We told you so! Single-payer health care plans provide poorer care

The First Street Journal has pointed out, more than once, that the waiting list scandal in the Department of Veterans Affairs medical care system was simply the common practice among single-payer health care systems in the developed world to contain costs. Americans are not used to such things, wanting, and expecting, and normally getting fairly prompt medical care.

And now comes confirmation of our point, kind of from the back side, from the Congressional Budget Office.  As Fox News reported:

Fiscal hawks are warning that new legislation passed in both chambers of Congress this week in response to the Veteran Affairs scandal could cost taxpayers more than $500 billion over the next decade.

A Senate source told FoxNews.com on Friday that lawmakers “passed a bill they didn’t read which led to Congress issuing a blank check with real consequences for the country down the road.”

The Committee for a Responsible Federal Budget rang the alarm bells over the bill on Thursday, releasing a statement saying the Senate version of the bill “violates every principle of good budgeting, and could add substantially to the national debt.”

The group claimed the bill could create an entitlement program bigger than Medicare Part D (the prescription drug program), citing in part nonpartisan congressional budget estimates.

The Congressional Budget Office estimates that preliminary costs for just one provision of the bill — which gives the VA authority to contract with private health care providers to ensure veterans get care — would exceed more than $35 billion through 2016. The CBO also estimates that the provision could ultimately cost $50 billion per year.

“If the program were permanently extended, and fully phased-in costs grew with inflation, the total cost could exceed $500 billion over the next decade before interest,” the CRFB warned.

Translation: enabling veterans using the VA health system to get the prompt attention which they deserve, and to which Americans believe that veterans, and everyone else, is entitled costs more money, a lot more money.

Congress had mandated that the VA provide what most Americans expect: prompt care. In order to qualify for bonuses, the VA medical care administrative leadership had to cook the books, and use tactics which made it appear that veterans were getting prompt appointments, when they were not.1 More, bonuses aside, they had to make it look like they were doing the jobs for which they were hired.  But the VA never had the resources to provide the care that the Congress had mandated, and now we have the (supposedly) non-partisan CBO telling us just how much more that the care everyone expects will cost.

Your Editor has, twice now, endorsed having the United States go to a single-payer health care system, because we are unwilling to impose market discipline and deny medical care to those who cannot or will not pay for it, but I have always noted that such would provide much worse health care. We at The First Street Journal are brutally realistic about these things,2 and understand that nothing is free, that everything has to be paid for, by someone, and that if you believe you can buy something cheaply, cheap is exactly what you’ll get.

  1. Whether any federal employees ought to qualify for bonuses is another matter entirely. Federal employees are already paid more than their private sector counterparts, and the ones eligible for bonuses are at the top of the federal pay scale. If they believe that they just have to be paid more, then they are welcome to try their luck with private employers.
  2. This sentence does not imply that any of the other authors on this site have endorsed the single-payer idea, but every one of us recognizes just how crappy single-payer health care coverage would be here.

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