Sometimes...

Sometimes you see an article or a blog that you think, "Hey they got it right." And sometimes (okay, like never) you discover that you're actually friends with the daughter of the guy writing it. It's pretty awesome that it happened today! And now, I invite y'all to read it too! (While you're doing that, I'll be reading the rest of his blogposts...)

Newsflash, there are millions of people under- or uninsured in this country that have to wait for care that many of us don't think more than twice about. It's not just a problem with the VA. Please read Dr. Michael Hein's (heindoc.com) assessment of the "The Real 'Secret' Wait List".

The Real ‘Secret’ Wait List – It’s not at the VA

There are millions of Americans without adequate access to primary care services. While these patients wait for access to care, undoubtedly tens of thousands of them die every year. That’s the real wait list.

The press has been excoriating The Veteran’s Administration in Phoenixbecause 40 Veterans may have died while waiting for access to primary care services. If it turns out to be true, it is unacceptable. Being on a waitlist does not necessarily mean that the time delay caused the deaths of those Veterans, but part of the Grand Bargain is that Veterans have access to healthcare for life. (“To care for him who shall have borne the battle and for his widow and his orphan.”) VA policy requires that Veterans be seen in primary care within 14 days of their desired appointment date. Clearly, the VA in Phoenix and likely others are struggling to meet that mandate.

Without excusing the possible deviation from policy, at least the VA knew about the Veterans, who needed to be seen. In contrast, millions of Americans needing access to primary care are invisible. They don’t even make a wait list. They die hidden behind the veil of anonymity.

“The growing shortage of primary care physicians has forced millions of Americans to seek care from emergency rooms and to delay or forego needed care in some instances, which has resulted in higher rates of preventable illnesses and even deaths, according to a new report.”[1]

Because the VA is under a high degree of scrutiny and one of the largest integrated healthcare systems in the country, providing 90 million outpatient visits per year, it’s an easy target for media-bashing. In contrast to reality, the American public generally believes that the system is ‘sub-par’, so they buy into the degradation of the VA by the media and those with a political agenda. The truth is that the VA delivers as good or better care than the private sector.[2]

“Former military service members using Department of Veterans Affairs hospitals are just as happy with their care as patients using private medical clinics, according to a leading customer-satisfaction survey.”[3]

“Of 10 general comparative studies assessing use of preventive services, acute and chronic care for multiple medical acute and chronic medical conditions, changes in broad health status including risk-adjusted mortality and patient satisfaction, each showed superior performance, as measured by greater adherence to accepted processes of care, better health outcomes or improved patient ratings of care, for care delivered in the VA compared with care delivered outside the VA.”[4]

So even in a good healthcare system, access to primary care is challenged. It is much larger issue in the private sector where there are millions waiting for access.

Maybe the US public and media should be righteously indignant about the state of our ‘best healthcare system in the world’ where 79 million are underinsured, with limited or no access to primary care, and reserve their vitriol for the real problem. It’s not the secret wait list at the Phoenix VA.

Limited Access to Primary Care – The Real Secret Waitlist

[1] American Academy of Family Physicians, “Senate Subcommittee Report Underscores Need for More Primary Care Physicians: Report Cites Causes, Effects of Primary Care Shortages.”http://www.aafp.org/news/government-medicine/20130206helpreport.html

[2] Rand Corporation. “Improving Quality of Care: How the VA outpaces other systems in delivering patient care.” RB-9100. Online:http://www.rand.org/pubs/research_briefs/RB9100/index1.html

[3] Hicks J, VA hospitals on par with private sector for patient satisfaction. The Washington Post Blog, April 17, 2014.http://www.washingtonpost.com/blogs/federal-eye/wp/2014/04/17/va-hospitals-on-par-with-private-sector-for-patient-satisfaction/

[4] Shekelle PG, Asch S, Comparison of Quality of Care in VA and Non-VA Settings: A Systematic Review. Health Services Research and Development Service, Evidence-based Synthesis Program, Department of Veteran Affairs, September 2010.http://www.hsrd.research.va.gov/publications/esp/quality.pdf