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November 11, 2011 3:35 PM Romney eyes vouchers for veterans

By Steve Benen

Mitt Romney spent part of his Veterans’ Day in Maudlin, South Carolina, visiting with a dozen vets, and wandering into some dangerous policy waters.

Talking with the veterans about the challenge of navigating the Veterans Affairs bureaucracy to get their health care benefits after they leave active duty, Romney suggested a way to improve the system would be to privatize it.

“Sometimes you wonder, would there be some way to introduce some private sector competition, somebody else that could come in and say, you know each soldier gets X thousand dollars attributed to them and then they can choose whether they want to go on the government system or the private system and then it follows them, like what happens with schools in Florida where they have a voucher that follows them, who knows.”

Even the most conservative Republicans rarely venture into privatizing veterans’ health care benefits. Last year, the Republican U.S. Senate candidate in Colorado went there, but it was problematic enough that his campaign quickly walked it back.

And I wouldn’t be too surprised if Romney’s team does the same today.

In the meantime, Romney’s willingness to voucherize veterans’ care should be a pretty big deal. For the Washington Monthly, this has been a long-time area of interest — in 2005, we published a Philip Longman piece on V.A. hospitals called, “The Best Care Anywhere.”

As Longman explained at the time, “Who do you think receives higher-quality health care. Medicare patients who are free to pick their own doctors and specialists? Or aging veterans stuck in those presumably filthy VA hospitals with their antiquated equipment, uncaring administrators, and incompetent staff? An answer came in 2003, when the prestigious New England Journal of Medicine published a study that compared veterans health facilities on 11 measures of quality with fee-for-service Medicare. On all 11 measures, the quality of care in veterans facilities proved to be ‘significantly better.’ … The Annals of Internal Medicine recently published a study that compared veterans health facilities with commercial managed-care systems in their treatment of diabetes patients. In seven out of seven measures of quality, the VA provided better care.”

Yes, the taxpayer-financed, government-run V.A. hospitals are some of the finest medical facilities in the country. That is, by the way, as it should be — men and women in uniform put their lives on the line for us, and providing them with world-class medical care and facilities is the least the country can do in return. In this case, it just so happens that world-class care comes in government-run facilities.

Romney, the Republican frontrunner, prefers to change this, and would apparently rather hand vets a voucher. Perhaps the inexperienced former one-term governor with no background on military policy hasn’t fully thought this through. For him to go this far on Veterans’ Day, of all days, seems remarkably tone deaf, even for him.

Update: A spokesperson for Veterans Of Foreign Wars made clear this afternoon, after being asked about Romney’s comments, “The VFW doesn’t support privatization of veterans health care.”

Steve Benen is a contributing writer to the Washington Monthly, joining the publication in August, 2008 as chief blogger for the Washington Monthly blog, Political Animal.

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  • Redshift on November 11, 2011 3:46 PM:

    To a market-worshiper, free markets always provide better service for lower cost, mysteriously accomplishing this even in an arena where higher profits result from providing worse service (like health insurance companies making it more difficult to get care.)

    This is an article of faith. If reality contradicts this, reality is wrong.

  • Peter C on November 11, 2011 4:02 PM:

    The 1% love markets because, unless they are perfect, markets favor the side which is more economically powerful.

    The 1% want everything to be for sale, especially our democracy.

  • TCinLA on November 11, 2011 4:07 PM:

    Always nice to watch Mittens prove my father right, that the way you understand those people is remove the second "m" from the name of their religion.

    What an idiot!!! I gave up my "gold plated" Writers Guild health insurance the day I qualified for VA care because the VA care is "platinum plated." And the VA, with its computerized health care records, is a safer place for me to go, since I never get a medicine prescribed that is a no-go with the other things I take (a common problem in the usual private system with its paper records that don't include anything that isn't from that particular doctor or office). When I consider the quality of care I get from the VA, as opposed to what I could get in the private sector, my only thought is, rather than "Medicate for everyone" for single-payer, it should be "VA for everyone."

    Question: does Mitt Romney actually have a brain?

    Of course, those vets in South Carolina were probably too stupid to realize what he was saying. When I went in the Navy, 1/3 of my recruit company was from Colorado, 1/3 from California, and 1/3 from South Carolina. It was the first time I ever met really stupid people in my life (as in the average score of the South Carolinians on the Armed Forces Qualification Test was around 28 - the average for the Navy of that test was about 60). I could not believe how ignorant of things the rest of us took for granted those boys were. And throughout my time in the Navy, the dumbest morons I met were all from either South Carolina, Alabama or the topper of all, Mississippi. I'm sure those South Carolina vets think they won the war in Vietnam. So it doesn't surprise me that Mittens the Moron (er, I mean Mormon) would put forth such an idiotic plan in such an ignorant place.

  • AngryOldVet on November 11, 2011 4:17 PM:

    As one of those receiving their health care thru the VA system, Mittens has issued fighting words. Besides the quality care that I receive, I have had very, very few contacts with anyone working for the VA who does not care about the patients!!! In my previous life in the for-profit health care system, I experienced damn few people who I was convinced gave a damn about anything other than making money.

    There is no fucking way in hell that I would trade my VA health care to go back into the for-profit health care system.

    Why the f*ck do repukes continue to insist that health care systems are only good if the wealthy can make a profit from them?

  • M. Paul on November 11, 2011 4:26 PM:

    "Vouchers for Veterans" ??? Are you kidding me?

    How about just starting with, "Respect and Honor", instead of alliteration from A$$ holes.

    Ok, back to lurk mode.

    M. Paul

  • T2 on November 11, 2011 4:37 PM:

    poor Mitt...so out of touch. In a week where !gasp! Republicans actually voted for a jobs bill to help returning Vets, Mitt floats a plan to make sure they get no health care benefits. Every other Vet from WW 1 to the present has been able to count on these benefits, but in the world of multi-millionaire Mitt Romney (R-Muslim), we'll just give them a worthless piece of paper when they finish getting shot at and tell them "see ya".
    That ought to really pick up the pace of recruitment for our all volunteer armed services, don't you think?
    Like "Join the Army and see the World (aka. Mid-East) and if you happen to lose your legs to an EID, here's a voucher to help you through the first couple weeks." After that, see you on the street corner. Maybe Mitt will flip a quarter out when his limo drives by.

  • Equal Opportunity Cynic on November 11, 2011 4:39 PM:

    Mitt Romney spent part of his Veterans’ Day in Maudlin, South Carolina...

    I believe that's spelled Mauldin, even though several of the GOP candidates would fit right in a town called Maudlin.

  • biggerbox on November 11, 2011 4:43 PM:

    At some point, the GOP's belief in private sector competition starts to seem like believing in the Tooth Fairy.

    While it is true that, in occassional special cases, a tooth gets exchanged for money, you wouldn't want to build national policy on it.

  • jonas on November 11, 2011 5:01 PM:

    Ah, vouchers. The solution to all public policy problems. At least Romney was smart enough to frame this as a series of rhetorical questions that can be walked back the next day if necessary.

    And how big, exactly, would these vouchers be? $500? $5,000? And what happens when your voucher's been spent at that wonderful, efficient, free market hospital or doctor's office and you still need help? Good luck with that.

  • trifecta on November 11, 2011 5:07 PM:

    Ok. You just came upon an ambush. You see half of your platoon killed by an IED, their guts lying on the ground in pools of blood. Another explosion goes off, and your brain rattles, and suddenly you can't feel your leg, because it's missing.

    Now it's time to get a voucher and hunt for a doctor. F U Romney. Seriously, F U.

  • fostert on November 11, 2011 5:15 PM:

    Unfortunately, I had second hand experience with this and got to do an apples to apples comparison. My mom and my roommate both had leukemia. Mom was treated at MD Anderson, arguably the best private cancer facility in the US. My roommate was treated at the Denver VA Hospital. Both got excellent care, although my roommate had no co-pays and my mom did. They got the same chemo, the same drugs, the same regular testing, etc. There were three differences I could see. The VA found ways to reduce costs without compromising treatment. For instance, mom got her neupogen shots in a preloaded epi-pen style syringe, while my roommate got the traditional syringe and a bottle. This is a shot that you need every day and costs about $2,500 per shot in the traditional syringe and $3,500 per shot in the pre-loaded version. The VA made the shot a little less convenient, but saved an easy $1,000 per day on leukemia patients. And I didn't mind administering the shots. Hey, he fought for me, right? The second difference was that the Denver VA was a little overcrowded while MD Anderson never was. But that's not the Denver VA's fault. We spent the last ten years sending them plenty of new patients. The amputee ward was the busiest hospital ward I've ever seen. It just wasn't designed with Iraqi IEDs in mind. But I have to say, the patients are very understanding of the VA's problem in this regard. The third difference was general demeanor of the staff. At MD Anderson, they were professional, but not really caring. Their job was to make money. At the Denver VA, the staff was really nice and attentive. And this was despite the fact that they are more overworked. Part of this has to do with there being a certain awe surrounding the patients. These guys often got their medical problems during wartime service. But there was still a different focus. The VA is not there to increase shareholder value, it is there to serve veterans, and that is what they do. And they do it very well. Yes, there is something wrong with the VA: it doesn't get enough funding.

  • Rudy Gonzales on November 11, 2011 5:27 PM:

    Vouchers for Veterans is a holy war! Romney is two bits short of a dollar and more stupid than I thought! Romney wants to make Medicare a voucher-like system which is not the way to go, period. Currently states have voucher-ed Medicaid system and it has not worked well as there is limitation of services, hospitals and physicians in the program. This adds different layers to go through prior to any service being rendered. Administrative cost are placed with well connected administrators whose primary mission is to limit expenses at the expense of the patient. These management costs are HMO"s and they are not easy to work with. The mimicking of Paul Ryan's manifesto in cutting back on expenses at the expense of the patient is tantamount to allowing the fox to guard the hen house. Federal oversight of this system and methodology is like having a life guard atop mount Everest watching the Mediterranean ocean! The Republican party wants to cut spending beginning with the social programs which they want to administer. They do not want to talk about spreading the tax pain across a greater portion of the population. The "Occupy Wall Street" demonstrators have brought to the forefront the non-production of jobs promised by the TEA party in the 2010 election. Also brought to light is the concentration of wealth in the hands of fewer and fewer people and the concentration of power in stricter, less compassionate hands. The right-winged radical fringe has compromised the TEA/GOP/Republican membership and continues to throw out words like, "Liberals" and "Class warfare" rather than effect jobs as they promised for the 2010 elections. When politicians create legislation forcing their limited mentality restrictions on abortion, they cross the line by forcing their narrow-minded religious beliefs onto others who may not go to their church. They are using the government to effect their religious life into others whether they want to or not. Religion in this case and many other cases should not be allowed by the elite few governing the masses. No one has the right to push or force his or her religious beliefs onto others, period! Medical procedures are to be discussed and decisions made by physicians and patients and their families. Politicians do not have any say in medical issues, period!

  • jjm on November 11, 2011 5:29 PM:

    It's time to tell these 1%ers to go blow.

    What, they don't have enough already? Got to take the last scraps?

    Romney should not have a chance in hell to make to the WH.

    If he does, it could only be because the people have not realized that 'markets' are like 'the house' in gambling: the house always wins.

  • Daryl P Cobranchi on November 11, 2011 5:42 PM:

    While it may seem maudlin, the name of the town is spelled "Mauldin."

  • Peter C on November 11, 2011 7:35 PM:

    “Sometimes you wonder, would there be some way to introduce some private sector competition, ..."

    Ah! Because doctors do a better job when they're in it for the money? How insulting.

    The profit motive runs on greed alone. The 1% want the only motivation in our society to be greed because greed is the only thing that really motivates them.

    I want doctors who care first about my well-being. I want insurance companies ("pay me NOW so you aren't ruined by health costs AND health problems in the future!") to rot in hell - the ghouls!

    When you get to the root of their thinking, their ideas are disgusting.

    What if we tried to ration greed instead of rationing care? "Sorry Donald (and Newt, and Mitt, and Hermann, and Mitch, and Sarah, and John, and ...), you've spent your greed ration today. No more for you."

  • bob h on November 12, 2011 5:58 AM:

    I suppose they were entertained by his insistence that although he spent his Vietnam era years Mormonizing in France, he really wished he were in Vietnam?

  • G L. on November 12, 2011 10:48 AM:

    I'm a vet and VA physician. I'm there to serve the vets (period).

    Scumbag profiteers and politicians of wall street: peddle your dribble elsewhere.

  • Matilda123 on November 13, 2011 8:11 AM:

    As the article ("Best Care Anywhere") referenced in this blog post clearly illustrates, VA's use of integrated medical records is a key factor in its success. Any voucher system by definition would be non-integrated, as patients would "shop" amongst individual providers, all of whom would have their own version of e-records, or none at all. The only exception would be if some entity required every provider to "be on the same page" and the only entity that could possibily do that would be the government. Which, of course, is Socialism in the eyes of Republicans.

    So a VA voucher system essentially kills the chance for a truly integrated system of medical while maximizing the profit motive. What a bleeping disaster.

    Romney reminds of me a the "sneaky little shits" in the "Hitler Youth" fraternity of the movie Animal House. Like the business consultant he was, he will do or say anything to please his client. No doubt he will walk back this stupid idea within days.

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