VA is the model for primary health care


By tovarichpeter   Follow   Sun, 2 Dec 2012, 10:36am   635 views   12 comments
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http://www.washingtonpost.com/opinions/in-the-va-system-the-future-of-primary-health-care/2012/11/30/c10d5cf0-3b2e-11e2-8a97-363b0f9a0ab3_story.html?hpid=z3

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  1. APOCALYPSEFUCKisShostikovitch


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    1   7:47pm Sun 2 Dec 2012   Share   Quote   Permalink   Like (3)   Dislike  

    This is insane. Any zoo in Somalia is better run than any VA hospital.

  2. bg


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    2   10:11pm Sun 2 Dec 2012   Share   Quote   Permalink   Like   Dislike   Protected  

    AF, I love your ability to see the glass half full of rotten zombie flesh on any given topic, but you have got this wrong. VA does a fantastic job of primary care. It is very well coordinated and inexpensive. The medical records and coordination of care are second to none. It really if a great model for caring for Veterans.

  3. Ceffer


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    3   11:08pm Sun 2 Dec 2012   Share   Quote   Permalink   Like   Dislike  

    I believe that the NHS in Britain began as pilot programs that expanded their veteran's hospitals to extended subscriptions. It has been suggested by some that the VA was a possible starting point for nationalized health here as well.

    Don't know if that is the way Obamacare "works", though.

  4. APOCALYPSEFUCKisShostikovitch


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    4   11:38pm Sun 2 Dec 2012   Share   Quote   Permalink   Like (2)   Dislike  

    Obamacare has one objective: make sure the insurers are able to rape every American to his last dime, the one that the fucking banksters weren't able to tear out of his flesh for the privilege of living indoors.

  5. michaelsch


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    5   11:16am Mon 3 Dec 2012   Share   Quote   Permalink   Like (1)   Dislike  

    Ceffer says

    Don't know if that is the way Obamacare "works", though.

    Obamacare is not about patient care. It cares for insurance and for insurers not for health care. As far as I know the only way it works at this phase is the following: It gives certain insurers free loans in exchange for their compliance with various regulations.

  6. demax


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    6   6:17pm Tue 4 Dec 2012   Share   Quote   Permalink   Like   Dislike  

    VA can negotiate with Big Pharma over drug prices and formulary management.

  7. elliemae


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    7   10:45pm Tue 4 Dec 2012   Share   Quote   Permalink   Like   Dislike   Protected  

    Once you're in the system, you are subject to waits and the red tape that exists in all medical systems. The VA is neither better nor worse at medical care.

    Getting signed up is a nightmare, it can take weeks or months, during which the hopeful enrollee must jump through many hoops, fill out shitloads of paperwork and travel to several VA clinics before they achieve success.

    There's a VA program called Aid & Attendance - for more info check out www.veteranaid.org. It's an awesome program, pays up to $1,700/month for veterans and $1,100 to their dependent spouses or widows if they require assistance with activities of daily living. There are income & asset limits - but the money is vital for lower-income vets who need to hire caregivers and pay for supplies.

    A&A takes at least a year to get. It used to be a few months, but the system is so fucked up that it's now over a year. People are often forced to go into nursing homes because they can't afford in-home care, which drains the Medicaid system more than the $ that would have been paid out.

    This delay isn't a new thing - it's gradually gotten worse over the years. This benefit has taken over a year since at least 2007.

  8. bg


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    8   11:09pm Tue 4 Dec 2012   Share   Quote   Permalink   Like   Dislike   Protected  

    elliemae says

    Getting signed up is a nightmare, it can take weeks or months, during which the hopeful enrollee must jump through many hoops, fill out shitloads of paperwork and travel to several VA clinics before they achieve success.

    Message me back channel if you need help registering. I literally get Vets registered routinely in less than 24 hours if they have discharge papers. Sometimes in 1-3 days if they don't, depending on what records are available for them. If someone doesn't have any record of being in the military, I have seen it take as long as 3 weeks. That is more about the branch of service than the VA, though. If the person (Vet or not) is having a medical emergency, they can be cared for without that paper work.

    VA has access performance measures that bench mark access to services against private hospitals. When you compare VA to public sector, VA often scores more highly. It very well may have been the case that it was hard to get into VA in the past. In my experience working in VA hospitals, this is no longer the case.

    I have gotten complaints that a Vet hasn't been able to get help from VA. In the most recent example of that, the person had been kicked out of basic training due to drinking. That person was right. was right. The VA wasn't going to help them get into a program. That one wasn't a Vet.

    I hadn't heard of that program. I will look into it for the Vets I work with.

  9. elliemae


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    9   11:56pm Tue 4 Dec 2012   Share   Quote   Permalink   Like   Dislike   Protected  

    In Vegas and parts of Utah, the signing on part takes weeks to months. As I said, the system isn't perfect, and it's damn hard to navigate if you are in need of medical care (hurting, suffering, etc) and are forced to travel all over using public transportation. If there is none (Utah rural areas), it's not the VA's problem.

    A year for assistance paying for a minimal amount of in-home care - or help paying for assisted living? It's friggin' criminal.

  10. jeffgrossman


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    10   6:35am Mon 8 Apr 2013   Share   Quote   Permalink   Like (1)   Dislike  

    I use to work at a VA emergency room. 75% of the patients I saw were there because their primary care phycian could not give them an appointment for 3 weeks, never mind the 6 month wait to get assigned a primary care physician. The vast majority of patients were on >10 medications just becuase it was easier to prescribe a pill rather than go through all medications and see what was really necessary.

  11. elliemae


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    11   12:29pm Sat 4 May 2013   Share   Quote   Permalink   Like   Dislike   Protected  

    I have a VA patient who requires a visit for mental health issues. It's not an acute issue - meaning no hospitalization required - but merely a visit to renew his medications.

    The meds that he's been taking for years take 3-6 weeks to attain their efficacy, and any lapses in treatment can cause huge problems for the patients. These meds have been prescribed by the VA for years.

    But the guy made a mistake of moving to a new area. He duly registered his change of address with the VA and was assigned a primary MD, who will review & renew prescriptions. He will also be referred to a psychiatrist for those medications considered to be psychotropics.

    The appointment I made for him yesterday for his new primary MD is at the beginning of the month of August. This is the first available apt, btw. And they won't make the MH appointment until he sees his primary, meaning another 3 month wait (at least). Depending upon the new Primary and the rules at the time of his visit, my patient might not be able to have his psychotropic meds renewed at that time.

    In other words, my patient - who has been diagnosed with PTSD and Depression - may be without his medications for 3-6 months. I know the system, I work in it. So don't tell me that the VA is an excellent model.

    At this point, there are long waits for appointments and red tape to become registered. If it's easy, no problem. But if there's a problem, the Vet suffers.

    Please don't try to tell me that the VA is the model for primary healthcare. If you're a depressed individual who served your country, it's easier to self medicate with drugs & alcohol rather than to attempt to maneuver through the system. Perhaps once you're in the room the service will be excellent and the model for US healthcare.

    But getting in the door is a problem, and it's only getting worse.

  12. Meccos


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    12   2:39pm Sat 4 May 2013   Share   Quote   Permalink   Like   Dislike  

    Having worked in the VA system... I would only recommend going to the VA only if you didnt care about your health...

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