30 NEWSWEEK.COM MARCH 27, 2020
HEALTH CAREpioneered a drive to increase the rate of toothbrush-
ing among patients at its hospitals, after discover-
ing it reduced by 90 percent the number of cases
of nonventilator, hospital-acquired pneumonia, an
illness that costs the U.S. $35 billion a year. “It’s rea-
sonable to expect that an institution that isn’t being
paid more to do more will avoid unnecessary costs,”
says Rand’s Anhang Price. “You might worry that
they have an incentive to undertreat patients, but
we can’t find evidence of that in the VA.”
Another critical area where the VA has leapt far
out in front of most of the rest of health care is in
addressing the “social determinants of health”—that
is, life challenges such as inadequate housing, pov-
erty and joblessness, as well as lifestyle and mental
health issues such as poor diet, loneliness, stress and
depression, that can have a big impact on health and
well-being. Social determinants have about four
times the impact on a patient’s health as the med-
ical care they receive. Other industrialized nations
spend twice as much on such social problems as they
do on health care; the U.S. spends half as much, and
the U.S. health care system by and large ignores them.
Through the VA, vets have access to professionals
who can help them cope with their life challenges,
including social workers, counselors, behavioral
coaches, acupuncturists and tai chi instructors. In
many cases, after meeting with a patient, a VA doc-
tor will simply walk the patient down the hall to
meet a counselor or a coach. “We want to offer a big
repertoire of tools for dealing with stress, chronic
pain and other whole-health problems,” says Ben
Kliger, a physician who runs the VA’s “integrative
health” and “cultural transformation” initiatives.
“Once a vet gets involved in these other services,
their overall costs tend to go down.”
“We’ve changed the conversation here so it’s not
just about disease,” he says.
High-Tech Medicine
the va frequently jumps ahead of the rest of
health care in adopting new technology. Back in 2010,
Eric Dusseux, CEO of medical-tech company Bionik,
went looking for hospitals willing to experimentally
deploy the company’s groundbreaking robots, de-
signed to exercise the arms of stroke victims. He soon
found a willing partner in the VA. Ultimately, it de-
ployed the robots in 12 of its hospitals, leading to the
largest study ever of robotic patient rehabilitation—astudy so successful that robots are now part of stan-
dard stroke-care guidelines due to the improved out-
comes and lowered overall costs from the technology.
“They were very receptive and forward-thinking,” says
Dusseux of the hospital system.
The VA is also pioneering the use of 3D printers to
create highly accurate models of the internal organs
of individual patients who are scheduled for complex
surgeries, so that surgeons can better prepare for the
operations by examining the models. In one of the
most ambitious health-data projects in the world, it is
analyzing the complete service histories and medical
records, along with DNA samples, of nearly 800,000
veterans in order to find links between their genes;
environments; habits such as diet, medications andCLOCKWISEF^5O^0TOP:^9 ETE5 ANSH
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