No quick fixes for problems at VA
A recent letter to the editor suggested, as a quick-fix for problems at the VA, that Congress pass legislation allowing veterans to use their insurance at any medical facility.
It’s not as helpful an idea as it may seem.
For one thing, that’s already supposed to be protocol in an emergency. Call the VA hospital. First thing you hear: “If this is an emergency, hang up and dial 9-1-1.” (My experience is with the Albany VA. I assume that’s a standing order everywhere; if it isn’t, it ought to be.)
On top of that, if it’s someone already in the system, medical records can be helpful, even necessary.
When I show up at my clinic or the hospital, the staff knows — or can quickly find — my medical history, prescriptions, allergies, adverse reactions and a dozen other factors. Those help diagnose a situation and determine the easiest and safest way to address it.
Another similar but distinct issue is the kind of patient a vet is likely to be. Most of us who are in the system, or would be if it operated everywhere as well as it does locally, fall into two categories.
There are old guys like me, with typical old-guy complaints. Not every hospital or clinic is ready on short notice to summon a geriatric crew to handle our ailments.
More critical — and this is the group worst-treated by the system today — are veterans of recent combat or conflict. They come into a hospital needing trauma treatment and care, which few civilian facilities can provide.
This last item, special needs, has played a big part in American history. Failure to meet them probably resulted in the death of two of our assassinated presidents, James Garfield and William McKinley.
Garfield was shot in a railway station. While he lay on a dirty floor, doctors probed bare-handed for bullets in his body. In so doing, they apparently shoved a fatal blend of dirt and germs into his internal organs.
McKinley was shot, got immediate medical attention, and was expected to survive. His misfortune was that, instead of an Army surgeon familiar with bullet wounds, it was a gynecologist who operated on him. McKinley died nine days later.
What can anyone do to clean up this mess corrupting so many parts of VA health care? I think there’s a metaphor in the deaths of those two presidents. People trying to fix things are not suited to the job. Or maybe they can’t see how much dirt there is.
Maybe they’re unwilling to rock the boat.
Whatever it is, they are not making anything better, and arguably are making things worse. People are dying while they conduct hearings and make speeches and polish resumes.
Instead of assigning the clean-up to politicians, or old generals who have been commandeered into the political system, President Barack Obama — or somebody, please, anybody — needs to realize the need is immediate and critical. Sending in the inexperienced is not a viable option.
My answer? Forget hacks and weary generals looking to accumulate one more star before fading away. Send in old-line first sergeants. (I can suggest a couple of candidates.) An NCO approach to problems is not political or polite. Kicking butt and taking names is their way. Getting things done is their objective.
Unfortunately, that also is not a viable option. The VA health care administration is civilian-run. Military officers hang around at the top, but the system does not run like a military command. It runs like what it is, a vast bureaucracy.
A bureaucracy with competent leadership and hard-working staff can do excellent work. Other times, other places . . . well, you read the news.
Back in 2007, a scandal was uncovered at Walter Reed Medical Center, the precursor of our present disgrace. I waited for Bush and Company, with their macho self-image, to send in a four-star general and a platoon of troops. Put the fear of demotion or dishonorable discharge into the hearts of hospital bosses.
Nothing of the sort. Several generals and a cabinet member did eventually disappear, quietly, leaving the scene unscathed. And those miserable conditions did not improve.
So I did not expect any realistic response when this latest round of negligence, incompetence and indifference hit the news. And thus far, there hasn’t been one.
A few chairs got shuffled, but nothing substantial has changed.
Phil Sheehan lives in Scotia. He served in the U.S. Army from 1954-58.
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