Washington Monthly
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Big Tech Should Stay Out of Healthcare
...The use of digital technology in health care has enormous promise, to be sure. But, as the Wall Street Journal's coverage of Google's Project Nightingale revealed, there is also a potential dark side to these projects. Ascension, it noted, "also hopes to mine data to identify additional tests that could be necessary or other ways in which the system could generate more revenue from patients, documents show." That detail raises a key question that's largely overlooked in our health care debates: should the drive to maximize corporate revenues determine how health information technology develops and becomes integrated into medical practice, or should that be determined by medical science and the public?...An alternative path exists. In the 1970s, the Veterans Affairs Administration (VA) developed VistA, an open-source code system that was the country's first EHR system... Read More »
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Clueless or Craven? The White House Gets the VA Story Exactly Backwards
Sad to say, the Obama administration seems clueless about what might be broken at the VA and how to fix it. Either that, or it is just cravenly saying and doing whatever it thinks is necessary to make the story go away. Evidence for the clueless hypothesis came on Friday, when White House Deputy Chief of Staff Rob Nabors weighed in with his diagnosis (pdf) of what ails the VA. The document is extraordinary in its contradictions, sloppy formulations, and non-evidence-based conclusions.
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How VA Outsourcing Hurts Veterans
On Thursday, Sen. Bernie Sanders, chairman of the Senate Veterans Affairs Committee, announced that he had reached a compromise with John McCain and other Senate Republicans on how to fix whatever it is that needs fixing at the VA...the bill also contains one provision that is a significant concession to Republican enemies of government. If enacted, it would lower the quality of health care received by veterans while setting back the movement for health care delivery system reform generally.
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Just how long are those wait times at the VA really?
You probably saw headlines earlier this week like this one from CNN “Audit: More than 120,000 veterans waiting or never got care.” Sounds pretty bad, and so does the lede CNN used...Want to know what that audit actually shows? Click here (pdf), or trust me to give you the main findings and some context...
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The Sabotage Device Within Obamacare
Much of the March/April issue of the Washington Monthly is about conservative efforts to sabotage key first-term accomplishment of the Obama administration via the regulatory and other implementation processes. Read More »
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The VA Waitlist Fiasco: VistA Should Not be Thrown Out With the Bathwater
Without a doubt, the death of American veterans as a result of the VA waitlist debacle is tragic and unacceptable. The Obama administration must move quickly and deliberately to fix the underlying problems and restore faith in the agency. If these issues were common throughout the VA network of hospitals and clinics, it might make sense to consider dramatic, earth-shaking alternatives like moving veterans to private providers and shuttering the VA. But they are not common. Indeed, as Washington Monthly reporter Phillip Longman has documented, the VA’s challenges are regional, not pervasive. Read More »
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VA Care: Still The Best Care Anywhere?
...[A]s the author of the title Best Care Anywhere, Why VA Health Care would be Better for Everyone, it’s been dispiriting to have it confirmed by a preliminary inspector general’s report that some frontline VA employees in Phoenix and elsewhere have been gaming a key performance metric regarding wait times. But what’s really has me enervated is how the dominant media narrative of the VA “scandal” has become so essentially misleading and damaging to the cause of health care delivery system reform...
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Veterans aren’t the only ones waiting for health care
But the big question with these stories about the VA is, "compared to what?" This scandal wouldn't exist if the VA didn't have performance metrics on its employees. If it didn't measure or care whether veterans get prompt appointments it could just do what the rest of the health-care system has done and not hold people responsible for these metrics. Read More »
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Who Should Head the VA?
...last Saturday, Cosgrove suddenly withdrew his name from consideration, stating that he still had work that needed doing at the Cleveland Clinic. What might that work be? Just hours before Cosgrove made his announcement, the intrepid trade magazine Modern Healthcare published a little noticed article that revealed a long pattern of safety problems at the Cleveland Clinic—problems that were so serious that the federal government repeatedly threatened to shut off the $1 billion a year the clinic collects from Medicare.
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