14 March 2017

VA-Care vs. ObamaCare vs. TrumpCare: do we have a good deal?

I recently had a VA appointment for which the clinician noted care that he didn't actually provide and didn't provide care for serious issues impacting my health. I complained about the falsification of records and inadequate medical treatment to what I believe were proper authorities.

That didn't work out.

I haven't heard anything from VA since my inquiry. I spoke to the local hospital patient advocate and to administrators but it seems difficult to find the right place to lodge a complaint. This seems to be a systemic problem in many medical organizations but particularly one as large as the VA.

 I have strongly recommended that VA modify its "I care" and integrated ethics programs by requiring a clinician or administrator to "own" a veteran's ethics complaint until routed to the proper authority. The VA constantly states that it is as easy as always doing the right thing and yet we see from 2014 on (the Phoenix waitlist scandal) VA's problems rest mostly in its individual and departmental failure to do just that.

In my recent experience, there was nothing but "we don't do that here" or "I don't know who handles this" useless responses. Even the VA National Center for Ethics in Healthcare, a function you might expect to be a clearinghouse for every sort of ethical complaint, responded that they could not resolve or even address complaints raised about employee ethical failures.

So I'm left a little unsatisfied, and greatly concerned because as a former health services administrator in the Air Force, if this happened to me what about a young private, sailor or airman unfamiliar with medical issues and trusting of the VA to provide the care and concern necessary?

Still, after a quarter century in the VA healthcare system I do believe it has gotten better year after year even faced with monumental budget and patient population problems.

It is so easy to bitch and moan about failures in VA healthcare but in total, I believe a disabled veteran has a better package than many other Americans. It is an earned benefit and treatment for what in other occupations would be considered on the job injuries, but all in all, there is much for which we should be  (and are) grateful. 

I also believe that such comprehensive care is warranted because unlike other Americans we cannot refuse hazardous or even life-threatening duties. In fact, we have to have the initiative to step into hazardous or life-threatening situations when necessary, and not just wait for orders to do so. 

Civilians just don't face occupational hazards such as IEDs, RPGs, or Agent Orange or enemy machine gun fire, but military folks don't even have the option of avoiding them: the law says we can't say no and few of us would shirk the duty of facing those hazards.

No soldier is in a foxhole, no pilot is in an airplane for the money. If they survive getting hurt and make it home, as much as possible of the burden of their care and recovery should be lifted from their own shoulders. The basic objective of VA benefits of all sorts is to give the veteran something of the same quality of life as enjoyed by his neighbor who chose not to serve.

So the country assigns us EisenhowerCare, KennedyCare, JohnsonCare, NixonCare, FordCare, CarterCare, BushCare, ClintonCare, ObamaCare or TrumpCare, all AKA the VA healthcare system, all paid for with a stripe on the sleeve or a bar on the shoulder. If you make it home with an injury or wound, the VA care is not too bad.

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