[Congressional Record Volume 152, Number 38 (Thursday, March 30, 2006)]
[Extensions of Remarks]
[Pages E484-E485]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




      VA EXPERIENCE SHOWS BENEFIT OF GOVERNMENT ROLE IN HEALTHCARE

                                 ______
                                 

                           HON. BARNEY FRANK

                            of massachusetts

                    in the house of representatives

                        Thursday, March 30, 2006

  Mr. FRANK of Massachusetts. Mr. Speaker, one obstacle we have when we 
seek to address what is clearly the number one domestic problem in 
America today--a healthcare system that is both unduly expensive and 
provides too little coverage for many Americans--is the objection to 
what some people are quick to call ``socialized medicine.'' The notion 
that a government role in healthcare is somehow inimical to the 
delivery of decent healthcare has prevented rational debate on this 
subject from going forward. Paradoxically, as the Secretary of the 
Department of Veterans Affairs, Jim Nicholson, recently noted in his 
speech at the Press Club, it is the healthcare delivery system in our 
country that is most completely a government operation that scores 
highest in consumer satisfaction. As Secretary Nicholson noted in that 
speech, ``For the sixth consecutive year, the American Customer 
Satisfaction Index reports that veterans are more satisfied with their 
health care than any other patients in America. VA outscored the 
private sector by a full 10 percentage points. And as you would expect, 
because of our first-rate care, veterans are now coming to us in ever 
greater numbers.''
  Mr. Speaker, the point must be underlined: the most popular form of 
medical care with those who receive it according to Secretary 
Nicholson, speaking on behalf of the Bush Administration, is a form of 
medicine that is entirely government run. I find it odd that people who 
would denounce Medicare as a form of ``socialized medicine'' don't 
apply that dreaded epithet to the one major medical care delivery 
system in our country which is entirely run by the public sector--the 
medical care delivered by the Department of Veterans Affairs.
  I ask that excerpts from Secretary Nicholson's speech be printed here 
because they are an absolutely irrefutable answer to those who claim 
that any increase in a government role in medical care will somehow 
cause deterioration in the quality of that care. The ability of some 
myths to survive reality is one of the most impressive and depressing 
features of the American political scene. But I hope that people 
reading Secretary Nicholson's remarks, and thinking about what they 
mean in the broader context, will refrain in the future from somehow 
arguing that an increase in a public sector role in medical care will 
necessarily lead to its deterioration. I join Secretary Nicholson as a 
Member of Congress in taking pride in the medical care we provide for 
our veterans. My only criticism is that we don't do it in even greater 
quantity--too many veterans are unable to get access to the system, and 
I believe that it is an area where more resources would allow us to do 
an even better job. But again to quote from Secretary Nicholson's 
speech, when the ``NBC Nightly News . . . aired a story about VA 
healthcare, saying that it is the envy of healthcare administrators and 
a model for healthcare nationwide,'' it ought to give pause to those 
who mindlessly repeat the assertion that quality medical care and a 
government role are incompatible.

       The VA is, I think, truly one of America's good news 
     stories. Following a decade-long healthcare transformation, 
     the VA is now at the forefront of America's healthcare 
     industry. And it's not just a proud secretary saying that, 
     but a host of other organizations within and outside of the 
     healthcare community saying that about us. For example, the 
     Journal of American Medical Association has applauded the 
     VA's dedication to patient safety. The Washington Monthly 
     magazine a few months ago had a feature article calling VA 
     health care, quote, ``the best care anywhere.''
       U.S. News and World Report described the VA as the home of 
     top-notch health care in its annual best-hospitals issue. And 
     since you're sitting down, I won't shock you unduly by 
     telling you even The New York Times recently said that the VA 
     is a model for our nation. And very recently, I think last 
     week or the week before, on the NBC Nightly News was aired a 
     story about VA healthcare, saying that it is the envy of 
     healthcare administrators and a model for health care 
     nationwide.
       And we are a model of humanitarian service in our 
     communities as well. Our VA employees come to the aid of 
     their communities and their citizens--veterans and non-
     veterans alike--in times of disasters and other emergencies. 
     To make my point, I need only to mention the heroic effects 
     and efforts of VA employees during Hurricane Katrina and 
     Rita. Not only did our staffs evacuate several hundred 
     patients out of our hospitals in the Gulf area to other 
     hospitals without losing one, and not only did they do it 
     quickly and efficiently, at great personal risk to themselves 
     and at great personal sacrifice and loss. One nurse told me 
     in Houston, where we relocated patients, that she for four 
     days could see her house in New Orleans, and she could see 
     only the roof and the chimney, but she went with her patients 
     when we evacuated them, not even knowing the disposition of 
     her own family.
       And when it's all said and done, it's the millions of the 
     men and women who we care for, though, who are our biggest 
     supporters. For the sixth consecutive year, the American 
     Customer Satisfaction Index reports that veterans are more 
     satisfied with their health care than any other patients in 
     America. VA outscored the private sector by a full 10 
     percentage points. And as you would expect, because of our 
     first-rate care, veterans are now coming to us in ever 
     greater numbers. Fully 7.7 million are now enrolled in our 
     system.
       This year VA doctors and nurses will treat over 5.3 million 
     veterans at one of our 14 points of healthcare access. That's 
     an increase of more than 1 million veterans coming to us 
     since President Bush came to office. We expect this year that 
     we will have 60 million patient encounters; that is, 60 
     million visits to our centers, clinics and hospitals. We have 
     154 major hospitals and over 900 clinics, and we dispense 
     pharmaceutical prescriptions to over three--excuse me, over 
     230 million times.
       We've achieved something that no other major integrated 
     provider has ever yet been able to do, and that is that every 
     one of these 7.7 million veterans enrolled in our system has 
     an electronic medical record.

  Time precludes me from telling you all of the advantages of safety 
and good medicine that that gives us, but let me mention anecdotally a 
couple of things.
  One, a young man came through Ronald Reagan airport. He was a 
diabetic. His insulin was in his luggage, and they lost his luggage. 
And he called his father in South Carolina, panicking, and his father 
said, ``Call the VA,'' because he was a veteran.
  He called our VA hospital here in north Washington. They said, ``Get 
in a cab and come out here.'' And by the time he got there, they had 
his medical record dialed up, knew his insulin regime, administered to 
him, gave him a supply and sent him on his way.
  And during that relocation of hundreds of patients in Katrina, we 
were able in every case, after we got them resettled into another 
hospital, to dial up their medical record.
  So electronic health records and their advantages to patient safety, 
for telemedicine, have put us at the forefront in health care delivery 
in this country, and we are very proud of that achievement. And I can 
say that because it didn't happen in the 14 months that I've been in 
the job. So I'm sitting on the shoulders of those who did make it 
happen. But it is a seminal achievement in health care.
  Two weeks ago I announced the creation of another front of 
technological initiative at the VA, which has the potential for untold 
ramifications in health care, and that's the creation of a new Genomic 
Medicine Program Advisory Committee, which will be to help me establish 
policies for using genetic information to help improve the medical care 
of our veterans.

[[Page E485]]

  The VA's commitment to move into this realm of research, to advance 
our knowledge of the relationship of the genome to a host of physical 
and mental conditions relevant to veterans, is completely in keeping 
with the investigative nature of VA medicine. For 75 years our 
researchers and clinicians have been breaking exciting ground in 
virtually every aspect of medicine, with most of their work resulting 
in new and better ways to treat the myriad illnesses of our veterans. 
From Nobel Prize-winning researchers--and the VA's had three Nobel 
Prize winners--from Nobel Prize winners to the CAT scan to paperless 
records technologies, to kidney transplants, to microchip-drive 
prosthetics, to medical school partnerships that have trained more than 
half of our nation's physicians today, we are leading the world in our 
care for our veterans.
  As I've outlined, we've done a great job so far. We are a world-class 
healthcare network when it comes to treating existing illnesses and 
disabilities. But then we ask ourselves, what if we knew how to 
identify the earliest possible signs of a veteran's predisposition to a 
particular disease? What if we knew in advance how a veteran would 
react to a particular drug therapy? What if we could reasonably 
forecast the risks a particular veteran might face with respect to some 
forms of cancer? What if, summing up, we could move from providing 
medicine that is preventative to medicine that is predictive?

  With the advent of the Genomic Medicine Advisory Committee, we are 
positioning the VA to take a new journey, a truly great journey along 
the DNA trail. It is a path still not well lighted. There are so many 
questions of ethics and privacy that we are not going to proceed down 
that trail without first assessing the risks and benefits to our 
veterans. But we know from past experience that once we determine that 
a VA program is in the best interest of our veterans, we move forward 
with all the resources we can muster.
  And when VA health care is on the move, we change the nation's 
healthcare landscape for the better. As medical practice incorporates 
the advances of science, we must harness VA's triple mission of health 
care, research and training to bring these advances to the veterans we 
serve.
  I'm confident our new push down the genomic road will benefit not 
only our veterans, but the larger national health care community as a 
whole, as so much of our other research has done, such as the 
development of the CAT scan and the pacemaker and the first liver 
transplant done at the VA.

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