Why the VHA outperforms all other sectors of American Health care

Nurses Activism

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emphasis added:

from american prospect:

http://www.prospect.org/web/page.ww?section=root&name=viewprint&articleid=12683

over the last decade or two, the vha system has become a worldwide leader in both the adoption and the invention of health-information technology, and it has leveraged its innovations into quantifiable gains in quality of care.

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indeed, the vha's lead in care quality isn't disputed. a new england journal of medicine study from 2003 compared the vha with fee-for-service medicare on 11 measures of quality. the vha came out "significantly better" on every single one. the annals of internal medicine pitted the vha against an array of managed-care systems to see which offered the best treatment for diabetics. the vha triumphed in all seven of the tested metrics. the national committee for quality assurance, meanwhile, ranks health plans on 17 different care metrics, from hypertension treatment to adherence to evidence-based treatments. as phillip longman, the author of best care anywhere, a book chronicling the vha's remarkable transformation, explains: "winning ncqa's seal of approval is the gold standard in the health-care industry. and who do you suppose is the highest ranking health care system? johns hopkins? mayo clinic? massachusetts general? nope. in every single category, the veterans health care system outperforms the highest-rated non-vha hospitals." what makes this such an explosive story is that the vha is a truly socialized medical system.

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in fact, the vha is also proving far better than the private sector at controlling costs. as longman explains, "veterans enrolled in [the vha] are, as a group, older, sicker, poorer, and more prone to mental illness, homelessness, and substance abuse than the population as a whole. half of all vha enrollees are over age 65. more than a third smoke. one in five veterans has diabetes, compared with one in 14 u.s. residents in general." yet the vha's spending per patient in 2004 was $540 less than the national average,

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the vha's advantages come in part from its development of the health-information software vista, which was created at taxpayer expense and is now distributed for free to any health systems that wish to use it. it's a remarkably adaptive program that helps in virtually every element of care delivery, greatly aiding efforts to analyze symptoms and patient reactions in order to improve diagnoses and treatments, reduce mistaken interventions, and eliminate all sorts of care redundancies.

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the system was set up to deal with the sick, so the emphasis is on learning how to best manage diseases rather than avoid the diseased; and the doctors are salaried, so they have no incentives to either over- or undertreat patients. moreover, the vha is not only empowered to bargain down drug costs; it also uses formularies (lists of covered drugs), and so is actually empowered to walk away from a pharmaceutical company that won't meet its offer.

read this article with an open mind.....

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Emphasis Added:

From American Prospect:

Read this article with an open mind.....

after the recent to do at Walter Reed, i am not so sure i want to go there......

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after the recent to do at Walter Reed, i am not so sure i want to go there......

Walter Reed is an ARMY hospital not a VHA hospital.

The Veterans Health Administration The mistreatment and poor conditions at the Walter Reed Army Medical Center were a front-page story recently, and they were rather conclusive in showing the system's inadequacy. But don't be confused: Walter Reed is a military hospital, not a VHA hospital. Poor reporting inaccurately smeared the quietly remarkable reputation of the best medical system in America.

http://www.prospect.org/web/page.ww?section=root&name=ViewPrint&articleId=12683

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Ummm....really? If that's so, why are so many vets being denied the care they need from the VHA system? Many are coming back from Iraq with physical and mental wounds, and they are not being allowed to access the system. I suppose 'researchers' can put a good spin on anything.:uhoh3:

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Ummm....really? If that's so, why are so many vets being denied the care they need from the VHA system? Many are coming back from Iraq with physical and mental wounds, and they are not being allowed to access the system. I suppose 'researchers' can put a good spin on anything.:uhoh3:

Ultimately its the deliberate underfunding of the system driven by the BUSHCO regime. It is not a perfect system. Often the Army is discharging injured soldiers using a "personality" disorder diagnosis. This disqualifies the veteran from VHA benefits. The Nation had an extensive article about the abuse of this administrative procedure about a month ago. http://www.thenation.com/doc/20070409/kors

But instead of sending Town to a medical board and discharging him because of his injuries, doctors at Fort Carson, Colorado, did something strange: They claimed Town's wounds were actually caused by a "personality disorder." Town was then booted from the Army and told that under a personality disorder discharge, he would never receive disability or medical benefits.

Town is not alone. A six-month investigation has uncovered multiple cases in which soldiers wounded in Iraq are suspiciously diagnosed as having a personality disorder, then prevented from collecting benefits. The conditions of their discharge have infuriated many in the military community, including the injured soldiers and their families, veterans' rights groups, even military officials required to process these dismissals.

They say the military is purposely misdiagnosing soldiers like Town and that it's doing so for one reason: to cheat them out of a lifetime of disability and medical benefits, thereby saving billions in expenses.

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The Fine Print

In the Army's separations manual it's called Regulation 635-200, Chapter 5-13: "Separation Because of Personality Disorder." It's an alluring choice for a cash-strapped military because enacting it is quick and cheap. The Department of Veterans Affairs doesn't have to provide medical care to soldiers dismissed with personality disorder. That's because under Chapter 5-13, personality disorder is a pre-existing condition. The VA is only required to treat wounds sustained during service.

Soldiers discharged under 5-13 can't collect disability pay either. To receive those benefits, a soldier must be evaluated by a medical board, which must confirm that he is wounded and that his wounds stem from combat. The process takes several months, in contrast with a 5-13 discharge, which can be wrapped up in a few days.

Abuse of administrative process and procedures by the military bureaucracy does not make the VHA a bad system.

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NEW YORK (Reuters Health) - In an equal access health care system, such as Veterans Affairs (VA) hospitals, the outcomes for African-American patients treated for heart disease are similar to, or better than, those of white patients, new research suggests.

In a setting where differences in access and treatment are minimized, "so are racial differences in functional outcome," Dr. Nancy R. Kressin from the VA Medical Center in Bedford, Massachusetts, colleagues report in the American Heart Journal.

They studied the care and outcome of 793 white and 229 black patients with the same degree of heart disease, namely, the restricted blood flow due to blocked arteries, who were treated at five VA hospitals.

http://www.sciam.com/article.cfm?alias=equal-healthcare-access-r&chanID=sa011&modsrc=reuters

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