VA Woes Aren't New—You Can't Get Good Care From a Shitty System

VeteransMark Sardella / FoterAs a third-year medical student in the 1990s, my wife did her surgical rotation at a Veterans Health Administration (VHA) facility. "The guys were great," she says, referring to the patients. "But the place was a dump."

She keeps remembering the flies that circled over a patient in an operating room during an open heart procedure.

A friend of mine, a Vietnam vet, experienced the VHA from the other side, as a patient. He couldn't get in to see a specialist during one of his bouts of health trouble so a nurse got on Skype and described his heart beat to a physician a hundred miles away.

There is such a thing as telemedicine, which brings far-flung patients closer to medical care through the miracle of electronic connections. Saying "thump-a-thump-a-thump-a..." into an old Dell laptop ain't it.

The VHA's problems go far beyond secret waiting lists and canceled appointments. Yes, it's bad that facilities delay the delivery of care to veterans into a future sometimes so distant that the would-be patients are more of a concern for morticians than for physicians by the time they make it to the front of the line. But the sad fact is that the care they finally receive often sucks.

In 2010, well before the current scandal, the Los Angeles Times reported, "Many veterans wounded in Iraq and Afghanistan are being buffeted by a VA disability system clogged by delays, lost paperwork, redundant exams, denials of claims and inconsistent diagnoses."

Three years earlier, Newsweek found "a grim portrait of an overloaded bureaucracy cluttered with red tape; veterans having to wait weeks or months for mental health care and other appointments, families sliding into debt as VA case managers study disability claims over many months, and the seriously wounded requiring help from outside experts just to understand the VA's arcane system of rights and benefits."

In 2008, the Department of Veterans Affairs' own Inspector General found lethal "pre-operative, intra-operative, and post-operative quality of care issues" at its Marion, Illinois, facility that resulted in "a mortality rate that was over four times the expected rate." It even discovered unqualified doctors performing procedures, and others practicing despite disqualifying disciplinary records.

The report conceded that the VHA has no real way to check its physicians' past for discipline issues.

I wrote the other day that the care provided to veterans by the United States government, in its facilities, on the taxpayer dime, is an all-too-typical example of what to expect from single-payer, government-run health systems. That's true.

The real threat to veterans in need of medical care isn't a passing scandal about bureaucratic delays and cover-ups; it's a history of shitty care provided by a system that's not really capable of offering better.

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  • UnCivilServant||

    +1 Alt Text.

  • Swiss Servator, CH yeah!||

    My parents both did rotations/assignments with the VA in the 1950s.... when I joined the Army, they warned me to stay away from the VA at all times.
    2chili is right - a guvmn't system full of civil service employees is not a recipe for efficiency, accountability or quality.

  • Pro Libertate||

    SINGLE PAYER IS THE GOAL. IT IS PERFECT.

  • AlexInCT||

    That's some strong stuff you are toking ther bro....

  • Swiss Servator, CH yeah!||

    Check sarcasm meter, plz.

  • Pro Libertate||

    To clarify, I would like a free market in medical services and health insurance. Certainly, I'd like one a whole lot freer than what we have now. In fact, I'd like one a whole lot freer than what we have before Obamacarousel.

  • Francisco d'Anconia||

    Incredibly simple...

    No competition = shit product.

    Rocket surgery.

  • creech||

    How does VA actually operate? Vets I worked with, who had employer insurance, used it and not VA. I would assume those vets over 65 would just use Medicare at the hospital of their choice. Indigent vets under 65, would use Medicaid at hospital of their choice, right?
    So VA is used by vets under 65 who aren't broke but can't afford (or don't want to pay for) private insurance? So why not just give them
    "Veterans Insurance" and let them go to local facilities instead of schlepping to some ratty, inefficient VA hospital many miles away?

  • Francisco d'Anconia||

    Best medical care I've ever had in my life was my Lasik surgery. Insurance doesn't cover. Wrote a check. Dirt cheep. Awesome service. Awesome result.

    Free market capitalism...BITCH!

  • Pro Libertate||

    A third of the country hates the free market regardless of all of the evidence for it. . .and all of the evidence against the alternatives.

    Another third mostly disagrees but is scared to publicly challenge the first third.

    The last third thinks that's all nonsense and wonders what the fuck is wrong with the other two-thirds.

  • JW||

    I posted on another site the other day, to someone who claimed that "just because something in a TOS, doesn't make it right." They objected to a perfectly legal term in the TOS.

    I replied that a TOS is only a set of rules that lays out how a company will do business with you. You have a TOS as well, it's just not posted on a website. If you don't like their terms, you are free to take your money elsewhere, just as they are free to refuse your money. That's how free people interact with one another.

    The response I got back was "You're so blinded by that free market bullshit."

  • american socialist||

    Does the evidence include comparisons of longevity , cost-per-patient and overall satisfaction with health care in single payer systems? Or no?

    As for the VA, we have an underfunded government system that some veterans are abandoning in favor of uninsured health care. That's a problem for libertarians? Shouldn't you all be raising the roof?

  • UnCivilServant||

    As for the VA, we have an underfunded overfunded government system that some veterans are abandoning in favor of uninsured actually getting health care.

    Fixed that for you.

  • Jordan||

    Does the evidence include comparisons of longevity , cost-per-patient and overall satisfaction with health care in single payer systems? Or no?

    Does the evidence account for the fact that government pays greater than 60% of all healthcare costs in this country? Does it adjust for lifestyle and cultural factors like violent crime rates, obesity rates, traffic accident rates, etc? No?

  • sarcasmic||

    It is immoral to profit off of sick people! That's what private health care does! It profits off of sick people! You libertarians are immoral scum when you support profits off of sick people! Profit is waste! It's money that could help people, but instead lines the pockets of the rich! We need to put people before profits! We must end private health care! Single payer is the only way to take profit out of medicine! It's a moral issue! Why do you lick the capitalist boots that hold you down?!?

  • american socialist||

    ^more of this.

  • AlexInCT||

    Too stupid to even see the parody?

  • Swiss Servator, CH yeah!||

    Yes.

  • Mt low rider||

    Blinded by the light...

  • ||

    Good principles lead to good outcomes. Bad principles lead to bad outcomes.

    It is not just that government employees are not punished for doing a bad job, they also are not rewarded for doing a good job. I worked in a state hospital and saw it on a daily basis. I also watched many quality employees leave out of disgust for the system, which I also eventually did.

    I was surprised to learn that our state hospital regularly outperformed private hospitals offering the same care. I looked into it and discovered that those private hospitals were funded with government money and mostly owned by state legislators who were simply looting taxpayers. In other words, the same lack of incentives plagued those facilities.

    Lack of proper incentives is the fatal flaw in all socialist schemes. We know it in theory and in practice. It has been tried countless times and has a 100% record of failure. How fucking stupid or cynical do you have to be to subscribe to an obviously flawed ideology?

    Yeah, lefties are the smart ones.

  • Dweebston||

    The simple solution is to push vets into the exchanges and subsidize their coverage. Dems can claim to have resolved the VA crisis, and the administration can trumpet n-million new ACA signups.

    Then push back implementation till 2017. Success!

  • Drake||

    Imagine being seriously injured or ill and being cared for by the people who run this blog. That's the VA.

  • Swiss Servator, CH yeah!||

    Squirrel Docs?

  • Juice||

    I've been told by Paul Krugman that the VHA is so not shitty that it's actually awesome. Who should I believe? You or someone who won a real, actual Nobel Prize?

  • ATXChappy||

    I guess it all depends on what your definition of awesome is. As a former Marine, I can honestly say, I have never, not once, heard a fellow veteran say anything good about the treatment they received from the VHA. Most stories end like a really bad joke. "...Damn near killed him"!

  • sarcasmic||

    What is a former Marine? I've been told that there are active Marines and inactive Marines, but no such thing as a "former" Marine.

  • R C Dean||

    +1 Jacket, Full Metal.

  • ATXChappy||

    That is something the Commandant of the Marine Corps started a few years ago. When I served (25 years ago), honorably discharged Marines where referred to "Former Marines" since there are statuses other than active and inactive (active reserve, inactive reserve, retired and so on). I guess it's a way to say the Marine served honorably and is no longer under any contractual obligation. But, you are good as long as you don't refer to a Marine as an Ex-Marine. That's reserved for people who couldn't hack it.

    http://blog.medalsofamerica.co.....r-marines/

  • ATXChappy||

    That is something the Commandant of the Marine Corps started a few years ago. When I served (25 years ago), honorably discharged Marines where referred to "Former Marines" since there are statuses other than active and inactive (active reserve, inactive reserve, retired and so on). I guess it's a way to say the Marine served honorably and is no longer under any contractual obligation. But, you are good as long as you don't refer to a Marine as an Ex-Marine. That's reserved for people who couldn't hack it.

    http://blog.medalsofamerica.co.....r-marines/

  • ATXChappy||

    That is something the Commandant of the Marine Corps started a few years ago. When I served (25 years ago), honorably discharged Marines where referred to "Former Marines" since there are statuses other than active and inactive (active reserve, inactive reserve, retired and so on). I guess it's a way to say the Marine served honorably and is no longer under any contractual obligation. But, you are good as long as you don't refer to a Marine as an Ex-Marine. That's reserved for people who couldn't hack it.

    http://blog.medalsofamerica.co.....r-marines/

  • Response||

    Didn't you all read the memo? Every government employee individually is too big to fail.

  • steve baker||

    You can predict a nation's future not by how it raises its children, but by how it cares for it's military veterans.

    We are screwed!

  • James Anderson Merritt||

    First, socialized medicine failed the Veterans, but I wasn't a veteran, so I didn't speak up...

  • ||

    Because Veterans are principled, committed, have proven ability and are fearless they are a threat to liberal progressives and fall under the ideological cleansing policy of the Democrat party. Veterans will be eradicated through neglect by the V.A., subdued by discrimination and vilification or executed in the streets. Veterans, the country we fought for and many died for is plotting our demise! We have to take back our future. The enemy is moving fast to secure their stranglehold on our future. What more can we lose but our lives if we don't wake up!!

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