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Opinion VA medical system needs new plan

George HasaraVeterans Administration Secretary Eric Shinseki has fallen on his sword by tendering his resignation. President Obama says he “takes responsibility” but believes, Shinseki had become a “distraction.” The current controversy surrounding VA hospitals including the alleged practice of delaying vital patient care, won't disappear as fast as changing a nameplate on an office door.

It's time for the system itself to retire. Of course, the solution isn't about eliminating medical care for veterans, but rather about changing the delivery vehicle. Depending on your outlook toward government, we should strive for the most efficient, or the least inefficient system possible.

The A-Team's Hannibal Smith was famous for saying, “I love it when a plan comes together.” The VA medical system is anything but a plan. It has evolved/mutated over time, especially in the aftermath of various wars. Addressing the medical needs of veterans can be traced all the way back to the American Revolution when pensions were established for disabled soldiers. However, other than a wooden leg, there wasn't a whole lot of medical treatment options available in the beginning. What has emerged today, is a twisted hybrid, driven (and hidden) at times more by political considerations than the medical needs of our veterans.

Imagine if other veteran's compensation programs took the same path as medical. Instead of tuition for the college of one's choice, a vet attended a federally-built and maintained institution that paired sub-par academic offerings with a lousy football team. Veterans would be limited in their choices.

Same scenario can be drawn for housing. In lieu of access to mortgages to the general housing market, veterans had the joy of getting into hock for a VA-built house, conveniently located where they didn't want to live, insulated with armysurplus asbestos. The Veterans Housing Administration would be another bloated bureaucracy built on a continual cycle of reform with directors stepping down without the program ever stepping up.

The current VA medical system cordons off vets as secondclass citizens. Hey veterans, you are so important that we are going to give you your own group of special hospitals and clinics that no one else has (or wants). Think about the outrage if the suggestion was floated that seniors be herded into special “Medicare” hospitals.

The VA institution is an excellent example of inertia of the status quo. In logical fallacy terms it is known as “the appeal to tradition” argument. Since these facilities have always been around (in our lifetimes) they must be valid and necessary. It's doubtful that the VA will be quick to surrender its multibillion dollar domain, but it is encouraging that movement is at least being made toward more patient services available at non-VA facilities.

In all fairness to Shinseki, the shortcomings of the VA didn't begin nor will they end with him. The problems are systemic. The current system is a “distraction” in the sense that it takes away the best medical treatment possible for our vets. No amount of resignations or claims of responsibility can fix that.


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