Veteran’s medical care and the private medical system. I rarely post about current events or politics. After reading a clear-minded, HONEST and APOLICTICAL post by Dr John Mandrola I’m making an exception.
The VA healthcare system — Can we handle the truth?
by JOHN MANDROLA, MD
“I am also connected to veterans’ healthcare. For it is in the VA system that I learned to be a doctor—a feeling doctor, an imperfect doctor, a human doctor. It’s ironic, and not often said, that the $48 billion-dollar VA healthcare system gives as much as it takes. It’s impossible to put a value on the benefit to society from the legions of caregivers who emerge from years of training in the VA system. Algorithms be damned; wealthy Americans benefit from what young doctors learn in the VA system. Veterans give when they serve in battle, then they give again as patients, as teachers.”
“And it’s not just the past that connects me to veterans’ healthcare. My wife Staci works as an attending physician in hospice and palliative care at the Louisville VA. When we share stories, I mostly tell of relieving the palpitations of the rich, she of relieving the suffering of dying veterans. Another irony of the VA: you don’t get Staci if you have private insurance.”
Indicting Obamacare:
“This is a huge mistake. Obamacare fails because it lacked the courage to do enough. Its proponents avoided the truth. (Maybe they had to.) What policymakers set out to do was to correct a great American scar—that a country this rich does not provide basic healthcare to all its people. The problem was that Americans were not told the truth. A leader (or leaders) should have said that to get care to all people, excesses and inefficiency would need to be removed. Hospitals would not look like luxury hotels. Medicine and surgery would be for the ill, not the worried-well. Evidence, not eminence, would guide medical care. And prevention of disease would come not from doctors but from patients.”
“But Americans didn’t get the truth. We got magical thinking about metaphorical free lunches, insurance reform, cost-saving EHRs, patient-safety “quality forums,” and the like. Nonsense. All of it.”
“The VA system is the truth. Rationing is the truth. Triage is the truth. Imperfection is the truth.
And yes, death, too, is the truth.”
Failure to see the obvious:
“You simply cannot deliver suburban excesses—the antithesis of efficient and honest healthcare–to the growing numbers of veterans. Thank goodness. Both Dr. Harlan Krumholz and Dr. Kevin Pho remind us that if evidence, not hype, is considered, the VA system performs either better than, or comparable to, the private sector.”
“Yet this should be obvious to anyone who reads anything about US healthcare. It’s clear that the private system is broken. If you hold up the US private system—with its humanity-extracting EHRs, expanding layers of bureaucracy, conflicts of interest, expense, inequalities, and geographic and racial differences in care–as a model that the VA should aspire to, you are not mastering the obvious. My colleague at theHeart.org Dr. Melissa Walton Shirley suggests veterans should be moved to the private system. I wouldn’t do that; veterans deserve better than our mess”.
“Yes, of course, patients die waiting for medical care. It’s utter nonsense to call that a scandal. Why? Because patients die regardless of medical care, and too often, as a result of medical care. This death-denying culture has led to a major humanitarian crisis, one playing out in nearly every ICU in this country.But please don’t misunderstand. I’m not arguing that medical care is pointless, or that we should not try to extend and improve human life. Rather, it is time to adjust the mindset that more care or faster care is always better care.”
Read the entire article click here. Can We Handle the Truth?
CURIOUS to the MAX 
I grew up on a Navy Base. I grew up being seen in a Navy hospital. It was vastly different than the private sector. I know it’s not the VA hospital, and I’ve heard both horror and honorable stories from those hospitals. But the Navy hospital was more clinic based. I rarely ever saw the same doctor. I had bone cancer as a child. A tumor in my right arm. I’m not sure if it would have been treated differently if I had been seen in the private sector or not, but I was taken care of. I did not have a private or even a semi-private room. I was in a ward. I was 15 when I had a bone removed from my hip and put in my arm. I was comforted by having people around me. I never felt I was given substandard care.
When in a private hospital I have been in private rooms and have been much more afraid, have waited long times for someone to answer my calls. Did I feel I had substandard care, no. But when my mother was being treated for cancer, I do feel she did. Was it the hospital’s fault? no, the doctor’s fault? partially (I feel she was more concerned with Quantity of life instead of Quality of life), the insurance company’s fault, YES.
Now I have Obama Care and I’m very happy it is available. my husband has been out of work for over a year. He was recently offered a part time contract job, if not for Obama Care we would not have an option for insurance. And we have very good insurance through Blue Cross. I’m very pleased with this. Is the system all sunshine and roses, no. but was it before? NO. At least now, people who could not get insurance can.
I don’t know how this changes VA benefits. One big problem we are having with injured veterans returning from the wars now is the fact that we can save many who would have died before. That sounds horrible and I don’t mean it that way, but we have many more veterans to treat who would not have come home in previous wars. This is a good thing, but it puts many more demands on the VA. Also, people are living longer, so veterans from previous wars are still using services from the VA. This too is a good thing, but it also puts more demands on the VA. I’m not sure these extra demands were thought about.
There’s a lot we can learn from other countries about how health care systems might ultimately work successfully. However, at this point I don’t think the American people can handle the truth!
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Wendy,
Thank you for a new first hand perspective. You have had more experiences with the health care system than most people – both in the past and present. Thank you for taking the time to share.
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I don’t think anyone that has served this country should ever, ever worry about adequate health care. Let me go one step further….they should also never have to worry about a home. What they see and what they go through……they deserve to be taken care of in a manner that befits this country. They don’t earn enough. There…..I’m off my soapbox.
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