Health Care Inquiry
There is not a more unhappy being
than a superannuated idol
--Joseph Addison
Each organism raises its head
over a field of corpses, smiles into the sun,
and declares life good
--Elias Canetti
_________________
If health care is really reformed, why not treat veterans like every other citizen? Universal access to health care should obviate the need for a separate veterans system, which would then seem superfluous.
The counter argument is that veteran's health needs require special treatment -- issues like atomic and chemical exposure (depleted uranium, for example), post traumatic stress and traumatic brain injury are but a few of these. Another key DVA issue is disability determination, to include service-connected compensation, but this issue could stand apart from its health care function.
Ranger requests input from those familiar with how other nations handle veterans health care issues. How are they funded, and is their treatment apart from that of the general populace? How are veterans treated specially, if at all?
Do veterans receive health care beyond that received by non-military citizens? Is the level of treatment received by veterans abroad sufficient? Does it exceed that received in the U.S. in any way?
Input is appreciated to help Ranger put this issue in a global perspective.
I'll take my answers off the air.
[Cross-posted @ MilPub.]
Labels: department of veterans affairs healthcare, veterans health care
posted by rangeragainstwar at 4:58 PM
5 Comments:
i always thought that something along the lines of tricare, but for everyone, would be the way to slide into universal coverage. or, better yet, universal access.
the only reason i have ever gone to the VA was for tropical medicine issues. i have one of the malarias that will recurr from time to time. there are also intestinal issues that crop up. there were bugs in those jungles that nobody knows about.
doctors go into the VA system for any number of reasons, beginning doctors like it for the sheer volume of cases they can see to get their skills honed. at a normal VA hospital a doctor's case load would be grounds for malpractice in the private sector.
which brings us to the second most common reason a doctor signs on the VA. malpractice judgements have made getting insurance unfeasible.
so, in the VA settings you can take your ticket and your chances. the the pettis VA in la jolla, they have some crakerjack tropical medicine guys that i've had some very good luck with.
for just about everything else, give me my union health plan.
My experience with the VA has been generally good but then I don't have any major medical issues that require constant attention. You mention the unique challenges posed by military injuries and exposures that might otherwise get lost in a wholly private, civilian-oriented health care system but that could be addressed in a number of alternate ways such as funding research and working through advanced civilian health care institutions like medical schools. And much of what VA does is little different from civilian medicine.
Perhaps the best argument for the VA system is that it has pioneered a health care innovations that have eluded our civilian medical system. VA did a good job of maintaining continuity of care when I moved to Washington from Arizona. VA often gets high ratings on its quality of care. In our otherwise private, profit health care system VA offers an alternative.
But the French have developed a system of medical records that individuals carry on a "carte vitale" that marries universal access to private practitioners so that kind of innovation is not entirely dependent on a publicly run system.
My main reservation about the VA is access. It's a 40 mile round trip to the nearest facility and it's damned hard to schedule appointments on the same day to minimize travel. It's not a big deal to me since I don't have to go there often and the distance is not that great. It is far worse for veterans with significant medical problems who live in more remote areas.
As I previously pointed out, the British have true cradle to grave guaranteed universal healthcare (not the patchwork mess that is Obamacare) and tried to do away with their veteran's hospitals and clinics, saying "they're no longer needed because we have the national health service." But when the people started coming back from Afghanistan and Iraq with all these service-related issues, they had to reverse course. It turns out that it takes a certain critical mass of TBI injuries coming into a hospital or clinic to justify having a TBI specialist on staff, for example, and if you dispersed the vets throughout the healthcare system, nobody could justify having a TBI specialist on staff.
If Britain, with their cradle to grave guaranteed health care, can't do without veteran's hospitals, I see no way that the U.S. with its ramshackle patchwork of insurers and providers could do so. The VA hospitals serve to concentrate treatment for things like TBI and PTSD into one place, where veterans can travel hundreds of miles to get there. Now, I do agree that for non-service-related health care probably we don't need VA anymore... but that's another issue.
Bad Tux,
We don't need the DVA for PTSD treatment since this could be contracted out or put on current regulations that permit fee basis treatment by non DVA specialists. PTSD is not restricted to soldiers.
I am VA rated for PTSD and I WILL NOT, i say again WILL NOT go to them for treatment. All of my dealings with them have been humiliating and demeaning. I've been evicted from VA Outreach counseling b/c my hostility was deemed disruptive by the counselor although the group had no such feelings or reaction. It was all his discomfort, not ours.Imagine throwing out a vet for feeling hostile when that's a signature emotion of PTSD. I'd rather die than go to those bastards again. The Va psych wards were actually worse, but i will not talk about that on open forum.
As for TBI it's a thorny issue indeed, but it's not isolated to the DVA. Do we not have regional specialty hospitals?. Do i not as a vet have to travel 168 miles to Gainesville for specialty clinic appts? Why do you think that this would be a bad thing if we went to a national care system that reduced driving to clinics.?
The VA doesn't have specialists in these fields as much as they have contracts with specialists to cover the topic.
I don't know , but i'll bet a beer the TBI specialists at Gainesville regional va ctr come from Shands Hosp at Uof Fl.I'll bet the same for B'ham and the UAB Med Sch.
My Va dr is British born and trained and she said that her Dad was WW2 and he never went to a veterans hospital as his care was good in the national system
It's all priorities, i guess.
Thanks for your input.
jim
BT,
I must clarify-my treatment for PTSD at the DVA was demeaning.
Generally the system is responsive , but rather slow.
I usually use my tricare except for routine stuff.
All my specialty stuff i do thru Mayo clinic , Jville Fl.Even their snack bar is superior.
My throat opn at Gainesville was a contract job thru Shands.Paid by the DVA.
Anybody that would use a VA surgeon is imho a little less than wise.
Unfortunately for some this is not an option.
That's why i'd favor larger issue national health care.
I ask you- why doesn't the Congress/ Pres/VP use the VA system.?
You get just 1 guess.
jim
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