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pyramider's Avatar
If the VA is so good in administering health care to our veterans, why is it so many veterans avoid the VA like its latrine duty?
If the VA is so good in administering health care to our veterans, why is it so many veterans avoid the VA like its latrine duty? Originally Posted by pyramider
That is a false statement. Please provide your source. Otherwise, I invite you to do your own independent research on this issue rather than relying on hearsay. Objective information is readily available; you need only take the time to find it. For a start, here's a newspaper article that summarizes the issue. You can take it from there.

http://tucsoncitizen.com/medicare/20...rnment-report/
A recent report by the Congressional Budget Office (CBO) says the VA (U.S. Department of Veterans Affairs) does a much better job controlling health care costs than the private sector delivery system which is used by Medicare and all private sector insurance plans.
The CBO estimates that the VA’s health care cost per enrollee grew by only 1.7 % from 1999 to 2005, which amounts to 0.3% annually. Medicare’s costs grew 29.4 % per capita over that same period, or 4.4 % per year. In the private sector insurance market (employer and individual plans) premiums increased by more than 70% during this period.
The CBO report also says that the VA scores better than the private sector when it comes to patient/customer satisfaction. In 2005, the VA achieved a satisfaction score of 83 out of 100 for inpatient care and 80 out of 100 for outpatient care. The same survey showed private-sector providers of got 73 for inpatient care and 75 for outpatient care.
Phillip Longman wrote a book titled Best Care Anywhere: Why VA Healthcare is Better than Yours. He is quoted in a May 28th health care blog saying, “In study after study published in peer‐reviewed journals, the VA beats other health care providers on virtually every measure of quality. These include patient safety, adherence to the protocols of evidence medicine, integration of care, cost‐effectiveness, and patient satisfaction. The VA is also on the leading edge of medical research, due to its close affiliation with the nation’s leading medical schools, where many VA doctors have faculty positions.”
The VA system is responsible for 24 million veterans and treated about 5.5 million last year. It has a budget of $50 billion and operates more than 1,400 VA facilities, including 950 outpatient clinics, 153 hospitals and 134 nursing homes. The VA computerized patient records system is recognized as cutting edge and a model for controlling costs for Medicare and the private sector.
So why didn’t the recent health care debate focus on the VA as a model for a re-designed American health care system that can control costs and deliver top-notch care? The answer is that the VA system, where the government owns the hospitals, clinics, and labs, and employs the doctors and nurses….. is socialized medicine.

Here is one more: http://www.joepaduda.com/archives/001836.html
Government-run health care - how bad is it? There's been a minor flurry of articles about the Veteran's Administration health care system recently, a flurry that is both welcome and a bit tardy. It would have been helpful indeed if these had come out during the furor over health reform. Better late than never.
Let's tackle cost first. The CBO's most recent report indicates the VA does a much better job controlling cost than the private sector delivery system (used by Medicare). According to the CBO,
"Adjusting for the changing mix of patients (using data on reliance and relative costs by priority group), the Congressional Budget Office (CBO) estimates that VHA's budget authority per enrollee grew by 1.7 percent in real terms from 1999 to 2005 (0.3 percent annually) [emphasis added] .2 Though not the decline in cost per capita that is suggested by the unadjusted figures, that estimate still indicates some degree of cost control when compared with Medicare's real rate of growth of 29.4 percent in cost per capita over that same period (4.4 percent per year)."
In contrast, the private insurance sector [pdf] saw premiums increase over 70% over the same period (I know this isn't exactly apples-to-apples, but no matter how you slice the apple, 70% is still a lot more than 1.7%)
How about patient satisfaction? Again, the VA scores better than the private sector.
"In 2005, VA achieved a satisfaction score of 83 (out of 100) on the ACSI for inpatient care and 80 (out of 100) for outpatient care, compared with averages for private-sector providers of 73 for inpatient care and 75 for outpatient care...For VA, the scores for inpatient and outpatient care were 84 and 83, respectively, while the average scores for the private sector were 79 and 81."
In the press, Maggie Mahar posted on Phillip Longman's new edition of Best Care Anywhere; Why VA Healthcare is Better than Yours; quoting Longman's foreword "Health care quality experts hail it [the VA health care system] for its exceptional safety record, its use of evidence-based medicine, its heath promotion and wellness programs, and its unparalleled adoption of electronic medical records and other information technologies. Finally, and most astoundingly, it is the only health care provider in the United States whose cost per patient has been holding steady in recent years, even as its quality performance is making it the benchmark of the entire health care sector."
Merrill Goozner published an interview with Longman, who noted "In study after study published in peer‐reviewed journals, the VA beats other health care providers on virtually every measure of quality. These include patient safety, adherence to the protocols of evidence medicine, integration of care, cost‐effectiveness, and patient satisfaction. The VA is also on the
leading edge of medical research, due to its close affiliation with the nation's
leading medical schools, where many VA doctors have faculty positions."
Longman's book is a timely update to his 2007 edition, providing new insights into the effectiveness of the VA's VistA IT infrastructure and coverage of adoption by the private sector of VistA.
Another recent article noted the system is responsible for 24 million veterans (treating about 5.5 million last year), has a budget of "$50 billion and operates more than 1,400 care sites, including 950 outpatient clinics, 153 hospitals and 134 nursing homes."
The piece quoted Elizabeth McGlynn, associate director of Rand Health and author of a study of the VA: "You're much better off in the VA than in a lot of the rest of the U.S. health-care system," she said. "You've got a fighting chance there's going to be some organized, thoughtful, evidence-based response to dealing effectively with the health problem that somebody brings to them."
I work closely with very large hospital and its administrators. They purposefully make thing more expensive. If you ever watch nurses, who are well paid, they spend most of their time in front a computer at the desk. CT and other high tech machines are idle 80%, and so then they have to charge 1000s just to turn them on. If it cost 2000 a day, and you only use it twice, it is $1000 charge. If you use 10 times, it is only a $200. Interdepartmental rivalries cause administrators to make profits on internal transactions, which is only used to fluff their accounts, and pass it to us, build their empire and raise there salaries. There was just an incidence where an elderly person was given way too pain medicine, and had internal bleeding in the abdomen from a botched biopsy, that they went for days doped and not able to complain. Your should see the collective doctors, like a union, lying about to avoid a lawsuit. So I disagree with your statement contain. Under utilization, over medication, excess procedures continues the escalation of health care costs. Originally Posted by lostforkate
Thanks for your comment. I have no doubt that what you say is true. Far too many hospital departments are managed as individual fiefdoms and far too many CEOs decide that their hospital must own the newest and most expensive technology rather than pooling with "competitors" to reduce costs for all and provide more cost-effective utilization. The expense entailed in procuring technology that's identical to that in a dozen other hospitals in the community is the single largest cause of escalating costs for health care.

I'm interested; is the hospital in question privately owned? Is it investor-owned? Is it an independent, free-standing facility, or is it one of a chain of health care facilities? Does it have any academic affiliations?
For most folks, the dude who did it is the reason this isn't good news. Otherwise, their arguments are rarely rooted in fact.
pyramider's Avatar
That is a false statement. Please provide your source. Originally Posted by Ken Dahl

Vietnam era veteran friends are my source. They speak from experience in dealing with the VA. So what do you got to say now?
I would like to see affordable health care for everyone. Health care is expensive period.

Just because a person is not rich does mean they deserve to die.

Health insurance companies should not be allowed to refuse coverage because of pre existing conditions. Health insurance companies want to cover people who are healthy. That does not make sense.

Human beings get sick. Nobody chooses to get sick. They did not become ill on purpose.
Trespasser's Avatar
Death Panels are about how to triage when resources are severely limited. It has nothing to do with cutting costs and nothing to do with socialism or a lack thereof. It is real insofar as it was a single written document of suggested guidelines. There are no actual committees staffed by human beings.

Suggestions to perform PSA and mammogram testing less often was bought and paid for my healthcare insurance lobbyists whose corporate masters were tired of paying for them. That's not socialism. That's corporations purchasing government power at the expense of further limiting our voice.
Cpalmson's Avatar
I know from close friends that the military system sucks, and that is the model that will be used to cram things down the American peoples throats.

On the surface, military care looks good, but it is not. First, they do NOT attract the best medical professionals. I'm not knocking the doctors that they get, but the pay is low compared to private practice. The one good thing the military docs do have is immunity from malpractice lawsuits.
Second, there is a shortage of doctors and caregivers. Just where do you think the military starts cutting when Obama slashes the budget by 1/2 a trillion? The lack of caregivers is so bad that in most instances, military personnel and their dependents are sent to emergency rooms or urgent care facilities in lieu of seeing their primary provider. Again, care is now being provided by the lowest common denominator. When I interned for a political agency, the number one complaint we received was from vets who were being screwed with by CHAMPUS (the vet version of health insurance). This was nearly 25 years ago. I'm sure the situation has gotten worse. I've known people who have gotten out of the military. They told me that they Tri-Care Prime (current military health insurance program) sucks. Doctors don't want to be in the system and those that are in the system are overloaded. Getting quality care is difficult. The best approach my friends have said is to get Tri-Care Standard. The premiums are higher, but you can see the doctor of your choice and don't have to rely on "system" provider for medical care. The bottom line is that those that want better health care will pay for it (like they always have). Those that think getting a plan like Tri-Care Prime is the best thing since sliced bread will most likely be disappointed. Is it really necessary to tax 300 million Americans to simply give 30 million uninsured the "opportunity" to but into a sucky system? I say no. The government fucks up everything it puts its hands into. For Obama, it is doubly worse. He can't walk straight without fucking something up. Can't wait until November. A Romney win, GOP control of Congress and good bye to Obamacare by Feb. 1st 2013.
Vietnam era veteran friends are my source. They speak from experience in dealing with the VA. So what do you got to say now? Originally Posted by pyramider
What I "got to say", as a Vietnam-era veteran myself (are you?) and for cpalmson as well, is, I provided for you objective, verifiable, current information from independent non-partisan sources, along with first-hand experience, 30 years and counting, as a beneficiary and health care professional, yet you blithely ignore it all and continue to lazily rely on hearsay from others because that's what conveniently fits your willfully ignorant and prejudiced preconceptions.

It takes effort to learn the facts, something that apparently neither one of you is up to. After all, why would you want to let facts get in the way of your opinions?
pyramider's Avatar
If I ignored the facts why is it a friend that was exposed to Agent Orange in six theaters was just diagnosed with diabetes, lung and pancreatic cancer just last year? Agent Orange is a known factor in all three types he was finally diagnosed with. Pancreatic cancers do not just pop up ... He is undergoing another round of chemo but fully expects to be dead within the year. Yeah, that was superior medical care. That is a fact.

Look around the VA the next time you are there. Actually talk to some of the veterans. As you said put some effort into it.
If I ignored the facts why is it a friend that was exposed to Agent Orange in six theaters was just diagnosed with diabetes, lung and pancreatic cancer just last year? Agent Orange is a known factor in all three types he was finally diagnosed with. Pancreatic cancers do not just pop up ... He is undergoing another round of chemo but fully expects to be dead within the year. Yeah, that was superior medical care. That is a fact.

Look around the VA the next time you are there. Actually talk to some of the veterans. As you said put some effort into it. Originally Posted by pyramider
I give up. You win, pyramider. Although I, too, am a VA health care beneficiary with a designated primary health care manager, I am obviously clueless. I bow to your wisdom and the force of your logic. In fact, I find your comments to be completely incomprehensible, so the fault must be mine.
pyramider's Avatar
I just hope you never have to depend on the VA if you come down with a life threatening disease.