...and the other truth that was revealed

In my anger over the (unsurprising) revelations at Walter Reed Army Hospital, I forgot to mention something very important. Fortunately two wmtc readers conspired to remind me.

When James noted that the wingnut spin on this debacle is "this proves the government can't run health care," M@ noted that the reality is quite the opposite. The short-term culprit here is privatized services, run for profit, through contracts handed out by patronage. The federal government is being run like Boss Tweed New York, but now tax cuts are handed out instead of turkeys.

Some bloggers who've teased out the whole IAP/Walter Reed/Weightman story are Liberal Avenger and Unbossed. I recommend reading both those great posts.

Paul Krugman addressed the larger issue in a recent column, brought to you by the good folks at truthout.
When Salon, the online magazine, reported on mistreatment of veterans at the Walter Reed Army Medical Center two years ago, officials simply denied that there were any problems. And they initially tried to brush off last month's exposé in The Washington Post.

But this time, with President Bush's approval at 29 percent, Democrats in control of Congress, and Donald Rumsfeld no longer defense secretary - Robert Gates, his successor, appears genuinely distressed at the situation - the whitewash didn't stick.

Yet even now it's not clear whether the public will be told the full story, which is that the horrors of Walter Reed's outpatient unit are no aberration [emphasis mine]. For all its cries of "support the troops," the Bush administration has treated veterans' medical care the same way it treats everything else: nickel-and-diming the needy, protecting the incompetent and privatizing everything it can.

What makes this a particular shame is that in the Clinton years, veterans' health care - like the Federal Emergency Management Agency - became a shining example of how good leadership can revitalize a troubled government program. By the early years of this decade the Veterans Health Administration was, by many measures, providing the highest-quality health care in America. (It probably still is: Walter Reed is a military facility, not run by the V.H.A.)

But as with FEMA, the Bush administration has done all it can to undermine that achievement. And the Walter Reed scandal is another Hurricane Katrina: the moment when the administration's misgovernment became obvious to everyone.

The problem starts with money.
Read Krugman's column here.


James Redekop said...

There's a big flaw in market-driven health care that I rarely see mentioned in the debates on the subject: it's not profitable to provide services to people who can't afford them.

Likewise with insurance. It's not profitable to insure low-income or high-risk people.

If a private company's primary duty is to its shareholders (I've even heard it said that a private company's only moral duty is to its shareholders, which leads back to the "they'd kill us and sell our organs if the return on investment was good" model), then it's the company's duty to refuse to engage in lossy ventures. And if that company's a health-care provider, there's nothing lossier than caring for people who can't afford the treatments.

There are only two kinds of organizations who can provide health care: governments, who don't have to be profitable, and companies, who do. If companies are going to do it, then the government has to make caring for low-income or high-risk people either mandatory or profitable -- or be happy with having millions of people struggle with little or no care, which seems to be Bush & Co's approach.

laura k said...

or be happy with having millions of people struggle with little or no care, which seems to be Bush & Co's approach.

It's not only Bush's approach. It's the United States's approach.

FDR, over the objections of private interests and much of Congress, instituted the safety net for the poorest Americans. Other than that, no one at the federal level has done anything about ensuring people's access to health care. As things have worsened with changes in the labour market, nothing has been done to increase access to health care, under any administration of either party.

The Clinton Administration's failed plan was a favourite of the insurance companies. They were foaming at the mouth in expectation of windfall profits - as the pharmacy chains and pharmaceutical companies are now with the so-called prescription drug benefit for seniors (which is no benefit at all).

I've even heard it said that a private company's only moral duty is to its shareholders,

A corporation has no moral duty unless the people running it choose to have one. Under a capitalist system, a private company's only duty is to its shareholders. That's why the government has to regulate corporations. That's why we need labour, environmental and health and safety regulations - because the idea of a moral duty just that, an idea.