consultants are sandburs

Friday, July 04, 2014

RAMSEY - Being challenged today, in an email, over using the VA as an example of government single payer working. Where are the problems, what are the answers, and is the Ramsey VA clinic still an example of the system working? What is the truth, locally?

FIRST: Two years ago, what was the story? Paul Levy reported in Strib of the then newly opened Ramsey VA clinic:

Article by: PAUL LEVY , Star Tribune - Updated: March 10, 2012

The new veterans medical clinic in Ramsey didn't open until Nov. 15. But just that last month and a half of 2011 was enough to push visits to the Anoka County veterans services office to an all-time high.

"We had a record number of veterans come into this office for the month of November, and for 2011 overall, and the reason is obvious -- it's the clinic," Allison Lister, the county's veterans services director, said last week.

"We always hear complaints," said Lister. "But in this case, I've yet to hear a negative comment concerning the clinic. Our veterans couldn't be more pleased."

Veterans are so enamored with the state-of-the-art community based outpatient clinic (CBOC) that they're still willing to wait to experience it, Lister said. The waiting list -- once as long as six months -- now is closer to two months.

Still, the demand to use the facility -- which serves the northwest suburbs and offers an alternative to the veterans medical centers in Minneapolis and St. Cloud -- has exceeded expectations.

Funding for three additional doctors has been approved, said Mitzi O'Brien, CBOC business manager with the Department of Veterans Affairs Health System in Minneapolis. [...]

"It's exciting," O'Brien said. "The Ramsey CBOC has opened a world of possibilities."

The Ramsey clinic serves veterans living in Anoka, Sherburne, Wright, Isanti, Mille Lacs and northwestern Hennepin counties. Anoka County alone is estimated to have more than 31,000 veterans -- more than the other areas using the Ramsey clinic combined.

"The number of veterans we had in November and December coming into our office and asking about the clinic was absolutely crazy," Lister said.

"That's calmed down. But the enthusiasm for this clinic has not."

The item is still online. Check it out. That is how facts and viewpoints were reported. That recently. Are things there different today? What is the evidence?

NEXT: I wondered why nobody had posed the question to me earlier. The email challenge to VA single payer success as proof of concept evidence supportive of moving the nation to Medicare for all, has to be viewed in context. A link was sent.

This is it, a PiPress link which describes a SNAFU situation - death of a veteran being the result - again, in the troubled Arizona system but something that never should have happened anywhere, with accountability clearly needed:

ALBUQUERQUE, N.M. (AP) — A veteran who collapsed in an Albuquerque Veteran Affairs hospital cafeteria — 500 yards from the emergency room — died after waiting around 20 minutes for an ambulance, officials confirmed Thursday.

It took between 15 and 20 minutes for the ambulance to be dispatched and take the man from one building to the other, which is about a five-minute walk, officials at the hospital said.

Kirtland Air Force Medical Group personnel performed CPR until the ambulance arrived, VA spokeswoman Sonja Brown said.

Staff followed policy in calling 911 when the man collapsed on Monday, she said. "Our policy is under expedited review," Brown said.

That policy is a local one, she said.

[...] Paul Bronston, a California emergency-room physician and chair of Ethics and Professional Policy Committee of the American College of Medical Quality, said it may sound ridiculous that staff had to call 911 but that practice is the standard at hospitals. [...]

The death comes as the Department of Veterans Affairs remains under scrutiny for widespread reports of long delays for treatment and medical appointments and of veterans dying while on waiting lists.

A review last week cited "significant and chronic system failures" in the nation's health system for veterans. The review also portrayed the struggling agency as one battling a corrosive culture of distrust, lacking in resources and ill-prepared to deal with an influx of new and older veterans with a range of medical and mental health care needs.

The scathing report by Deputy White House chief of staff Rob Nabors said the Veterans Health Administration, the VA sub agency that provides health care to about 8.8 million veterans a year, has systematically ignored warnings about its deficiencies and must be fundamentally restructured.

Marc Landy, a political science professor at Boston College, said the Department of Veterans Affairs is a large bureaucracy with various local policies like the one under review in Albuquerque.

Although the agency needs to undergo reform, Landy said it's unfair to attack the VA too harshly on the recent Albuquerque death because it appears to be so unusual.

The item is quoted at length. Suitably so. The email concluded:

The VA is in shambles!

One such incident, in the troubled Arizona system, is not proof of total failure.

Medical malpractice happens too often, on too widespread a basis, and the answer is not to constrain the tort lawyers who prove it in court, but to look at how to get better bang for the buck from the entire national healthcare apparatus.

BOTTOM LINE: Reader comment is requested, specifically from veterans who have used the Ramsey VA clinic and have had good or bad experiences they might wish to highlight. Either the system works locally or not, and before the entire process is condemned; what is the evidence? Here. Ramsey. The Town Center VA clinic?

How good or bad are things? Why? What is the answer?

Chicken Little provides little help with regard to such basic as-yet unanswered but important public questions.

As with current criticism of the Postal System, has the deck been stacked against system success, and if so what political moves led to it, who made those moves, and if inadequate funding is at all the problem, spend the money to make it work. Anything less than suitable funding is an outrage. Cut the military budget at the joint chiefs salary levels on down to the service academies and their unneeded overlarge classes of graduates looking to make the joint chiefs; cut the weapons contracts; economize, but don't screw the veterans.

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