Via the Sideshow: Walter Reed is not a VA hospital, but an army hospital, which belongs to a different system. This is important because a lot of people, including Gordo, are drawing the wrong lesson from the scandal and attacking the best health care system available to non-millionaires in the United States.
First, the VA is mind-bogglingly cheap. In 2005, the VA system cost $28.2 billion to operate; in 2004, it had 7.4 million enrolled veterans, for a per capita cost of $3,800. That’s still higher than the average of almost every country in the world, but is finally lower than this of Luxembourg, Norway, and Switzerland, unlike the general US average.
In contrast, Medicare and Medicaid cost $900 billion in 2005 and had 80 million enrollees, for $11,000 per capita. It’s expectable for them to cost somewhat more than the national average, because old people, who’re on Medicare, use more health services than younger people. But Medicare and Medicaid’s total cost divided by the USA’s entire population is already higher than the per capita cost of almost every public health care system in the developed world and almost as high as this of the VA system.
The VA is not only cheap but also good. On many indicators, the VA system is rated the best health care system in the US, largely thanks to a rebuilding effort in the 1990s produced by the system’s shocking state of neglect. The VA system reproduces many of the elements of good public health care: a focus on prevention, since enrollment is for life; a centralized database keeping track of who has gotten which tests and is suffering from what condition, since all VA hospitals are managed by the same system; efficient administration and a small paperwork burden, because of the centralized database.
That’s why, as Paul Krugman documents, opponents of public health care do their best to deride the VA system and instead promote bloated, inefficient programs extending Medicare, such as Medicare Part D. Walter Reed plays right to their hands, since it allows them to shift their argument from an ideological opposition to public health care, which is unpopular, to an attack on the government’s incompetence, which everyone likes to hear regardless of whether it applies.