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home : opinion : opinion May 24, 2016

5/29/2014 10:42:00 AM
A glimpse at government run health care
Bill Forhan

Whenever I criticize Obama Care one of my progressive critics always likes to remind me that he and I were once covered by socialized medicine. His point is that we were both in the military and during that time the military provided for our health care and that care was just wonderful. I will admit that while on active duty it made sense that the military had its own medical care system. A system that was capable of moving to whatever area of the globe where the military was currently engaged. And as long as our dependents were located on a military base their care was never a concern. But, move them away from that base, and the care became much less reliable or convenient.
Now comes the scandal about problems with the Veterans Administration's program to care for those that have risked so much for us. For those of us who know someone that has tried to access care through the VA, it is not surprising.
Officially, President Herbert Hoover created the Veterans Administration in 1930 in order to consolidate veterans' services although programs to care for our military go back as far as 1636 according to the VA's website. Since 1930 the VA health care system has grown from 54 hospitals to 152 hospitals, 800 community based outpatient clinics, 126 nursing home care units and 35 domiciliaries (institutional homes for the disabled and homeless).
In 2009, President Obama appointed Secretary Eric k. Shinseki to lead a massive transformation of the VA into a high-performing 21st century organization that can better serve veterans. Under the leadership of Secretary Shinseki, the VA adopted three guiding principles to govern the changes, namely being people-centric, results-driven, and forward-looking. These principles are reflected in the 16 major initiatives that serve as a platform from which transformation is being executed. The 16 major initiatives are: Eliminating veteran homelessness; Enabling 21st century benefits delivery and services; Automating GI Bill benefits; Creating Virtual Lifetime Electronic Record; Improving Veterans' mental health; Building Veterans Relationship Management capability to enable convenient, seamless interactions; Designing a Veteran-centric health care model to help Veterans navigate the health care delivery system and receive coordinated care; Enhancing the Veteran experience and access to health care; Ensuring preparedness to meet emergent national needs; Developing capabilities and enabling systems to drive performance and outcomes; Establishing strong VA management infrastructure and integrated operating model; Transforming human capital management; Performing research and development to enhance the long-term health and well-being of Veterans; Optimizing the utilization of VA's Capital portfolio by implementing and executing the Strategic Capital Investment Planning (SCIP) process; Improving the quality of health care while reducing cost; Transforming health care delivery through health informatics.
The problem here is all of these initiatives are about the agency. Few of them address the question of whether the VA is the best way to provide the services our veterans need. For example, consider the initiative that says, "Enhancing the Veteran experience and access to health care." The initiative should not be to "Enhance" the veteran's experience. The initiative should be, "To improve veterans' access to health care."
I have long said that the best thing for veterans is to get the VA out of the medical provider business. After their service is over veterans disperse all over the country. Mostly back to their home communities, most of which do not have VA medical facilities. Vets are then forced to find the "nearest facility" that can provide VA care. That is not always convenient and, as with all medical issues, getting timely service is often critical.
The real solution is to privatize VA medical care. Establish a program that allows veterans to get access to needed health care at any local medical facility. The VA should simply become another agency that provides payment for the care that veterans cannot or should not have to provide for themselves.
In his response to the latest scandal President Obama said the wars in Iraq and Afghanistan have shown that "we have to work even harder as a nation to make sure all our veterans get the benefits and opportunities they've earned...They've done their duty, and they ask nothing more than that this country does ours - now and for decades to come."
The problem with VA medical care has finally reached critical mass. It is imploding because it is about preserving a government agency, not about meeting the needs of the constituents it is charged with serving. It is time to end the current system and privatize the service.
And by the way, anyone still wondering about the impact of Obamacare, need look no further than the VA to see the in-effectiveness of government run health care.

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