1. It creates a medical system that delivers care that is unevenly distributed. V.A. care is harder to access in rural areas than in big cities.
2. V.A. care in the cities is often linked to teaching institutions where veterans "medical care" is driven by the needs of students to learn, rather than the health of the veteran. Patients often get "care" they do not need for the sake of educating students. Providers who are also teaching/research faculty often reduce patients to a pool of lab rats and breathing cadavers, as medical staff can play it fast and lose with little fear of lawsuits.
3. The V.A. system often allows people to perform procedures that would not be considered qualified in a private facility, such as a "Tech", (a C.N.A. with a week of special training) performing and teaching a procedure as dangerous as a colonoscopy.
4. Under funding in the V.A. system often results in the failure to treat minor conditions that will lead to major problems in time.
Those calling the V.A. system "socialist", and point to it as an example of quality government provided medical care have limited understandings of the V.A. system. The gender inequality, the abuse of patient autonomy, and more, abuses that admittedly also goes on in the public sector is hyperbolized in the V.A. system. If a "public option" is passed, we can expect that:
1. Insurance companies will make sure that public option care is inferior care
2. The public option will be under funded and funding will be subject to political whims
3. A two tier medical system will be established where one groups health is subjugated to rationing, an abusive load of students, understaffing, improper staffing, neglect of minor medical conditions that turn in to major medical conditions. In our current medical system those with the money to sue are treated one way, those perceived to have less resources another. A public option system will not change this reality. Medical Care systems that treat all patients equally as we would with single payer or a non-profit national health care system that most of the developed world enjoy, tend to be much less abusive and much more responsive to patients rights and needs.
4. A one-payer system will offer more choice not less; we only have to demand that choice. In these other countries, homeopathic medical care is often used rather than expensive, often less effective and more dangerous pharmaceuticals. More preventive care is offered. If patients rights are violated it is a political rather than a civil or private matter. Bottom line is patients have more power when we all are in the same boat together and thus are encourage and empowered to act together.