What the… Sack of Peanuts?

I’ve been in Los Angeles for the past 30 hours and just got the kids to bed. I was checking in on my feeds and saw this article on Slate with a salacious (and kind of awesome) headline (click here to read it) and whoa. Whoa. Whoa. Whoa.

Several people have left comments (including me!) about how awful the Veteran’s Administration is (for those who don’t know what the Veteran’s Administration is, it’s commonly referred to as “VA” and can be read about here. They provide healthcare to veterans. Here’s the page for VA healthcare.

Which made the Slate article kind of interesting because several groups have found that the VA provides better healthcare than the private system in the U.S. What?


From the New England Journal of Medicine, “Effect of the Transformation of the Veterans Affairs Health Care System on the Quality of Care”

From the RAND corporation: Improving Quality of Care How the VA Outpaces Other Systems in Delivering Patient Care (Link is a PDF)

From the American Public Health Association coees a study comparing VA healthcare to Medicare: Risk-Adjusted Mortality as an Indicator of Outcomes: Comparison of the Medicare Advantage Program With the Veterans’ Health Administration

From Washington Monthly: “The Best Care Anywhere”


  • Lesley

    and just got the kids to bed

    Kids, plural, feels good doesn’t it?

    You’re preaching to the converted, Jon, but it’s all appreciated.

    For your viewing enjoyment. http://tinyurl.com/qvnom5

  • aek1974

    I’ll preface this by saying I haven’t read your links. But I have experienced VA care first hand. My dad is in his 60s. Retired and uninsured. He has several pre-existing conditions that would keep him from getting standard health insurance. In Dec, he was admitted to the local VA and consequently diagnosed with congestive heart failure. He was admitted through the ER, and would remain in the hospital for 4 days shy of a month. I cannot say enough about the care he received. And he never paid a dime out of pocket – for nearly a month in the hospital – and at least 75% of his stay was in the Step Down Unit (not quite intensive care, but more closely monitored than on the regular medicine floor). Never did they try to skimp on his care because he was w/out the financial ability to pay for his care.

    My dad was just released Saturday after another 8 day stay in the VA – this time renal failure brought on by dehydration. (A stomach bug + blood pressure meds + diuretic = being admitted into ER w/ BP of 57/31 – and a message from his doc that “He’ll likely be okay IF we can just get him through tonight.”)

    I would classify the care he’s received during his 2 hospitalizations as excellent. WIth solid follow-up and maintenance care. And when I read about the failings of the VA, I often stop to wonder where things fall through the cracks. And are we really just lucky because of our location? (The VA in our town is one of the best in the region (I think it benefits from it’s connection to the local University’s Hospital and Medical School…) I definitely think that the VA and the military have made it incredibly difficult for patients to seek and obtain the necessary treatment for mental health issues (and this is such a huge issue these days…and such an overlooked issue since Vietnam). (If you haven’t already, listen to last weekend’s Bob Edward’s Weekend for an excellent piece on the VA.)

    Anyway, if this was a model for socialized medicine, I wouldn’t balk. It’s not perfect. But neither is the care I receive through my private insurance.

    I saw my mom through a terminal illness, and as if a terminal diagnosis wasn’t enough, we spent much of her illness fighting to keep her medical insurance intact. (When someone w/ a brain tumor can no longer work due to their illness, then they are no longer “employed”. Thus no longer eligible for the companies private insurance. And when that is a family owned business and my mom hasn’t been drawing a salary to try to keep the place afloat…well, that just makes it doubly difficult to prove employment.)

    I’m not sure I’ve made a salient point here – except that I know there are pockets of VA care out there there are superb. And I count my blessings to have been on that end of the experience. Without them, I would either be without my father, or bankrupt from his care.

  • brebolivar

    Loving the VA is like a religion – physicians who work at the VA think it can do no wrong. You have to admit though, they were the first to have electronic medical records, that’s one good thing.

  • http://www.oxcart.net tmsand

    Republicans don’t hate great healthcare, socialist or not. The question is not how can we get the best helthcare period. The question is how can we strike a compromise between great care and cost – because that is reality. That probably makes me a cold hard person, but band-aids don’t grow on trees.

    According to CBO testimony in 2007(http://www.cbo.gov/ftpdocs/78xx/doc7811/02-15-Veterans.pdf), the VA’s real medial spending is projected to increase 88% by 2025.

    But this is different. Even the Priority 7 patients who “suck on the teat” of the socialized medical care provided to them paid for it. Even if they never set foot outside the comforts of the US they offered to do so if needed. That’s what earned them the services they are provided with. This group is not an analogue for the rest of society.

    I would love free medical care for everyone, but I know that isn’t possible. At least the free lunch provided to Veterans is one I feel good about providing.

  • steve-o

    As someone who spent most of his life being treated at military hospitals, not that i was sick, just accident prone, I can tell you from firsthand experience, that the care given at a military hospital (read – government run) is beyond substandard.

    Are the doctors necessarily bad at what they do? No, I wouldn’t say that. What I would say though is that in all the treatments I went to them for, particularly CHRONIC ear infections (i.e, having 6-7 a year), not once did they ever send me to a specialist. As a result, I ended up growing a chlosteotoma in my ear drum (similar to cancer – left untreated it can end up with causing meningitis and death). When I saw the specialist now (I’m no longer under the military health care but my employers coverage) he said this could have been easily prevented had the right care been given. A simple ear tube.

    I’m sure there are some people like the above poster who have recieved great care from the VA, but the vast majority of military folks I talk to can say nothing good about the military system.

  • carpediem

    Republicans have done everything they can to poke holes in the existing medicare program, and overall we have not fought for the integrity of the existing social medical programs in this country, so I’m sure that there are improvements that could be made across all of the programs, including the VA. However, the VA is where our representatives in congress receive their healthcare, and I’m sure they are taking care of their own.

    Here is a letter written to Obama by a guy named Thom Hartmann, a progressive talk show host. You may have seen him occasionally on popular programs like Olberman and Maddow. He has a suggestion that eliminates the need to debate public option or no, will Democrats try to kill Grandma?, and all the other useless and time wasting arguments from people trying to undercut real healthcare reform. He says fine, eliminate the public option…go here to see what he suggests in it’s place http://www.thomhartmann.com/2009/08/16/dear-president-obama/. I think it’s pure genius.

  • http://lookthroughthelinz.blogspot.com/ lookthroughthelinz.blogspot.com/

    I’m loving the Slate article. I imagine I’ll be passing that one on to several appreciative friends.

    Now here’s a little different perspective for you – I work at the VA. Not at the hospital, at a regional office. I’m the person who decides how much money a veteran will receive for any disabilities incurred in or caused by their military service. It’s a weighty job, for sure. And one that I never thought I would have. Or love.

    Because how many raging pacifists (if there is such a thing) do you know that work at the VA? Yeah, not many. I digress.

    Each and every work day I sift through veterans’ medical records, trying to determine how their service-connected disabilities fit with how much money VA law says I can give them. Most of those medical records come from VA healthcare facilities. I’ve seen records from almost every VA facility in the country. And you know what? Even though VA healthcare is far from perfect (I swear to god some of these doctors pass out diagnoses of PTSD like candy), I can definitively tell you that the majority of the veterans receiving healthcare at a VA facility would be unlikely to be receiving the same healthcare in the private sector.

    After all, any veteran who set foot in Vietnam during that era will automatically be compensated and treated for type II diabetes or prostate cancer because of presumptive exposure to Agent Orange. Do you know how tenuous that link is? Very. And how many veterans were actually exposed to toxic amounts of Agent Orange? Very few. But we have an aging population of Vietnam vets who are likely to be diagnosed with those (among others) diseases in their lifetime anyway, and we’re taking care of them. Because we can.

    And I kind of love that a homeless veteran will be getting the same medical care as a veteran living in posh suburbia.

    My favorite argument to make to Republicans who are so terrified of universal healthcare (i.e. SOCIALISM, OH MY GOD), is that the VA is socialized medicine. I’ve gotten more than a few blank stares. Surprise, surprise.

    Are there things I would change about VA healthcare? Absolutely. But at the end of the day, people are almost always getting the care they need. And you know what? If we all had the same access to mental health services and medication as the veterans do, we’d be the better for it.

    I’d actually love to hear more of your thoughts regarding VA healthcare, etc, and would be happy to provide any information about what really goes on inside the VA to anyone who asks. {end ramble}

    My name is Lindsay. I’m a bleeding heart liberal pacifist. I work at the VA. I give away the government’s money to veterans. And I love it.

  • sadie-girl

    I was recently discharged from the Army, and I can say the VA is a mixed bag. I haven’t had any problems getting healthcare. But my dad who is a Vietnam Vet does have problems. As Lindsay stated, many Vietnam Vets have diabetes b/c of Agent Orange. Well, he has diabetes, but he isn’t getting compensated for it. Why? They claim no record of him being there. I think the problem is too many vets and not enough doctors, nurses, and admin/case workers to support people.