Rio Grande Valley Veteran’s Health Care Needs Must Be Addressed
There continues to be a lot of political heat and appropriately so about the medical services provided to Veterans of the Rio Grande Valley. Although there are outpatient service offices located within the Valley itself the closest VA hospital is in San Antonio. Many veterans believe that our area is long overdue for a full fledged hospital however a study done in 2007 found that there not enough veterans in the potential service area to warrant a hospital. One of the main sticking points with veterans was that they often had to wait long periods of time to get appointments with specialists and found traveling to San Antonio very difficult.
In reviewing the complexities of this problem we also have to recognize current problems that plague American health care in general not just veterans. Over the past few decades there has been a general move to try to put major health care facilities within 30 minutes travel of each other. What has happened is that you have available redundantly expensive services who become “jacks of all trades” but ” master of none”. For example, hospitals X-Y-Z like to treat disease A because it pays well so they each buy machine A which treats disease A. In reality the number of patients could have all been treated at just hospital X so the consumer is paying for technology and waste he does not need. Health care research now clearly shows that results improve while complications and costs go down with the more experience a medical facility has in treating problems. No one can argue that large university affiliated medical centers can offer many services that are superior to small community hospitals in many areas. Another problem, is that in the medical economy, there is a very different level of reimbursement for medical services across various demographic groups. Medical providers, such as physicians and hospitals, “cherry-pick” certain demographic groups which offer the most reimbursement and the least risk. We have too many hospitals which are too close together offering the same services in every city of the United States.
All veteran’s do not receive all their health care through the VA especially those that have been separated from the Armed Forces for some time. Like other Americans, they are become eligible for Medicare at age 65 or if they retired after a good 20 years in the service they are eligible for special insurance programs that are in addition to VA Services. The majority of veterans who are able to work and are not poor receive health care through sources other than the VA currently. However, the lack of availability of private health care is driving many veterans who under the age of 65 back to the VA System. Also, the stringent service-connected issues that used to limit care to just a few health problems that could be treated by the VA has now been appropriately lifted somewhat. Compounding this, is the fact that veterans as a group overall are becoming poorer, less educated, and less insured than the general population. Many point to the inadequate programs that were created to help veterans develop themselves after the Vietnam War as a primary contributing factor.
For many years VA hospitals were seen to be clearly substandard to other similar sized hospitals. In the 1980’s and 1990’s VA Hospitals went through some very dramatic changes. Many of these hospitals become more integrated into major university medical centers so that standards and practices became shared. By 2003, studies published by prestigious medical journals such as the New England Journal of Medicine where showing that the quality of care in the VA was equaling or sometimes beating the quality of care in the private sector. One of the reasons this occurred was because the VA accepted the ideas of standards of practice and rigorous review of care which were not so accepted in non-academic private hospitals.
The problems of accessibility and availability of care for the Veterans of the Rio Grande Valley are similar to others in the Rio Grande Valley who have to travel to Houston for specialized medical services. Although the Valley has a population of nearly one million people it is not possible that at this point you could develop a fully functioning major medical center to the same standards as the Audie Murphy Medical Center in San Antonio. Certainly a small hospital could be built in the Valley but but it would be hard for it to match the standards of a major university affiliated medical center. Such a facility would probably become a “dumping” ground for surrounding hospitals and providers to place poor veteran’s who had chronic needs for hospitalization with poor reimbursement. A recent VA study showed that the VA is only growing at a rate of 5% a year in available long term care beds whilst the real need is a growth of over 25% a year.
Many rural health problems in other countries have been addressed by providing free and timely transportation. In addition for those who do not require in-patient services but need to stay in the area for several days for medical follow-up temporary medical hotels should be considered. Transportation and housing issues for ambulatory veterans of the Rio Grande Valley are currently inadequate.
When the time comes for the Valley to have its own VA hospital it should definitely be located within a modern major university medical center. Stand alone VA hospitals which contract out to private hospitals have not in the past resulted in the same quality of care as those in university medical centers.
The current situation is clearly in need of change. The writer believes that anyone who served in the U.S. military with an honorable discharge even with no service connected disability should be afforded the option of free care at the VA. No matter where you live the quality of this care must equal a nationwide standard. It should not be less in the Rio Grande Valley than it is in San Antonio.
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