More Health Care Distortions and Misunderstandings

Matthew Yglesias reports on a distortion of the health care debate from Tom Colburn but unfortunately both he and Steve Benen repeat a common misunderstanding in the liberal blogosphere.

On CSPAN this morning, Senator Tom Coburn made the case against a government-run insurance plan on the strange grounds that a government-run health care delivery system would be ineffective. Specifically, he claims that “the VA is not up to the level of care of the rest of the country.” In reality, as Phillip Longman has detailed it’s true that VA Health Care is not of the same quality as health care elsewhere—it’s better.

The important point is that nobody is talking about promoting a government-run health care delivery system like the VA. Such proposals are not on the table. There is no need to confuse valid arguments for reforming the insurance system with such arguments which only play into the right wing’s scare tactics about government taking over health care. However I wish liberal blogs would cut out such claims about the VA. Citing flawed reports on quality of care undermine the validity of more truthful arguments for health care reform, especially among those who are aware of all the flaws in the VA system.

Evaluations of quality in health care are very primitive, and typically come down to what is reported as opposed to measures of actual quality. They measure only a handful of parameters but do not measure the quality of care in other areas and doctors in private practice typically do not have the time to devote to reporting what they are doing as the VA does. Systems which grade based upon a handful of parameters but which are labor intensive to report work to the benefit of the VA but do not represent the actual quality of care.The VA’s computer system gives them a huge edge in such quality measures which has little to do with actual quality.I have discussed this in more detail in previous posts such as here.

When you move beyond the flawed measures cited in the other blogs, care from the VA is highly mixed.  The problems with their care is one reason why many people, including Democrats, have been arguing that the VA system should be changes so that vets can receive reimbursement for receiving treatment elsewhere in private practices.

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  1. 1
    Fritz says:

    Sounds like some groups are getting cranky…

    President Obama said Saturday he wants to help pay for his health care overhaul by slowing Medicare and Medicaid spending, but hospitals, medical technicians and others are resisting.
    The high-stakes struggle over medical care is heating up as Obama declares the status quo unacceptable.
    The president suggests trimming federal payments to hospitals by about $200 billion over the next 10 years, saying greater efficiencies and broader insurance coverage will justify the change. Hospitals, especially those with many poor patients, say the proposed cuts are unfair and will harm the sick and elderly.

  2. 2
    Ron Chusid says:

    Obama might be doing this backwards. His idea, which on the surface seems to make sense, is to try to save money in Medicare spending in order to expand health care coverage.

    It may be necessary to do this in the reverse order. If more people have medical coverage, hospitals will no longer lose the type of money they do on unreinbursed care. The increased revenue from having more insured would make it easier to handle some cuts in Medicare.

    It also depends where the cuts come from. The main cuts Obama has pushed so far have been to Medicare Advantage plans. Such cuts would primarily cut insurance company profits and not cut revenue for hospitals. These cuts are fine, but there is limited room for cuts which will actually impact hospitals.

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