VA Aim is to Privatize Health Care

[Richard1954]

I saw my primary care doctor today at Temple Texas  Medical Center... .the nurse got into a conversation with me and my wife about the direction VA Health care appears to be taking.. In her opinion, based on all she has seen and talking to her Union.. VA seems to be setting itself up to go private... She said this has been in the works for some time.... and is based on cost and savings analysis .. Guess we have to wait and see.

[GBArmy]

No question; it will be somehow partially or completely absorbed into Medicare. When the Vietnam -era veterans die off, say in 15-20 years, the fewer numbers of veterans will make it easier for the politicians to "save" money. The voting block of veterans will be under 1%, so they will eliminate veteran benefits. It's the easiest prediction a person can make. No brainer. They then have "more" money to buy votes with giveaways. They will then reinstate the draft, because fewer people will volunteer because they see how veterans are treated.

[Buck52]

Well I hope it don't happen in my life time  taking away our benefits would destroy 90% of the 1% of veterans that get benefits and keep their families  sheltered, clothed and fead,

 My VA  Check and wifes SS Check is all we got coming in and I imagine it is like that for most of  our nation's Veterans. that are past 65   even 55

now some choose to live outside the US  Like the Philippines and Malaysia  even Vietnam...they can live like Kings in those countries  but without their benefits coming in that would stop .

if they make the VA Private and we can choose the private Dr's for what ever reason and anywhere we choose maybe it could be a good thing?

[GBArmy]

Buck the big problem with that is civilian medical people won't have the time or inclination to "learn" about the problems we have, especially associated or "secondary" issues. For example, say Vietnam veteran; he has diabetes. Is the doc going to be on the lookout for other presumptives not only associated with that disease, like neuropathy, but other A.O. issues not related like heart issues or cancers? It's the same problem with Gilf War syndrome and Burn Pit diseases. It is too high a hill for many docs to climb. Too much work to put in for too few of a customer base. Too much of a learning curve. IMO the VA Medical side is way ahead of the civilian side in this area. Especially in the diagnosis and initial care. Maybe follow-up treatment is often lacking, but they are more likely to discover other issues up front. Of course I am only talking about the Health side, not benefits. That is a different cat all together. If they eliminate VA health care, they will be throwing out the baby with the bath water. Again, IMO.

[paulstrgn]

I don't think we need to worry about the compensation part for a while, at least not until SS goes belly up.

I do worry about VA health care becoming privatized, I can see them performing unnecessary test and procedures to be able to bill the government more.

[broncovet]

Im unconcerned about them privatizing VA.  We need to ask:

Is VA health care better or private care?

In many/most cases private care is better.  Do you see presidents, senators, billionaires, movie stars, etc., who often have an unlimited supply of money, waiting in line to see our VA doc?  Never.  They can afford the best care and its never VA care.    Its been that way for a very long time.  

Do you see VAMC's ranked with the Cleveland Clinic and other top hospitals?  No.  

The question is, "Why".  That is, why is VA medical care inferior?   I know the reason.  We learned it in Economics, back in the 70's.  Its called "economies of scale".    Its like trying to put out a million acre forest fire, or trying to stop a Tsunami.  They dont stop until they "burn themselves out".    The question is not "if" VA will "burn down", the question is When it will burn down.  Some say its already on fire.    Va is so large we cant even see the flames.  I can not see a forest fire in California , either, for the same reason, I cant see a "fire" in one or more VAMC's.    

Here is how it works and why VA care is inferior.  

A very tiny "mom and Pop" company can not operate efficiently (even tho its very efficient in some ways).  Why?  Well does "Mom" have an accounting degree?  Nope.  Does Dad understand how the electronics in his computer works for the delivery van?  Nope.  They were not trained in these things.  They are very specialized and you have to go to school to learn these things, and more.  And, nobody can learn them all.  So we specialize.  

When a firm becomes larger, and more efficient, they hire accountants, marketing (sales) speciailsts, media gurus, computer gurus, people who write and program "apps" for  the phone, etc. etc.  And the company grows and becomes more efficient learning to do things faster, better, more efficiently up to "about" 500 to 1000 employees.  However, when a company "gets too big" the efficiency drops.  The owner or manager cant "know" each of 12,000 employees.  People go to work for the company with ulterior motives, often to steal from their employer.  They steal time, money, products.  This gets worse with larger and larger companies, and their productivity, falls off as they continue to grow.  

    Example:  Medicare.  Its a nightmare.  Thousands of employees.  Billions of dollars stolen.  Graft, Nepotism.  Same way with VA.  No matter whose economic model you use, the federal government is always inefficient, and down right corrupt as is both VA and medicare.  

    However, in a medical office with 12 doctors and 15 nurses, 25 medical assistants, 1 accounting and billing office, a great manager can make this company run very well and very efficient.  Someone is in charge of calling clients to remind them of their appointment, or to come in early for medical tests.  Someone is in charge of billing, to make sure the doctors office gets paid.  Someone is in charge of keeping the office clean.  If there is a letdown in any of these areas, the manager or owner notices right away, and fires that employee, or otherwise fixes the problem quickly.  

     I dont think medicare or VA care can be fixed, because of economies of scale.   Its like changing the wind's direction.  Its too large.  VA has a powerful union, and bad employees are moved, mostly, and not fired.  Bad management, time after time, is moved from one VAMC to another.  The problems dont go away, they get worse.  Both the VA and medicare are "too large" to be fixed.  

     With our government we (try) to fix that problem with have state and city governments not in charge of zillions of people, but instead far less.  But then STATE city, federal, county governments cant seem to agree on who does what.  Marijuana is legal in Colorado, illegal in the federal government and VA.  That is a good example.  Why cant a Veteran, who gets marijuana legally  in Colorado to ease his pain, do the same in Virginia?   Are opiods a good alternative?    No.  They caused the opiod crisis.    The federal government cant even manage correctly ONE aspect of medical care, pain, let alone all of it.  Its politically charged and crippled by an inefficient and inept congress and government, unable to manage millions of people.  

Edited December 4, 2019 by broncovet