Health Care Confidential..... by Paul Krugman

[Toots]

http://www.topplebush.com/oped2502.shtml

American health care is desperately in need of reform. But what form should change take? Are there any useful examples we can turn to for guidance?

Well, I know about a health care system that has been highly successful in containing costs, yet provides excellent care. And the story of this system's success provides a helpful corrective to anti-government ideology. For the government doesn't just pay the bills in this system -- it runs the hospitals and clinics.

No, I'm not talking about some faraway country. The system in question is our very own Veterans Health Administration, whose success story is one of the best-kept secrets in the American policy debate.

In the 1980's and early 1990's, says an article in The American Journal of Managed Care, the V.H.A. "had a tarnished reputation of bureaucracy, inefficiency and mediocre care." But reforms beginning in the mid-1990's transformed the system, and "the V.A.'s success in improving quality, safety and value," the article says, "have allowed it to emerge as an increasingly recognized leader in health care."
<snip>
Last year customer satisfaction with the veterans' health system, as measured by an annual survey conducted by the National Quality Research Center, exceeded that for private health care for the sixth year in a row.
<snip>
How does the V.H.A. do it?
<snip>
The secret of its success is the fact that it's a universal, integrated system. Because it covers all veterans, the system doesn't need to employ legions of administrative staff to check patients' coverage and demand payment from their insurance companies. Because it's integrated, providing all forms of medical care, it has been able to take the lead in electronic record-keeping and other innovations that reduce costs, ensure effective treatment and help prevent medical errors
<snip>
Oh, and one more thing: the veterans health system bargains hard with medical suppliers, and pays far less for drugs than most private insurers.

[enlightenment]

1. Interesting, but the VA does not cover "all veterans"

and has a number of other restrictions Krugman doesn't mention. I like the point he's trying to make -- but he set himself up for refutation.

edited to add a link -- this is the VA page that talks about eligibility. Note the qualifiers - potentially, may.

http://www.va.gov/healtheligibility/home/hecmain.asp