Barry Fagin, Featured, Health Care

Give veterans health care choice, not broken VA monopoly

It is time to abolish all Veterans Affairs hospitals. Every single one. Give our veterans vouchers for medical care.

This isn’t all that radical an idea. Anybody ever heard of the GI Bill? Whether you’re talking about the post-World War II version or the recently modified one, it provides funds for the education of veterans and their dependents. Would anyone seriously suggest offering free classes at Veteran Affairs University as the best way to show the thanks of a grateful nation?

icon_op_edThe GI Bill also offered low-cost mortgages to soldiers coming home. Should we have instead offered them public housing? Of course not. The very idea is insulting to their memory.

But somehow we’re stuck on the idea that government needs to be involved in the direct provision of medical care to veterans. This idea is rooted in the primal politics of symbolism, so it’s hard to dislodge. But it flies in the face of everything we know about providing a quality service at a reasonable price.

Just within the past few weeks, we’ve been confronted with further cognitive dissonance as more of the latest VA “scandal” unfolds. I use the scare quotes because none of this should surprise us any more. Long waiting lines, fudging the books to appear to meet largely fictional metrics, people dying while waiting for treatment, how naive do we have to be? We’re like the inspector in “Casablanca,” “shocked, shocked” to find that a government bureaucracy isn’t doing what it’s supposed to.

If direct government provision of health care is so fantastic, why aren’t the rest of us clamoring for it? Even if you like Obamacare, surely its extensive reliance on health insurance (instead of government-provided doctors, nurses and hospitals) has not escaped your attention.

I have no doubt that within VA hospitals there are plenty of dedicated employees, trying the best they can to do right by their patients within the confines of a broken system. These are exactly the kind of people who need to get out of the VA and into the private sector. That is exactly what a medical voucher system for veterans would help them do.

Good counselors, physical therapists, nurses and doctors who can treat veterans with the compassion and quality they deserve stand to benefit the most from a freer market in veteran care. It’s the incompetent staffers and the paper-pushing bureaucrats who’ll lose out. As well they should.

Yes, I understand the symbolism of caring for wounded soldiers in an American government hospital. They served their country, now their country should serve them. But what’s more important: The picture of the American flag on the hospital where they recuperate? Or the quality of care they receive? And if vouchers from a grateful nation can get them better treatment, isn’t that the right thing to do?

If abolition of VA hospitals is too radical for you, how about this: Leave the hospitals in place, but give veterans a choice. They can have free care in a VA hospital, or a voucher/insurance proposal for private care.

Force the VA to compete for patients just like anybody else. How many vets would choose the VA? How long would VA hospitals remain open? That ought to tell you something in and of itself.

When the Greatest Generation came home and wanted to start their lives anew, we didn’t build houses and force them to live there. We gave them resources and freedom to choose. When they wanted to learn, we didn’t build them colleges and force them to enroll. We gave them resources and freedom to choose.

When it came to medical care, however, we built them hospitals and told them to suck it up. In light of the latest VA revelations, it is time to admit our mistake.

When America’s veterans need medical care, don’t give them socialized medicine. Give them resources and freedom to choose. Presumably, freedom is something they understand quite well.

Barry Fagin is a senior fellow at the Independence Institute, a free market think tank in Denver.  He can be reached at


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