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Oct-05-2009 20:16printcomments

Socialized Medicine Works, says VHA

A look at the positive side of veteran's healthcare in the U.S.A.

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(CALGARY, Alberta) - The VHA has adopted a government run medical model to which most veterans would give high marks. Rick Tanner, 66, served in Vietnam and spent three decades in the U.S. Navy. He retired in 1991 with a bad knee and high blood pressure and now receives comprehensive care with few co-payments and a system that utilizes an electronic records system more advanced than almost anywhere in the private hospital system. “The care is superb,” said Tanner of San Diego. The record- keeping is “state of the art.” The veterans agency, whose projected budget this year is $45 billion, shows that the government can provide care that patients like and that can offer savings compared to private insurers. Researchers publishing in the New England Journal of Medicine, the British Medical Journal and the Annals of Internal Medicine have all endorsed the system. HealthcarePapers, a Canadian policy journal devoted an entire issue to it in 2005. The abstract of the coverage said: “Veteran Affairs (VA) Veterans Health Administration (VHA) is the largest integrated healthcare system in the United States, treating close to five million patients annually through its 163 hospitals and 15,000 physicians. Comparable in operational size to the province of Ontario, it is an efficient and innovative system for Canadians to learn from. In particular, the VHA is an excellent example of healthcare transformation through the use of information technology (IT)”. In 2008 the system employed 19,000 salaried doctors in 153 medical centers and more than 900 outpatient clinics. The system treated 5.1 million veterans and millions more are enrolled. “I really get annoyed every time I hear these talking heads talking about ‘the government can’t run anything,’” said John Rowan, 64, president of the Vietnam Veterans of America. “Most veterans would give it a fairly good rating.” Perception problems originate from confusion with 2007 reports of the moldy, rodent-infested housing at Washington’s Walter Reed Army Medical Center, a facility run by the Defense Department, not Veterans Affairs. “The thing that I find so ironic about the whole health- care reform debate is that most of the tactics and strategies that are being talked about as far as how to change the system, all of those things have been in play at the VA for over a decade,” said Kenneth Kizer, who oversaw veterans health for President Clinton and is credited with transforming the agency. Under Kizer, the system adopted performance measurements and began focusing on a “continuum” of care, thinking about the long-term outlook for patients and setting up a what Kizer called a “network model” for everything from veterans facilities to home care. =============================================== Daniel Johnson was born near the midpoint of the twentieth century in Calgary, Alberta. In his teens he knew he was going to be a writer, which explains why he was one of only a handful of boys in his high school typing class—a skill he knew was going to be necessary. He defines himself as a social reformer, not a left winger, the latter being an ideological label which, he says, is why he is not an ideologue, although a lot of his views could be described as left-wing. He understands that who he is, is largely defined by where he came from. The focus for Daniel’s writing came in 1972. After a trip to Europe he moved to Vancouver, British Columbia. Alberta, and Calgary in particular, was extremely conservative Bible Belt country, more like Houston than any other Canadian city (a direct influence of the oil industry). Two successive Premiers of the province, from 1935 to 1971, had been Baptist evangelicals with their own weekly Sunday radio program—Back to the Bible Hour, while in office. In Alberta everything was distorted by religion. Although he had published a few pieces (unpaid) in the local daily, the Calgary Herald, it was not until 1975 that he could actually make a living from journalism when, from 1975 to 1981 he was reporter, photographer, then editor of the weekly Airdrie Echo. For more than ten years after that he worked with Peter C. Newman (1979-1993), Canada’s top business writer (notably a series of books, The Canadian Establishment). Through this period Daniel also did some national radio and TV broadcasting with the CBC. You can write to Daniel at:

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Scott October 6, 2009 4:32 pm (Pacific time)

Engle, thanks for your service, and for your great comments on the VA healthcare system. I can only imagine what the general public (is it 80% who say they like their existing healthcare) would think about being "cared" for by the VA.

Engle October 6, 2009 9:27 am (Pacific time)

Daniel Johnson I am a service-connected veteran and I use the VA system quite frequently. Because of my accumlative experience using the system I have learned how to navigate within it which helps avoid the many obstacles one encounters in such a huge system, but not always, and it is getting tougher even for someone with my experience. You will find far more people who are having difficulty getting timely health care than those that are. It is difficult to measure (accurately) veterans attitudes about the VA because of an inherent concern that there may be a negative backlash. This system was created to deal primarily with just one special population, the "disabled/service-connected veteran." In the mid 1990's the system was opened to non-service connected veterans and this population is growing faster than the resources, for example medical staff and medical diagnostic equipment. This in turn has made waiting times longer, plus things like MRI's and colonoscopys are more difficult to get. Then after getting a dignosis waits are getting longer for the needed medical procedures to fix the vet. For example, the VA will often use other procedures for checking your plumbing than a colonoscopy, and these other procedures will miss from 25 to 40 percent of your colon. Not good. With the downed economy the demands on VA hospital services is growing faster and waits are getting longer. There is rationing going on because of these demands, thus you have a primary doctor who orders certain procedures, but a panel of bean-counters actually decide what will be done. You might say these bean-counters in the final analysis have the power of life and death by deciding what procedures (and drugs)will be available. Many veterans who live far away from facilities, and say they are 100%, will on occasion be allowed a "fee basis" treatment via private medical services and even rehab. services. The thing is the VA is getting slower and slower remunerating these private organizations that it's getting harder to find any that will help. Not unlike people on medicare trying to get a doctor. Needless to say the VA is an excellent example of what happens when the demand outstrips the resources and provides a window into the future for all those medical facilities which may soon have more demand than available resources. It takes a long time to train medical and technical staff. Not only that, you want to make sure the people who get in this profession see it as a rewarding one, otherwise quality will plummet.

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