VA System: Better Care with Less Profit Incentive

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In summary, the conversation discusses the VA healthcare system and how it is often criticized but actually provides cost effective and high-quality care. The system is scrutinized and held accountable, unlike private healthcare providers. While it is not perfect, the VA removes the profit incentive and prioritizes patient health. The conversation also touches on the differences between military and VA hospitals and the issues faced by patients in both. Finally, it raises the topic of government interference in the private healthcare sector and the unsustainability of single-payer systems.
  • #1
airborne18
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I just got back from one of my appointments at the VA.

For all of the bad people say about the VA, it is actually a great system and it illustrates how dysfunctional our health care system has become.

First, the VA is the most scrutinized government agency and they take their lumps when they deserve them. But consider how little we scrutinize private health care providers. People cite the number of actions against the VA, yet they are public record, but the private system never has to disclose the mistakes and the lawsuit settlements. Their is a huge incentive in never admitting mistakes in the private system.

Next, the care at the VA is cost effective and overall very good. Yeah there are some odd rules, but considering they treat people who have the highest rate of chronic illness, they do an outstanding job. And the fact that they are all connected, they have a large experience base with what treatments are effective, and which are a waste. Also every doctor or nurse knows exactly what medical issues I have and my history.

While money and budgets are a factor, it is not something that each person considers when examining the patient. They tell me which tests I should have, and which treatments are available. And they will even say which ones the VA just doesn't like doing due to cost. But also most VA hospitals are connected with major medical research and teaching hospitals. I see specialists at University of PA and Thomas Jefferson Hosp. It is the benefit of all the federal funding they receive.

I have serious chronic medical issues, and I have been through the mill with the private system. And trust me it sucks. Doctors and health care providers treat insurance cards, and when you have chronic problems our system fails.

Is the VA system perfect, nope. But it is amazing how good care can be when you remove the profit incentive. And the first concern of the medical professionals is my health.

The other benefit is that everyone at the VA I deal with knows me. Last time I had an appointment they picked up that I was not my normal self and I didn't realize how bad I was, but they did.

I know the VA is a popular target for everyone, and it used to really bite, but I will take the irritating parts of it because it is far superior to our private system.
 
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  • #2
airborne18 said:
... but I will take the irritating parts of it because it is far superior to our private system.
Now if I simply say, no, trust me, the private system is far superior, where does that get us?
 
  • #3
mheslep said:
Now if I simply say, no, trust me, the private system is far superior, where does that get us?

Lol. Well I doubt a coin toss will solve it, so I guess there is no point in arguing.
 
  • #4
LOL, the worst medical experience I ever had was in a military hospital. They almost killed me. They had to send me out to a real hospital to fix their botched surgery. But, a single individuals experience doesn't speak for an entire system whether private, military, or public.
 
  • #5
drankin said:
LOL, the worst medical experience I ever had was in a military hospital. They almost killed me. They had to send me out to a real hospital to fix their botched surgery. But, a single individuals experience doesn't speak for an entire system whether private, military, or public.

Military hospitals are horrible. I always thought is was funny that the pharmacy filled prescriptions by rank.
 
  • #6
airborne18 said:
Military hospitals are horrible. I always thought is was funny that the pharmacy filled prescriptions by rank.
I'm guessing Drankin means a VA hospital. In what way do you distinguish between 'military' and VA hospitals? Active duty only versus veterans only?

BTW, had you heard about the Walter Reed scandal broken by the WaPo in 2007 at the height of the Iraq war?

http://en.wikipedia.org/wiki/Walter_Reed_Army_Medical_Center_neglect_scandal" [Broken]l
Building 18

WRAMC's Building 18 is described in the article as rat- and cockroach-infested, with stained carpets, cheap mattresses, and black mold, with no heat and water reported by some soldiers at the facility. The unmonitored entrance created security problems, including reports of drug dealers in front of the facility. Injured soldiers stated they are forced to "pull guard duty" to obtain a level of security. In an attempt to alleviate the toll that Building 18's condition is taking on the wounded soldiers, a staff team headed by a clinical social worker at WRAMC obtained a grant of $30,000 from the Commander's Initiative Account for improvements; however, "a Psychiatry Department functionary held up the rest of the money because she feared that buying a lot of recreational equipment close to Christmas would trigger an audit." By January the funds were no longer available.

SecDef Gates essentially fired two General Officers and the Sec. of the Army over the issues at WR (I am happy to know.)
 
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  • #7
Nope, I meant a military hospital. And, yes, I know they are different hospitals entirely. The vets get better medical than our active duty folks in my experience.
 
  • #8
drankin said:
Nope, I meant a military hospital. And, yes, I know they are different hospitals entirely. The vets get better medical than our active duty folks in my experience.
Apparently. I was looking for examples of each. For instance, Walter Reed takes both Vets and active duty, so what would its classification be?
 
  • #9
The profit incentive works fine with healthcare provided you have a free market. While we have a private sector for healthcare in America, there is so much government interference with it, that I wouldn't exactly call it free-market.

And the two single-payer systems that we already have, Medicare and Medicaid, are unsustainable and part of the reason for the rising costs in the private sector of healthcare.

Free-market healthcare doesn't mean unregulated. I wouldn't want a nationalized automotive industry, but automobiles, although free-market, are heavily regulated. I wouldn't want a nationalized building construction industry, but building construction, although free-market, is again very regulated.

Nationalized agriculture doesn't work. We do not need nationalized homeowner's insurance or nationalized automotive insurance. I do not see why we need nationalized healthcare or nationalized health insurance. They should all be free-market, and regulated as required.
 
  • #10
CAC1001 said:
The profit incentive works fine with healthcare provided you have a free market. While we have a private sector for healthcare in America, there is so much government interference with it, that I wouldn't exactly call it free-market.

And the two single-payer systems that we already have, Medicare and Medicaid, are unsustainable and part of the reason for the rising costs in the private sector of healthcare.

Free-market healthcare doesn't mean unregulated. I wouldn't want a nationalized automotive industry, but automobiles, although free-market, are heavily regulated. I wouldn't want a nationalized building construction industry, but building construction, although free-market, is again very regulated.

Nationalized agriculture doesn't work. We do not need nationalized homeowner's insurance or nationalized automotive insurance. I do not see why we need nationalized healthcare or nationalized health insurance. They should all be free-market, and regulated as required.
Agreed, in detail, with every paragraph.
 
  • #11
airborne18 said:
Is the VA system perfect, nope. But it is amazing how good care can be when you remove the profit incentive. And the first concern of the medical professionals is my health.

This statement is entirely nonsensical. You imagine that the VA is not concerned with maximizing its annual budget (or that this is somehow distinguishable from a "profit incentive")? Or that VA doctors are more concerned with your welfare than their own and their families, eg the size of their paychecks? Inane.

Anecdotal "I had a great time" stories such as this are only useful for telling us about you, not for telling us about the VA.

Anecdotally, I can tell you that my own experience with the private system as an insured individual, a privately insured employee, and a state employee has always been top notch. Does my story have more or less weight than your own, and which tells us more about the states of the two systems? It would be futile to try and draw any conclusions.
 
  • #12
CAC1001 said:
The profit incentive works fine with healthcare provided you have a free market. While we have a private sector for healthcare in America, there is so much government interference with it, that I wouldn't exactly call it free-market.

And the two single-payer systems that we already have, Medicare and Medicaid, are unsustainable and part of the reason for the rising costs in the private sector of healthcare.

Free-market healthcare doesn't mean unregulated. I wouldn't want a nationalized automotive industry, but automobiles, although free-market, are heavily regulated. I wouldn't want a nationalized building construction industry, but building construction, although free-market, is again very regulated.

Nationalized agriculture doesn't work. We do not need nationalized homeowner's insurance or nationalized automotive insurance. I do not see why we need nationalized healthcare or nationalized health insurance. They should all be free-market, and regulated as required.

Medicaid is just a worthless program. And Medicare is the golden cash cow of the medical system. The problem is access to care. I live in an area with a high percentage of retired, and doctors only want medicare. They screen all patients and they only have availability for medicare patients.

I am not sure what you mean by government interference.. Doctors and can pick and choose patients, and that forces a large segment to use emergency rooms for primary care. Doctors can choose to relocate to population centers that are more profitable than others.

Doctors don't have to treat any patient. And they can overtreat those who have great insurance, and endlessly treat those with medicare ( with zero oversight ). Heck my neighbor's mother goes to the doctor everyday. Her doctor charged medicare for 7 office visits for a single flu shot.
 
  • #13
I did a quick check and spotted this.

...In study after study published in peer‐reviewed journals, the VA beats other health care providers on virtually every measure of quality. These include patient safety, adherence to the protocols of evidence medicine, integration of care, cost‐effectiveness, and patient satisfaction. The VA is also on the leading edge of medical research, due to its close affiliation with the nation's leading medical schools, where many VA doctors have faculty positions. The VA has its problems, but compared to those found elsewhere in the U.S. health care system, it offers "Best Care Anywhere."...
http://www.gooznews.com/node/3360

A quick check of published papers
In fiscal year 2000, throughout the VA system, the percentage of patients receiving appropriate care was 90 percent or greater for 9 of 17 quality-of-care indicators and exceeded 70 percent for 13 of 17 indicators. There were statistically significant improvements in quality from 1994–1995 through 2000 for all nine indicators that were collected in all years. As compared with the Medicare fee-for-service program, the VA performed significantly better on all 11 similar quality indicators for the period from 1997 through 1999. In 2000, the VA outperformed Medicare on 12 of 13 indicators...
http://www.nejm.org/doi/full/10.1056/NEJMsa021899
 
  • #14
mheslep said:
Apparently. I was looking for examples of each. For instance, Walter Reed takes both Vets and active duty, so what would its classification be?

Walter Reed is a military hospital. But not sure what point you are trying to make.

See here is the problem with the private medical system, there is no oversight and the industry does not police itself. Problems just compound, unlike the federal facilities where every problem makes national news.

here is a doctor in Delaware. Other doctors heard complaints and none of his buddies reported him. He molested hundreds of patients. in other words pretty much most of his patients.

http://attorneygeneral.delaware.gov/family/childviolence/earlbradleypr.shtml [Broken]
 
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  • #15
airborne18 said:
I am not sure what you mean by government interference.

Not taxing employer-provided health insurance which causes distortions, not allowing people to purchase health insurance across state lines, mandates from various state governments on what health insurance companies must cover, etc...there are other aspects I am not thinking of right now.
 
  • #16
CAC1001 said:
Not taxing employer-provided health insurance which causes distortions

I think this is the first time I've ever heard someone complain about something NOT being taxed.

CAC1001 said:
, not allowing people to purchase health insurance across state lines,

Yep. Completely agree.

CAC1001 said:
mandates from various state governments on what health insurance companies must cover, etc...

Yep. Completely disagree.
 
  • #17
Just did a little Googling, here is what seems like a very interesting article on the subject:

http://www.washingtonmonthly.com/features/2005/0501.longman.html [Broken]

A physician trained in emergency medicine and public health, Kizer was an outsider who immediately started upending the VHA's entrenched bureaucracy. He oversaw a radical downsizing and decentralization of management power, implemented pay-for-performance contracts with top executives, and won the right to fire incompetent doctors. He and his team also began to transform the VHA from an acute care, hospital-based system into one that put far more resources into primary care and outpatient services for the growing number of aging veterans beset by chronic conditions.

According to this article, many are skeptical of government healthcare for the exact reasons that I cited, basically, that the free-market works far better and more efficiently than government in almost everything else. It says that healthcare can be an exception though.

If we look at the thus far success of the Bush Medicare Prescription Drug program and the measures taken by Dr. Kizer, it seems if certain free-market principles are incorporated into government healthcare programs, they can work.

For example, one criticism of government programs is that there is little incentive for government employees to provide quality service because it is almost impossible to fire them. But a government program in which they can be fired (like doctors) if they are bad, this could improve things a lot.

What would be very interesting would be to compare the British National Health Service to the VA system and see what differences there are between the two (b/c from my understanding, the British system has some major problems).
 
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  • #18
Char. Limit said:
I think this is the first time I've ever heard someone complain about something NOT being taxed.

Not taxing employer-provided health insurance is why most health insurance in America is provided by employers, which makes it where if a person loses their job, they lose their health insurance. It also bankrupts businesses (like GM).

Yep. Completely agree.

:smile:

Yep. Completely disagree.

I don't know of any specific studies on this, but I know each state provides different levels of mandates on health insurance companies, so I wouldn't find it surprising if this affects healthcare costs.
 
  • #19
CAC1001 said:
Not taxing employer-provided health insurance is why most health insurance in America is provided by employers, which makes it where if a person loses their job, they lose their health insurance. It also bankrupts businesses (like GM).

It also makes manufacturing more expensive in America than in other countries.
 
  • #20
CAC1001 said:
Just did a little Googling, here is what seems like a very interesting article on the subject:

http://www.washingtonmonthly.com/features/2005/0501.longman.html [Broken]



According to this article, many are skeptical of government healthcare for the exact reasons that I cited, basically, that the free-market works far better and more efficiently than government in almost everything else. It says that healthcare can be an exception though.

If we look at the thus far success of the Bush Medicare Prescription Drug program and the measures taken by Dr. Kizer, it seems if certain free-market principles are incorporated into government healthcare programs, they can work.

For example, one criticism of government programs is that there is little incentive for government employees to provide quality service because it is almost impossible to fire them. But a government program in which they can be fired (like doctors) if they are bad, this could improve things a lot.

What would be very interesting would be to compare the British National Health Service to the VA system and see what differences there are between the two (b/c from my understanding, the British system has some major problems).

The Medicare Prescription program is not a success.

The private system has more layers of waste and beauracracy then the VA. Just because the consumer does not always see it, does not mean it is not there. If you get taken to an emergency room you will have bills coming from doctors, the hospital, and labs. And it really gets irritating when you find out one of the doctors does not accept your insurance, or is not in-network.

Insurance companies and doctors have created a system where they can pick and choose who they treat and who they cover. If they were really regulated they would not be allowed to drop people when they become chronically ill.

You even concede that forcing them to provide coverage is one of the obstacles. Well that is the problem. People get sick, and they buy insurance to cover them. That is why the insurance companies are in the business. Letting them decided after the fact, what they will and will not cover is the problem with our system.

We have medicare because insurance companies said it would cost too much to cover the aging.. yeah sick people. So you can't blame medicare, when it is the result of profit driven care.

Remember when HMO's were so great, until people kept getting screwed by the not in-network clauses. People would be transferred during emergencies to other facilities and HMO would not cover them because the hospital was not in-network.


I understand why people think we have a great system, because they are not chronically ill.
People think all of those benefits you get from work are great, because they do not use them. Long term disability does not last forever, and you will quickly lose health insurance and become uninsurable if you are chronically ill.

I have been through it. The best care I ever got from our private health care system was when I had the money to pay cash. Because doctors didn't order all kinds of worthless tests or endless followups.

I have been dropped by more insurance companies than I care to count.

The VA is not perfect, and 20 years ago it sucked. But private doctors don't hire qualified people. You can go to school for 6 months and be qualified to be an aide. Most hospitals don't have an army of RN's.

The difference is that at the VA patients have rights, and there is a way to actually complain and get results. Try that with your doctor or local hospital. Plus my medical records are private. In the private world everyone who is involved with billing can see your records, even the HR department at your work. Drug company reps get access to presciption records, has nothing to do with care, just sales.
 
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  • #21
CAC1001 said:
What would be very interesting would be to compare the British National Health Service to the VA system and see what differences there are between the two (b/c from my understanding, the British system has some major problems).

It's hardly a comparison. One scheme covers a small subset of the population, whereas the other covers the entire population.
 
  • #22
airborne18 said:
That is why the insurance companies are in the business. Letting them decided after the fact, what they will and will not cover is the problem with our system.
Nonsense. What you're describing is fraud, and has always been illegal in the U.S. No one is opposing anti-fraud laws to enforce policy agreements.

If private insurance companies are so bad, then it should be extremely easy to compete with them. Why is it that none of the people bashing them have any interest in setting up a (government or private) insurance system to compete with private insurers instead of trying to control them, or force people to buy it?

If they really thought they could do better, they would have no reason to fear private competition.

That's like the USPS claiming that UPS and FedEx are terrible, and advocating that government control them to make them "better" instead of fairly competing with them for our business.
 
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  • #23
airborne18 said:
The Medicare Prescription program is not a success.

Thus far, it has been beating its expected costs, and it has expanded access to prescription drugs for many seniors and poor.

You even concede that forcing them to provide coverage is one of the obstacles. Well that is the problem. People get sick, and they buy insurance to cover them. That is why the insurance companies are in the business. Letting them decided after the fact, what they will and will not cover is the problem with our system.

I am assuming you are referring to the mandates I was talking about from states? I agree that certain things should probably be mandated, however in some states things like hair loss treatment and marriage counseling are mandated. That type of stuff, IMO just leave out.

If I buy auto insurance, I don't need it mandated they cover a broken tail light. Or for homeowner's insurance, I don't need a broken window covered. If they mandated that kind of stuff, we'd see homeowner's and auto insurance prices shoot up.

We have medicare because insurance companies said it would cost too much to cover the aging.. yeah sick people. So you can't blame medicare, when it is the result of profit driven care.

Medicare itself is a fine program in terms of what it does, however the mechanics of how it works as not good as the costs to it are way out of control. It also suffers from waste, fraud, abuse, corruption, etc...in terms of it raising healthcare costs, this is because if a person on Medicare goes to a hospital say, the hospital is limited in what they can charge the person, even if the actual costs of the services are more than what they can legally charge. These costs have to be made up somewhere else, and get passed onto the private sector in the form of insurance companies denying care, raising prices, etc...Medicare needs reform, and by reform, I don't mean cuts, I mean changes to the mechanics of how it operates so it can continue to do its job.

I have read of a program in I think Singapore where the Medicare equivalent is basically a health fund people pay into their whole working life, and then when retired, this healthcare fund pays for their health needs. However, anything catostrophic is insured by the government, so if something happens that would completely drain their health account, the government insures it. For the most part, however, the health accounts are enough, so the system sustains itself (I could imagine shifting Social Security to something like this as well in the future).

Remember when HMO's were so great, until people kept getting screwed by the not in-network clauses. People would be transferred during emergencies to other facilities and HMO would not cover them because the hospital was not in-network.

I understand why people think we have a great system, because they are not chronically ill.
People think all of those benefits you get from work are great, because they do not use them. Long term disability does not last forever, and you will quickly lose health insurance and become uninsurable if you are chronically ill.

I have been through it. The best care I ever got from our private health care system was when I had the money to pay cash. Because doctors didn't order all kinds of worthless tests or endless followups.

I have been dropped by more insurance companies than I care to count.

Actually, most people I have heard say what you said, although in a shorter phrase: "America has the finest healthcare, if you can afford it." But the healthcare system everyone agrees is screwy in certain ways.

The VA is not perfect, and 20 years ago it sucked. But private doctors don't hire qualified people. You can go to school for 6 months and be qualified to be an aide. Most hospitals don't have an army of RN's.

Interestingly, that article I cited also says the same thing you are saying: That the VA system used to be horrible and the example pointed to by conservatives for why government healthcare is bad and won't work, but since then it apparently has gone through a huge turnaround.

On private doctors, don't know about them, but I'd imagine it would depend on the doctor regarding who they hired.
 
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  • #24
cristo said:
It's hardly a comparison. One scheme covers a small subset of the population, whereas the other covers the entire population.

But could the VA system, provided it really is a good system, be scalable, assuming the proper resources (numbers of doctors, nurses, etc...) are there?
 
  • #25
CAC1001 said:
I agree that certain things should probably be mandated, however in some states things like hair loss treatment and marriage counseling are mandated. That type of stuff, IMO just leave to the private sector.

If I buy auto insurance, I don't need it mandated they cover a broken tail light. Or for homeowner's insurance, I don't need a broken window covered. If they mandated that kind of stuff, we'd see homeowner's and auto insurance prices shoot up.
It seems many people have this weird notion that such mandates are mandates on insurers, when in fact they are mandates on consumers. Consumers are prohibited from buying medical insurance unless they agree to buy "hair loss" insurance.

What's more amazing is how the big insurance companies can form a lobby to lobby government to force people to buy their most expensive product, while outlawing less expensive, more basic insurance, and use taxpayer money to buy that same expensive product for many, then convince (far too many) Americans that anyone who opposes such a plan is in the "pocket" of insurance companies.

Does anyone really think that big insurance companies didn't want to sell policies that cover everything under the sun? That they oppose forcing people to buy their product? That they oppose coverage mandates forced on their customers? How stupid can people possibly be?
 
  • #26
Healthcare won't work efficiently with the ridiculously heterogeneous population that the US consists of.
 
  • #27
CAC1001 said:
But could the VA system, provided it really is a good system, be scalable, assuming the proper resources (numbers of doctors, nurses, etc...) are there?

I don't agree with the comparison to the Canadian or British system to the VA. The VA covers a wider geogrpahical area than the UK system, but it does have a limited set of the population.

The US does have a public system, or used to, where the County hospitals were the provider of last resort and were free. But that system has fallen apart.

The issue with the US system is that elderly patients are over-treated. And they have such a powerful lobby and voting block that it is impossible to reform it. Ideally the US should set up a medical system for the elderly that was similar to the VA. But it will never happen.

Private doctors need to be put out of the medicare business. That would be the ideal reform for everyone. It would cut waste and fraud and offer an avenue to treat the poor as well.


The VA is not a perfect system. And the fact that travel is required, even though they pay for it, for some care. If you told medicare patients they had to drive for care there would be riots in the streets. The other issue is that care varies from facility to facility, though long term they are fixing it. In Florida where there are a ton of retired Veterans, you hear a ton of complaints.

Take me, my health care easily cost the VA 120,000 a year. ( i know my meds cost 5,000 a month ). I have a doctors appointment 7-8 times a month. An MRI 2-3 times a year. 2 cat scans a year. Physical therapy 3 times a week for half the year. Neuro study once a year. Plus all the gastro crap ( pun intended ). And then add in dental.

The private system could not come close to providing me care that is cost effective.

And I have 24 hour phone access to a doctor, nurse, or mental health professional. Or I can talk to my doctor by leaving a message and they actually will call me back. When I am sick I can go over to the VA office and get seen immediately.
 
  • #28
Al68 said:
It seems many people have this weird notion that such mandates are mandates on insurers, when in fact they are mandates on consumers. Consumers are prohibited from buying medical insurance unless they agree to buy "hair loss" insurance.

What's more amazing is how the big insurance companies can form a lobby to lobby government to force people to buy their most expensive product, while outlawing less expensive, more basic insurance, and use taxpayer money to buy that same expensive product for many, then convince (far too many) Americans that anyone who opposes such a plan is in the "pocket" of insurance companies.

Does anyone really think that big insurance companies didn't want to sell policies that cover everything under the sun? That they oppose forcing people to buy their product? That they oppose coverage mandates forced on their customers? How stupid can people possibly be?

The average person does not understand insurance. Did you ever wonder why they ask you if your injury is work related or from a car accident?

Do you know what your liability for medical actually is? I bet you don't.

Guess who covers your medical if you are hit by a car?

Do you know how much medical coverage you have if you are in a car accident? Guess how much it will cost if you are in an accident and have to be flown from the scene? Guess who covers that?

Do you know the maximum amount your health insurance will payout?

If you are sick and end up on long term disability, you are screwed after a while. And once COBRA runs out, if they don't drop you for some technicality, you are on your own.

It is not that hard to be wiped out by medical bills in the US.

My father-in-law is going through it right now. He had a stroke and is blind. Too young for medicare and he has too many health problems. They have too much money for medicaid and he is not eligible for Medicare until 24 months of his disability.

I went through it with my issues. Went through a ton of money in medical bills.
 
  • #29
airborne18 said:
Walter Reed is a military hospital. But not sure what point you are trying to make...
Yes, the Army's primary hospital, but clearly WR also treats veterans.
 
  • #30
airborne18 said:
...
Take me, my health care easily cost the VA 120,000 a year.
I.e. that costs the taxpayers $120,000 a year, at least. BTW, given you don't pay the bills, how do you arrive at that cost figure?
( i know my meds cost 5,000 a month ). I have a doctors appointment 7-8 times a month. An MRI 2-3 times a year. 2 cat scans a year. Physical therapy 3 times a week for half the year. Neuro study once a year. Plus all the gastro crap ( pun intended ). And then add in dental.
The private system could not come close to providing me care that is cost effective.
What makes you think the above treatment is 'cost effective' at $120K? If the question is can private insurance provide the kind of extensive treatment you describe, I know from personal experience that it can and does.
 
  • #31
mheslep said:
I.e. that costs the taxpayers $120,000 a year, at least. BTW, given you don't pay the bills, how do you arrive at that cost figure?
( i know my meds cost 5,000 a month ). I have a doctors appointment 7-8 times a month. An MRI 2-3 times a year. 2 cat scans a year. Physical therapy 3 times a week for half the year. Neuro study once a year. Plus all the gastro crap ( pun intended ). And then add in dental.
What makes you think the above treatment is 'cost effective' at $120K? If the question is can private insurance provide the kind of extensive treatment you describe, I know from personal experience that it can and does.

My cost are estimates based on bills they would have charged my private insurance, if I had any.

Private insurance does at its discretion. I have been dropped by private insurance, yeah they really don't like people who have chronic conditions. Once I found out I was dropped from a clerk when I was checking in for tests. priceless.

Look at what is going on because insurance companies have to treat pre-existing conditions for children. Insurance companies are not offering child policies.

That really underscores how broke our system is, and illustrates my point. Insurance companies should be able to drop sick people, and only cover the healthy. Great systems.

So basically the government is footing the bill so insurance companies can profit. You can't blame government medical insurance, and then lobby for private insurance that can cherry pick, and the drop people that impact their bottom line. I mean it is simply cost shifting people back into government programs. It is self-defeating.
 
  • #32
mheslep said:
Yes, the Army's primary hospital, but clearly WR also treats veterans.

Walter Reed is not the Army's primary hospital. It is the primary hospital in the military for treating orthopedics. And they treat tricare patients, not veterans. I can't go there.
 
  • #33
airborne18 said:
I have been dropped by private insurance, yeah they really don't like people who have chronic conditions.
I agree insurance is a bad way to attend to chronic conditions. By definition, insurance is for covering the unexpected. Insurance is not the way to address, say, wrecks from pile ups in the Demoltion Derby every Saturday night. For health care, high risk pools with government subsidies seems to be the way to go for chronic conditions - not run by government doctors, only subsidized by it. The US had a good version of risk pools on the table with McCain's campaign in my view.
http://www.politico.com/news/stories/0510/37013.html
Obamacare version:
http://www.healthinsurance.org/risk_pools/
 
  • #34
Relevant question: what do people think about the idea of doing away with traditional* US malpractice suits altogether and avoiding the expense and defensive medicine? If the answer is no, then why is ok for the US VA?

The Department of Veterans Affairs is a department of the United States Government. As such, the Department generally can’t be sued due to the legal theory of “sovereign immunity.”
http://veteranmedicalmalpractice.com/faq.html

* meaning no jury trials, and you have to seek an administrative solution before suing only in federal court.
 
  • #35
Al68 said:
It seems many people have this weird notion that such mandates are mandates on insurers, when in fact they are mandates on consumers. Consumers are prohibited from buying medical insurance unless they agree to buy "hair loss" insurance.

Wasn't aware of that, thanks for the clarification.
 
<h2>1. What exactly is the VA System and how does it differ from other healthcare systems?</h2><p>The VA System, or Veterans Health Administration, is a government-run healthcare system specifically designed to provide medical services to veterans of the United States armed forces. Unlike other healthcare systems, the VA System is funded and managed by the federal government and has a unique focus on the needs of veterans.</p><h2>2. How does the VA System prioritize patient care over profit?</h2><p>The VA System operates on a budget that is not tied to profits or financial incentives. This means that healthcare providers within the system are not financially motivated to perform unnecessary procedures or prescribe expensive treatments. Instead, the focus is on providing the best possible care for veterans, regardless of cost.</p><h2>3. What are the benefits of a healthcare system with less profit incentive?</h2><p>A healthcare system with less profit incentive, like the VA System, can lead to more patient-centered care. This means that the focus is on the individual needs and well-being of patients, rather than the financial gain of the healthcare providers. It can also result in lower healthcare costs and reduced healthcare disparities.</p><h2>4. Are there any drawbacks to a healthcare system with less profit incentive?</h2><p>One potential drawback of a healthcare system with less profit incentive is that it may result in longer wait times for certain procedures or treatments. Additionally, there may be less competition and innovation in the healthcare industry without the drive for profits. However, the overall benefits of patient-centered care may outweigh these potential drawbacks.</p><h2>5. How can other healthcare systems learn from the VA System?</h2><p>The VA System has been recognized for its high-quality care and patient satisfaction. Other healthcare systems can learn from the VA System by implementing similar patient-centered approaches and prioritizing the needs of patients over profits. They can also learn from the VA System's use of technology and data to improve healthcare outcomes and efficiency.</p>

1. What exactly is the VA System and how does it differ from other healthcare systems?

The VA System, or Veterans Health Administration, is a government-run healthcare system specifically designed to provide medical services to veterans of the United States armed forces. Unlike other healthcare systems, the VA System is funded and managed by the federal government and has a unique focus on the needs of veterans.

2. How does the VA System prioritize patient care over profit?

The VA System operates on a budget that is not tied to profits or financial incentives. This means that healthcare providers within the system are not financially motivated to perform unnecessary procedures or prescribe expensive treatments. Instead, the focus is on providing the best possible care for veterans, regardless of cost.

3. What are the benefits of a healthcare system with less profit incentive?

A healthcare system with less profit incentive, like the VA System, can lead to more patient-centered care. This means that the focus is on the individual needs and well-being of patients, rather than the financial gain of the healthcare providers. It can also result in lower healthcare costs and reduced healthcare disparities.

4. Are there any drawbacks to a healthcare system with less profit incentive?

One potential drawback of a healthcare system with less profit incentive is that it may result in longer wait times for certain procedures or treatments. Additionally, there may be less competition and innovation in the healthcare industry without the drive for profits. However, the overall benefits of patient-centered care may outweigh these potential drawbacks.

5. How can other healthcare systems learn from the VA System?

The VA System has been recognized for its high-quality care and patient satisfaction. Other healthcare systems can learn from the VA System by implementing similar patient-centered approaches and prioritizing the needs of patients over profits. They can also learn from the VA System's use of technology and data to improve healthcare outcomes and efficiency.

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