Universal Healthcare and the VA Healthcare

The hot topic this election year is Universal Healthcare, neither canidate offers solutions to this issue. At some point in the near future we will have socialized medical care in this country. There are pros and cons on this subject. There are two constants to this issue; 1. Healthcare costs are out of control and 2. Large segement of our soceity have no insurance.

This article is written from the view of healthcare worker that has 32 years experience in Radiology and 27 years experience with Vetereans Affairs Healthcare. I will present a view from inside the healthcare system. There will be pros and cons on this article, which continues the discussion.

If you think that our healthcare is the best in the world, those of you that believe that are ignoring reality. The reality is that there are European countries with government run healthcare that are the best.

We need to take control of the insurance companies and the pharmacueatical companies. This will eliminate the insurance companies from mandating how a physican treats his or her patients. It also will control costs of medications, and eliminating pharmacy reps from visting physicans and hospitals pushing the more expensive drugs. Pharamacy reps. visted our hospital weekly providing lunch for the medical staff.

The federal government needs to take over private healthcare system and integrate the system into the VA. I will provide background on the VA and why our private healthcare needs to be intergrated into this system. On July 21, 1930 President Hoover signed an executive order consolidating agencies administrating veterans healthcare and benefits. The new agency became responsible for all medical services and benefits provided to war veterans. Retirement benefits for the civilian employees were also included.

From 1931 to 1941 the number of VA hospitals grew from 64 to 91. Currently the VA operates 175 medical centers, 900 ambulatory care and community-based outpatient clinics, 136 nursing homes, 43 residential rehabilitation treatment programs, nearly 90 comprehensive home-care programs, spinal cord injury centers, supervises 120 national cemeteries, and in November 1994 established the Center for Women Veterans.

This agency manages the largest medical education and health professions training programs in the United States. These facilities are affiliated with more than 105 medical schools, 55 dental schools, and more than 1200 other schools. The VA is the second largest federal agency with approximately 236,000 employees. Second only to the Department of Defense in the number of employees. The VA was elevated to cabinet status in 1988 when President Reagan signed legislation. By 1988 the VA was the largest independent federal agency in terms of budget.

With budget cuts taking a toll on the VA, our focus was changed to operating as a business, this change provided the opportunity to market services to our private healthcare communities. The marketing opportunities provided additional revenue streams to supplement our budgets. Private healthcare providers were able to refer patients for diagnostic tests, that otherwise were not available.

Since 2000 the VA has been on the cutting edge of medical research and practice of medicine. They have been leading the way in the use of bar coding to improve accuracy and reduction of errors in the administration of medications. They are also the leaders in computerized medical records, medical records of patients are available throughout the network. These two systems have made care more efficient and cost effective.

The DOD and Va have formed an alliance that allows active duty military and their families, and military retirees to receive care at VA’s. In some cases military hospitals have merged with VA hospitals providing cost effective savings. How would this system provide care in Universal healthcare. Private sector hospitals compete with each other for patients and doctors, therefore creating turf wars. This is costly, inefficient, overlapping of services, poor care and long waiting times.

The VA is like WalMart, the similarties is buying supplies and medications at lower cost. There operating costs are lower, and providing services to the community with sharing agreements. There are management teams in the VA that could assist in merging and integrating private hospitals into the system.

There are eligibility requirements that are verified for qualifing to use the system. Verification of military service, citizenship, gross household income (spouse and dependents, if any), and insurance. The income and insurance is on a sliding scale, patients with high income and insurance pay for a portion of their care than the insurance is billed. Those with insurance lower income, their insurance is billed and what the insurance has not covered is absorbed by the system. Patients with medicare supplemental health insurance, the insurance pays for the billed services. Patients with no insurance would receive care at no charge.

There are co-pays in this system for medications, diagnostic tests, and physican appointments. Integrating our private healthcare systems into this large and long standing system would provide every American with quality healthcare. Yes, there have been horriy stories about the VA and the care provided. Speaking from experience with working in the VA system, these issues were addressed at our hospital proactivitly. Private healthcare systems in this country do not address the issues proactivitly.

There are just as many horriy stories about private hospitals that are not reported by the news media. The VA has its pros and cons on the care provided. In a system as large as this one, you will have problems. But those problems are addressed by the administration of the hospital where the problems occur. The VA system is divided into regions, each of these regions have flagship hospitals. Flagship hospitals are those facilities that provide exemplery care and services to the patients and their families.

There are not many if any private hospitals that could meet the standards set to be named a flagship hospital. Those hospitals that fail to meet the standards set by the region are reviewed, and changes are made in administration to raise their performance to the levels expected. This system would provide every American with quality healthcare that is efficient and cost effective.