As VA Goes, So Goes ACA?

So it goes.
Kurt Vonnegut, Jr (1922-007), Slaughter House 5

ACA critics are wont to compare ObamaCare to the VA health system. The cite the VA as an example where a single-payer government-run system might lead – a mindless unaccountable bureaucracy with rationing and long waiting lines.

The VA has the nation’s largest integrated, coordinated health system connected by a single health information system. But last year the VA’s problems became glaringly apparent, with veterans said to be dying while waiting for months to be seen and a widespread shortage of physicians, nurses, and other care givers.

Things aren’t getting any better. Demands for VA services is up 50% this year, costs are growing because of a growing population of aging veterans with dementia and chronic disease, costs of new drugs for hepatitis C and cancer are mounting exponentially, and the VA faces a $2.7 billion budget shortfall. Access has expanded with 2.7 million more appointments and authorization for 900,000 people to see physicians outside the VA system. Physician workloads have grown by an average of 21% across the system, but no supply of more physicians is in sight.

The principal VA problems are increased demand, shortages of physicians and nurses, lack of office space, and a complicated, seemingly intractable, querulous, whistle-blowing bureaucracy full of infighting and finger-pointing superimposed on a larger political debate about the size and role of government and its inherent inefficiencies.

And so it goes. Whether ObamaCare is headed in the same direction is unknown. But so it goes with the VA.