Berwick, president of the Institute for Health Care Improvement and one of the nation's top health-care quality experts, praises the VHA's information technology as "spectacular".
The story of how and why the VHA became the benchmark for quality medicine in the United States suggests that much of what we think we know about health care and medical economics is just wrong.
But when it comes to health care, it's a government bureaucracy that's setting the standard for maintaining best practices while reducing costs, and it's the private sector that's lagging in quality.
Richard Cogan, a senior fellow at the Center on Budget and Policy Priorities in Washington, told The New York Times in 1994: "The real question is whether there should be a veterans health care system at all.
Iowa: Belmond Health Care Center (Belmond); Kingsley Nursing and Rehab Center (Kingsley); Emmetsburg Care Center (Emmetsburg); Ruthven Community Care Center (Ruthven)
Indiana: Union Hospital Transitional Care Unit (Terre Haute); George Davis Manor (W.
Louisiana: Chalmette Medical Center Skilled Nursing Facility (Chalmette); Mary Joseph Residence for the Elderly (New Orleans); Touro Infirmary (New Orleans); Subacute Care United of Meadowcrest Hospital (Gretna)
Massachusetts: Heywood Transitional Care Center (Gardner); Greenery Extended Care Center (Worcester); South Cove Manor Nursing Home (Boston); Jordan Rehabilitation & Nursing Center (Roxbury)
Companies lose good people when they can't come to work because of poor child care arrangements," argues NBCDI's Moore.
Quality child care is one of the most critical issues facing our employees," says NationsBank spokesperson Martha Larsh.
An estimated 5,600 public and private employers provide some form of child and dependent care assistance, and another 500 offer elder care assistance.
To continue attracting the most qualified workers, businesses must help employees identify viable child care options.
What should happen would include increased incentives for people to purchase longterm care insurance; a better way for upper income people to protect their assets, along with acceptance of some private responsibility to pay for one's own care if one can afford to; and a public program for those truly in need, addressing both adequate coverage and adequate reimbursement.
As for what will happen, I don't believe that there are the public dollars available to provide comprehensive long-term care for the entire population; that could run as high as $60 or 70 billion.
Evrett Benton, Executive Vice President and General Counsel; Question 1: "Long-term health care seems to come at the end of all other health care considerations with regard to payment from government organizations, with doctors and acute care being the |squeaky wheels' that get the first grease.