Going public

The Department of Veterans Affairs demonstrates that government can do health care right

Once upon a time, back when President Barack Obama still professed that a public option was an essential element of health-care reform, he challenged the private health-insurance industry at a town-hall meeting.

“I think private insurers should be able to compete,” Obama said slyly. “They do it all the time. I mean, if you think about it, UPS and FedEx are doing just fine, right? … I mean, it’s the post office that’s always having problems.”

The president was implying that private shipping services such as UPS and FedEx are kicking the government-run post office’s ass, and there’s really no reason to expect the competition to turn out any differently in the health-care arena. The private health-care industry has nothing to fear. After all, competition is what the free market is all about.

However, if my own experience is any indication, the private health-care industry has plenty to fear from the proposed public option. As a U.S. Navy veteran, I belong to a select group that has a choice between private and public health care. Forget about all those horror stories you’ve read about the Veterans Affairs. If the choice is between the VA and private health care as it exists today, I’ll take the VA every time.

When I was honorably discharged in 1982, I wasn’t really aware that my veteran’s benefits would be available to me for the rest of my life. The few visits I made to the VA hospital in San Francisco only confirmed the horror stories that were rampant back in those days. Fortunately, I scored a union job in the shipyard, and the insurance benefits were primo: full medical coverage and 80 percent dental. I more or less forgot about the VA.

The shipyards closed down in the late 1980s, and I’d never enjoy private health care of that quality again. By the early 1990s, I’d made the transition to journalism and got hired by SN&R. A wide selection of health-care options were still available: Kaiser Permanente, where all the services are offered under one roof; networks such as HealthNet, where separate doctors, clinics and hospitals are organized under one umbrella; and plans that permitted employees to choose their own physicians.

In the mid-1990s, health-insurance costs began to explode. The amount taken out of my salary grew, the number of available options shrunk. Kaiser—my favorite private health-care provider—jacked up its rates, pricing it out of SN&R’s range. That circumstance was repeated several times, forcing employees to change different doctors on each occasion. You could sense the health-care system was falling apart.

In the late 1990s, during a stint as a communications specialist for a large, Sacramento-based health-care corporation, I discovered firsthand just how rotten-to-the-core the system had become. Six-figure administrators with no apparent function wandered the executive suites. Physicians openly bragged about pooling healthy patients and excluding the sick. The workforce was shunned. It’s the only job I’ve ever quit.

I got fired from all the rest, which is how I came to rediscover my VA health benefits earlier this decade. After my private health insurance expired, I went to a satellite clinic in Santa Rosa, where I quickly learned the VA has dramatically improved since my discharge from the Navy.

For starters, VA hospitals have partnered with universities such as the UC Davis School of Medicine. When I visit the VA hospital at Mather, I know I’m going to see a top-flight physician. Moreover, the administration’s nationwide computerized medical-record system is state of the art. No matter what hospital or clinic I go to, all I have to do is give them my social security number and my complete medical record appears on the computer screen. In fact, I can access it myself online, in addition to refilling prescriptions and making doctor’s appointments.

I have to make some hefty co-payments for medications, but it’s still by far the best health care I’ve enjoyed since my days in the shipyard. Somehow, the VA manages to do all this with 10 percent to 15 percent less administrative overhead than private health-care providers.

The president surely knows this, which is why I think he was kidding when he made that crack about the post office. It’s no wonder industry executives are up-in-arms about the public option: In order to compete, their role will be eliminated. They should be afraid. Very afraid. The job market is pretty grim these days.