This was an interesting discussion between Krys Boyd of NPR/KERA's Think radio program and Dr. Harold Kudler, chief consultant for Mental Health Services for the VA system.
Being a physician is like a brother/sisterhood. I do my best not to disparage other physicians, even when I think they are wrong. But this interview had lots of glaring oversights, only a few that I want to mention.
[If it was working, we wouldn't be talking about it.] Dr. Kudler thankfully made mention that the VA system isn't working to its full potential and that they have some stellar programs. I would assert that the system can't work and won't ever work to its full potential because it keeps getting in the way of its own trajectory. I remember working at the VA as a psychiatry resident, and the bureaucracy of medicine was, for lack of a better word, insane. The time and effort it took to do what was medically or psychiatrically indicated was enormous and preempted any benefits from innovation and efficiency.
[Our vets get the best care.] Yes, some veterans in some places get fantastic care. But this idea does not extend to every veteran. As Jon Stewart on the Daily Show demonstrated, the paperwork (literal paper) that vets have to endure is simply inexcusable and unexplainable. So yes, for those people who do make it into the system and get service-connected, things go pretty smoothly (again, on the provider side, not so much.) But for the countless other vets waiting at home to get in to see a VA provider, times are hard.
[Let the market work.] The VA system in its entirety cannot quickly adapt and adjust to best serve the needs of their people, period. It's a mini economy that's bloated and inefficient because it's tied to the government. I love government, and I think it's a necessary evil for a civilized society. But government really shouldn't have a hand in anyone's direct health care decisions.
My proposal: sell all VAs to private companies. Institute the P.S.Y.C.H. plan, and put all veterans into the system with the caveat that their contribution to their country creates a percentage of service connection that can be used as credits for any health care costs they incur.
Again, I don't believe that all health care should be "free". After all, someone's paying for it. I also believe that even military men and women should be responsible for their own personal decisions (smoking, poor eating habits, etc.) and as such should not receive service connection for that. But for PTSD caused by deployments, for cancers related to toxin exposure, for traumatic brain injuries from combat, etc, those men and women deserve the full extent of what our healthcare delivery system can give – lifelong intensive therapy with concomitant medical care.