Government Run Health Care

By John Ballard

As a former member of the Army Medical Service Corps I take issue with those who argue that government can't do anything right, particularly health care. (I love it when Tea Party people want to get government out of their life but not mess with Medicare or the Social Security.) And all that nutty talk about socialism misses the only true socialist health care system in the country, that of the Armed Forces and Veteran's Administration. Medical professionals on salary, from lab techs to surgeons, working in government-owned facilities using government supplies... What would you call it?

So take a look at this about Electronic Health 'Records from Joe Paduda.

1. The VA is a very, very large health system that has implemented an EHR program and saved taxpayers over $3 billion dollars - so far. Implementing EHR is difficult, time-consuming, and a lot of work. Yet it can, and has, been done.

2. This is a creditable result, and one that should encourage other integrated health systems to find out what the VA has done and, perhaps, do something similar. After all, if the gubmint can do it, it should be child's play for the vaunted free market...

Unfortunately, it appears as if the private sector isn't as competent in this area as the VA.... First, the VA spends considerably more (as a percentage of total expenditures) on IT than the private sector does. Yet the VA's ratio of IT capital spending to total spending is considerably less than the private sector's.

The VA spends more on IT, with a big chunk of that invested in implementation and maintenance. And the results show the impact:

"The VA has achieved close to 100 percent adoption of several VistA components since 2004. In contrast, the private health care sector has not reached significant adoption of any of these systems. Adoption in the private health sector of inpatient electronic health records stands at 61 percent; use of inpatient bar-code medication administration is at 22 percent; computerized physician order entry adoption stands at 16 percent; and outpatient electronic medical record adoption is at 12 percent"

Finally, the implementation of the VA's VistA system has delivered significant improvements in the quality of care delivered. Here are just a couple examples...

• 
  For preventive care process measures such as cancer screenings, the VA had higher performance during 2004-2007 relative to the private health care sector


• VA patients with diabetes had better glucose testing compliance and control, more controlled cholesterol, and more timely retinal exams when compared to the Medicare health maintenance organization (HMO) private-sector benchmark.
  


• The VA averaged about fifteen percentage points higher than the private sector on preventive care for patients with diabetes and seventeen percentage points higher for patients with diabetes who have well-controlled cholesterol
  

What does this mean for you?

EHR can, and has, delivered significant savings and RoI [return on investment] while increasing quality.

The next time someone bemoans the government's incompetence and complete lack of ability to run anything, tell them about the VA. And tell them to stop parroting Fox talking points; they are a poor substitute for actual thinking.

Ya get that part about starting in 2004? Six. Years. Ago.
This is not new.
And it's not rocket science.
But it's damn hard work and should have been implemented in the much celebrated private sector long before gubmint got hold of it.

(btw, Didja know the VA and Medicaid both negotiate with drug companies for better prices?   But Medicare cannot? Wonder why????  How do you spell "P-O-R-K"?  When you start reading about health care you find so much sh** you start holding your nose...)