The results were released this month of a Veterans Affairs study showing that VA post-surgery patients—non-cardiac—had a 40% lower risk of 30-day mortality after leaving the hospital, than non-VA hospital patients did. This goes against the Wall Street narrative that the VA should be more and more privatized, if not totally so, because it is by definition centralized, government-care, and as such, it is bound to be no good. The Wall Street narrative denigrates the VA as “socialist” medicine, and instead, upholds for-profit hospitals and insurance.
The study, published in JAMA Surgery, reviewed 4.6 million cases, was risk adjusted, and covers the period 2015 to 2018. Moreover, apart from the question of competency of the review, there are several aspects of VA care which could be expected in advance, with or without a study, to show better results. There is, for example, what the VA calls “wrap-around care"—which sees to all kinds of post-surgery, and post-hospital needs, especially for frail, poor and other high-risk patients. This includes transportation, providing all medicines, and other services.
The senior author of the study team article is Dr. Daniel E. Hail, a surgeon with the VA Pittsburgh Healthcare System. He said in a Jan. 12 press release, “The VA’s wrap-around services and integrated care networks provide significant value to my patients. That might go a long way to explaining these findings.”
A co-author, Dr. Paula K. Shireman, from the South Texas Veterans Health Care System, specifically addressed the common claim that subsidizing private sector treatment for veterans is automatically superior, because it is usually quicker. Shireman said it is “great” whenever vets get better care, “But timeliness is only one aspect of high-value care—the outcomes need to be good as well, and these data put the burden of proof on those who assert that the private sector is as good or better than the VA for providing surgical services and ensuring optimal surgical outcomes for veterans.”
The “issue” with the VA is that it is starved for resources.
