VA medicine works, but the VA system does not.

The VA has a problem

A problem that began when the US decided to fight two ground wars in the Middle East. The Bush Administration wrongly assumed that these would be ‘weekend wars’, with few casualties. Ten years later, we have a huge problem.

MASH has gotten better since Vietnam

We now have the best critical care system that has ever backed up troops in the field. Transportation of those wounded in battle has become remarkably faster. The ‘Golden Hour’ response time, getting an injured person into a critical care facility in under an hour, has been perfected to such a degree that soldiers who would have died in World War II have a much better chance of surviving that first hour, and consequently, surviving the battle. Ironically, this is part of the problem. No one planned for, or anticipated this increase in battlefield survivors.

The VA system is flooded

Many more soldiers who would have died as a result of injuries in World War II, are surviving their injuries. However, they require a higher level of care. Soldiers who returned from World War II endured PTSD, but did not talk about the problem. Todays soldier is willing to acknowledge this health care issue.  The VA doesn’t have the trained medical staff to handle the caseload. The system is strained.

Build more VA Hospitals?

Time to consider letting other hospitals share the load. This is an enormous task, because the VA system, while an efficient system of health care delivery, is an archaic system of processes, at best. The care is good. The system is a relic from the Vietnam era. The computer systems are fifty years old, good for health care, terrible at connecting to anything else. The patient hand-off from the Department of Defense to the VA system is an embarrassment.


Avik Roy has an excellent article in Forbes that deserves a good read.

“The scandal is that the VA’s fundamental flaws have been perpetuated not only by politicians, but also by leaders of veterans’ groups. There is a way to fix the VA and do right by our vets. But to understand the solution, we have to first understand the problem.”

via No, The VA Isn’t A Preview Of Obamacare — It’s Much Worse.