hearts and minds

March 25, 2020

New Research Compares Health Care Provided by VA Medical Centers to Health Care Provided by Private Corporate-Owned Facilities

Filed under: Health care crisis — Hearts & Minds @ 2:45 am

We don’t have to depend only on our own experience, on personal anecdotes which we happen to hear, and on subjective opinion polls, in order to evaluate and tell the truth about the quality of the health care that is provided by VA hospitals compared with the quality of the health care that is provided by corporate-owned and operated medical centers.

A new peer-reviewed, comprehensive research study was published in the Annals of Internal Medicine in March 19, 2019, titled: “Veterans Health Administration hospitals outperform non-VHA hospitals in most health care markets”.
https://annals.org/aim/article-abstract/2718687/veterans-health-administration-hospitals-outperform-non-veterans-health-administration-hospitals
This scientific study was reported by Physicians for a National Health Program, in its Summer, 2019 Newsletter. National PNHP , in association with the famed, heroic Medical Committee for Human Rights, which was formed about sixty years ago, has persistently organized, done public education, and promoted “Medicare for All” for many decades. The PNHP quarterly newsletter has long been, by far, the best source of accurate, factual information and advocacy regarding the health care crisis in the USA. On page 8 of the summer, 2019, quarterly issue, the PNHP Newsletter stated:

“Several [previous] studies have found that VA care nationwide is at least as good, on average, as care in the private sector. However, none have directly compared VA care to private care in the same community. In a new analysis of 15 hospital quality measures across all 121 regions that have both a VA hospital and a private facility, VA care was significantly better for 14 of the 15 measures, with one measure showing no difference. … The findings underscore the folly of the Trump Administration move to take billions of dollars out of the VA budget to pay for private sector care.”

Apparently, VA hospitals do more than just make veterans feel ‘at home’ and ‘understood’ – which, of course, is undeniably important. VA hospitals also provide objectively measurable health care outcomes that are superior to those provided by corporate owned facilities. And now a research study has been completed which proves that, comparing performance in all regions across the entire country. This study provides both a national summary, and local comparisons in all regions.

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Physicians for a National Health Program (PNHP) has long been organized and working for comprehensive health care for all on the basis of medical need, not fragmented health care based on ability of each individual patient to pay or the fine print in that patient’s policy – one of countless, ever-changing insurance policies. Health care provided to all, based on medical need, costs far less per capita than health care provided based on what each person has in their policy or wallet, with every procedure, bandage and bag of saline billed to individual patients. Among the helpful, important articles in the Winter 2019 Newsletter of PNHP, consider just the following very brief excerpt from page 5. The article cited two peer-reviewed studies, which were published in the May 2018 and the October 2018 issues of JAMA Internal Medicine:

Corporate medicine and for-profit care
“The investor-owned firms that dominate the dialysis market profit when more patients start dialysis. Older studies indicate that for-profits had higher death rates. A new analysis found that older patients with incident (i.e. new) kidney failure treated in the VA system were less likely to be started on dialysis within two years than comparable patients who received care in fee-for-service Medicare (53% vs 82%). The crucial difference is that besides being less likely to start dialysis within two years, the VA patients’ mortality rate was also 9 percent lower. That means both a better quality of life, and also a longer life for VA patients with kidney failure. Another recent study found that patient satisfaction was markedly lower in investor-owned clinics than in non-profit facilities.”

So, if you are diagnosed with and treated for new kidney failure, you are more likely to be rushed into dialysis prematurely, and you are also more likely to subsequently die of kidney failure, if you are insured by Medicare (which is now only an insurance program … which means that you will be diagnosed and treated at a private corporate-owned clinic or medical center, using a for-profit dialysis service, that is not run by the government) than if you are in a VA medical center that is funded, administered, staffed, operated, and overseen entirely by our government.

Saving the VHA from privatization will help save many Americans – not only American military veterans – ALL Americans – from the adverse consequences of a corporate administered and controlled for-profit health care system … as long as we work together to protect and learn from the VHA example and apply that example to get the health care that we ALL need. We’ve become mired in distracting arguments about whether outsourcing VA health care to private, corporate owned providers is or is not privatization; about whether such outsourcing, enabled and encouraged by the Mission Act and its new regulations, will or will not lead to privatization. But that argument itself demonstrates that privatization is indeed the agenda. Nobody of influence in government, in think tanks, in the mass media – nobody in corporate-ruled America – is urging what is really needed – that VA health care should be expanded, rather than contracted out, fragmented, and outsourced. The only – and the phony – subject that is on the table (as far as they are concerned) is, “How can private corporations ‘help’ the VHA solve a problem it [supposedly] ‘can’t’ solve itself?”
We need to challenge that. We all need to ask, “Who or what is preventing the VHA itself from solving that problem?”

Instead of outsourcing VA Health Care to private corporate administered providers (who provide lower quality of health care while charging more for it to cover complicated administration and billing, and to gild speculators and top executives) – the VA Health Care system should effectively expand its top-quality services to ALL veterans and their families, including providing those services in geographic and clinical areas that are currently under-served.

There is no question that VA Health Care is superior both in terms of quality of provided care, and in terms of cost-effectiveness, to any other health care system in the USA. Means-testing now being used to ‘qualify’ veterans for ‘benefits’ enables and hastens the dismantling of this government program that works really great and serves an important need. Veterans who don’t qualify under the current – and future – means-testing guidelines should not be denied VA Health Care. Such veterans should be able to apply Medicare or any other insurance they may have, for VA Health Care. Why don’t all veterans get to “choose” the VHA for their health care? Why do some veterans “deserve” it and others don’t? Making VA Health Care a “welfare” program, rather than a “health care for ALL veterans” program, has made it – and those veterans and their families who do “qualify” – vulnerable to being discredited, de-funded, cut-back, and ultimately squeezed out.

Expanding VA Health Care should be the demand of ALL veterans – indeed, of ALL Americans. The outstanding VA health care system is a model for less costly, better quality, comprehensive health care for EVERYONE. Outsourcing, privatizing (whatever you want to call it) VA Health Care is exactly the opposite direction that is needed by veterans and by ALL Americans. It is undermining by far the best, most successful health care system in the USA.

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It is important that all Americans understand that saving the VA, and stopping privatization of the VA, is important to the well-being and the health of all of us. The VHA must not be perceived by Americans as an exclusive, elite health care system, which provides better health care to military veterans than everyday people who are not veterans have either a right to or a need for. (To be sure, there are specialized types of health care that is needed by combat veterans, compared to persons without that experience. But what quality of health care, and whether or not needed health care will be provided, or whether someone deserves a certain kind or quality of health care or not, should never be questions confronting health care providers.) All Americans need to see VA health care as an example of the kind of health care that ALL of us should and would receive if the quality of comprehensive health care provided on the basis of medical need were the objective of health care in the USA … instead of the purpose of health care being the highest profits for corporations and Wall Street investors.

The VHA is today being threatened with imminent privatization, partly BECAUSE it is a shining example of the kind of national health care system that all America needs but does not have. We cannot afford to allow that example to be undermined and destroyed by corporate profiteers. Privatizing the VHA will not only result in poorer quality health care being provided to veterans, at a higher cost to taxpayers, it will also disappear the one concrete example in the USA of exactly what we all need in order to get health care outcomes that are far better than our current system provides, which is designed, first and foremost, to maximize profits. Comprehensive national health care is exactly what we as a country need to prepare for, and be able to respond appropriately and effectively to large scale health emergencies such as pandemics. We ALL need to help each other, and to help veterans protect and strengthen the VHA example. And veterans need to see that ALL Americans – not just veterans – need and should have a health care system that is organized and run very much like the VHA.

Only 6% – that’s six percent – of all Americans are military veterans. Military veterans can’t win this fight alone – either to protect and strengthen the VHA itself, or for the health care that we all need. We need to work together to win this uphill struggle. We can’t allow corporations and the super-rich to divide us and cause us to abandon each other to struggle alone.

Save Our VA! VA quality health care for ALL!

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