VA medical care touted for high quality, low cost

"... the VA experience shows that it's possible for government to be a good player, an accountable player in that mix." — Dr. Greg Felice.

Doctors say VA care is a model of efficiency

by Lorna Benson, Minnesota Public Radio
August 18, 2009

Minneapolis — One argument against a public insurance option in the current debate over health care is that government typically isn't as efficient or proficient as the private sector. But some say that the Department of Veteran Affairs medical care is actually an excellent example of how the government is leading on health care quality and cost.

A third of the nation's 24 million veterans get their health care from the VA. Most qualify because they have an injury or illness that is in some way connected to their military service.

The Minneapolis VA has 80,000 patients who receive care at the hospital and its affiliated clinics. This year, the government is giving the medical center about $500 million to care for those vets. That's a lot of money, but that's also a lot of patients - including some with very traumatic injuries.

(Continued here, with audio.)

Healthcare debate: Note from a reader

by Leigh Pomeroy

We have a semi-regular reader who often disagrees with us on many issues and lets us know when he thinks we are wrong. Below is one recent email from him and my paragraph-by-paragraph response regarding Vox Verax's post of the FactCheck.org article entitled "Seven Falsehoods About Health Care." I am posting Patrick's email and my response here as an ongoing effort to encourage healthy debate. (NOTE: Patrick's response to my comments will be posted soon.)

PATRICK: You're kidding, right? Did you see the sources cited by 'fact check'?

VOX VERAX: FactCheck.org is a project of the Annenberg Public Policy Center at the University of Pennsylvania. They are highly respected in all but fringe circles.

P: I am not sure if you know this -- I do because I was in the Policy Forum a few years back and we discussed this matter with several members of Congress and right and left think tanks on our trip to Washington -- but Medicare is going broke, along with Medicaid and now Social Security is going broke faster because of the recession.

VV: Correct. Peter G. Peterson has been hammering on this for years, and I highly respect his opinion. BTW, he's a Republican.

P: So, let's put everyone on Medicare with ObamaCare?

VV: What is ObamaCare? Define it.

P: We won't be able to make enough paper to print that amount of money. Did you actually hear Obama say that a doctor would order a tonsillectomy rather than medication to ease the swelling because the doctor gets paid more to do the tonsillectomy?

VV: True. Similar things happen too often, mostly with back problems. I've not heard about it for tonsillectomies, but I'm not surprised. There are countless studies that show that:

1. Successful treatment outcomes too often have little to do with money spent or intervention given.

2. Doctors who own their own test equipment (e.g., MRI scanners) prescribe more tests using that equipment with little or no difference in patient outcomes.

Not all doctors are mercenaries, as Obama's statement would imply, but too many are because the waste in our system is often what makes the payments on their Mercedeses.

I suggest reading "Not What the Doctor Ordered" by Jeffrey C. Bauer, which I helped write and edit.

P: I was stunned when I heard that -- just stunned, that someone would accuse the medical profession in such a way. Who the hell would want to be a doctor under ObamaCare when he holds such disdain for them?

VV: A lot of doctors agree with what he has to say because they're sick of the waste and the people milking the system (insurance companies and some doctors and other healthcare providers) too.

Before the AMA talked the state legislatures and Congress into giving physicians a virtual monopoly on the delivery of medical care, being a doctor was a solid, middle-class profession, like being a teacher. You became a doctor because you wanted to serve people, not because you wanted to get rich.

P: I just don't get the obsession with the left's run-to-the-government for every single societal ill -- real and perceived.

VV: Governmental intervention usually comes about only AFTER a certain group within a society takes an unfair advantage of another part of that society, creating an imbalance in justice. The Wall Street meltdown last year and the government's actions to stem it is a classic example. (Unfortunately, most of those who created the problem have not been and probably won't be appropriately punished.)

P: I am all for public option health insurance if they would give me an 'out'.

VV: No one will be required to take the public option.

P: Give me the deduction to go buy my own private health insurance on the open market in any state that I want to purchase it in and let me choose what I want covered.

VV: So if you choose not to insure yourself for cancer and you can't afford the treatments, you should then just be left to die?

P: We do this already for life insurance, auto insurance, home insurance, flood insurance and I've never heard anyone be denied a claim who had these types of insurance or get thrown off.

VV: Auto insurance is required if you own a car. Home insurance is required if you own a home and have a loan. Flood insurance is required in some areas.

P: For those who are poor or need 24-hour care, they can choose among the many public options we have out there today.

VV: Yeah, and who's going to pay for it? Santa Claus?

P: Turns out Canada's health care system isn't so peachy after all, either.

http://www.google.com/hostednews/canadianpress/article/ALeqM5jbjzPEY0Y3bvRD335rGu_Z3KXoQw

VV: Canada's system has problems, which the Canadians admit. All systems do. The question is: Which system has the best outcomes and has the most support of the people? That's the one you want to look to. The problem in the U.S. is that despite our system being the most expensive in the world, there are a lot of people unhappy with it and its statistical outcomes show it isn't as effective as systems spending less. If you really want a model that works, check out this:

http://minnesota.publicradio.org/display/web/2009/08/17/va-clinic-care/