Fix Military Health-Care First

Megan McArdle asks, if politically-managed health care is so great, why isn’t military health care a shining example to be emulated? [h/t Instapundit]

It’s an important question to ask and answer because the military health-care system is a completely socialized system. If we can politically manage health care in the real world then the military system should be a shining example of medical care in America. Yet care for both for service personnel and their dependents sucks. 

My son-in-law is in the Army. His knee was injured in a minor training accident in basic. 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. 

My daughter cannot take my granddaughter to see the pediatrician without scheduling an appointment three days in advance. If she develops a fever my daughter has to decide whether to tough it out or take her to the emergency room.  So, not only does the dependent system make care hard to get, it also increases cost because emergency-room visits cost more than visits to the doctor’s office. 

The military system has all the advantages that proponents claim for politically managed health care. The military system is huge and can buy medicines and technology in giant bulk discounts. Military health-care personnel work for far less than the market rate. (In addition, they are under military discipline, something no civil system can ever match.) The military has an integrated and uniform computerized records system. The military studies treatments for effectiveness and standardizes treatments based on those studies

All of these nominal advantages fail because the military health-care 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. Patients have no other choices in health care, so the system faces no market pressures. The politicians who oversee the system are more interested in cost control than in quality of care.

Leftists always seem befuddled when you ask them to demonstrate that their ideas work on a small scale before imposing them on everyone in the country. Since they believe that articulation and deductive logic constitute proof, they see no need to experiment. For the rest of us, however, ideas need testing.

The military health-care system is the perfect test bed for politically managed health care. If leftists can create a military health-care system that provides all of the advantages they claim for their fantasy system then they will be on much firmer ground.

Besides, they deserve it.

9 thoughts on “Fix Military Health-Care First”

  1. Sorry to say this, Ms Love, but fixing military health care is a govt issue and can and of course should be fixed by the govt (Bush cut the heck out of VA funding and it was restored in part by Obama); but that ought not preclude doing more than one thing at a time. If VA hospitals are socialized, then notice that this is not what the Dems want in their health plan, and ought we close down VA hospitals because they are run by the govt–socialized?If yes, then why not end federally insured bank protection? All the vets I know used the VA hospitals in preference to private health plans, and they are happy with the service the deserve and do get.
    I qualify for such care if wanted but use coverage from my wife’s plan instead, simply because parking remains a problem at the closest VA hospital in my area.

    One of the odd things about Obama is that he seems able to deal with any number of things at
    pretty much the same time rather than doing but one and waiting till that is done, fixed, finalized, before moving on to another concern.

  2. I think the idea that military health care should be solved by the government is the entire point of the post. Because it’s a totally socialized system, the government should at least be able to get that right before worrying too much about “fixing” our health care system. Based on what I’ve heard about the VA, I have my doubts that the care there is particularly good.

    Doing too many things at once is the sign of someone seriously inexperienced. There’s a fine line between doing more than 1 thing and doing too many things.

  3. I am confused. There are many specific credible complaints about failures in the VA system and military medicine. Yet there seem to be an enormous number of people such as harry angstrom who are ready to vociferously defend the VA and the military health system and claim these 2 have quality so high that it is unmatched anywhere in the world.

    So who are these defenders, why do they defend, and what proof do they have that allegations such as those made by Megan are a pile of horse-puckey?

  4. All three previous posters have made the usual civilian mistake of confusing the Military Medical system (which serves Active Duty members and dependents and retirees) with the VA system. The former is run by the Department of Defense, the latter by the Department of Veterans Affairs. They are two different systems with two different missions. Given the absolute ability of the DoD to tinker with the Military Medical system, the author’s point is spot on – if the government can’t get it right in the most tightly controlled environment possible, what hope is there for success on a truely national scale?

  5. Harry Angstrom,

    Sorry to say this, Ms Love, but fixing military health care is a govt issue and can and of course should be fixed by the govt…

    Well, yes, that was the entire point of my post. We should turn the military health care system into a test bed for all the methods that we want to apply to the civilian system.

    Note that I said the military health care system, not the VA. They are two entirely separate systems. Of course, we can also test somethings in the VA system.

  6. ought we close down VA hospitals because they are run by the govt–socialized?

    The VA system, not the subject of the post but of your comment, is the most politicized health care system on earth. You may prefer to go to a VA hospital but you are in a minority of people who have access to private care. A friend of mine, a retired oncologist, goes to the VA because an old pal of his, an internist in Santa Barbara where they both live, is the VA internist. I have worked in VA hospitals and they are OK for vets with no insurance and, in wartime, can be a godsend for troops injured where the VA has some good rehab facilities.

    I have a number of family who are either active duty military or retired. The biggest problem the military has is the willingness of young doctors to spend years in the bureaucracy of the medical corps. I’ve been there as an enlisted man and as a medical officer. The military is great for trauma care; none better in the world. Their training is superb as they are one of the most sophisticated users of virtual reality on earth. Dependent care is something else. That may get better as Obama destroys private medicine. The military has gotten into trouble by taking some very questionable docs. Maybe that will be less of a problem as doctors flee the “public option.”

    I have a bit of that here.

  7. Well … it’s a mixed bag, really – there are so many variables. I had great care, as a military member overseas – even when I was an OB-Gyn patient, and my daughter had very good care as a dependent-of-active duty. It’s a bit more problematical as a retiree on Tricare, and generally in pretty good health. Frankly, I go so far between appointments (at Brooke Army Medical Center, which is THE showplace for military medical care) that I tend to have a different primary care provider each time. So, it’s probably a good thing for me, that they tend to forget about me, altogether, in between appointments.
    But when I was on active duty, I was usually seen at Air Force clinics, and sometimes by foreign-contract doctors. My one experience, while assigned to the Army and having to take my medical needs to the troop clinic at Yongsan AIG was so purely horrible, that eventually I preferred to take a two-hour bus ride to Osan AB to the Air Force clinic there. Before I chose to do that, I ran into about every dysfunctional medical practitioner imaginable, from doctors who could barely understand and speak English, to administrators who insisted that whatever your ailment, if you didn’t take it to the troop clinic- which was scheduled for only four hours a day – you were just SOL. Unless you were bleeding arterially, had compound fractures, an incipient heart attack or a temperature of over 105 – eh, you could just suck it up and drag your malingering a** to the troop clinic, thank you very much.

    My idea of socialized medical hell is for us all to be condemned to go to something like the Yongson AIG troop clinic, now and forever, amen.

  8. SgtMom, I know what you mean. I once ran a sick call on active duty as an Air Force EM. I had been pulled out of medical school in 1961 when the Berlin Wall went up. There were two medical students in our reserve unit. I ran sick call and the other medical student ran the Flight Surgeon’s Office. The doctors all took off most of the time. It was good experience for me at the time, but maybe not so good for the folks on sick call.

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