Opinion: In the name of health care freedom, millions of veterans may lose theirs

The article operates from a bad premise. If you take the water allegory they mentioned, in order to make it a true allegory, you would have to have both houses doing farming operations, and using the food to feed the local town. When the upstream farm expands, the downstream farm has to contract. But either way, the town is still fed.

An expansion of community care will reduce VA care and VA's pot of money. But they will also have less to care for, meaning their reduced resources are now allocated to equally reduced requirements.


I agree that this *could* have disastrous long-term effects for the VA. But that is what happens with a sub-standard product in the free market. All that has to happen to make it work is to make funding for community care capped at VA care funding levels. No, you can't see a therapist every single day. And no, we won't pay your therapist $350 / hr. The therapist gets what the VA charges for therapy, and does visits at the same frequency as the VA. If the VA continues to lose customers then it is because the VA is offering a substandard product.

The article says the VA provides better care with shorter wait times. From my *personal* experience I disagree, but only in part. Routine care (semi-annual check-up, med management, therapy) is pretty responsive with relatively short wait times. Of course, there are a LOT of cancelations by the provider, but rescheduled are usually within a week or two. Specialty care, however, is a months-long wait. When I was using the civilian system with Worker's Comp, wait times for specialty care was measured in days. Because I could shop around between 6 specialists in the area to find the earliest opening - which I cannot do with VA. The level of care I have gotten for most things has been pretty doggone good. A few hiccoughs here and there, but overall good. I am on my 5th PCP in 6 years, and that ain't great. But 4 of the 5 were outstanding, as far as I am concerned. And the 5th was average, not bad. Some of the specialty care has been meh. And the therapy was so bad I just quit. But I am pretty sure that was the two therapists I saw, and not the system itself. And I have a new therapist now, and that may be getting better, too.

So, I will be sticking with VA, because my local VA has their stuff together. But every time a vet kills themself while on hold with the suicide holiness, or because they were denied care, or because they had a 6 month wait for therapy.... Every time a vet comes out of surgery with the wrong leg amputated, or is prescribed the wrong meds, or is told they have a 8 month wait for a vital surgery... Every time those things happen, people are going to look for alternate care - as they should.

I understand that the VA I know and use has come a hell of a long way from the VA of even 20 years ago, let alone 50 years ago when the Vietnam generation of vets were starting their VA journey. I understand that my VA experience is not everyone's experience - even today. My local VA has done enough to keep me as a customer. If other VAs are not, the answer is not to restrict people from seeking better care. It is to let them get the better and more responsive care they need. And ten let that be a wake up call to the local vA that they need to do better.

Free markets work when they are allowed to. Even in health care. If the VA is scared of losing market share in a free market economy, then they should probably improve their product.