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Why The VA Scandal Is A Red Flag For Single-Payer Advocates

Mon, 07/21/2014 - 10:33am
Kevin Pho, MD

“I will not stand for it.”

That’s what President Obama said about the deepening VA health care crisis.  It’s also a lightening rod for how partisans want to frame the ongoing health debate.

Some are eager to link the VA scandal to Obamacare, and more broadly, government-run health care.

Others extol the virtues of the VA, holding it as an ideal of what our health care system should look like.

The truth, as always, probably lies somewhere in the middle.

In USA Today, internist Katherine Chretien reminds us that the VA still does good, and that the scandal shouldn’t overshadow that.  She points to various studies showing that the VA outperforms private insurers in various quality metrics (assuming, of course, that those numbers haven’t been doctored):

Researchers found that the VA outperformed Medicare fee-for-service care on all 11 quality measures chosen in a study published in The New England Journal of Medicine in 2003. A study published in 2005 by the RAND Corporation compared VA care with a national sample and found that VA patients were more likely to receive recommended standards of care. A 2011 study, focused primarily on whether there were racial differences in care, showed that overall quality of care in the VA continued to increase from 2000 to 2009.

My first clinical rotation as a third-year medical student was in the VA, and I have done many rotations there, as well as shifts in the emergency room.  I saw first-hand the benefits of an integrated system, and more important, the strengths of a unified electronic medical record.  No question that the VA has some good things going for it.

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