Up until a few days ago, I was a strong advocate of single payer U.S. health care. However, an experience with the Veterans Administration health care system last Tuesday caused me to lose some if not all of my confidence in a single payer system.
Since 2001 I’ve been using the VA health care system. I didn’t have a choice when I lost my job at the hotel where I worked in Lionville, PA. Luckily for me I had signed up for the VA health care system in 1998 just in case I would ever need it. Lucky because in 2001 the Bush administration discontinued the eligibility of non service connected (meaning we didn’t have a service connected disability) veterans like me from using the VA health care system which I was promised when I joined the Army in 1960. This act alone (making veterans like me ineligible to use the VA system) was the main factor in causing me to change my political registration from Republican Party did not care for me or my well being unless I was connected to the power structure. Since I neither was employed, rich or have political connections, I was on my own according to the Republican Party. My first doubts about the Republican Party began during the 1992 Republican Party convention in Houston Texas after the hateful homophobic speeches of Pat Buchanan and Pat Robertson. That was my first clue that I, as a gay man, was not welcomed in the Republican Party unless I turned straight. But that is another story for a future blog posting.
The VA health care system was a lifesaver for me. During the time I was unemployed I had one medical emergency and two operations. The VA took excellent care of me. In fact, they took better care of me than my private health care ever did. The one major operation I had with my private health care system almost killed me. I contracted a staph infection and it took me six months and three operations to finally get rid of it. I barely survived. The whole ordeal was a nightmare which I will never forget. I never received an apology from any of my private medical care providers for what happened to me, including the doctor I went to who insisted it was "all in my head" when I complained of horrendous headaches. It was only when my surgery scar burst from the build up of pus that I was delivered to the contagion ward of the hospital in an ambulance. Then the medical establishment realized that something was dreadfully wrong.
I liked the VA health care system because they seem to really care about me. I wasn’t just a number to increase the doctor’s volume of patients. The VA had a different attitude. Since they’re not operating for profit, they took more time with me. My doctor (or nurse practitioner) actually sat down with me and made eye contact with me and discussed my health. I had annual labs to monitor my health. Except for the fact that since I moved the main VA facility was now 90 miles away (as opposed to ten minutes away when I lived in Pennsylvania), I was very happy with the VA system. No, I couldn’t choose my doctor but I always had the best doctors available for me when I went to the VA for care.
Alas, it seems that has changed now. Last year the VA opened an outpatient facility in Georgetown. No longer would vets like me have to travel 90 miles one way to Wilmington, DE just to take labs or to visit our doctor. Now we could travel to the outpatient clinic in nearby Georgetown. It all looked good on paper. However, what looks good on paper and what is reality are two different things.
I have visited the VA Outpatient Clinic in Georgetown about a half a dozen times. Every time I have visited them I have a different doctor. This wasn’t good. There was no continuity. The last time I visited I had a doctor and I expressed my concern about the turnover. He assured me he would stay there because he said he liked treating “old vets” like me. I think that was a compliment. So imagine my disappointment this past Tuesday when I visited the VA Outpatient Clinic for my labs. A lot of red flags went up.
First, there was no sign in sheet. There were no instructions as to what to do. I see the obese woman behind the glass partition (what’s with the glass partition? Afraid someone is going to rob them?) I asked her “where is the sign-in sheet?” She looked up at me with a dull look and said “Hepa.” I said “Hepa?” She repeated “Hepa.” I said “Oh, it’s a privacy thing?” She said “Yeah.” Okay. Then I tell her I have an appointment for my labs. She now asks my name (why didn’t she do that sooner?)
I take my seat. A short time later a woman in a white medical jacket comes out and proceeds to rip a new one for one of the veterans. I don’t know what he did but she said to him “Sir! You will have to wait your turn! There are 30 other patients before you and you will have to wait your turn! Do you understand?” Oh that was nice. Not what you would call professional or respectful. Even if the vet was inquiring about when his turn was I don’t think that was an appropriate way to answer his question. The woman turns on her heel and stomps in the back to continue doing whatever it was she was doing before this hapless vet dared to ask his question. An uncomfortable tension settled over the rest of us vets in the waiting room. What next?
Then I was called into the back to get my blood drawn for my labs. It was all very organized, including the needle at the ready. My brother had told me a few weeks earlier that whenever a medical person inserts a needle into your arm you should see them break open a new needle and throw that needle away. I didn’t see that and I’m ashamed to admit that I didn’t question it either. I should have. I was intimidated by the white jacket woman who was administering a needle to the veteran sitting next to me. Yes, they were taking our blood simultaneously. Yes, we were on a production line.
After three vials of blood were taken from me I returned out front and inquired as to when my next appointment would be. The usual procedure was to schedule an appointment the next week to go over the results of the labs or blood test. I was told that they would contact me “if there was a problem.” Otherwise, if I wanted a copy of my labs I could call them next week. So there you go. No longer did I have a doctor, or even a nurse practitioner to discuss my medical condition with me. I wasn’t asked if this is what I wanted. The decision was made for me.
Another incident which also caused me great concern was that they had no record of my partner Bill. He had not heard from them in over a year about getting his labs. He went with me and inquired at the front desk. He was told “You’re not in the system.” Not in the system? He’s been in the system since the early 90’s. They made an appointment for him and also a follow up appointment to review his labs. Why didn’t they make a follow up appointment for me?
As I was leaving I overheard another vet questioning the person at the front desk as to why he had not received his heart medicine. The woman at the front desk didn’t seem to care. The old veteran was pleading with her that he needed his medicine. She finally advised him to see the woman around the other side of the front desk. Hopefully that woman took care of his problem.
All these events on this past Tuesday morning in the span of about a half an hour left my confidence in the VA health care system very shaken. It has even affected my sleep. That’s when I know something is serious because I rarely have problems sleeping. I can sit in front of a TV or read a page or two of a book and I’m off in Wonderland in only a few minutes. Not now, I’m waking up during the night worried about my health care.
This morning I decided to do something about it. I called the VA in Wilmington and explained my concern to the operator. She immediately connected me to a woman who is the patient’s advocate for veterans. She wasn’t in so I left a message. Much to my surprise, she called me back in about 20 minutes. I told her of my experience at the Georgetown outpatient clinic and explained my concerns. She told me that the Georgetown clinic was having a great deal of difficulty keeping a doctor. She said part of the problem was probably the computer system which was frustrating to use for the doctors and nurse practitioners. She seemed genuinely concerned about my loss of confidence. She offered to reconnect with a primary health care provider at the Wilmington location. She acknowledged that it would be a long trip for me but I told her that didn’t concern me as much as I needed a primary health care provider. The trip by the local American Legion Post 28 van takes up half of my day. That is a small price to pay for the peace of mind to have a permanent, consistent health care provider with whom I can discuss my medical condition.
The lesson I am taking from my experience this past week was even though I ran into difficulty with the single provider system that I’m using through the VA, I was able to resolve the problem immediately through the VA’s patient advocate and thus stay with the system that has provided me the best health care I have ever received in my life. I have regained my confidence and peace of mind and now I can sleep again at night.
