Jan 02 2010 NY Times Letter on “Health Care That Works”
A Letter to the Editor of the NY Times in September, 2009 cited house calls for the sick as the way to reform health care.
To the Editor:
Nicholas D. Kristof’s column extolling the virtues of the Veterans Affairs health care system (“Health Care That Works,” Sept. 3) is right on target. But he doesn’t mention another way the V.A. system has found to provide more and better care to its patients and save lots of money at the same time — house calls.
All across the United States, thousands of chronically ill veterans have been getting house calls from doctors and nurses through the V.A.’s Home-Based Primary Care program. It is far and away the system’s most popular program. And it saves a bundle of money.
A V.A. analysis in 2002 showed that veterans who got house calls spent 62 percent less time in hospitals and 88 percent less time in nursing homes and cost the system 24 percent less than their colleagues seen in offices.
The sickest 10 percent of Medicare enrollees consume about two-thirds of its budget. Encouraging house calls to that population could cut Medicare costs substantially and provide money to cover the country’s uninsured.
The Independence at Home Act is a provision in the House’s health care reform package that would accomplish just that. The act encourages doctors to take on the care of a home-bound population by allowing them to share in the savings they engender. This is real health care reform — a change in the health care system, not simply in its financing.
New York, Sept. 3, 2009
The writer, an internist, provides house calls to 50 homebound elderly and disabled people