HEALTH CARE QUALITY-VA AND PUBLIC AREAS

No one should be surprised at the VA Health Care fiasco. Nor should anyone be surprised in the coming years at similar conditions in the public health care field.

It is true that the happenings in Phoenix is typical of the entire VA system. The VA has an internal system grading exercise which hospitals are graded from 1 star to 5 stars according to meeting various criteria standards which not only included quality of care, but also waiting time for a primary care physician appointment, availability of consultants and waiting time for appointments, hospital admission, readmission, mortality, and morbidity rates, as well as many other not disclosed standards.

Not surprisingly the Phoenix unit for I believe the 2012 reporting year received a 1 star rating as did Atlanta. In the newspaper data the only 5 star VA hospital/health care complexes to receive a 5 star rating was Boston.

All 151 VA medical facilities are accredited by The Joint Commission

 (JACH) which recognized 19 VA medical facilities as top performers in 2011/2012 and 20 VA medical facilities in 2010.  Nine VA facilities have been rated as top performers for two consecutive years – a noteworthy distinction. (online.wsj.com/articles/veterans-affairs-hospitals-vary-widely-in-patient-care-1...) (click) 

There ws a very negative TV  program about the VA in April.

 (http://abcnews.go.com/Primetime/story?id=132383)

But the lesson that we should learn is the conditions that have created the VA mess are present in the public ACA world; not enough physicians and/or specialists, or facilities including hospital beds in an area. Funding deficiencies for the area which will restrict available resources.

All of these will result in delays in receiving care. Anytime there is a waiting list there will be someone who has found a way to game that list; be it the patient or administrative personnel.

There has also been a change in the quality and number of students entering the medical education field. Most who graduate will veer to the more remunerative specialties. The primary care field is becoming understaffed. Lack of highly trained doctors has resulted in an increase use of Practice Assistants and Nurse Practitioners’. In multi-provider groups the fees charged are the same no matter who provides care; in fact a physician may never see the patient  yet the patient is billed for that service.

What we are increasingly receiving is a form of rationing in providers and/or quick accessibility to certain aspects of care.