Monday, August 22, 2005

That's your big federal bureaucracy, eh?

Excellent piece on the VA system from Wapo.

I've heard (and read) a fair amount about the great quality of the VA system, but this piece lays out key points quite effectively. What are said key points, you ask? Some pretty amazing statistics about the quality improvement of the VA system in 10 years, including:

• Since 1995 the number of patients has doubled to about 5.2 million. This is while over 12,000 staff were cut and the cost per patient was reduced by half.

• Amazing Health Information Technology (HIT) program with electronic patient records, including lab tests, prescriptions, and nifty scannable bracelets. (For anyone who takes more than two prescriptions, how great would it be to just be scanned rather than spell everything out every time you go! I'm psyched!)

• Performance typically better than the private sector -- check out these results "In 1990, before Baltimore began tracking its performance, rates of screening for breast and cervical cancer were 50 percent and 17 percent, respectively. In 2003, they were 88 percent and 87 percent." Let me tell you, 87% for cervical cancer is amazing by private practice standards.

And of course, the crowning glory on why we need single-payer care:
Medicare officials point out that the VA has the advantage of being an integrated delivery system -- that is, a health plan in which most of the doctors are salaried employees and all care is coordinated and tracked. In Medicare, physicians work for themselves and patients are free to pick and choose their services.

Exactly. Which is why Medicare (and Medicaid, for that matter) are sending the deficit sky-high, not to mention drowning in quality assurance and fee reimbursement quarrels.

So I guess my response to ginormous bureaucracy healthcare would have to be -- thank you government!


At 8/31/2005 5:05 PM, Anonymous StealthBadger said...

My grandfather lost his legs during the time of WW II and has had "interesting times" dealing with the VA depending upon the political climate. He didn't lose them in combat, he worked on the railroad - that was considered to be an occupation of national importance at the time, and you were eligible for VA benefits. It's insane the hoops he's had to go through for assistance at times. As much as he's been smeared, and as much as I disagree with some of his economic policies, Clinton did wonderful things for military personnel, and the VA in particular.

No matter what anyone says, the VA has always been a ripe target for Republicans with a budget axe to grind, because the blame for the actual cuts gets passed around so much it's hard to tell who's done what. This is precisely because of what you touch on - like Social Security, it's a concrete contradiction to the claims that bureacracy is bad. It's like Canada's healthcare system. Sure, the VERY BEST our healthcare system has to offer is better than Canada's best... But compared to their average, or to the VA's, our private healthcare system blows chunks.


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