I saw my VA health man the other day, to talk about my meds – including weighing the pros and cons of going on a cholesterol-lowering drug; plus I asked for an eye exam and had blood drawn.

Everything looks good.  I’m in the pink.

On the way out the door, I got a couple of memos.  One had to do with what appears to be an already operational online medical link to VA.  What a concept! – I said to myself.  The helper at the primary care desk, a vet himself, said, “Please tell the American people we’re terribly sorry for taking the initiative on this.  We mean well, y’know?”

I told him I would try to say something good about it when I had the chance.

He cried and said thanks.

Boo hoo.

VA has been computerized in a number of important ways for some time.  The system was seriously upgraded during the Clinton era, which means that patients have had the benefit of doctor consults with their complete history a click away, in a clinic, in an operating suite, or at bedside for a good fifteen years or more.  And during this time it’s been easy as pie for a veteran to request a download to a CD of a complete medical file if he or she wants to move, say, from Boston to LA, or from Detroit to Dallas.

Can you say:  “Portability”?

So this online link is available now through VA; and soon, civilians may have the same cost-saving hi-tech fix, assuming the administration’s plans come to fruition.

But of course, the dead-enders on health reform will cry, darkly, about that dastardly, really awful government takeover of health care.  Never mind that, according to the link above, it seems tech companies stand to make a bundle on government contracts which will allow them to expand the use of computers across the nation – like a cyber chicken in every pot, right in your home!

But dammit there must be some way to delete this whole idea from that humongus, 2,000 page health bill.  There’s gotta be a way!

This is  just terrible.  Right Nail in the Head?


  1. nailheadtom says:

    Big deal. Medical records have always been the most expensive part of the health care conundrum. If they were free, our problems would be over, right? You wouldn’t even have had to go to the VA, no, they’ve had the system for some time and you still had to show up in person, but your were “in the pink”, so those computerized records are keeping those arteries open. The computer record keeping eliminates MRIs, CAT scans, stitches in fingers, and enemas. And without a doubt the VA budget is shrinking, too.

  2. nailheadtom says:

    If the next proposed budget is financed, VA medical spending will have increased 55% since 2006, from $31.3 billion to $48.5 billion. The average medical expense during the year, per each living veteran, will be about $1800.

    • dirigo says:

      I can live with that. I mean, I don’t need a nose job or a tummy tuck. Know what I mean?

      As long as the baseline readings are in the black, I don’t need a Cadillac in my colostomy bag.

      How about you, sailor?

      • dirigo says:

        Oh, the president signed a measure to fund VA a year in advance. That’s a first.


        By the way, can we count on you for a tithe maybe, to help defray the cost of caring for all those who put it on the line for YOU in Iraq and Afghanistan?

        Whattya say? It’s getting close to Christmas. You don’t want to be a Scrooge, do ya?

        Or do you insist on burying yourself in your rebuttal stats, never thinking about the implications, or contingencies related to your enthusiasm for war on the cheap?

        No fault death.

        • nailheadtom says:

          “all those who put it on the line for YOU in Iraq and Afghanistan”

          According to the progressive left, those two places have nothing to do with us, whatever is being put on the line is for GWB’s Oedipus complex or big oil or Dick Cheney’s stock portfolio. Can’t have it both ways.

  3. cocktailhag says:

    It’s really remarkable. The VA budget went up? Gosh, I wonder why. That statistic was brought up by a righty, no less. Such mental disconnects leave me in awe.

    • nailheadtom says:

      “civilians may have the same cost-saving hi-tech fix”

      I didn’t advance the argument.

      • dirigo says:

        Yes, it’s possible the people “at large” could benefit, eventually, from such a technological template, now in place and operating (dare I say it?) in one of the largest hospital systems in the world?

        This is bad?

        • nailheadtom says:

          It’s not bad, it’s financially inconsequential in the argument for a government-run health care system.

          By the way:

          • dirigo says:

            I’m not necessarily pushing for a total, government-run health system.

            Chase your own rabbits if you must, but don’t assume I want to chase them with you.

            I was merely pointing out, Mr. Wizard, that there is now available a technological template for average Americans to eventually have the means to monitor their own health (should they choose to take the responsibility) and have a connection to doctors who can advise and treat them. That was the nature of what I was told is now available within VA by the caregiver I mentioned.

            That’s about all I’m trying to “report.”

  4. sysprog says:

    I spent years not seeing doctors, until an incident a few months ago.

    And these past few months, I see that things have changed.

    My own doctors use a more primitive technology than what the VA uses – - but already the communications between them, me, the testing lab, and the pharmacy (and those wonderful folks at the insurance company) have now become almost all electronic – - little paperwork, fewer faxes, and almost no phone calls.

    Here’s a story about one of the ways that more advanced technology (based on something like the VA system and then building on it) may possibly be connected to both decreased costs and improved care.

    No, Bosworth’s system and other similar technology won’t bring our medical spending down to France’s level (they spend half as much per capita as we do) and certainly not down to the UK’s level (they spend far less than France does) . . . but it may help a bit.

    How much of a bit?

    Why not look at, oh, what the heck, some actual numbers from some actual experts . . .

    Healthcare system wastes up to $800 billion a year
    Mon Oct 26, 2009 6:10pm EDT

    By Maggie Fox, Health and Science Editor

    WASHINGTON (Reuters) – The U.S. healthcare system is just as wasteful as President Barack Obama says it is, and proposed reforms could be paid for by fixing some of the most obvious inefficiencies, preventing mistakes and fighting fraud, according to a Thomson Reuters report released on Monday.

    The U.S. healthcare system wastes between $505 billion and $850 billion every year, the report from Robert Kelley, vice president of healthcare analytics at Thomson Reuters, found.

    “America’s healthcare system is indeed hemorrhaging billions of dollars, and the opportunities to slow the fiscal bleeding are substantial,” the report reads.

    “The bad news is that an estimated $700 billion is wasted annually. That’s one-third of the nation’s healthcare bill,” Kelley said in a statement.

    “The good news is that by attacking waste we can reduce healthcare costs without adversely affecting the quality of care or access to care.”

    One example — a paper-based system that discourages sharing of medical records accounts for 6 percent of annual overspending.


    - – Reuters, 10/26/2009


    Six percent of the waste might be a mere forty or fifty billion bucks.

    But, as the NYTimes said back in 1938,

    “It’s a billion here and a billion there, and by and by it begins to mount up into money.”
    - – NYTimes, January 10, 1938

    You want more?
    But wait, there’s more!
    Here’s some more stuff from that Reuters article

    * Administrative inefficiency and redundant paperwork account for 18 percent of healthcare waste.
    All this could help explain why Americans spend more per capita and the highest percentage of GDP on healthcare than any other OECD country, yet has an unhealthier population with more diabetes, obesity and heart disease and higher rates of neonatal deaths than other developed nations.


  5. nailheadtom says:

    “The U.S. healthcare system wastes between $505 billion and $850 billion every year, the report from Robert Kelley, vice president of healthcare analytics at Thomson Reuters, found.”


    With that kind of exactitude, Mr. Kelley should be running the US census. Then he could say that the US population is between 200 million and 683 million. Pretty valuable information.

    • sysprog says:

      “financially inconsequential”

      Defend that.

      Go ahead.

      • nailheadtom says:

        According to the VA itself, IT is 3% of their budget. If IT expenses were cut 50%, it would reduce budget requirements 1.5%, or, in the 2010 budget perhaps $720 million, a stupendous amount of money to a normal person, almost enough to build a really nice football stadium, but parking meter change for Pinnochia Pelosi, Barney Frank and the rest of the capital utopians. If the goal is reasonably priced effective health care, get the government out of the picture. We don’t have government regulated auto body shops, at least not yet.

    • dirigo says:

      My point in raising the question of applying computer power to the national health network (by building on the established and effective system now in place in VA) is to BEGIN a modest discussion about how to bring down the cost of administration, duplication, and other waste in the system due to a reliance on old technology: paper.

      This is well understood, and the variance in the estimates only demonstrates there’s much to do and much to gain by using the latest technology effectively, whatever the fine print in the health bill.

      Such a change in the use of technology might, over time, result in hard and real savings to health consumers (who would, naturally, learn more about how to take care of themselves); less stress on doctors, who also have to practice “defensive” medicine to preempt malpractice suits; and some clarity on how insurance companies gouge everyone in the health system (by preventing rather than supporting treatment).

      Sounds like a win-win to me.

      What does this have to do with ideology? Nothing.

      • sysprog says:

        Well there’s something ideological about an aversion to data and science, and an aversion to just doing things a little better, but it isn’t just a right-left thing.

        The right doesn’t have a monopoly on stupidity. The “New Labour” administration in Britain just yesterday fired their main drug policy advisor because he said there was no scientific basis for the “New Labour” administration reclassifying cannabis as a more harmful drug, with stiffer criminal penalties. And here in the USA, some of my leftish friends ignore data and reject science on certain pet issues such as vaccines.

        • dirigo says:

          I guess I should ask: what does using this technology effectively, to make people healthier, have to do with politically oriented bias and stupidity?


          • nailheadtom says:

            You’re right, making use of advancing technology only makes sense. However, administration officials have pushed forward the idea that computerized records are some kind of a quantum leap in health care. It just ain’t so. The concern is that health care expenses are devouring too much of the GDP and that sick individuals are exposed to financial disaster. Computer records don’t address that.

  6. dirigo says:

    “Just admit that it happened. Then it’s over.”

    — Heather Paxton
    — Iraq war veteran
    — U.S. Army

  7. rmp says:

    I just realized that you made this excellent post Dirigo and after reading the other comments, there is not much left to say because the value of computerized records is so obvious. Of course, RWAs and the idiots who support their crap, will make their normal socialized medicine and privacy arguments so they can continue to live in the first half of the 20th century.

    • dirigo says:

      Yeah, Nail in the Head’s a big help isn’t he?

      I know I could count on him as part of a sandbag detail.

  8. mikeinportc says:

    There’s also a problem with doctors that don’t know it’s up and running (properly), or intentionally don’t tell their patients. Last week ,one of my father’s doctors sent him (to a private facility) for a test. My father told him that he’d already had the test at the VA. The doctor said that he didn’t see the result, and couldn’t access it, so get it anyway. What was the first thing that happened at the test facility? They checked the computer record, and the first thing up was the test in question. Despite that, the doctor insisted on a new test. I wonder how many times something like that plays out.( I.e., how much is wasted by duplication, because of the lack of portability, lack of acceptance of such a system., or golddigging ?)

    Btw nailhead, the VA system has one advantage (at least) over other systems. It can negotiate on drug prices.Medicare , by law, (thank you, Billy Tauzin ):( . The hodgepodge of private entities can, but don’t have the clout to do it as effectively.
    Two + years ago, when my father first started needing medication on a regular basis (diabetes & related heart problems) , I urged him to go to the VA. He didn’t , but after a second hospitilization last year, with a more serious incident, and more expensive drugs , that he (nor I) could afford , he went . ( Get drugs ,NOW!, or die) . What would have cost $114/mo through Medicare, cost $23/3mo.s through the VA. That was just one drug, out of five. That is how much we’re being ripped off. Go after that, if actually want to reduce costs. I suspect similar , if less dramatic, price differences would exist across the board, between single-payer vs the current system.

  9. mikeinportc says:

    ^ .. Medicare , by law,.. can’t…

    • dirigo says:

      Yeah, Mike the VA’s power to negotiate for drugs is huge, something I’m sure pharma is terrified of “civilians” getting the benefit of.

      Doctors used to be “gods” at one time, probably back in the day when they really were more independent, like the true family doctor, and less influenced by business consultants, marketers and related “favors” from pharma. Medical payola. I’d say that influence takes some of the edge off the Hippocratic oath.

  10. mikeinportc says:

    (anybody else have trouble with the cursor taking a temporary leave of absence, or keystrokes not registering? Seems to happen to me only here,Salon, & one other place – also a Typepad site)

    ..that he couldn’t afford….