The Decatur, Georgia Veterans Administration Health Care campus annually treats nearly 120,000 veterans facing a variety of illnesses, treatment regimens and surgical needs. It is one of the busiest VA campuses in the nation, and it is currently operating under a state of emergency.
Consider this a potential preview of Medicare For All. The U.S. Veterans Administration is the largest civilian agency in the federal government. Despite doctor and nursing staffing shortages, the VA employs more than 400,000, a number just slightly less than our entire standing U.S. Army.
Though patient outcomes continue to be troubled, along with access to and inconsistent quality of care, the entire VA health care system is government funded and controlled, and though some of its facilities are not aging well, the agency does not lack for resource or bi-partisan congressional support. But big budgets don't necessarily mean excellent or even efficient performance and fixed salaries and federal salary caps don't make for the most promising job opportunities for the best and brightest in health care.
Infection rates in operating rooms and other issues became so problematic that all routine surgeries at the Decatur campus were suspended in September, with hopes of resuming in November, once new nursing and support staff have been trained or re-trained. Joe Marrable, a veteran battling cancer on the Decatur campus also died in September, covered with more than 100 ant bites. Pest infestations also closed the campus canteen the same month.
Soon to be retiring U.S. Senator Johnny Isakson, Georgia's senior senator and chair of the Veteran Services Committee joined a loud chorus calling for a change in leadership of the VA campus. Regional VA Director Leslie Wiggins was put on administrative leave on September 17th, Dr. Arjay K. Dhawan, Regional Medical Director was moved to administrative duties, pending further investigation, and seven other staff members were reassigned to non-patient care duties. And terminating the employment of poorly performing administrative and federal union VA staff remains a major problem.
"It’s just the culture, and I don’t know what it’s going to take to change it other than a complete house cleaning,” said Sheila Meuse, a retired VA whistle-blower and former assistant director at the VA hospital in Decatur.
Nationwide, the VA has the additional challenge of several thousand open physician and nursing staff positions. VA system salaries typically lag their private sector counter-parts at for-profit and non-profit hospitals alike. And the VA’s model with all employees working for the federal government, no insurance company and all care provided by one provider...is also VERY much like the much vaunted ‘Medicare For All’ being touted by the bulk of potential Democratic candidates for President.
There are still millions of physicians, specialists and nurses of all stripe, employed in private practices, and many of them do not accept Medicare, or are challenged by performing procedures and providing care at Medicare determined reimbursement rates lower than the actual costs of providing that same procedure or service. As most any Medicaid or Medicare patient can share with you, this often means restricted options and long waits for even the most basic appointments, procedures and patient care.
Thankfully, the Veterans Choice and Veterans Mission Acts, championed by Georgia Senator Isakson, passed with rare bi-partisan support and signed into law by President Donald Trump, are providing our veterans with a long needed safety valve of seeking care outside of the VA healthcare system.
But unfortunately our Atlanta VA system is far from alone in operating on broken down equipment, with low employee morale and unexpected deaths among routine patient outcomes. Our veterans deserve better, promises made to them and their families still need to be kept, and though I do not view health care as a Constitutional right, American citizens do deserve the right to make a choice in the structure and nature of their health care provider system.
In the most recent Democratic Presidential candidate debate, Vice-President Joe Biden mentioned a Congressional Budget Office (CBO) estimate of $34-trillion over 10 years for Medicare For All (which Biden does not support), and those costs could be covered only four short months if we eliminated the entire Pentagon, all military service branches, every weapon system and bullet. There is virtually no way to fund this plan which also has absolutely no operational quality guarantees. That's my diagnosis anyway...