Not only does it work, but it is run by....the government. And they do it cheaper and in most cases, better than private hospitals.

How VA Hospitals Became The Best

No longer a nation's shame, veteran care is acing competitors hospitals can only dream of the futuristic medicine Dr. Divya Shroff practices today. Outside an elderly patient's room, the attending physician gathers her residents around a wireless laptop propped on a mobile cart. Shroff accesses the patient's entire medical history--a stack of paper in most private hospitals. And instead of trekking to the radiology lab to view the latest X-ray, she brings it up on her computer screen. While Shroff is visiting the patient, a resident types in a request for pain medication, then punches the SEND button. Seconds later, the printer in the hospital pharmacy spits out the order. The druggist stuffs a plastic bag of pills into what looks like a tiny space capsule, then shoots it up to the ward in a vacuum tube. By the time Shroff wheels away her computer, a nurse walks up with the drugs.

For the sixth year in a row, VA hospitals last year scored higher than private facilities on the University of Michigan's American Customer Satisfaction Index, based on patient surveys on the quality of care received. The VA scored 83 out of 100; private institutions, 71. Males 65 years and older receiving VA care had about a 40% lower risk of death than those enrolled in Medicare Advantage, whose care is provided through private health plans or HMOs, according to a study published in the April edition of Medical Care. Harvard University just gave the VA its Innovations in American Government Award for the agency's work in computerizing patient records.

And all that was achieved at a relatively low cost. In the past 10 years, the number of veterans receiving treatment from the VA has more than doubled, from 2.5 million to 5.3 million, but the agency has cared for them with 10,000 fewer employees. The VA's cost per patient has remained steady during the past 10 years. The cost of private care has jumped about 40% in that same period.

The roots of the VA's reformation go back to 1994, when Bill Clinton appointed Kenneth Kizer, a hard-charging doctor and former Navy diver, as the VA's under secretary for health. Kizer decentralized the VA's cumbersome health bureaucracy and held regional managers more accountable. Patient records were transferred to a system-wide computer network, which has made its way into only 3% of private hospitals. When a veteran is treated, the doctor has the vet's complete medical history on a laptop. In the private sector, 20% of all lab tests are needlessly repeated because the doctor doesn't have handy the results of the same test performed earlier, according to a 2004 report by the President's information technology advisory committee.

Private hospitals, which make their money treating people who come to them sick, don't profit from heavy investments in preventive care, which keeps patients healthy. But the VA, which is funded by tax dollars, "has its patients for life," notes Kizer, who served in his post until 1999. So to keep government spending down, "it makes economic sense to keep them healthy and out of the hospital."

Tom Bock, commander of the American Legion, has another idea: allow elderly vets not in the system who are drawing Medicare payments to spend those benefits at a VA facility instead of going to a private doctor, as is now required by Medicare. "It's a win-win-win situation," he argues. Medicare, which pays more than $6,500 per patient annually for care by private doctors, could save with the VA's less expensive care, which costs about $5,000 per patient. The vets would receive better service at the VA's facilities, which could treat millions more patients with Medicare's cash infusion. - Time
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It seems that all it took was a President hiring a guy who was both qualified and motivated. What a novel approach!

Thanks for the info, DG. It's good to know when something is working. I dream of a day when health care is available to all of us who seek it.

(It's amazing this guy still has his job what with being hired in by Bill AND doing a very good job.)

I am very thankful that somebody finally stepped in and improved the conditions of the VA hospitals. If anything in this Country needed improvement, this was surely it.

Now all we have to worry about (sic) is the Privacy of Health Information Act (HIPPHA). Is that the abbreviation? The reason it worked is because the health information was in a central database. I can't imagine what damage could be done to me via my medical records being accessible to the masses. I may not be able to get a job, or someone may sabotage my reputation for their benefit. Or whether I can afford benefits, or maybe I should pay ten times as much for them.

I'm all for solutions, but at what cost?

The chances are that, if you have been treated in a hospital in the last decade or so, your information is already in a computer, just not one accessable to all those who may need the information to treat you. "The masses" don't have access to restricted files. Yes, accidents happen, and, yes, there is always the chance of the illegal sharing of information, but those chances exist with or without computers. Considering all the information that already exists in a computer file about any given individual, only a small percentage is really accessable to the "masses", and most of that was in public domain, i.e. published telephone numbers, law suits, criminal proceedings, etc.

Your health insurer would, in any case, have access to any information on anything that it paid for, and I think that the chances of your information being shared with anyone is more likely to happen between one insurance company and another than it is in any other scenario, whether computers are involved or not.*

If, however, one would choose not to participate in a universal health care system, my guess if that you could continue to pay for your own coveage with a private insurer and even go to a doctor who also did not participate.

This concern aside, one thing is certain. A health care system that is better than the ones available to most citizens can exist in the US, would cost significantly less than current systems, and is run by the federal government.


*Years ago, I did a report on the 1947 Centralia, Illinois mine disaster, in which about 100 miners died in a mine collapse. About 85% of the miners had $1000 worth of life insurance, the others had $1500. The funerals for that 85% cost just under $1000. The funerals for the rest cost just under $1500. The funerals, including the caskets and cemetery plots, were, for all practical purposes, identical.

For anyone eligible on both medicare and Veterans' Benefits, the VA prescription system is far superior to the Medicare Part D boondoggle with its complicated rules, co-pays, and donut holes. Partly that is accomplished by a limited drug formulary in which a prescription is selected for its effectiveness and equivalence rather than its profit margin. Rather than a $2.00 per pill prescribed Nexium, VA will furnish a month's supply of omeprazole for $8.00. A savings of $120/month, not to mention the Medicare Part D premium avoided. It's almost worth being shot at!

The Medicare Part D plan also does not allow the government to negotiate prices. The VA plan does. Gee, I wonder who benefits from that and why it was written that way.