Speaker of the House Nancy Pelosi says a new national health-care system – whatever shape it ultimately takes, if passed – can benefit from the model provided by the Department of Veterans Affairs, which operates the largest managed health-care system in the nation, with more than 1,000 hospitals, clinics and nursing homes.
"First of all, the VA is the VA," said Rep. Pelosi, D-Calif., during an interview with The American Legion Magazine. "It's a respected brand name. Where there is confidence, we want more confidence."
In independent studies over the past decade, VA has consistently outperformed private-sector hospitals and clinics in patient-satisfaction surveys. A recent book by Phillip Longman, "Best Care Anywhere: Why VA Healthcare is Better Than Yours," makes the case that VA's "prevention before treatment" approach separates it from all other providers in the country, both in terms of quality and cost.
Public perception aside, Pelosi added that VA's successes in medical-records management and prescription-drug pricing cannot be ignored as national health-care reform moves through Congress. "VA has been in the lead of information technology," Pelosi said. "That is very important not only to lower cost, but to the person.
"It is better for the person when your records are where you are, and you don't need to go someplace else to find out what medications you have been taking over the last 10 years. Then, there is the issue of being able to negotiate lower prices for prescription drugs. We now have that in our bill and hope it survives the conference because, again, it lowers cost."
The American Legion's position throughout the national health-care reform debate has been cautious, except on one point: that whatever happens will not adversely affect DoD and VA health-care systems.
To that point, Pelosi said, "TRICARE is not affected, and many veterans are not in the VA health-care system. Millions of them will benefit from the health-care legislation that we are putting forth. It has three principles: affordability for the middle class, security for our seniors – many of our veterans are seniors – and then responsibility to our children.
"We have to do this in a fiscally sound way, as we improve care, as we improve quality, as we lower cost, as we expand coverage to include many more people, and as we retain choice. We have to do it in a fiscally sound way so that we are not heaping one dime on the national deficit, and that goes out for 20 years."
Pelosi said the VA health-care system will soon shift to much firmer fiscal ground, thanks to the Veterans Health Care and Budget Reform Transparency Act, signed last month by President Obama. Appropriations will now be set a year in advance for VA health care, which has chronically started new fiscal years without budgets in place, forcing facilities to function on previous years' funding levels, regardless of patient numbers and other variables. The move will "remove all doubt that funding will be there in a timely fashion," said Pelosi, who credited The American Legion and other veterans service organizations for their persistency on the issue.
"We take great pride in what we have done," Pelosi said, recounting a number of legislative accomplishments for veterans in the first session of the 111th Congress. "But The American Legion and other (veterans service organizations) have been working on these issues for such a long time. We are blessed with the opportunity to carry the ball across the finish line. They have really done the work."
The full interview with Speaker Pelosi, which looks at priorities for the second session of the 111th Congress, is scheduled to appear in the February issue of The American Legion Magazine.