Civilized industrial nations have searched for many years for an appropriate response to public health. Individual health care financing in the United States was somehow attached to one’s job as a part of the benefit package. A good job came with good health insurance. By 2008 there were fifty (50) million individuals without health insurance. Obamacare has brought that number down to thirty (30) million. But costs and quality of care still confound us.
I am one who believes in the ‘single-payer’ model as the solution. Our present convoluted system is so confusing that we require CPA’s to help us maneuver. OK – maybe that is an exaggeration. Even with Medicare we remain financially threatened so we purchase ‘supplemental’ plans’. Those plans are confusing – but we wade into the issue driven by fear of losing our home if we fail to make the correct insurance choices.
The Veterans Administration is a federally supported health care system for veterans of the United States armed forces. The following article was posted recently on the website of Psychiatric Services:
The Quality of Medication Treatment for Mental Disorders in the Department of Veterans Affairs and in Private-Sector PlansReceived: November 24, 2014Accepted: July 01, 2015AbstractObjective:The quality of mental health care provided by the U.S. Department of Veterans Affairs (VA) was compared with care provided to a comparable population treated in the private sector.Methods:Two cohorts of individuals with mental disorders (schizophrenia, bipolar disorder, posttraumatic stress disorder, major depression, and substance use disorders) were created with VA administrative data (N=836,519) and MarketScan data (N=545,484). The authors computed VA and MarketScan national means for seven process-based quality measures related to medication evaluation and management and estimated national-level performance by age and gender.Results:In every case, VA performance was superior to that of the private sector by more than 30%. Compared with individuals in private plans, veterans with schizophrenia or major depression were more than twice as likely to receive appropriate initial medication treatment, and veterans with depression were more than twice as likely to receive appropriate long-term treatment.Conclusions:Findings demonstrate the significant advantages that accrue from an organized, nationwide system of care. The much higher performance of the VA has important clinical and policy implications.