ABOLISH, NOT GROW, VA HEALTH CARE SYSTEM

U.S. Sen Bernie Sanders is passionate about ensuring all Americans have health insurance. The Democratic presidential candidate is right to support offering Medicare to everyone, which makes fiscal and moral sense.

Sanders is also passionate about honoring this country’s veterans. But he is wrong about preserving and fortifying the Veterans Administration health care system.

During a recent visit to Iowa, Sanders released a plan that includes immediately filling nearly 50,000 vacancies within the VA, spending $62 billion (yes, billion with a b) to repair and update infrastructure in VA facilities and loosening regulations that qualify veterans for VA care.

These are not good ideas.

To really improve veterans’ access to a wide range of care, Congress should abolish the VA system, give veterans health insurance to visit any provider or hospital they choose and invest the money saved in the health care infrastructure all of us rely on.

The VA operates about 1,300 hospitals, nursing homes and clinics nationwide. Many veterans do not live near a facility, which forces them to drive long distances. Though Congress has expanded the ability for veterans to more easily get care in the private sector, that has created additional bureaucracy, red tape and expenses.

With a health insurance card in hand, veterans could visit health providers, hospitals and emergency rooms near where they live. They could have the same family physician as their spouses. They could go to any counselor, pharmacy or physical therapist they choose. They wouldn’t have to drive in a snowstorm from a rural location to a VA hospital.

The VA system, which serves about 9 million people, also doesn’t make sense for the roughly 320 million nonveteran Americans who cannot access its facilities and expertise.

You may live right down the street from a VA hospital. Your taxes fund it. It may provide excellent care. But you’re likely among the 97 percent of Americans who can’t use it.

Sanders also wants to beef up the workforce at the VA, which already employs nearly 15,000 doctors and 61,000 nurses. That is easier said than done. Where would those workers come from? Thousands of new professionals are not going to miraculously appear out of thin air. The federal government will invariably siphon many of them from the private sector, where they are already in short supply. When they become government employees with the VA, they abandon the private health care system the rest of us rely on.

In addition, Sanders wants to expand health insurance access to members of the National Guard and provide veterans with dental care — an important and often overlooked part of health care. But it does not make sense to run a parallel health care system and use billions of taxpayer dollars to maintain aging facilities and pay health professionals available to only a small segment of the population.

Sanders certainly has good intentions: “We may argue in a democracy about the wisdom of this war or that war, but I hope there is no disagreement that the men and women who put their lives on the line doing their duty defending our country deserve the best quality care we can provide them,” he said.

They do deserve the best care. And much of it exists in hospitals, universities, the Mayo Clinic and numerous facilities throughout the private sector. With government-funded health insurance, veterans could access all of it.

Before the Affordable Care Act was implemented, researchers found that about one in 10 nonelderly veterans did not have health insurance or had not used care available from the Veterans Administration.

Obamacare was expected to dramatically help veterans because it expanded Medicaid, thus covering more low-income people, and provided subsidies to help pay for private health insurance.

It appears the law did exactly that.

From 2013 to 2015, the uninsured rate for veterans fell by an estimated 42%. Over this time, veterans also experienced fewer unmet health needs, suggesting that increased coverage translated into improved access to care, according to an Urban Institute study.

Politicians who want to help veterans should recognize how the ACA has provided health insurance. So should Republican governors who still refuse to expand Medicaid in their states.

— USA TODAY