By Phillip Longman
Top Care at any place, second version demonstrates how an ongoing caliber revolution within the nation’s veterans hospitals presents deep classes for reforming the U.S. future health care process as a complete. the hot version is very well timed with the winding down of the nationwide debate over well-being care coverage reform, as a way to unavoidably shift concentration of reform to the perform of medication itself. The VA, through making wide use of digital clinical files and evidence-based drugs, has constructed a version of twenty first century wellbeing and fitness care that reinforces defense, rate effectiveness, and sufferer satisfaction. And in so doing, it has confirmed that almost all of we predict we all know approximately well-being care is simply mistaken. New to this version: • dialogue of massive alterations in well-being care politics for the reason that 2007, and the way the VA version of care suits in. • New insights on how the VA version will form twenty first century overall healthiness care. • How Bush management regulations undermined many profitable facets of VA well-being care, and the way the Obama management is commencing to placed subject correct for our wounded warriors. • up-to-date insurance of federal details expertise tasks in future health care, and the teachings supplied by means of the VA’s “open resource” software program improvement. * New info at the carrying on with effects of publicity to Agent Orange, and its deeper implications for rethinking who must have entry to VA care. * a suggestion for rolling out a brand new civilian model of the VA that now has won political viability in gentle of the general failure of different methods to wellbeing and fitness care reform. A civilian VA is a real “public alternative” in health and wellbeing deal with which Progressives and different american citizens needs to rally.
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Additional resources for Best Care Anywhere: Why VA Health Care Is Better Than Yours (2nd ed)
It is, in fact, the largest integrated health-care system in the United States. Most of its doctors have faculty appointments with academic hospitals. Over the years two have won the Nobel Prize for medicine. Its innovations have included the development of the CT scanner, the ﬁrst artiﬁcial kidney, the development of the cardiac pacemaker, the ﬁrst successful liver transplant, and the nicotine patch, plus many advanced prosthetic devices, including hydraulic knees and robotic arms. Health-care quality experts also hail it for its exceptional safety record, its use of evidence-based medicine, its health promotion and wellness programs, and its unparalleled adoption of electronic medical records and other information technologies.
These machines were jealously guarded by a tight circle of “high priests,” working out of the VA’s central ofﬁces and its main computer center in Hines, Illinois, who regarded anything involving bits and bytes as their exclusive preserve. Predictably, as with many other institutions of the time, the software these high priests wrote, or more often procured from private vendors, wasn’t very good, in large part because the people who actually had to use it had little role in its development. 2 Nor were the high priests, whose ﬁefdom was known as the Ofﬁce of Data Management and Telecommunications (ODM&T), much better at developing software with medical applications.
S. 24 You might well think that the untold story here is that the VA engages in rationing. And indeed, according to a RAND study published in the New England Journal of Medicine in 2006, VA patients received only about 67 percent of the care that experts believe they should get. S. 25 Because the VA lacks any ﬁnancial incentive to engage in overtreatment, it saves money by avoiding unnecessary surgery and redundant testing. But “rationing” is hardly the 8 / BEST CARE ANYWHERE right word to explain the VA’s cost-effectiveness.
Best Care Anywhere: Why VA Health Care Is Better Than Yours (2nd ed) by Phillip Longman