By W.T. “Bill” McKibben
The Buffalo News, Sept. 25, 2016
The Veterans Affairs health care system is America’s favorite political football. We love our vets and are quick to pick up on any failure to care for them or treat them well. We were all stunned by reports of vets dying while waiting to see a doctor. A closer look reveals that they were waiting to be accepted into the VA health care system and be assigned to a primary care doctor. The image of sick and dying vets already within the VA system waiting for care is simply false.
Worse, this myth has been unfairly projected onto the doctors and all those delivering care to the vets in the system. The truth is vets in the system never wait when they need to see a doctor. The VA’s prevention-based approach is very different from the greed-driven, treatment-based system most Americans are stuck with.
A doctor’s appointment for those in the VA system, whether it’s with a vet’s primary physician or a specialist, is never for anything urgent, it’s for a regular checkup, follow-up, specialist consult or a routine medical test.
When vets need immediate care, they don’t call for an appointment. Instead, they just head to one of the system’s 1,700 medical centers and clinics. Not just for emergencies, that’s where vets go for a cold, the flu, or anytime they need to see a doctor. The VA’s facilities are set up to act as immediate care centers as well as standard emergency rooms.
Altogether the VA operates America’s largest integrated health care system, serving nearly 9 million vets annually. It has hundreds of clinics plus 152 medical centers that have full hospital facilities, as well as emergency room/immediate care centers.
The major difference in the care that vets receive – and the source of its superiority – is the VA’s focus. The VA utilizes the system prevalent in every developed nation in the world except America: the prevention-based system as opposed to the treatment-based system most Americans have. Our nation spends twice as much as any other nation in the world on health care. And yet our outcomes rank down among the Third World countries.
When a provider’s only revenue source is to treat or medicate, that’s what he does; and sadly too often greed takes over. Overtreatment and overmedication trigger thousands of deaths and health issues in America every year, but not at the VA. Just like providers all over the world, those at the VA – some of the most skilled medical practitioners in America – are paid to prevent health care issues, not just to treat them.
The VA’s prevention-based approach delivers much better outcomes. Better than Medicare, even though the VA has a more vulnerable patient base. The VA is treating a bunch of beat-up old folks and some horrifically beat-up younger vets. By comparison, Medicare patients, in general, are much healthier than our vets. Yet even with that disadvantage, the VA gets better outcomes than Medicare, and it does it for less – nearly 40 percent less per patient.
It’s clear that we need to follow the rest of the developed nations on this planet and make some dramatic changes. We need to adopt a single-payer, prevention-based system. Big Pharma hates this idea, for-profit hospitals hate this idea and, sadly, even some health care providers hate this idea.
We spend twice as much as any other nation on health care with more than half the cost coming out of taxpayer funds. That would lead one to believe that with a more cost-efficient single-payer system, we might find that we have been paying for a better system all along and throwing away half of what we currently spend. It’s time we got our money’s worth.
W.T. “Bill” McKibben is a Buffalo-based author. He was a Medicare Part B and health care insurer consultant for more than a quarter century.
