Steve Robinson’s melodramatic rhetoric regarding Veterans Affairs employees gaming performance metrics for wait times misinterprets facts to discredit single-payer health care and the VA (“VA corruption devastating for Michaud, single-payer fans,” June 7).
He confuses the VA health care system, a monopoly, with the single-payer system that’s been advocated by people such as Sen. Bernie Sanders.
The single-payer, universal health care system, as exemplified by Canada – and our own Medicare – is a monopsony. In a monopsony, instead of having a single seller, as in a monopoly, there is a single buyer.
A state monopsony would allow many advantages and eliminate many of the vices that exist under our privately controlled oligopoly of health insurance giants and health care conglomerates that buy, sell and trade care for considerable reward, while distributing care according to who can pay and impoverishing many Americans.
When the VA decided to offer financial incentives for lowering wait times, it was borrowing a tactic of the private sector. HMOs (notoriously) and today’s accountable care organizations use financial incentives to increase cost efficiencies, as recommended by the National Commission on Physician Payment Reform.
Mr. Robinson alleged: “Federal workers systematically defrauded transparency protocols to slake their greed.”
It’s as likely their deception was to avoid sanction. In an authoritarian organization, in the face of unreasonable demands, rather than raising protest, it’s sometimes easier to deceive your superiors.
The tempest over the fraudulent manipulation of wait-time data leaves few voices to ponder the reasons for excessive wait times, which suggest shortages of professionals. This is at the heart of the matter, for which there may be much blame to go around.
Perhaps our continual wars and the vast numbers of veterans who’ve sought help from a beleaguered VA system have something to do with this particular scandal, with its accompanying sound and fury.