Here is what one typical private cardiologist says, and you be the judge of the medical conflicts of interest in private healthcare:
"I put in over 200 stents per year. I work for a group of 4 cardiologist. The cost of a stent is anywhere from $1,500 to $3,000. The overall cost to do the procedure, what the hospital charges is anywhere from $16,000 to $22,000."
Other private doctors approach healthcare the same as the cardiologist above. The private healthcare industry makes its big money by doing expensive procedures, surgeries, hospitalizations, and ordering a lot of expensive tests, and writing prescriptions for expensive medicine. There is no profit motive in conservative and preventive healthcare.
The doctors, nurses, staff and employees at VHA are salaried, so they are free to focus on healthcare. There still are many dedicated doctors and healthcare professionals who go into medicine for the right reasons, instead of for a golden brick road to riches.
Important contributions to healthcare and reducing medical errors is VHA's dynamic medical records technology, conscientiously following best medical practices, and providing preventive healthcare. The VHA has no incentive to risk veterans' lives by doing unnecessary procedures and irresponsible surgeries.
Veterans Health Information Systems and Technology Architecture (VistA)
The VHA was an early pioneer in electronic health records (EHR). Four decades ago a group of VHA doctors working on their own time, and unauthorized, invented a computerized health record keeping system. They named it Veterans Health Information Systems and Technology Architecture (VistA).
With VistA doctors, nurses and medical staff could keep veterans' medical records on a computer network, instead of on the old-fashioned paper records. On VistA a veteran's medical records and medical history is updated with new medical information, doctors' orders, hospitalizations, immunizations, lab work, x-rays, etc. and medications. In the 1980's VistA was revolutionary. It was also open-source technology, meaning all health organizations could use it free.
VistA improved the efficiency of veterans' medical treatment, reduced medical errors, updated preventive care needed, and provided for pharmacists to review all medication. With VistA a veteran can go to any VA facility anywhere and get the same quality of follow up medical care.
Unexpectedly, VistA turned into a revolutionary medical research tool. With long-term records of veterans, VHA was able to research which treatments had the best outcomes, track the cause of medical errors, reduce unnecessary surgeries, and isolate the source of hospital acquired infections. VistA improved the development of best medical practices.
Decades later when the private healthcare industry caught on to EHR, their concern was to use it for billing. That speaks volumes about the priority of private healthcare. It has only been in the last decade that the private healthcare industry has started struggling with electronic medical recordkeeping. The private sector is still struggling because most private healthcare is disjoined, scattered and ad hoc. Private healthcare does not have a comprehensive medical record keeping capability.
In the 21st century, private healthcare is still in the clipboard era, and healthcare providers expect patients to check off the boxes and fill in the blanks of their medical history. Even HMO's such as Kaiser Permanente, Cleveland Clinic and Mayo Clinic are trying to catch up to the VHA on EHR. Even those private medical facilities which have comprehensive medical recordkeeping, they are using systems that were originally designed top-down for billing.
Many dignitaries from foreign national health care services beat a path to VHA, so that they could emulate the VistA free open-source technology. They came from Germany, France, Japan, and many other countries. They still are coming. In 2018 Open Source EHR Alliance (OSEHRA) announced that it is launching VistA internationally.
Sadly, VHA which invented VistA will not be a party to the international initiative. The Trump administration has decided to scrap VistA. Instead, the VHA will be privatizing its EHR-system with a commercial off-the shelf electronic health record keeping system.
The privatization of VHA electronic health records
The corrupt politicians and commercial IT vendors have succeeded in destroying VistA at VHA. Trump and Congress have decided to spend billions of dollars from VHA's budget on installing a top-down off the shelf commercial EHR.
In May of 2017 the Secretary of the Veterans Administration David Shulkin announced that the VHA is seeking to "build private-public partnerships to improve veterans' care". A private-public partnership is where the public pays, and the privateers profit. Said Shulkin at the announcement: