The key to the V.A.â€™s success is its long-term relationship with its clients: veterans, once in the V.A. system, normally stay in it for life. This means that the V.A. can ... make much better use of information technology than other health care providers. ... which reduces both costs and medical errors. The long-term relationship ... also lets the V.A. save money by investing heavily in preventive medicine, an area in which the private sector â€” which makes money by treating the sick, not by keeping people healthy â€” has shown little interest.
The result is a system that achieves higher customer satisfaction than the private sector, higher quality of care by a number of measures and lower mortality rates â€” at much lower cost per patient."
Easy to get high marks when you are just screening healthy people and sending them away. But arguably you should rate a health care system for how it treats the whole person when they are sick and in distress. So on the heels of data showing that the VA formularies reduce life span and increase suffering, the Congressional Budget Office shows that returning vets are waiting longer for care they never get...
Here's Donna Shalala who co-chairs the federal task force reviewing care for Iraq vets:
"Without designated care coordinators to plan the best treatment path for new patients, an untold number ended up lost.
In addition, injured combatants must go through two antiquated disability assessments -- one by the military and one by the VA -- to determine what treatment options are available. This means that many are forced to jump through bureaucratic hoops that might not even get them to the right place, Dr. Shalala said.
"For veterans' families to give up everything just to coordinate this care themselves is fundamentally unfair," she said. "The process is too old-fashioned. It has nothing to do with modern medicine, and we ought to be embarrassed."
Hey Paul, that gives "long term relationship" a whole new meaning. Sounds like single payer care to me. Krugman's response will likely be to blame Bush for not spending more. That won't wash. Spending on the VA has doubled under his administration. And spending more, as the UK and Canada health systems have shown, doesn't reduce waiting. Or insure that doctors can actually practice effective medicine instead of guideline driven drivel.
If Krugman and others really cared about vets and not ideology they would support the following reform: Giving vets the freedom they were fighting for in Iraq. Let them choose where to go for health care. If they can't get immediate care in the VA, give them cash to buy a policy with a health plan that will offer to do so.
Vets will die waiting for Congress and the VA to act.