Looking to Veterans’ Health Care Model

The Affordable Care Act's (ACA) passage does not signal the health care debate's end. Rather, it's the end of one phase and the beginning of another. The ACA's most substantial reforms dealt with questions of access by expanding insurance. At the same time, it invests in a series of pilot programs to jump start the conversation on how to improve the quality of care. One model that can offer insight into improving the quality of care is the Veterans Health Administration.

It may surprise you to find out that our veterans receive some of the best care in the nation. Many people falsely associate the horror stories of places like Walter Reed Army Hospital with the VHA. But Walter Reed is not part of the VHA; it is run by the army. This, and the VHA past history, have colored the general population’s perceptions of the VHA. But the reality of the current situation is overwhelming positive.

In a 2004 study by the RAND Corporation which compared the quality of care in the VHA system with the quality of care in the rest of the country shows that the VHA is ahead in nearly every quality measure. RAND attributes this to two factors. The first is the utilization of technology, which allows for better coordinated care and reduced medical errors. The other was the VHA’s performance measurement system.

The VHA keeps meticulous records and is constantly trying to hit certain performance goals. According to the RAND study, “… performance measurement has a “spillover effect” that influences care: VA patients were more likely than patients in the national sample to receive recommended care for conditions related to those on which performance is measured. … This provides strong evidence that, if one tracks quality, it will improve not only in the area tracked but overall as well.”

The VHA is also better at controlling costs. According to a CBO report, “Adjusting for the changing mix of patients (using data on reliance and relative costs by priority group), the … (CBO) estimates that VHA’s budget authority per enrollee grew by 1.7 percent in real terms from 1999 to 2005 … that estimate still indicates some degree of cost control when compared with Medicare’s real rate of growth of 29.4 percent in cost per capita over that same period ....”

While no system is absolutely perfect, the VHA system is vastly superior to our current one. When the next phase in the health care debate begins again, we would be better off if we look to the VHA for guidance. 

Posted in Health Care | Related Topics: Health Care Reform  Veterans 

6 Comments

Pat says:

August 9, 2012 at 8:24 am

My husband can vouch for the VA system.  Had he stayed in the insurance run health care system—I would be a widow—more than once.  The VA is proactive, they saved his life, we have nothing but praise for the system.  It is a model to be followed.  It is a patient centered model.

John L says:

August 3, 2012 at 10:45 am

The VA is a similar model to the British National Health System.  The hospitals are owned by the government and the medical personnel are paid by the government.  The British love their NHS. Not even the Tories mess with it.

Navy Nancy says:

August 3, 2012 at 6:54 am

What I would like people to know about the VA Healthcare system that I think many people do not know is that not all US veterans receive health care at the VA.  Veterans with service connected disabilities are seen first, and services are provided to other veterans as resources are available.  “Means testing” is done to screen veterans for income eligibility.  Veterans with ” too much” income are told they are a “Priority Eight” for getting health care services at the VA.

So about 20 percent of US veterans go to VHA for health care.

VA also bills the insurer when providing health care services to insured veterans for non service-connected medical conditions.

How “Socialistic” is that??

Nancy says:

August 2, 2012 at 11:28 am

We need to maintain an attitude that it is a work in progress. Our current system did not get so messed up overnight and it will take time and strong will to gain the improvements in access,affordabilty, delivery and outcomes. A great read for anyone interested in learning more about how our system compares to the rest of the developed, industrialized world’s systems is “The Healing of America” by TR Reid. We have been so brain washed if even half of his research is accurate.

Ginny says:

July 26, 2012 at 12:59 pm

I agree, and how well it works. ACA is NOT socialized medicine and is more expensive and less effective than the VA model.

David Zeller says:

July 26, 2012 at 9:23 am

The VA is the very definition of socialized medicine. THIS needs to be conveyed to people.