Is VA health care a good template for the public option?

I was reading this article about the need for the public option. It laid out a great case for reform, but when it laid out successful single payer templates that we already have, the author included VA. When I think of Veterans' health, I always wind up thinking about veterans missing out on benefits due to red tape. Is there much truth to this? If so, I hope there are better models we could use.

http://www.huffingtonpost.com/guy-t-saperstein/the-only-good-option-for_b_253339.html

My partner & I both go there.

when you finally get in, getting qualified for it can be an ordeal, from what I understand.

Perhaps it's the protocols for transferring GIs to the VA system that's the problem rather than the VA care itself.

FYI - growing up, my Dad worked at the VA here in Durham. It is very well maintained and partly staffed with docs from Duke across the street doing rounds at both hospitals.

I would think that at least some of the VA system would make a great template. Didn't they recently switch to an electronic medical records system?

And thus a very poor example for what a public option would represent. People with a public option would use the same health facilities as people with private sector insurance.

There is never enough parking.

Other than that, I have no complaints about our VA health care.

Called them hospitals like St. Elsewhere, using VA software that could be repeated. We've had premier hospitals built with overlapping, exotic services, replacing the more urgent need for primary care delivery to more people, watching patients over a lifetime, preventative care.

The VA healthcare system is the best no doubt.

really good.

but they are a health service. They are a certain kind of single payer system most similar to what England has where all the doctors are paid on salary so both delivery of services and payment for service are through one system.

That is quite different from our single payer Medicare model where doctors are private but insurance is done through a single payer, government insurance. That's more similar to Canada.

the payment for service in one is fee for service to any licensed care provider and in the other system care providers work for an employer, the entity which pays the bills.

In England as in the VA, doctors and other care providers work for the health care ministry or whatever they decided to call it.

I've been using the VA for years, and now have diabetes, Lyme disease, some undiagnosed joint problems, and a retinal occlusion leaving me blind in one eye.

Opthamology has been great, as far as I know. Since there are no second opinions unless I want to pay big bucks to an outside opthamologist for one, I have no idea if my bad eye could have been saved with other treatment. They did do a pretty good job with my cataracts and I got a pair of free glasses. They rotate residents every 6 months or so, and I've seen a dozen or so different ones over the past three years.

The computerized system everyone talks about is absolutely necessary because of the turnover in personnel.

Lyme disease they haven't been so great with. One appointment with the infectious disease clinic and I watched the doctor look up Lyme on Yahoo. They were going to put me on antibiotics, then decided not to bother. That's the last I saw them

The undiagnosed joint problems could be arthritis, gout, Lyme effects, or something else. No tests or consult with the orthopedic clinic. If there is an orthopedic clinic.

Diabetes? Went to a class, got a free meter, they mail me metformen and glipizide, get quarterly a1b tests, see the dietician every so often, but never saw an endocrinologist. They do keep me going to the podiatry clinic, though.

I fell and cut my head a while back, so I went to "my doctor" at the local VA clinic. I was informed to never, ever show up at primary care when I was actully sick or injured-- they had no way to deal with it. Had to go to the VA center emrgency room 60 miles away to get stitched up. Same thing when I got some kind of bug bite that got infected-- waited a few days because I had an appointment at the center then. The emrgency room did do a great job stitching me up, though. Hope that surgeon's still around if I need more cutting and sewing.

Oh, and dermatology. Great service there, if you can get an appointment, but they have a really tough time keeping residents. Six months at least for an appointment unless your skin is falling off.

The current VA systmem is barely able to meet the needs of the narrow class of citizens it was designed to serve. To develop a VA style system for the "public option", the feds would have to spend many billions of dollars. They would have to build many hospitals & clinics. They would have to pay for the equipment for all of these facilities. They would have to pay for a professional and support staffs to operate the facilties. It does not look like any ways near the money needed to accomplish this goal is available.

just use the existing hospitals and clinics.

The VA model is a completely Government owned and operated systems

That way, you wouldn't have to go through the hassle of converting hospitals and clinics over or building wholly new public hospitals and clinics. Rather, you'd only be removing private insurance corporations from the equation and pushing them into the realm of just offering supplemental insurance to cover what Medicare doesn't cover. In France, for instance, public health insurance will cover roughly 80% of all costs. You cover the rest, and you are free to purchase supplemental to cover the remaining 20%.

The way you propose is more akin to Great Britain in 1948 when they passed the National Health Service Act. They then built up the infrastructure for it on top of the remnants of their old health care system. Of course, they achieved this feat after their national infrastructure was totally devastated because of the last world war, making their efforts even more remarkable. They did it in the ashes of war. If they could do that, the US could easily match that and beat it if it had the political will.

Most Americans would want it, IMO. It's very easy to explain and Obama and the Dems would win the argument hands down. I think I read that majority of Americans would pay more taxes for a single payer system a while back.

The GOP used to delay admitting long term patients till they died, thus saving money....Also, their doctors were not always the best.


mark

The one in OKC used to be horrible. It was considered a death house by many of the vets in my family. They would drive either to Dallas or Wichita. Those VA hospitals are second to none.

They have very good doctors, too.

The "Public Option" people keep talking about deals mostly in the realm of insurance.

The VA system is much more comprehensive than simply insurance. It includes its own medical facilities and care delivery mechanisms, much like the National Health Service in Great Britain, although the NHS is built to service an entire nation, not just current and former members of the military.

Partially disabled vet and no complaints about VA care from me.

You need to check out Phillip Longman's 2007 book Best Care Anywhere: Why VA Health Care Is Better Than Yours or his shorter 2005 article in the Washington Monthly.

The New England Journal of Medicine published a study that compared veterans health facilities on 11 measures of quality with fee-for-service Medicare. On all 11 measures, the quality of care in veterans facilities proved to be "significantly better."

the National Committee for Quality Assurance today ranks health-care plans on 17 different performance measures. In every single category, the VHA system outperforms the highest rated non-VHA hospitals.

See more here: http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=6240611&mesg_id=6241200

VA health care goes far beyond single payer and is more like the UK model where all health care providers work for the government, not just the insurance part. VA had a mixed reputation until it underwent a big reform effort starting in 1995 and is now tops in outcomes and cost.

Post-Vietnam it was known as being terrible. But after reforms initiated in '95 it now beats Medicare and private private providers on all counts (see previous post). Do you have a link or any other facts to back up your assertion? Remember, Walter Reed is NOT VHA!

These days it is the BEST system in the country.

And that is IN SPITE of the GOP over the last eight years.

Could it be better, YES.. and the VA as well as TRICARE could very well be the model of a single payer system nation wide.

Just one caveat, I'd keep some VA centers open since some war time injuries are that specialized.