I have a piece in yesterday’s NR Online–my first CEI publication–that may seem a little counterintuative coming from a free market organization like CEI. In essence, I argue that the key to making Walter Reed work better is making it more like the Department of Veteran’s Affairs Health System. While it’s not perfect (what is?) the VA health system is one of the Federal government’s best run agencies. It works a lot like Kaiser Permenente—incidentally, probably the best sizeable private health system in the country. It’s really a giant HMO with a great computer system. While the care quality and outcomes are good, consumer choice is limited.
While I think the military can learn a lot from the VA, for a number of reasons, I think it’s a terrible model for the country as a whole. It does save money while producing acceptable —even good—health outcomes but it limits choice and leads to rationing of care. Even in cases where it is good for health, it’s bad for freedom. The UK, has in fact, imposed a VA-like system (National Health) on just about everyone. While it’s cheap for taxpayers and free-at-point-of-service, the National Health has serious problems.
But the distinction I’d like to draw, I think, raises an important point. It’s fine, in my judgement, for the government to impose regulations and procedures on itself that it should never impose on the private sector. Rights, after all, belong to the people. Government itself doesn’t have them.
Service in the military, of course, is not about free choice. If it can improve force readiness and health while saving taxpayer money simply by limiting free choice for servicemembers, DOD should do just that. Quite often, of course, government does just the opposite and subjects the private sector to regulations while exempting itself.
The last time the Democrats controlled Congress, the Hill’s Great Defenders of the Workers could (and did) fire employees when they talked about forming unions or complained about workplace discrimination. It wasn’t until 1994 that the great bulk of employment law even applied to Congress itself.