Is VA medical care better or worse than private health care? Actual review/comparison

[broncovet]

   I just had Robotic hernia surgery (community care, that is private care paid for by VA, as my VA does not offer Robotic surgery).  

Here is how this went:  

    The robotic surgery was necessary because my first TWO hernia surgeries at VA failed.  My wife, a retired RN, indicated that its not unusual for hernia surgeries to fail.  Sometimes the repaired hernia can be re injured from lifting too much weight, for example, but that is not the only reason hernia surgeries have to be redone.    Its my opinion that the VA doc actually did a good job, considering they had to rush me through it.  But Veterans deserve the best, not substandard overburdened health care.  I got a great result form the private care hernia surgery. 

   VA always says "they need more money (from congress) to fix the problem."   However, its been shown time after time, that more money does not fix the problem.  After getting more money, VA mis management manages to squander the extra funds, with little/no, actual health care improvement.  Sometimes its actaully worse, when VA gets more money because they come up with a plan to spend the money, much of which often winds up in pockets of politically well connected contractors and overbloated VA (mis management) employees.  Its the same way with VA benefits, VA launches "program after program" to reduce wait times, and the wait times are worse than they were in 2002 when I first applied.  They always have a fancy name for the new program, such as Pact ACT or, what was the last one that failed?  

   Interestingly, I got to compare "VA health care (surgery)" and private surgery, because I had both.  Its my opinion, while VA did a good job, it was not near as good as private care. 

   I felt "herded into surgery like cattle" at the VA health care.  Similar to non surgery, Veterans get a very limited time with the doc, its "hurry hurry, hurry, done, next" pretty much like when we were in the military.  Not so with private care.  They took the time to thoroughly answer questions "because they could" and were not required to rush me through it".  

   This is my educated guess as to WHY.  The VA is, frankly corrupt.  Its a huge, huge organization, mostly managed by the VASEC which is a manager who rarely has serious experience managing this large of a hospital/benefits, but rather is a politically well connected appointment not based on management or medical skill Set, like in private practice.  There are just too many of these job appointments in VA management that are basically jobs  as "favors" for getting someone elected as opposed to hiring someone with a skill set of serious medical management, in many levels of VA managment.  

     Case in point:  I have a friend who is a psychiatrist.  He applied at my local VA AND my local VA was hiring doctors.  They needed him.  IT took VA 3 years to decide whether or not to hire him, so he gave up.  So, he is in private practice, basically because of VA mismanagement and red tape.  He is working in private practice.  Many/most people dont want to wait 3 years to get a job which pays "less" than private practice!  

     VA has some very good employees often who do their very best in a very badly managed system.   But, like many mismanaged companies, they dont turn out a good product.  In the private world, mismanaged companies do what mismanaged companies do: They fail.  However, with VA mis management is rewarded with more money from congress.  

Edited June 11 by broncovet

[relatively happy camper]

I prefer community care.  I won't comment on the benefits section of the VA other than to say it's even worse!!!

[Vync]

I agree! Here's a brief overview of my experience involving getting lumbar epidural pain injections for almost 20 years.

Private care: Exam, MRI, Cardiology release, and procedure took about three days total.

VA care: Primary Care exam, Pain Clinic exam, MRI, Cardiology release, and procedure took about 9 weeks total.

Community Care: Entire process took about 14 weeks from request to procedure due to repeated denials, red tape, plus the usual visits.

 

Private care is very efficient and effective. They can be legally held responsible.

VA care often uses student docs trying to get experience, but they cannot be legally held responsible. Too much red tape overhead and unnecessary barriers created by higher ups.

 

Keep in mind that veterans and dependents who have TriCare, or dependents who use CHAMPVA can go to a provider, show their card, and get care when and where they need it, just like as if they had private insurance. Vets who have VA care, the ones who actually served, but did not retire, do not have this luxury unless they happen to have private insurance and pay out of their pocket.

I have friends and relatives who work for the VA. They do so because they care about trying to improve the treatment provided to our veterans. Many of them have also had extremely long waits between applying and being interviewed for job openings.

[Tbird]

Since I started receiving care in the community it has improved my health. Example for over 20 years the VA has told me I have IBS and just need to live with it. Community Doctor said its not IBS it’s microscopic colitis he put me on meds and haven’t had a stomach attack. This is after daily attacks and two to three severe attacks a week. 

Community care gave me cataract surgery, so I can see.

Community care fixed a deviated septum, so I can breathe.

Community care prescribed power chair and the VA is providing it for me.

Its been fantastic for me.

[broncovet]

Its rather incredible to me.  Remember, VA docs may quit VA go into private practice, and, private practice docs may quit their practice and go to work for the VA so its even possible to get THE SAME DOCTOR at both private practice and one that works at VA.  THERE are many doctors who are contractors for the VA, and they may ALSO have their own practice.  

The difference is often NOT the doctor, but rather the onerous rules from VA which often compromises the health care for Veterans, that private practice Docs  dont have to follow.  

     Its easy to assume "the VA has my back" and, indeed, sometimes that happens.  At other times, however, "assuming VA knows both what they are doing, and that they give Veteans uncompromised care" is just not the case.  

    The VA care at VAMC in xyz city, is almost certainly not the same as the VA care in ABC city, and you could well get vastly different results. 

     When I make decisions on my health care, I try to "take out" whether or not they are VA or non VA, but rather if I really think that doctor prioritizes my health and is skilled enough to do it right.  It is highly possible that in some circumstances VA health care is your best choice in your city.  If your VA is ran well, and there are few if any private docs in your area, then VA may be best for you. 

    However, if everything else is equal, I would always go for private practice care, just because private care docs do not have to comply with VA's onerous rules. 

     EXAMPLE: 

      VA docs must order medications "on the VA formulary list" regardless of whether or not the one on the VA's list is the best med for the Veteran.  That is just wrong to compromise a Veterans health because the medication the VEteran needs is NOT on the VA's approved formulary list.    

Edited June 24 by broncovet

[Lemuel]

Community care from the VA is better than Medicare advantage or CHAMPVA. VA picks up the co-pay through community care.  The CHAMPVA and MEDICARE Advantage stiff the co-pay so you cannot get specialty care.  CHAMPVA killed my wife with delay finding a neurologist and a cardiologist reduced her seizure medication without consulting the neurologist.  Result -- status epilepticus and death 3 days after the reduction.

If you have a MEDICARE Advantage plan including CHAMPVA, my advice is to ignore the CHAMPVA card if you need a specialist.  Tell your PC to ignore it and pay the co-pay for specialty care.

Edited June 24 by Lemuel

[Lemuel]

Here is an article on the why.  If it is like this in Denver-Cheyenne it is probably like that elsewhere.  Probably from political interference.  Leaders at the VA Eastern Colorado Health Care System in Aurora Created An Environment That Undermined the Culture of Safety | Department of Veterans Affairs OIG (vaoig.gov)