VA scandal lessons are not about the viability of single-payer

By Paul Hochfeld, M.D., Chinh Le, M.D., Betty Johnson and Mike Huntington, M.D.
Corvallis Gazette-Times, Letters, June 16, 2014

We would like to thank Bill Dougherty for his question of whether a single-payer health insurance plan can still be advocated (Letters, June 5, “If VA is example of single-payer, that should be avoided”).

It offers us the opportunity to respond with an unequivocal “Yes!”

There is no question that the issues raised by the recent VA care scandal needs to be addressed, and can be fixed. We still need to acknowledge that in many domains, such as quality and safety of care, cost control, patient satisfaction and ultimately patient health outcomes, the VA has kept pace with, or surpassed private sector health systems, despite its severe constraints and demands (source: New England Journal of Medicine, June 5, 2014).

A statewide, or a national single-payer system would be different from the VA system, as we envision health care financed from an equitable public funding source, but locally administered and privately delivered.

“Gaming the system,” using misaligned performance measurements as financial incentives, organizational insularity and secrecy is seen in many sectors of our society, but it is especially damaging in the current medical industrial complex. What needs to be learned from the VA scandal is a cautionary note that no system can be insulated from public accountability and transparency.

Paul Hochfeld, M.D., Chinh Le, M.D., Betty Johnson and Mike Huntington, M.D., live in Corvallis.