12. Ryoo JJ, Malin J. Reconsidering the veterans health administration: a model and a moment for publicly funded health care delivery. Ann Intern Med June 7, 2011;154:772–773.
13. ACSI Scores for U.S. Federal Government, American Customer Satisfaction, selected years. http://www.theacsi.org/index.php?option=com_content&view=article&id=63&Itemid=101/.
14. Leape LL, Berwick DM. Five years after To Err Is Human: what have we learned? Journal of the American Medical Association 2005;293: 2384–2390.
15. Jha AK, Shlipak MG, et al. Racial differences in mortality among men hospitalized in the veterans affairs health care system. Journal of the American Medical Association 2001;285:297–303.
16. Woolhandler S, Himmelstein DU. Competition in a publicly funded healthcare system. BMJ December 2007;335:1126–1129.
17. Healthcare program serving U.S. vets wins government innovation award: hi-tech VistA program one of two federal initiatives to win $100K grant. press release. Ash Institute for Democratic Governance and Innovation at Harvard University’s Kennedy School of Government. July 10, 2006. http://www.innovations.va.gov/innovations/docs/HarvardNewsRelease.pdf.
18. The Health Care System for Veterans: An Interim Report. Congressional Budget Office. December 2007. http://www.cbo.gov/ftpdocs/88xx/doc8892/MainText.3.1.shtml, box 3.
19. Quality Initiatives Undertaken by the Veterans Health Administration. Congressional Budget Office. August 2009. http://www.cbo.gov/ftpdocs/104xx/doc10453/08-13-VHA.pdf, Figure B-1.
20. Nugent GN, et al. Evaluating cost for veterans health care, Med Care Res Rev 61:4 (December 2004):495–508.
21. Asch SM, et al. Who is at greatest risk for receiving poor-quality health care? New England Journal of Medicine 2006;354:1147–1156. http://content.nejm.org/cgi/citmgr?gca=nejm;354/11/1147.
22. Ibid.
23. Oliver A. The veterans health administration: an American success story? Milbank Quarterly 85:1, January 2007.
24. Jha AK, DesRoches CM, Campbell EG, Donelan K, Rao SR, Sowmya R, Ferris TG, Shields A, Rosenbaum S, Blumenthal D. Use of electronic health records in U.S. hospitals. New England Journal of Medicine 2009;360:1628–1638.
25. Office of the Press Secretary, the White House. President Bush touts benefits of health care information technology. Department of Veterans Affairs Medical Center, Baltimore, Maryland. April 27, 2004. http://www.whitehouse.gov/news/releases/2004/04/20040427-5.html.
Chapter 2
1. Russell R. The Shadow of Blooming Grove: Warren G. Harding in His Times. Reprint. Norwalk, CT: Easton Press; 1988.
2. Daugherty HM. The Inside Story of the Warren G. Harding Tragedy. Whitefish, Mont.: Kessing Publishing; 1960:179.
3. Quoted by Klein R. Wounded Men, Broken Promises. New York: Macmillan;1981:41. Only Yesterday. New York: HarperCollins;1931.
4. Klein. Wounded Men, Broken Promises. p. 42.
5. Quoted by Klein, ibid., p. 42.
6. Department of Veterans Affairs, Office of Facilities Management. History of veterans healthcare. http://www.va.gov/facmgt/historic/Medical_Care.asp.
7. Ibid.
8. The National Institutes of Health and The Veterans Administration. Advisory Committee on Human Radiation Experiments—Final Report, chapter 1. http://www.eh.doe.gov/ohre/roadmap/achre/chap1_4.html; George M. Lyon, M.D., Assistant Chief Medical Director for Research and Education. Presentation to the Committee on Veterans Medical Problems, National Research Council. December 8, 1952 (Appendix II, Medical Research Programs of the Veterans Administration) (ACHRE No. VA-052595-A). http://www.gwu.edu/~nsarchiv/radiation/dir/mstreet/commeet/meet3/brief3.gfr/tab_i/br3i1c.txt.
9. Shortly before he died in 2001, an interviewer asked Ken Kesey how he first came to experiment with LSD. He answered: “I was connected to the VA hospital. Vic Lovell was working over there as a student of some kind, and when the drug experiment started, they set up a version of the VA hospital in Palo Alto. I went over and applied for a job, and a week or so later had a job. They put me on the same ward with the doctor that’d given me those early pills. He was not doing his experimentation anymore; he had quickly learned that this could be a real problem for the American government. One night, I came back in with my keys and went into his room, into his desk, and took out a lot of stuff. That was the source of most of our—all of our drugs—for a long time.” See “Digital Interviews” Web site: http://www.digitalinterviews.com/digitalinterviews/views/kesey.shtml.
10. Quoted by Klein. Wounded Men, Broken Promises. p. 62.
Chapter 3
1. Doctors pull plug on paperless system: California’s Cedars-Sinai turns off its computerized physician order entry system after physicians revolt, demonstrating that implementing new technology is easier said than done. American Medical News, February 17, 2003.
2. Associated Press, Computer sought by VA too costly, outdated. March 20, 1977.
3. Brown SH, et al. Vista-U.S. Department of Veterans Affairs national-scale HIS. International Journal of Medical Informatics 2003;69:136–135.
4. Interview. June 28, 2006.
5. Timson G. The history of the Hardhats. http://www.hardhats.org/history/hardhats.html.
6. Ibid. For a tribute to pioneering work of Ted O’Neil, see this You-Tube video compiled shortly after his death by fellow Hardhat Tom Munnecke: http://www.youtube.com/watch?v=LFRpw_oygr4.
7. Timson G. The history of the Hardhats.
8. Ibid.
9. Tomich N. Computers: new look at VA woes. U.S. Medicine, November 15, 1981.
10. Timson G. The history of the Hardhats.
11. Cited by Brown SH, et al. The history of the Hardhats. p. 138.
12. Tomich N. Operating MUMP systems are integrated without hitch. U.S. Medicine, August 15, 1982, p. 1.
13. Byrne CM, Mercincavage LM, Pan EC, Vincent AG, Johnston DS, Middleton B. The value in investments in health information technology at U.S. Department of Veteran Affairs. Health Affairs (Millwood) 2010 April;29(4):629–638.
14. Timson G. The history of the Hardhats.
15. Tomich N. Congress urged to fund DHCP. U.S. Medicine, May 1987, p. 1.
Chapter 4
1. Interview by Spotswood S. Quality, access priorities in VA cancer care. U.S. Medicine, October 2005. http://www.usmedicine.com/article.cfm?articleID=1167&issueID=80.
2. National PBM Bulletin, July 21, 2004, Department of Veterans Affairs, Pharmacy Benefits Management Services. http://www.pbm.va.gov/alerts/Rofecoxib.pdf.
3. Spotswood S. VA’s vaccination plan prepares patients. U.S. Medicine January 2006. http://www.usmedicine.com/article.cfm?articleID=1236&issueID=83.
4. Management Brief, Health Services Research & Development Service, No. 6, December 2002. http://www.research.va.gov/resources/pubs/docs/hsr_brief_no6.pdf.
5. Khuri SF, et al. The Department of Veterans Affairs’ NSQIP: the first national, validated, outcome-based, risk-adjusted, and peer-controlled program for the measurement and enhancement of the quality of surgical care. National VA Surgical Quality Improvement Program. Annals of Surgery 1998;228(4):491–507.
6. Interviewed by Spangler D. VA electronic Rx records aid Katrina relief response. U.S. Medicine, November 2005. http://www.usmedicine.com/article.cfm?articleID=1202&issueID=81.
7. Oliver. The veterans health administration: an American success story? http://www.milbank.org/quarterly/8501feat.html.
Chapter 5
1. Editorial. More than veterans need. St. Petersburg Times (Florida), January 16, 1996, p. 10A.
2. Department of Veterans Affairs, Office of Inspector General. Audit of Veterans Health Administration resource allocation issues: physician staffing levels; 5R8-A19-113. September 29, 1995; Kilborn PT. Veterans expand hospital system in face of cuts. New York Times, January 14, 1996, sec. 1, p. 1, col. 3; National Desk.
3. Kilborn PT. Veterans expand hospital system in face of cuts. New York Times, January 14, 1996, sec. 1, p. 1, col. 3; National Desk.
4. Kizer KW, Dudley RA. Extreme makeover: T
he transformation of the veterans healthcare system. Annual Review of Public Health 30 (April 2009):313–339.
5. Kizer may have been the first to use the phrase “patient centered” in articulating a vision of health care delivery system reform. The first sentence of his 1995 report to Congress on his plans for the VHA reads: “The reorganization plan presented in this document should be viewed as the first step in transforming the Veterans Health Administration (VHA) to a more efficient and patient-centered health care system.” Today, “patient-centered health care” is a buzz phrase on the lips of nearly all health-care policy wonks. Office of the Assistant Deputy Under Secretary for Health. Vision for change: a plan to restructure the Veterans Health Administration. March 17, 1995. http://www.va.gov/healthpolicyplanning/vision/2chap1.pdf.
6. The use of prostate screening has since become controversial. See Brownlee S and Lenzer J. Can Cancer Ever Be Ignored? New York Times Magazine, October 5, 2011. http://www.nytimes.com/2011/10/09/magazine/can-cancer-ever-be-ignored.html?_r=1&ref=magazine.
7. Office of the Assistant Deputy Under Secretary for Health. Vision for change: A plan to restructure the Veterans Health Administration. March 17, 1995. http://www.va.gov/healthpolicyplanning/vision/2chap1.pdf.
8. Lichtenberg FR. Older Drugs, Shorter Lives? An Examination of the Health Effects of the Veterans Health Administration Formulary. Medical Progress Report, no. 2, October 2005.
9. Blumenthal D, Herdman R, eds. Description and Analysis of the VA National Formulary, executive summary. VA Pharmacy Formulary Analysis Committee, Division of Health Care Services. Washington, DC: Institute of Medicine, National Academies Press; 2000.
10. Smith S. Recasting the lowly formulary. Minnesota Medicine 89, April 2006.
Chapter 6
1. CBO Budget Options, Volume 1: Health Care. December 2008.
2. Kohn L, et al, eds. To Err Is Human.
3. Klevens, et al. Estimating health care–associated infections and deaths.
4. Aspden P, Wolcott J, Bootman JL, Cronenwett LR, eds. Preventing Medication Errors: Quality Chasm Series. The National Academies Press; 2007.
5. McGlynn EA, et al. The First National Report Card on Quality of Health in America. Rand Corp.; 2006.
6. Office of the Medical Inspector, VHA. VA Patient Safety Event Registry: first nineteen months of reported cases, summary and analysis, June 1997 through December 1998; Pear R. Report outlines medical errors in VA hospitals. New York Times, December 19, 1999, sec. 1, p. 1, col 6.
7. Editorial, Progress on medical care, New York Times, December 28, 1999.
8. Wiebe C. Patient safety concerns could spur bar code adoption. Medscape Money & Medicine 2002;3(2).
9. Wood D. RN’s visionary bar code innovation helps reduce medication errors. NurseZone.com, April 30, 2004. http://www.nursezone.com/Nursing-News-Events/devices-and-technology/RN’s-Visionary-Bar-Code-Innovation-Helps-Reduce-Medication-Errors_24580.aspx.
10. Johnson CL, Carlson RA, Tucker CL, Willette C. Using BCMA software to improve patient safety in Veterans Administration Medical Centers. Journal Healthcare Information Management 2002 Winter;16(1):46–51.
11. Leape LL, Berwick DM. Five years after To Err Is Human: what have we learned? Journal of the American Medical Association 2005;293: 2384–2390.
Chapter 7
1. Kleinke JD. Dot-gov: market failure and the creation of a national health information technology system. Health Affairs 2005;24(5):1246–1262.
2. Casalino L. Markets and medicine: Barriers to creating a “business case for quality.” Perspectives in Biology and Medicine 2002;46(1):38–51.
3. Urbina I. In the treatment of diabetes, success often does not pay. New York Times, January 11, 2006, p. 1.
4. Snyderman R, Williams RW. The new prevention. Modern Healthcare 2003;33:19.
5. Federal Trade Commission and the Department of Justice. Improving health care: A dose of competition. Report. July 2004, p. 24. http://www.ftc.gov/reports/healthcare/040723healthcarerpt.pdf.
6. Leonhardt D. Making health care better. New York Times Magazine, November 3, 2009, p. MM31.
7. World Wide Pursuing Perfection (WWPP). Pursuing perfection in Whatcom County. http://www.wwpp.org:8080/wwppDiscuss/.
8. Homer J, et al. Models for collaboration: how system dynamics helped a community organize cost-effective care for chronic illness. See table, p. 30. http://www.wwpp.org/static/gems/wwppDiscuss/sdp.
9. Kolata G. Health plan that cuts costs raises doctors’ ire. New York Times, August 11, 2004.
10. Anderson GF, et al. Health care spending and use of information technology in OECD countries. Health Affairs 2006;25(3):819–831.
11. Protti D and Groen P. Implementation of the Veterans Health Administration VistA clinical information system around the world. ElectronicHealthcare 7(2)2008:83–89. http://www.longwoods.com/publications/electronichealthcare/560.
12. Rossi S. International expertise sought on e-health standards. Computerworld: The Voice of IT Management. (Australia). http://www.computerworld.com.au/article/157496/international_expertise_sought_e-health_standards.
13. Aldrich M. Safety First: Technology, Labor, and Business in the Building of American Work Safety, 1870–1939. Baltimore: Johns Hopkins University Press; 1997.
14. Bureau of Labor Statistics, National Compensation Survey Table 2. Medical care benefits: Access, participation, and take-up rates. March 2009. http://www.bls.gov/news.release/ebs2.t02.htm.
15. Quoted by Pear R. Trade commission challenges a hospital merger. New York Times, August 21, 2011. http://www.nytimes.com/2011/08/22/us/22health.html.
16. Ibid.
17. Hendrix A, Buck J. Employer-sponsored wellness programs: should your employer be the boss of more than your work? Southwestern Law Review 38:3 (Spring 2009):465–502. http://www.swlaw.edu/academics/cocurricular/lawreview/pastissues/vol38_no3.
18. Russell LB. Preventing chronic disease: an important investment, but don’t count on cost savings. Health Affairs, January/February 2009;28(1):42–45.
19. See, for example, Hospital Compare, a Web site maintained by the U.S. Department of Health and Human Services. http://www.hospitalcompare.hhs.gov/.
20. Destiny Health, Opinion Research Corporation. Study reveals Americans resist doing healthcare homework; making more information available may not solve cost crisis. Press release. http://www.businesswire.com/news/home/20060814005734/en/Study-Reveals-Americans-Resist-Healthcare-Homework-Making.
21. Baker DW, Einstadter D, Thomas C, et al. The effect of publicly reporting hospital performance on market share and risk-adjusted mortality at high-mortality hospitals. Medical Care 2003;41(6):729–740. http://www.ahrq.gov/research/oct03/1003RA3.htm.
Chapter 8
1. Williams M. The doctor factor. Washington Post, December 31, 2003, p. A19. For a posthumous collection of her columns, see The Woman at the Washington Zoo: Writings on Politics, Family, and Fate. New York: Public Affairs; 2005.
2. Wennberg JE, Gittelsohn AM. Variations in medical care among small areas. Science, December 14, 1973, pp. 1102–1108.
3. Fitzhugh M. Wrestling with variation: an interview with Jack Wennberg. Health Affairs. http://content.healthaffairs.org. (Type title into Web site’s search box.)
4. See, for example, Welch HG, Sharp SM, Gottlieb DJ, Skinner JS, Wennberg JE. Geographic variation in diagnosis frequency and risk of death among Medicare beneficiaries. JAMA. 2011;305(11):1113–1118.
5. Fisher ES, Wennberg DE, Stukel TA, Gottlieb DJ, Lucas FL, Pinder EL. The implications of regional variations in Medicare spending, II: health outcomes and satisfaction with care. Annals of Internal Medicine 2003;138:288–298.
6. Fisher ES, Wennberg DE, Stukel TA, Gottlieb DJ, Lucas FL, Pinder EL. The implications of regional variations in Medicare spending, I: the content, quality, and accessibility of care. Annals of Internal Medicine 2003;138:273–287.
7. For a good introduction to this literature, see The Dartmouth Atlas of Health Care. http://www.dartmo
uthatlas.org/.
8. Gibbs N, Bower A. Q: What scares doctors? A: Being the patient. Time, May 1, 2006 (cover).
9. Asch SM, et al. Who is at greatest risk for receiving poor-quality health care? New England Journal of Medicine 2006;16:354(11):1147–1156.
10. Baker L, Atlas SW, Christopher CA. Expanded use of imaging technology and the challenge of measuring value. Health Affairs November/December 2008, 27(6):1467–1478; Fazel R, Krumholz HM, Wang Y, et al. Exposure to low-dose ionizing radiation from medical imaging procedures. New England Journal of Medicine 2009;361:849–857; Board on Radiation Effects Research. Health Risks from Exposures to Low Levels of Ionizing Radiation: BEIR VII, Phase 2. Washington, DC: National Academies Press; 2006.
11. Lauer MS. Elements of danger: the case of medical imaging. New England Journal of Medicine 2009;361:841–843.
12. Asch SM, et al. Who is at greatest risk for receiving poor-quality health care? New England Journal of Medicine 2006;16:354(11):1147–1156, table 3.
13. Frederick LA. The Big Change: American Transforms Itself, 1900–1950. New York: Harper; 1952: 202.
14. Roemer MI. Bed supply and hospital utilization: a natural experiment. Hospitals 1961;35:36–42.
15. For a journalistic look at how this bureaucratic and political process works behind the scenes, see the Wall Street Journal’s brilliant exposé of the so-called Relative Value Scale Update Committee, an obscure group convened by the American Medical Association that effectively sets Medicare reimbursement rates for different specialties and whose influence over the direction of the American economy is rivaled only by the Federal Reserve. Mathews AW, McGinty T. Physician panel prescribes the fees paid by Medicare. Wall Street Journal, October 26, 2010. http://online.wsj.com/article/SB10001424052748704657304575540440173772102.html.
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