The VA is far from perfect and is really noticeably worse than many other country's nationalized health systems. But it's not obviously worse than private health insurance in the US and generally veterans are as happy with their health care as other people. I think the VA example tends to dispel the notion that single payer would save that much money but it works about as well as other approaches, of which the US has way too many.
> The VA is far from perfect and is really noticeably worse than many other country's nationalized health systems. But it's not obviously worse than private health insurance in the US and generally veterans are as happy with their health care as other people
If you want to convince people to support a single-payer system, this is quite possibly the worst argument you could use. Any veteran or anybody who has had any experience whatsoever with the VA will instantly assume you don't know what you're talking about.
The VA is, on the whole, atrocitous. There are a couple of regions which do relatively well, because the system is federated, but on the whole, it's almost universally considered to be a disaster, even by people who are supportive of the program's existence.
If you want to convince people that a single-payer system wouldn't end up like the VA, start by acknowledging the problems with the VA, not denying them.
> The VA is, on the whole, atrocitous. There are a couple of regions which do relatively well, because the system is federated, but on the whole, it's almost universally considered to be a disaster, even by people who are supportive of the program's existence.
Yeah, this is bullshit. The VA and its effectiveness has been studied quite a bit. Its quality has been found to generally exceed the quality of private hospitals. The media and conservatives paint this idea that the VA is "atrocious" but it has no basis in reality.
The scientific evidence for universal healthcare is overwhelming. The only "controversy" -- exactly like the "controversy" around climate change -- exists within people who have carefully decided to ignore the evidence and buy into the propaganda. The problem here is not the VA. The problem here is that many Americans have abandoned reality.
> Its quality has been found to generally exceed the quality of private hospitals. The media and conservatives paint this idea that the VA is "atrocious" but it has no basis in reality.
That's certainly one way to summarize the research around the VA, but it's a highly misleading one. It's easy to cherry-pick the metrics on which the VA performs well, but they're not representative of the big problems that the VA has: massive disparity between regions, accessibility of care, timeliness of interventions, adherence, and so forth. This is why VA hospitals have dramatically worse patient satisfaction rates than their non-VA counterparts. (They actually got in trouble a couple of years ago for misrepresenting and hiding the data around this for a while, until independent studies were done which forced them to admit that they'd redefined their internal metrics to make themselves look better).
As someone who has experience with Medicare and the VA, both on a personal level and on a professional level, nothing makes me more skeptical of arguments advocating single-payer healthcare than people willfully ignoring the vast documented problems that exist with both of those systems. That doesn't mean they're not fixable problems. If you want to advocate for single-payer healthcare and argue why these problems could be fixed in a single-payer system, fine. But don't go around pretending that they don't exist - you can't fix a problem by ignoring it and hoping it will go away.
Your response to scientific studies that demonstrate the VA actually provides better care than private counter parts is to dismiss them all as dishonest cherry picking. You offer up no studies or data of your own. You have no evidence for your claims except vacuous appeals to personal anecdote. You've somehow reached the conclusion that the entire VA, a $200 billion dollar program that cares cares for ten million of Americans, is "atrocious" based on ... what?
I think this pretty much proves the point.
The point here by the way is not that the VA is perfect. Nobody has claimed that, though you seem to keep insisting that people must admit something they don't claim. The actual evidence we do have shows the VA has problems but still offers better care so I'm not sure how we're "ignoring" anything. It seems like you're the one ignoring the plain facts and have chosen to buy into a convenient falsehood. Until people like you are willing to even look at the evidence -- and the evidence for universal healthcare is overwhelming at this point -- real discussion is pointless.
> Your response to scientific studies that demonstrate the VA actually provides better care than private counter parts is to dismiss them all as dishonest cherry picking. You offer up no studies or data of your own.
To be entirely honest, you alluded to research around the VA (but did not offer up any studies or data of your own). I responded by alluding to research around the VA which provides a different conclusion (but did not offer up studies or data either, although I did at least state the actual metrics used to draw said conclusion).
> Until people like you are willing to even look at the evidence -- and the evidence for universal healthcare is overwhelming at this point -- real discussion is pointless.
We're not discussing scientific evidence here. At best we're discussing your interpretation of (possibly-scientific) research that you've seen in the past but haven't actually named.
There is one point on which we do agree, though: that it's pointless to continue. It's pointless for me to continue a discussion with someone who starts a thread with bold claims and no supporting data, and then criticizes someone who responds in kind for the exact same thing. To be honest, it's also pointless to continue discussions of healthcare policy on Hacker News beyond a certain point too, because of the inherent political makeup of the site. Even the most well-researched comments which reference primary sources alongside research published in peer-reviewed journals are routinely downvoted because they express skepticism of monopsonic healthcare models. Instead, the top comments are usually low-effort criticisms that contain no rigor, depth, research, or citations, but do contain witty, biting criticisms of US healthcare and political soapboxing. In that sort of environment, there's not much of an incentive for people with domain knowledge who've studied these issues to participate in earnest.
So I guess that's one thing we can agree on: the futility of continuing this comment subthread.
