare subsidies. That means they could be exposed to thousands of dollars a year in out-of-pocket insurance costs…And now the White House is suspending the law to create a double standard. The Office of Personnel Management (OPM) that runs federal benefits will release regulatory details this week, but leaks to the press suggest that Congress will receive extra payments based on the FEHBP defined-contribution formula, which covers about 75% of the cost of the average insurance plan. For 2013, that’s about $4,900 for individuals and $10,000 for families.” (Editorial, “Congress’s ObamaCare Exemption,” The Wall Street Journal, 8/5/13)

I listened to a recent episode of the Weekly Standard podcast, and guest Bill Kristol was advising the GOP to make exactly this proposal, saying that it was a strong move by the Republicans. I agree. We now have vulnerable Democrats going on record in favor of special perks for themselves and their staff, as well as the hated individual mandate. As soon as people see the sticker shock of being forced to buy insurance, or pay a fine, we are going to have a valuable tool in the 2014 elections. The left-wing media isn’t going to be able to protect the Democrats from their own votes.

UPDATE: The Weekly Standard approves of what the GOP is doing.

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