Veterans Administration gets a new boss.

[theeedude]

Problem is its a social compact similar to social security.
The agreement is serve x years get VA, wounded in duty get VA.
Be pretty cruel to change the agreement once someone needs it.

OK, but no more of my money for it.

 

[theeedude]

The main reason is that veterans tend to be dramatically over represented when it comes to specific kinds of ailments. For example what percentage of the US population is an amputee vs. what percentage of veterans?

So what? And other professions like coal miners are over represented in black lung. It's an occupational hazard. Are we going to have a separate health system for every group with an occupational hazard?

 

[fskimospy]

So what? And other professions like coal miners are over represented in black lung. It's an occupational hazard. Are we going to have a separate health system for every group with an occupational hazard?

No, just large ones with very specific, specialized, and expensive needs.

Number of coal miners in the US: ~80,000.
Number of veterans in the US: ~22,000,000

There are more veterans diagnosed with PTSD than there are total coal miners. If you think there's a case to be made that veterans can get equivalent care (or close to it) from regular hospitals in a way that will save money I'm all for it. I haven't seen a good case for that yet.

 

[interchange]

Unfortunately, the downside to the VA's efforts to eliminate social problems and suicide is that people with motivation to get their needs met (tangible or emotional) purely through entitlement are being catered to by these policies. The veterans who most need help are likely among the 2/3 who are not in VA care. Imagine having severe internal distress due to intrusive images of your buddy being eviscerated by an IED or feelings that you are such an overwhelming failure that suicide is your only tangible solution to this distress. How easy would it be for you to waltz into a doctor's office and spill your beans about these traumas or feelings of failure in front of a stranger working for a healthcare system with a strong public perception of screwing veterans? The matter is further complicated because soldiers are generally taught to handle awful things by denial, drowning in alcohol, etc. And VA employees who spend all day catering to entitlement often find themselves too demoralized to inter-personally connect to the people that are at risk.

So I don't have a great solution. But I know that a fantasy that we can address all the needs of our veterans and prevent all veteran suicides by magically beefing up our services is not the answer.

 

[theeedude]

No, just large ones with very specific, specialized, and expensive needs.

Number of coal miners in the US: ~80,000.
Number of veterans in the US: ~22,000,000

There are more veterans diagnosed with PTSD than there are total coal miners. If you think there's a case to be made that veterans can get equivalent care (or close to it) from regular hospitals in a way that will save money I'm all for it. I haven't seen a good case for that yet.

So? Are you saying PTSD can't be treated outside of the VA? If individual insurance covers it and there is demand, those same doctors treating it at the VA can treat it outside the VA. Seniors have special needs too, but they just have Medicare, and providers treat geriatric conditions just fine without having to set up special senior hospitals.

 

[boomerang]

So why has the VA consistently been a problem for nearly every modern President D or R?

Commodus has got it all figured out. He functions at genius level. He says that liberals don't always think of money first when faced with a problem and then goes on to say that more money is required and then he adds a little disclaimer about oversight and blah, blah, blah.

Really, you guys have got it all figured out. Just throw money at it and declare it fixed. It just really makes it so much easier. If you'd just bypass all the shit in between now and your ultimate goal things would get so much better so much sooner. Take everything away from everybody and have the .gov spend it as they see fit and everything will be really, really good. We could attain the status of Venezuela very quickly. But hide that toilet paper well and don't get caught hoarding it.

Oh, you asked why. Because of Republicans - of course. Simple. Either that or the wholesale corruption of our government where it's nearly impossible to get fired. That, and those that pursue a career in the medical field that don't do so well in their studies need jobs too.

I worked an apprenticed trade for the majority of my working life. It came to pass that it was felt to be unfair to people that sought the job but couldn't pass an aptitude test and that couldn't handle the coursework at college were denied those jobs. So, they developed a two-tiered path to achieve the goal of becoming a journeyman. Some had to take the test, go to college and serve 7,328 hours working in the trade to become a journeyman. Some didn't have to take the test, didn't have to go to college but worked 7,328 hours and achieved journeyman status. Both got the same wage. It had a curious effect on those that had to put forth more effort to attain the same results. They decided there was no reward contained within the system for their extra efforts and many just rolled over and played dead.

But equality of outcome was achieved and that was the goal. The same principles that governed much of my working life are alive and well within our federal government. Whether you can or you can't, whether you will or you won't, whether you do or you don't, the compensation and accountability is the same. If you try to soar with the Eagles while surrounded by Turkey's you get your wings clipped. Never hire anybody smarter than yourself because they'll just make you look bad is in play too. Until accountability within the VA becomes the norm and not the rare exception it doesn't matter how much money you throw at the problem, the problem won't get better.

But that could be difficult and could result in some hurt feelings so maybe it's just better to borrow it from those that will lend to us and give it to the VA. Better to do something than nothing.

 

[fskimospy]

So? Are you saying PTSD can't be treated outside of the VA? If individual insurance covers it and there is demand, those same doctors treating it at the VA can treat it outside the VA. Seniors have special needs too, but they just have Medicare, and providers treat geriatric conditions just fine without having to set up special senior hospitals.

No, I'm saying the same thing that I said before, that veterans tend to have large concentrations of people with specific conditions that are expensive and not that prevalent in the larger population. I imagine people with experience treating those with PTSD related to combat are more effective than standard therapists as well. Then we can get into the amputees, and all the other service related disabilities.

What benefit are you getting from veterans going to regular hospitals anyway? Are you saying their treatment will be better? Cheaper? What? From what I've seen the VA is cheaper than Medicare, but if you're going to suggest changing the system there should be some concrete benefit you can point to.

 

[Moonbeam]

Unfortunately, the downside to the VA's efforts to eliminate social problems and suicide is that people with motivation to get their needs met (tangible or emotional) purely through entitlement are being catered to by these policies. The veterans who most need help are likely among the 2/3 who are not in VA care. Imagine having severe internal distress due to intrusive images of your buddy being eviscerated by an IED or feelings that you are such an overwhelming failure that suicide is your only tangible solution to this distress. How easy would it be for you to waltz into a doctor's office and spill your beans about these traumas or feelings of failure in front of a stranger working for a healthcare system with a strong public perception of screwing veterans? The matter is further complicated because soldiers are generally taught to handle awful things by denial, drowning in alcohol, etc. And VA employees who spend all day catering to entitlement often find themselves too demoralized to inter-personally connect to the people that are at risk.

So I don't have a great solution. But I know that a fantasy that we can address all the needs of our veterans and prevent all veteran suicides by magically beefing up our services is not the answer.

You have the solution. You understand what the real problem is. The solution, then, is to make what you know more widely known so the real issues get faced. How best to do that is, of course, another problem that requires an individual and unique solution, I would say, one that applies to you and that only you can solve.

 

[Moonbeam]

No, I'm saying the same thing that I said before, that veterans tend to have large concentrations of people with specific conditions that are expensive and not that prevalent in the larger population. I imagine people with experience treating those with PTSD related to combat are more effective than standard therapists as well. Then we can get into the amputees, and all the other service related disabilities.

What benefit are you getting from veterans going to regular hospitals anyway? Are you saying their treatment will be better? Cheaper? What? From what I've seen the VA is cheaper than Medicare, but if you're going to suggest changing the system there should be some concrete benefit you can point to.

There is a lot of guilt, in my opinion, regarding veterans, cannon fodder we would so much like to throw away and forget about, wars we fought and sent other people to die in to aleviate our fears, monsters we create to scare people with to get votes, etc. We and our lust for war created so much of the carnage we now don't want to pay for. We will always deny veterans the benefits we promise because we will not address our real problem, our inner fear and how we got that way.

 

[Sunburn74]

The VA would be best served allowing an option for either Medicare or VA care across the board. You should know VA care is vastly superior when you can get it. All medications for example are 10 dollars per month even if they are the sort of medication which costs 20k per month that and they get them mailed out a for free to their homes. Rehabs are free and generally more extensive than what is offered at private facilities. And there are a lot of specialized services built to address issues specific to veterans. The problem with VA care is facilities are sparsely spread out across the US and so vets who do not the live in big cities really struggle to get access to all these benefits. Vets who love out in the woods probably benefit from Medicare (and if they have it due to age tend to use it) whilst those in cities can get the full spectrum of VA services.