“…an organized, nationwide system of care…” | The Fireside Post “…an organized, nationwide system of care…” | The Fireside Post
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Gary L. Clark is an author. After a thirty year career he retired to become a writer. He has written three novels, one is published He recently completed the annotation of a self-help book on faith-based self-help. Mr. Clark is the Editor of thefiresidepost.com. He lives in St. Joseph, Missouri.

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“…an organized, nationwide system of care…”

April 18th, 2016 • Related • Filed Under

Veterans AdministrationCivilized industrial nations have searched for many years for an appropriate response to public health.  Individual health care financing in the United States was somehow attached to one’s job as a part of the benefit package.  A good job came with good health insurance.  By 2008 there were fifty (50) million individuals without health insurance. Obamacare has brought that number down to thirty (30) million.  But costs and quality of care still confound us.

I am one who believes in the ‘single-payer’ model as the solution.  Our present convoluted system is so confusing that we require CPA’s to help us maneuver.  OK – maybe that is an exaggeration.  Even with Medicare we remain financially threatened so we purchase ‘supplemental’ plans’.  Those plans are confusing – but we wade into the issue driven by fear of losing our home if we fail to make the correct insurance choices.

The Veterans Administration is a federally supported health care system for veterans of the United States armed forces.  The following article was posted recently on the website of Psychiatric Services:

Articles

The Quality of Medication Treatment for Mental Disorders in the Department of Veterans Affairs and in Private-Sector Plans

Katherine E. Watkins, M.D., M.S.H.S., Brad Smith, Ph.D., Ayse Akincigil, Ph.D., Melony E. Sorbero, Ph.D., Susan Paddock, Ph.D., Abigail Woodroffe, Ph.D., Cecilia Huang, Ph.D., Stephen Crystal, Ph.D., Harold Alan Pincus, M.D.
Received: November 24, 2014
Accepted: July 01, 2015
http://dx.doi.org/10.1176/appi.ps.201400537
Abstract
Objective:
The quality of mental health care provided by the U.S. Department of Veterans Affairs (VA) was compared with care provided to a comparable population treated in the private sector.
Methods:
Two cohorts of individuals with mental disorders (schizophrenia, bipolar disorder, posttraumatic stress disorder, major depression, and substance use disorders) were created with VA administrative data (N=836,519) and MarketScan data (N=545,484). The authors computed VA and MarketScan national means for seven process-based quality measures related to medication evaluation and management and estimated national-level performance by age and gender.
Results:
In every case, VA performance was superior to that of the private sector by more than 30%. Compared with individuals in private plans, veterans with schizophrenia or major depression were more than twice as likely to receive appropriate initial medication treatment, and veterans with depression were more than twice as likely to receive appropriate long-term treatment.
Conclusions:
Findings demonstrate the significant advantages that accrue from an organized, nationwide system of care. The much higher performance of the VA has important clinical and policy implications.
It was in “Conclusions” that I found a couple of morsels of wisdom.  Most obvious is the conclusion that the VA outperforms the private sector.  This flies in the face of media barnstorming for a story that does not have to be true – only believable., i.e. – The VA is corrupt and incompetent.
 The second morsel was the notion of “an organized, nationwide system of care”.  This statement reinforces my notion that a single payer system would greatly benefit all Americans.  And here we have a reputable study that affirms the idea.
The idea of a single payer is not pie-in-the-sky political rambling.  There are many studies that affirm this notion.  So what is the problem?  The problem is that people are afraid – scared to change – fearful of centralized responsibility and authority in any matter.
We must move past our fears and look honestly at the facts.  We cannot make wise decisions based on fear – or any other emotional response to world events.  Psychologists have been preaching this for years:  Think, feel, act is preferable to Feel, act, think.  
 Let us pay attention to the facts for therein lies the truth.

There Are 3 Responses So Far. »

  1. Comment by Nancy Belle on 18 April 2016:

    I had a friend,who was first a fellow employee and next my employer and my friend as well. A Vietnam veteran, he used and trusted the VA health system. He was totally health conscious, exorcised daily, did not smoke and made a great effort to make healthy choices in what he ate. A few years ago he was diagnosed as Type 2 Diabetic. This in complete opposition to his lifestyle. He accepted the diagnosis and diligently added the necessary regimens to his daily rituals. He became increasingly weaker and weaker and experienced stomach and back pains that he could not explain. Once again he used the VA for help. Several weeks ensued before he could get in to see the doctor(s). When he was finally seen, tests and ultrasounds, x-rays etc. were performed and a new diagnosis of stage 4 Pancreatic Cancer was given. There was barely enough time to gather the family together. A son in Korea, a daughter in Missouri, another daughter in California and a sister in Illinois. I myself learned of the fact he was dying and in hospice less than one week, before he died. He was in the process of renewing and expanding his business of twenty years, with hopes of bettering his life and those of his employees and family. Maybe an earlier diagnosis wouldn’t of helped, but somehow I doubt it. Too many similar events with too many of our veterans speaks of how inept, at the least, the VA took care them. The very fact that he fought in Vietnam was a indicator of cancer as a possibility and steps to rule it out should have been considered immediately. I pray that the VA is now going down the correct road to help our Men who have served. To ignore that they were not caring about them, for a long spell, would be another mistake by all of us.

  2. Comment by Gary Clark on 18 April 2016:

    The article reference a study compared the VA to private health – and the VA scored better than the private. Nancy – I get that some people have had different experiences – there are plenty of anecdotal stories both for and against the VA.

    My father, who had a purple heart, received excellent care from the VA. My son is the Public Affairs Officer for the VA hospital in Iowa City, Iowa. The following is from an email response to this post from one of my admirers:

    “If you hate the government taking care of our Veterans, You are going to really hate the privatization of the government taking care of our Veterans. Because that is exactly what would happen. You are not privatizing Veteran benefits. Special interests (the Koch Brothers) want the money from the health care that Veterans receive, even though everyone who knows anything knows that would ruin the care that Veterans receive. Interestingly enough, we aren’t talking about privatizing the GI Bill, or VA Home Loans, or the National Cemetery Administration, or disability benefits, or widower and orphan care, or Homeless outreach, or any of the other major initiatives that pay the Veterans what they have earned by agreeing to die for our country. Nope, just the MRI’s and the Cat scans. That is where the money is.”

  3. Comment by Nancy Belle on 20 April 2016:

    I personally would prefer the inadequate practices of the VA be addressed, and those corrupt individuals that have caused them, brought to justice, than to see the VA removed and privatized. We the people and the government these men and women served, owe a debt of care and allegiance to everyone of them.