Department of Veterans Affairs Research Centers Have Many Problems, GAO Report Finds
Studies conducted at the 115 Department of Veterans Affairs research centers nationwide continue to have "extensive problems" despite three years of efforts to address the issues, according to a General Accounting Office report presented yesterday to the House Veterans Affairs Oversight and Investigations Subcommittee, Hearst/Richmond Times-Dispatch reports. Cynthia Bascetta, director of veterans health issues for the GAO, told the subcommittee that the VA "has not taken sufficient action to strengthen protections for human subjects." The report also found:
- VA research centers have "continuing weakness" that place study volunteers at risk.
- VA researchers do not receive adequate instruction to protect study volunteers from abuse.
- The VA does not provide adequate funds for research centers to protect study volunteers from abuse.
- The VA lacks a system for researchers to report "adverse events" in studies.
USA Today yesterday examined the VA health care system, which has controlled prescription drug costs in "ways unequalled in private or public health care" in the United States. According to USA Today, the VA "shows that the government can operate a vast health care system and force drug companies to sell drugs at lower prices" and could serve as a model for Medicare reform as lawmakers debate legislation to establish a prescription drug benefit in the program. VA per-patient expenditures decreased from $5,019 to $4,928 between 2001 and 2002; Medicare per-patient expenditures increased from $6,214 to $6,604 over the same period. In addition, an HHS study conducted in 2001 found that the VA on average paid 52% less than Medicare for 24 medications. The VA also has controlled prescription drug costs through discounts negotiated with brand-name pharmaceutical companies, as well as the use of generic medications and preferred treatment lists. Marilyn Moon, a health economist at the Urban Institute, said that lawmakers should "follow the VA's example and force lower prices from drug makers" for Medicare beneficiaries, according to USA Today. The VA "indicates that you can indeed negotiate and get a good deal," she said. However, CMS Director Thomas Scully said that Medicare beneficiaries account for about 50% of the U.S. prescription market and "is too big to demand price concessions," USA Today reports. The VA accounts for only about 2% of the market, Scully said. "The VA can go out and negotiate good prices. If we did it, we wouldn't be negotiating. We'd be price fixing," Scully said (Welch, USA Today, 6/18).
Meanwhile, the June 14 issue of National Journal examines efforts to end the "annual gap between demand and a limited supply of funds" in the VA health care system. In recent months, lawmakers and the Bush administration have made three proposals that could help address the issue. According to National Journal, none of the proposals is a "silver bullet for all of the VA's problems," but "precisely because they are more modest than past plans, they just might have a shot at being enacted" (Freedberg, National Journal, 6/14).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.