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What the right fails to understand about the VA health care system

The VA system is a classic example of a socialized model. That doesn't mean it's ineffective.
A sign marks the entrance to the Edward Hines Jr. VA Hospital on May 30, 2014 in Hines, Ill. (Scott Olson/Getty)
A sign marks the entrance to the Edward Hines Jr. VA Hospital on May 30, 2014 in Hines, Ill.

On NBC's "Meet the Press" yesterday, Sen. Ron Johnson (R-Wis.) made his case against the Department of Veterans Affairs, which will sound familiar to those familiar with the larger debate.

"It's a reflection of the fact that the VA health care system is a government-run, single-payer, bureaucratic health care system. And it doesn't work.... You know, we've spent so much money on the VA. And we've increased funding, overall, about 2.3 times in the last ten years, on healthcare spending, 1.5. And it's still a mess."

Johnson's almost half-right. The VA system is as the senator described it: this is a classic example of a socialized model. It's reminiscent of the British NHS, insofar as the system for veterans' care is entirely government-run, with government-owned facilities and medical professionals who are government employees.

It's precisely why so many conservatives are critical of the VA: the right has ideological objections to socialized health care, and in the patchwork model of health care in the United States, this is the only real socialized patch.

The trouble is the Wisconsin Republican's assumption that this approach "doesn't work."

The editorial board of the Washington Post  noted a while back that the VA system "as a whole outperforms the rest of the health care system by just about every metric. Surveys also show that veterans give VA hospitals and clinics a higher customer satisfaction than patients give private-sector hospitals."

The assessment was consistent with a RAND Corp. study that found in nearly every category, "VA patients received consistently better care across the board, including screening, diagnosis, treatment, and access to follow-up."

Two years ago, Alicia Mundy wrote a piece for the Washington Monthly, which highlighted "a mountain of independent evidence" that shows that "while the VA has an assortment of serious problems, it continues to outperform the rest of the U.S. health sector on nearly every metric of quality -- a fact that ought to raise fundamental questions about the wisdom of outsourcing VA care to private providers."

For much of the right, the result is a kind of cognitive dissonance. The VA system works, and many leading advocacy groups that champion veterans' interests are eager to leave it in place, but the system is socialized, which means it couldn't possibly work and necessarily has to be replaced.

Indeed, according to David Shulkin, the man Donald Trump fired as his VA secretary last week, the motivation behind his ouster was the Republicans' privatization push, which he opposed.

The facts, however are stubborn. Ron Johnson criticizes the VA system as "a government-run, single-payer, bureaucratic health care system," as if the description itself is proof of the system's flaws.

It's not.