Transformation of Government Health Care: Experience of the New Veterans Health Administration

Award Year:
Shoou-Yih Daniel Lee, Bryan Weiner
Health Reform, Quality of Care
Many Americans strongly oppose the idea of "government-run" health care, preferring market-driven strategies for solving the problems of the U.S. health care system. Yet, over the last decade, the federally financed Veterans Health Administration (VHA) has become one of the great success stories of health care improvement in America. How did the VHA, a massive, government-operated health system, rescue itself from congressional threats of overhaul and privatization? And how did the VHA become a model of high-quality, lower-cost care that now surpasses Medicare and private health plans on many quality measures? Shoou-Yih Daniel Lee, Ph.D. and Bryan Weiner, Ph.D. probe these questions in their case study of the VHA's success. Using a framework of "punctuated change," Lee and Weiner explore how VHA's leaders and management responded to Congress, overcame organizational inertia, and set a new course. Their project, Transformation of Government Health Care: Experience of the VHA, considers the importance of leadership, the paths and pace of change, internal and external resistance, and the leverage points that help move change along. Their findings should provide a clearer picture of how the VHA became a quality-driven health system and how other public and private health care systems might use the lessons of its success.