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News Health Care

  1. Oct 4, 2010 #1
    I just got back from one of my appointments at the VA.

    For all of the bad people say about the VA, it is actually a great system and it illustrates how dysfunctional our health care system has become.

    First, the VA is the most scrutinized government agency and they take their lumps when they deserve them. But consider how little we scrutinize private health care providers. People cite the number of actions against the VA, yet they are public record, but the private system never has to disclose the mistakes and the lawsuit settlements. Their is a huge incentive in never admitting mistakes in the private system.

    Next, the care at the VA is cost effective and overall very good. Yeah there are some odd rules, but considering they treat people who have the highest rate of chronic illness, they do an outstanding job. And the fact that they are all connected, they have a large experience base with what treatments are effective, and which are a waste. Also every doctor or nurse knows exactly what medical issues I have and my history.

    While money and budgets are a factor, it is not something that each person considers when examining the patient. They tell me which tests I should have, and which treatments are available. And they will even say which ones the VA just doesn't like doing due to cost. But also most VA hospitals are connected with major medical research and teaching hospitals. I see specialists at University of PA and Thomas Jefferson Hosp. It is the benefit of all the federal funding they receive.

    I have serious chronic medical issues, and I have been through the mill with the private system. And trust me it sucks. Doctors and health care providers treat insurance cards, and when you have chronic problems our system fails.

    Is the VA system perfect, nope. But it is amazing how good care can be when you remove the profit incentive. And the first concern of the medical professionals is my health.

    The other benefit is that everyone at the VA I deal with knows me. Last time I had an appointment they picked up that I was not my normal self and I didn't realize how bad I was, but they did.

    I know the VA is a popular target for everyone, and it used to really bite, but I will take the irritating parts of it because it is far superior to our private system.
  2. jcsd
  3. Oct 4, 2010 #2


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    Now if I simply say, no, trust me, the private system is far superior, where does that get us?
  4. Oct 4, 2010 #3
    Lol. Well I doubt a coin toss will solve it, so I guess there is no point in arguing.
  5. Oct 4, 2010 #4
    LOL, the worst medical experience I ever had was in a military hospital. They almost killed me. They had to send me out to a real hospital to fix their botched surgery. But, a single individuals experience doesn't speak for an entire system whether private, military, or public.
  6. Oct 4, 2010 #5
    Military hospitals are horrible. I always thought is was funny that the pharmacy filled prescriptions by rank.
  7. Oct 4, 2010 #6


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    I'm guessing Drankin means a VA hospital. In what way do you distinguish between 'military' and VA hospitals? Active duty only versus veterans only?

    BTW, had you heard about the Walter Reed scandal broken by the WaPo in 2007 at the height of the Iraq war?

    http://en.wikipedia.org/wiki/Walter_Reed_Army_Medical_Center_neglect_scandal" [Broken]l
    SecDef Gates essentially fired two General Officers and the Sec. of the Army over the issues at WR (I am happy to know.)
    Last edited by a moderator: May 5, 2017
  8. Oct 4, 2010 #7
    Nope, I meant a military hospital. And, yes, I know they are different hospitals entirely. The vets get better medical than our active duty folks in my experience.
  9. Oct 4, 2010 #8


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    Apparently. I was looking for examples of each. For instance, Walter Reed takes both Vets and active duty, so what would its classification be?
  10. Oct 4, 2010 #9
    The profit incentive works fine with healthcare provided you have a free market. While we have a private sector for healthcare in America, there is so much government interference with it, that I wouldn't exactly call it free-market.

    And the two single-payer systems that we already have, Medicare and Medicaid, are unsustainable and part of the reason for the rising costs in the private sector of healthcare.

    Free-market healthcare doesn't mean unregulated. I wouldn't want a nationalized automotive industry, but automobiles, although free-market, are heavily regulated. I wouldn't want a nationalized building construction industry, but building construction, although free-market, is again very regulated.

    Nationalized agriculture doesn't work. We do not need nationalized homeowner's insurance or nationalized automotive insurance. I do not see why we need nationalized healthcare or nationalized health insurance. They should all be free-market, and regulated as required.
  11. Oct 4, 2010 #10


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    Agreed, in detail, with every paragraph.
  12. Oct 4, 2010 #11
    This statement is entirely nonsensical. You imagine that the VA is not concerned with maximizing its annual budget (or that this is somehow distinguishable from a "profit incentive")? Or that VA doctors are more concerned with your welfare than their own and their families, eg the size of their paychecks? Inane.

    Anecdotal "I had a great time" stories such as this are only useful for telling us about you, not for telling us about the VA.

    Anecdotally, I can tell you that my own experience with the private system as an insured individual, a privately insured employee, and a state employee has always been top notch. Does my story have more or less weight than your own, and which tells us more about the states of the two systems? It would be futile to try and draw any conclusions.
  13. Oct 4, 2010 #12
    Medicaid is just a worthless program. And Medicare is the golden cash cow of the medical system. The problem is access to care. I live in an area with a high percentage of retired, and doctors only want medicare. They screen all patients and they only have availability for medicare patients.

    I am not sure what you mean by government interference.. Doctors and can pick and choose patients, and that forces a large segment to use emergency rooms for primary care. Doctors can choose to relocate to population centers that are more profitable than others.

    Doctors don't have to treat any patient. And they can overtreat those who have great insurance, and endlessly treat those with medicare ( with zero oversight ). Heck my neighbor's mother goes to the doctor everyday. Her doctor charged medicare for 7 office visits for a single flu shot.
  14. Oct 4, 2010 #13

    Ivan Seeking

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    I did a quick check and spotted this.


    A quick check of published papers
  15. Oct 4, 2010 #14
    Walter Reed is a military hospital. But not sure what point you are trying to make.

    See here is the problem with the private medical system, there is no oversight and the industry does not police itself. Problems just compound, unlike the federal facilities where every problem makes national news.

    here is a doctor in Delaware. Other doctors heard complaints and none of his buddies reported him. He molested hundreds of patients. in other words pretty much most of his patients.

    http://attorneygeneral.delaware.gov/family/childviolence/earlbradleypr.shtml [Broken]
    Last edited by a moderator: May 5, 2017
  16. Oct 4, 2010 #15
    Not taxing employer-provided health insurance which causes distortions, not allowing people to purchase health insurance across state lines, mandates from various state governments on what health insurance companies must cover, etc...there are other aspects I am not thinking of right now.
  17. Oct 4, 2010 #16

    Char. Limit

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    I think this is the first time I've ever heard someone complain about something NOT being taxed.

    Yep. Completely agree.

    Yep. Completely disagree.
  18. Oct 4, 2010 #17
    Just did a little Googling, here is what seems like a very interesting article on the subject:

    http://www.washingtonmonthly.com/features/2005/0501.longman.html [Broken]

    According to this article, many are skeptical of government healthcare for the exact reasons that I cited, basically, that the free-market works far better and more efficiently than government in almost everything else. It says that healthcare can be an exception though.

    If we look at the thus far success of the Bush Medicare Prescription Drug program and the measures taken by Dr. Kizer, it seems if certain free-market principles are incorporated into government healthcare programs, they can work.

    For example, one criticism of government programs is that there is little incentive for government employees to provide quality service because it is almost impossible to fire them. But a government program in which they can be fired (like doctors) if they are bad, this could improve things a lot.

    What would be very interesting would be to compare the British National Health Service to the VA system and see what differences there are between the two (b/c from my understanding, the British system has some major problems).
    Last edited by a moderator: May 5, 2017
  19. Oct 4, 2010 #18
    Not taxing employer-provided health insurance is why most health insurance in America is provided by employers, which makes it where if a person loses their job, they lose their health insurance. It also bankrupts businesses (like GM).


    I don't know of any specific studies on this, but I know each state provides different levels of mandates on health insurance companies, so I wouldn't find it surprising if this affects healthcare costs.
  20. Oct 4, 2010 #19


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    It also makes manufacturing more expensive in America than in other countries.
  21. Oct 4, 2010 #20
    The Medicare Prescription program is not a success.

    The private system has more layers of waste and beauracracy then the VA. Just because the consumer does not always see it, does not mean it is not there. If you get taken to an emergency room you will have bills coming from doctors, the hospital, and labs. And it really gets irritating when you find out one of the doctors does not accept your insurance, or is not in-network.

    Insurance companies and doctors have created a system where they can pick and choose who they treat and who they cover. If they were really regulated they would not be allowed to drop people when they become chronically ill.

    You even concede that forcing them to provide coverage is one of the obstacles. Well that is the problem. People get sick, and they buy insurance to cover them. That is why the insurance companies are in the business. Letting them decided after the fact, what they will and will not cover is the problem with our system.

    We have medicare because insurance companies said it would cost too much to cover the aging.. yeah sick people. So you can't blame medicare, when it is the result of profit driven care.

    Remember when HMO's were so great, until people kept getting screwed by the not in-network clauses. People would be transferred during emergencies to other facilities and HMO would not cover them because the hospital was not in-network.

    I understand why people think we have a great system, because they are not chronically ill.
    People think all of those benefits you get from work are great, because they do not use them. Long term disability does not last forever, and you will quickly lose health insurance and become uninsurable if you are chronically ill.

    I have been through it. The best care I ever got from our private health care system was when I had the money to pay cash. Because doctors didn't order all kinds of worthless tests or endless followups.

    I have been dropped by more insurance companies than I care to count.

    The VA is not perfect, and 20 years ago it sucked. But private doctors don't hire qualified people. You can go to school for 6 months and be qualified to be an aide. Most hospitals don't have an army of RN's.

    The difference is that at the VA patients have rights, and there is a way to actually complain and get results. Try that with your doctor or local hospital. Plus my medical records are private. In the private world everyone who is involved with billing can see your records, even the HR department at your work. Drug company reps get access to presciption records, has nothing to do with care, just sales.
    Last edited by a moderator: May 5, 2017
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