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Sunday, May 25, 2014

A Memorial Day weekend reflection -- apropos of the VA scandal

My late Dad and all four of his brothers were in WWII for the duration. Only Pop and my uncle Warren survived the war years. Three uncles I never got to meet and know.

One of my Mom's brothers was in the D-Day invasion, coming ashore on one of those LSTs so horrifically depicted in Spielberg's "Saving Private Ryan." I did not find the movie's cinema veritae entertaining. It was, "oh, shit; this is just what they described to me over the years."

I visited the D-Day Omaha Beach cemetery in 2004

Pop left a leg behind on Sicily after his munitions glider crashed during a night landing. He was pinned in the wreckage overnight, both legs crushed up under him and badly broken. They had to amputate the right one just above the knee. He subsequently spent a year in recovery and rehab stateside, in Atlanta. He married my mother after that, walking haltingly with the gimpy gait that came with the relatively crude artificial leg of the time.

Had they had the battlefield triage MASH technology and tx's/px's of Vietnam during WWII, my Dad would probably not have lost his leg. Conversely, had they only had such technology during George W. Bush's Afghanistan and Iraq wars of the 2000's, we'd have had far fewer survivors -- the physically and psychically mangled survivors that will now require ruinously expensive lifetime care in many, many cases.
Early this month at the National 9/11 Museum opening ceremony, participants recounted the litany of loss that day when nearly 3,000 innocent civilians were murdered. In all the reporting on the opening, there was much discussion about the challenge the curators faced in how to present the Sept. 11 narrative.

Thirteen years later it’s still hard to wrap one’s head around the magnitude of the loss experienced that day. One day, loved ones were here — the next they were not.

Still harder to comprehend: the staggering global bleed-out since the U.S. decided to wage a global war on terrorism in response. More than 6,700 American soldiers have lost their lives and more than 57,000 have been wounded. By some expert estimates, as many as 200,000 of the soldiers that served in Iraq and Afghanistan are living with some form of traumatic brain injury.

And that’s just “our” people. [from]
My sister's late husband, my beloved brother-in-law Tony Poggi, succumbed prematurely -- tragically -- to the after-effects of his Agent Orange exposure during his "tour" in Vietnam.

Tony refused to sign up for his VA benefits, on principle. Did it cost him his life?

My Dad was a "WWII 100% Service-Connected Disability" bene. He took every penny they gave him. A lot of pennies, as it were. He always got good service and good care, to the extent I can determine. The VA even paid for his dementia-addled nursing home care from 2001 to his death in 2008. During my time looking after him after he'd gone senile, I was always able to get him prioritized, even before I became his legal guardian. One VA administrator told me "don't worry, WWII disabled veterans are a specialty of mine." Fair or not, there is a service pecking order within the sprawling VA bureaucracy.

The VA is in the throes of scandal these days. Touted for their EHR (VistA) and touted for their heretofore high patient satisfaction scores (see below), they now find themselves under serious partisan political assault -- over their apparent gaming of the scheduling backlog system.
Independent 2013 Survey Shows Veterans Highly Satisfied with VA Care
Higher rating than Private-Sector Hospitals on Average

WASHINGTON — The American Customer Satisfaction Index (ACSI), an independent customer service survey, ranks the Department of Veterans Affairs (VA) customer satisfaction among Veteran patients among the best in the nation and equal to or better than ratings for private sector hospitals.   The 2013 ACSI report assessed satisfaction among Veterans who have recently been patients of VA’s Veterans Health Administration (VHA) inpatient and outpatient services.   ACSI is the nation’s only cross-industry measure of customer satisfaction, providing benchmarking between the public and private sectors.
In 2013, the overall ACSI satisfaction index for VA was 84 for inpatient care and 82 for outpatient care, which compares favorably with the U.S. hospital industry (scores of 80 and 83, respectively).   Since 2004, the ACSI survey has consistently shown that Veterans give VA hospitals and clinics a higher customer satisfaction score, on average, than patients give private sector hospitals. These overall scores are based on specific feedback on customer expectations, perceived value and quality, responsiveness to customer complaints, and customer loyalty.  One signature finding for 2013 is the continuing high degree of loyalty to VA among Veterans, with a score of 93 percent favorable.  This score has remained high (above 90 percent) for the past ten years...
Politicians on all sides of the aisles routinely laud "our sacred obligation" to our veterans. They do not, however, routinely Walk their Talk. Flying off secretly to photo-op with the troops in Afghanistan on Memorial Day weekend doesn't constitute meeting the Sacred Obligation.

Jon Stewart unequivocally calls bullshit.

Veterans with service-connected conditions and injuries should have carte blanche, IMO. They should be able to present their VA cards at any clinical site and get treatment. The closed system "government-run healthcare" comprising the VA is part of the problem.

More to come...

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