Let's talk about the VA

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Specializes in Education, research, neuro.

I live in a city that has (far as I know) a fine VA. A friend of mine was being seen for a chronic pancreatitis problem and in some of the images, the radiologist saw a teeny tiny spot on the guy's lung. Within a week it was biopsied. Within another week he had a lobectomy and stands a great chance being part of the 5% of patients that beat this type of cancer. He says the care he received in the ICU and on the units was superb. I believe him.

I know a bunch of VA nurses and would let any of them take care of me. Again, superb.

With all those caveats, please give me your view of the implosions in (how many now?) 26 VA hospitals across the country.

Even at our VA, I have seen big appropriations (our congress-people bringing home the bacon) that are given to the VA... and the patient care areas and efforts of the hospital never expand. The office space metastasizes and the bureaucrats multiply.

I think our VA is clean. (It's a small-ish town and word gets out.) But the system at large seems to exist to serve the bureaucracy. The veterans are an after-thought. I believe the IG's report that waiting times were fudged so that directors could get bonuses is entirely believable.

But that's just me. I would like to know what you think.

Full disclosure: I am a veteran, though I have always used private health insurance.

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Specializes in Dialysis.
I am a veteran, though I have always used private health insurance.

I think all veterans should be entitled to make the choice you made. The concept of choice is an existential threat to those who view the VA system as deserving a monopoly on the delivery of veterans healthcare.

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Specializes in Critical Care.
I think all veterans should be entitled to make the choice you made. The concept of choice is an existential threat to those who view the VA system as deserving a monopoly on the delivery of veterans healthcare.

Since at least part of the current problem is a lack of funding, it seems extremely unlikely that we're going to buy private plans for veterans any time soon.

We currently spend about $5,000/year for patients in the VA system, which is ridiculously cheap compared to what it costs to cover people in the private sector, and unfortunately it's too cheap. Since congress hasn't played along with at least keeping up with per person costs in the VA system ($8,000 per patient has been suggested as what's needed to provide access comparable to the private sector), it would seem even more unlikely that they would be willing to fund what it would cost to buy veterans private plans, which would run $12,000 and up. If congress won't increase funding by a couple thousand per beneficiary, I'm not sure how we could expect that they would double, triple, or quadruple the current expenditures.

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Specializes in Education, research, neuro.

The funding of the VA has tripled since the World Trade Towers fell and we entered into protracted combat. I would not mind tripling it again. When the current administration came on-board, they made sure extra billions (sorry, don't have the figures) were there for the VA. Here's the problem: the service to the vets, the actual patient care... did not expand in relationship to the increases in the budget. And they never do. Even at our VA which as I indicated is pretty d*nm good they somehow don't have the funding to keep their ER open over the weekend. But we get new administrative layers and layers. Last year, the VA (system) spent $500,000,000 on furniture... office furniture. Not MRI machines. Not clinical laboratory services. Not extra doctors and nurses.

I have not heard anyone talking about getting rid of the VA system. I haven't heard anyone talking about buying vets their own health insurance plans. What I have heard people talking about is... each vet has an account or voucher. If their VA cannot see them in X amount of days, the vet gets his health care wherever he/she wants and THAT VA (the one that could not accommodate him or her) picks up the tab.

The VA bureaucracy is doing what bureaucracies do... keeping themselves alive (even if patients die.) This was the finding of the internal VA review done in (I think around 2009?) and it's what the IG is reporting now.

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Specializes in Vents, Telemetry, Home Care, Home infusion.

My agency provides homecare to Philadelphia, PA and Wilmington DE vets post hospitalization. Almost all have appointments to be seen in clinic within 2 weeks post hospital discharge and followup within a month for specialists. Both are managed by same area mgmt team. These VA patients hospital synopsis and medical history superior to all Philadelphia area hospitals. Sorry to hear others are not as well run.

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Specializes in Education, research, neuro.

God willing, we will find those VA's that work and those that are crooked. I hope administrators that created two sets of books get investigated by the justice department (a suggestion of Senator Blumenthal from Delaware) and if found guilty of fraud and defrauding the government (their fat bonuses)... I want to see them in orange jump suits and hand-cuffs...

Not that I'm a vindictive person or anything...

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Specializes in Dialysis.

Blue cross platinum plan in the state of Tennessee is 7,000 per year.

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Specializes in Dialysis.

Very hard to quantify what the VA spends per veteran on direct healthcare as there are 8 priority groups. The cost for each veteran per year in these groups ranges from a low of 869 dollars to a high of 21,110 dollars.

Utilization - NATIONAL CENTER FOR VETERANS ANALYSIS AND STATISTICS

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Specializes in Education, research, neuro.

I don't know. I just watched the History Channel presentation on the Chosin Reservoir. Oh, dear, dear, God. How could someone keep a set of double books, putting veterans in a holding pattern so they could get bonuses. God forgive them.

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Specializes in Critical care, tele, Medical-Surgical.

Bernie Sanders, John McCain strike VA deal

Sens. Bernie Sanders and John McCain have struck a deal on legislation to reform the Department of Veterans Affairs to expand veterans' access to health care and make it easier to fire VA officials for misconduct.

The compromise measure, announced Thursday on the Senate floor, includes pieces of three VA bills that have been introduced in the Senate.

The legislation would allow veterans to see private doctors outside the VA system if they experience long wait times or live more than 40 miles from a VA facility. And it incorporates provisions from legislation introduced in the Senate by Sen. Marco Rubio (R-Fla.) making it easier to fire VA officials...

... Similar legislation overwhelmingly passed the House last month and is included in the Sanders-McCain deal with the addition of an appellate process.

The bill also includes the construction of 26 new VA medical facilities in 18 states and uses $500 million in unobligated VA funds to hire additional VA doctors and nurses...

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The VA as a whole needs total reform. It is sad that the men and women who put their lives on the line for this country have been subjected to substandard care if they receive care at all. The VA in my experience has not put veterans first and turns a blind eye to the neglect and insubordination of their employees hired to provide care for those who have served.

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