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Jun 24, 2009

Military Healthcare is Not a Shining Example

Fix Military Healthcare First
06/24/09 - ChicagoBoyz by Shannon Love

We should test ideas and promises at a scale smaller than "everyone".

[edited] Megan McArdle asks (Via Instapundit): Why isn’t military healthcare a shining example, if socialized, politically managed healthcare is so great,? In fact, care sucks for both service personnel and their dependents.

My son-in-law in the Army injured his knee in a minor training accident. The Army hospital botched his treatment and almost cost him his career. Almost everyone in the military can tell a similar first- or second-hand story of poor treatment.

Pediatrician appointments must be arranged three days in advance. If my granddaughter develops a fever, my daughter must decide to tough it out or take her to the emergency room. The rules make care hard to get and increases costs by relying on emergency room visits.

The military system has all the advantages claimed for politically managed healthcare.

  • It is huge and can buy medicines and technology at bulk discounts.
  • Their personnel work for far less than the market
  • They are under military discipline that no civil system can match.
  • They have an integrated, computerized records system.
  • The military standardizes treatments according to measured effectiveness.

All of these nominal advantages fail because the military healthcare system is a giant, politically managed system.

  • The shear size of it makes it difficult for those at the top to know what is going on in the system. Small scale, bottom-up innovation is difficult.
  • The system pays for the training of its personnel (just as Obamacare plans to), so managers have a disincentive to remove the careless or the incompetent. [A manager must spend money to train any replacements.]
  • Patients have no other choices, so the system faces no market pressure. [It is a pre-paid service.]
  • Politicians are more interested in cost control than in quality of care.

Leftists seem befuddled when asked to demonstrate that their ideas work on a small scale before imposing them on everyone. They believe that articulation and logic is enough and see no need to experiment.

For the rest of us, ideas need testing.


VA Medical System in Shambles
06/24/09 - Fox News by Joseph Abrams (via Instapundit)

So, a healthcare agency administered by government, for say 60 years, for veterans, isn't yet managed properly? Who would have thought that? (smile) Where is the internal oversight, dialogue, and search for excellence? More importantly, who are you going to sue?

[edited] Veterans Affairs hospitals botched radiation treatments to nearly 100 vets and exposed 10,000 to HIV and hepatitis viruses. Veterans advocates and lawmakers say the VA health system is in dire need of proper oversight and funding.

Veterans groups and lawmakers say VA hospitals have permitted these violations because federal regulations allow doctors to work with little outside scrutiny. They say the VA health system, with its under-funded hospitals and overworked doctors, is showing signs of an "institutional breakdown," in the words of one congressman.

"Lack of inspections, lack of transparency" were likely to blame, said Joe Wilson, deputy director of the Veterans Affairs and Rehabilitation Commission for the American Legion, who testified before Congress this month on transparency problems in a budgeting arm of the VA.


Canada's Healthcare Has Hidden Costs
"Access to a waiting list is not the same thing as access to health care"

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