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VA Hospital Scandal Points to Madness of Single-Payer Health Care

Advocates of single-payer have long pointed to VA hospitals as examples of how a single-payer, government-run health care system can work in America. But this NYT story on a whistleblower’s letter complaining about a “pattern of problems” at one Mississippi VA hospital paints a much less appealing portrait of these institutions:

The problems over the last six years include poor sterilization procedures, chronic understaffing of the primary care unit and missed diagnoses by the radiology department…

The final whistle-blower, a retired ophthalmologist who was active in the physician’s union at the medical center, told the special counsel that a former radiologist at the hospital “regularly marked patients’ radiology images as ‘read’ when, in fact, he failed to properly review the images and at times failed to review them at all,” the special counsel’s letter to the White House says. In some cases, fatal diseases were not diagnosed, the letter says.

One hospital, of course, can’t justify a sweeping indictment of a whole health care concept—except for the fact that, as the NYT says, this particular facility “had been considered one of the better medical centers in the department’s sprawling system of 150 hospitals.” If systematically poor treatment can persist unaddressed for six years at the top of the VA hospital system, what goes on at the bottom?

One lesson of this story is that—just possibly—putting the whole health care system under government control wouldn’t work here. There are certain fiscal advantages to a single-payer system, but too many people have focused on these cost savings without also noticing the failures and limits that come with them. Both this scandal and the revelations earlier this year of horrific conditions in a Stafford hospital in single-payer Britain give us a preview of those pitfalls.

More importantly, a single-payer system can’t keep up with the pace of innovation and change in health care. Top-down government controls that regulate drugs, technologies, and new treatment delivery mechanisms are by nature complex, clumsy, and reactive. They aren’t good at responding quickly to new developments, and they’re susceptible to groups with vested interests who are skilled at using government controls to keep us mired in the status quo.

This Mississippi VA hospital is a foretaste of what could happen if we cede more control of health care to government-run systems. Let’s hope we don’t go down that road.

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