Monday, September 21, 2015

Is it time for the states to pick up the slack on VA medical?

I am a veteran.  I joined the Army at the ripe old age of 17 and 1 day.  I went Combat Arms, specifically, Recon Scout.  Subsequently, I served as an Infantry Weapons Instructor, As a Crew-Served Weapons Instructor Committee Chief; XO in an Army Reserve Infantry Company, Chief of an Infantry Division's AG Field Operation; a Force Modernization Officer; Oakland Army Base Chief of Administration and Command Adjutant.

They were a bunch of titles.  But at base, I was a soldier.  And when I signed up during that little tiff in SE Asia, I was promised, head to foot, free medical care for life.

Well... it hasn't exactly worked out that way.

Now, I'm means-tested and the costs of that medical care that was supposed to be free... isn't.

Lately, it's been my little finger.  Three operations; the second and third as a result of a screw up by the VA on the first (took the sutures out too soon, apparently) and that has resulted in the removal of my 2nd knuckle in that finger, with the bones now fused together, and the third operation, which is the removal of the wire put in that finger as a result of the second operation, because said wire was trying to come out through the skin.

The first operation was on me.  I smashed that finger, literally, at a local charity event operating a game for little kids.

But the second and third were not on me.  Yet, I get to pay money for those, hours in time, hours/days in pain, and a permanently bent finger... that looks like a road grader worked it over.

Not, that, at my ripe old age, the looks matter that much, but at this point I alternate between being glad SOMETHING is there where a finger should be... and the desire to have stuck to my guns so to speak and just have them cut it off.  It would have been easier... and far cheaper... to just have had it amputated.

I could have blamed it on the Yakusa or something.

My case, likely, is not all that unusual.  The wait times for these procedures are horrific.

My second operation, promised to my wife and I to take place within 60 days, actually took 6 months.  because of the improperly attached ligament in my finger, it was literally pulling itself out of it's socket, on my right hand... my writing hand.

Every time I had to write, it felt like an ice pick was being jammed into my knuckle.

The reality of all of this, then, is simple: the VA is incapable of taking care of the veteran population we have and we need to start looking elsewhere.

Yes, there is a new program called "Veteran's Choice," $18 billion of your dollars wasted... but in my case and the case of many thousands of others, that has proven to be a disaster.  Designed to enable medical care outside the VA system in cases where the wait date is 30 days out or more, getting the necessary authorization to make that happen seems not unlike winning the lottery.

Anyone looking over this blog can read about my adventures with the VC program.

So, my solution is to look at having the various states take over the medical systems and replace the VA hospitals with state ran, but federally (and state where needed) financed facilities to pick up the slack.

This is coming from a different place, so to speak; one that tells me first that the outcomes can't be any worse than what we have now and second, that state facilities where the veteran is located can be more efficient in actually treating the veteran population that continues to grow at a rapid rate as the kids we sent off to get blown up in the SW Asian theater come home and as the military downsizes in order to be able to spend more on Obamaphones.

Yes, I know that the obligation is federal and that, therefore, the fed should pay for it.

But it simply doesn't work.

Setting up another program that no one can use like Medicaid or whatever, or adding the veteran population to the medicare roles simply won't work.

Reimbursement rates for these programs are horrific and getting someone to treat you is as rare as hen's lips.

Right now, we have a choice: we can go on the snide and just keep doing what we're doing hoping for a different outcome.

Or, we can try something different.

I believe eliminating the VA system for health care and turning those facilities over to the various states is one way to go about it.

I believe that because what we're doing now is hardly what we can call "working."

I believe that some version or variation of this idea can be implemented.  I haven't nailed down the how and the why of it just yet, but I'm working on it.

Meanwhile... the debt we owe our veterans is a debt coming home to roost.  Do we quibble over waiting for the fed to get this fixed?  Or do we take it out of their hands and do it ourselves?

How that debt is paid is the question.

And it's time to start the discussion.

The fed doesn't care: they've had a decade and a half to straighten out this lunacy.  And how has that worked out for us?

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