Who's the pinko now?

At some point (maybe after the Schiavo case fades from the news; maybe because of it), Americans are going to have to discuss health care again. Medicaid is now looking considerably less healthy than Social Security, and the state of private insurance is, if anything, worse than when Clinton campaigned on fixing things. Insurance agencies have a vested interest in getting wider business for their current structure, but a number of things indicate that there might be better ways. A recent article at Slate argues that we have empirical evidence that socialized medicine works, in the example of the long-running Veterans Health Administration.

The superiority of VA hospitals is so obvious that by now it ought to be common knowledge. But it isn't, because an insane political consensus that firmly opposes turning health care over to the government—because the government is presumed incapable of doing anything well—doesn't want to hear that government hospitals are outperforming private hospitals.

Surprisingly, much of the success results not from the patients (who are a more at-risk cohort than the Medicare patients they were compared to), nor to simple efficiencies of scale (although those control costs dramatically), but from the fact that patients are tracked over the long term, meaning that health care decisions are (a) made with more complete medical records at hand, and (b) made in the interest of long-term outcomes, not just quick turnaround. Investing in technology to follow up on chronic patients, for example, will only benefit organizations that can be fairly certain of having those patients in the future; what is the benefit to a private company whose more healthy patient may be a gift to a different health plan in a year or two? Interesting things to mull...

(via rc3.org)