Ray Nothstine, Associate Editor at the Acton Institute, had his Acton Commentary, “Veterans First on Heath Care” republished by The Citizen, a newspaper in Fayetteville, Georgia. Nothstine explains in the article that the federal government needs to prove that it can provide adequate health care for 8 million veterans before we can trust them to provide health care reform for the entire United States. Nothstine points out flaws with medical system operated by the Veterans Administration. It is a timely piece especially among the constant health care reform debate that is occurring in the United States.
As Congress continues to hash out what will likely be more or less bad health care reform legislation, it is worth considering what health care providers themselves can do to fix the system.
One outstanding case study is The Nun and the Bureaucrat: How They Found an Unlikely Cure for America’s Sick Hospitals. The book is a compilation of quotations, factoids, and anecdotes from employees and administrators of two hospital systems, Catholic SSM Health Care in St. Louis and Pittsburgh’s Regional Health Care Initiative. It tells the story of the implementation of “systems thinking” at these institutions. In short, the health systems’ executives perceived serious inefficiencies and dysfunctions in their hospitals (with, sometimes, life or death consequences) and determined to borrow a method successfully used in other business enterprises and apply it to the medical field.
Individual hospital outcomes reported include:
–85 percent reduction in hospital acquired infections (often fatal and each entailing costs of $30,000-90,000).
–medication error rate reduction from .16 per thousand dosages to .01 per thousand.
–reduction of acute diabetic complications from 13.5 percent to 5 percent.
Besides better patient outcomes and cost-saving, hospital staff reported higher levels of morale and satisfaction in their work.
In this particular case, conscientious and innovative CEOs initiated change. What might drive innovation and improvement more broadly in the health care sector is placing both control and responsibility squarely in the hands of “consumers” (patients), spurring competition and setting up the right framework of incentives. Any legislation that fails to recognize this connection will fail to move us toward a health care system that more effectively serves its intended purpose.
Amongst the health care debate Ray Nothstine offers a good analysis of Verterans Health Care. Nothstine brings a good argument to light for those to consider who are in support of reforming health care. Many supporters of reforming health care look to the health care provided by the Veterans Administration (VA); however as Nothstine is able to demonstrate, the VA health care system is far from perfect. Nothstine also provides real life situations that demonstrate the flaws of the health care system managed by the VA.
Nothstine advises those who want to reform health care and model it after the VA health care system to proceed with caution:
Veterans’ health care has accomplished amazing feats, and many of the health officials and workers who work in that industry do so because of their desire to serve those who served their country. But the government must and should do a better job taking care of veterans, especially those wounded in America’s wars. The government needs to prove it can handle existing obligations before proposing the adoption of any universal government plan. If it cannot handle the challenge of caring for 8 million veterans, how will a government bureaucracy manage a system dealing with 300 million Americans?