Doctors Group Points to VA as Cautionary Tale for Health Care Changes

A doctors group opposed to the federal health care overhaul is taking a new tack, singling out Veterans Affairs for criticism and claiming the rest of the American health care system is in danger of following in its footsteps.

In a briefing to congressional staffers late last month sponsored by the Association of American Physicians and Surgeons, doctors predicted the law would drive up costs and drive physicians out of independent practice. They pointed to the VA as an example of what could happen if too many bureaucrats start meddling in the system.

Jane Orient, director of the association and a doctor who used to work for the VA, claimed she was unable to take proper care of her patients while at the VA "without breaking the rules." Calling the VA an example of "single-payer, socialized medicine," she said patients were passed around the system and that there was little incentive for doctors to work hard.

Orient claims the same problems could flare in the rest of the health care system with the implementation of the federal overhaul.

The federal health care law, though, by no means creates a single-payer system -- in which the government cuts out insurance companies and takes responsibility for health care. Rather, it eventually would give lower-income Americans subsidies to buy required private insurance coverage while putting new restrictions on the insurance companies themselves.

Also, the VA has been striving to improve its image since Orient worked there in the 1970s. Serving 6 million veterans at more than 1,500 locations, the department maintains it has the world's most comprehensive veterans' assistance network. Studies have shown the VA has improved over the years, making strides in fields like preventive care -- when some political candidates criticized the VA last year as inferior to the private system, the commander of Disabled American Veterans declared "VA health care is clearly the best anywhere."

But the VA has been dealing with a rash of headlines lately about possible infections contracted by patients at facilities that weren't using proper hygiene practices.

Orient claims the VA is missing the incentive to properly treat patients and expressed concern that Medicare, Medicaid and the changes mandated by the new health care law will further depersonalize medicine and harm patients.

She and other members of the association took issue with a provision in the law that encourages "accountable care organizations" -- regulated networks of hospitals and doctors that are supposed to coordinate care for large numbers of Medicare patients.

Orient, who also opposes private insurance coverage for routine medical expenses, said this system would divert resources needed for patient care.

Backers of the provision disagree. "The idea is to modernize the Medicare system to incentivize quality of care over quantity of care, to make sure you get value, not volume," Rep. Chris Van Hollen, D-Md., said.