VA vs. Commercial Medicine Providers

[Graybeard]

My only commercial (UC Irvine) ALS clinic day was a day before I was formally diagnosed with bulbar onset. It was about six specialties, one after another, and very little of it soaked in. Only one gave me a card with contact info.

After my EMG the next day, they set me up for bipap and a peg tube, and said to come back to see the neuro in two months. This was a week before Christmas, 2013, and when the whole bunch left for the holidays, their answering machines did not admit they would be gone for ten days. The two commercial visiting nurse outfits were worse than nothing following my peg tube operation. Meanwhile, a commercial hospice company was trying hard to sign me up for hospice through Mediscare.

Right after I had sent out my ALS letter to friends and family, a PALS widow in Seattle sent me email and in the conversation following, alerted me that all vets with ALS are classed as service connected disability, and to contact the PVA. I was a draftee in 1965-7, and had no reason to suspect I was eligible for VA care.

I was enrolled in VA within 3 weeks, and had my first PCP visit 3 weeks after that. What followed were dedicated appointments with so many disciplines I can't even count. The Nutrition group set me up with gravity bags so I finally could get adequate food, and begin to regain part of the 66 pounds I had lost to that point.

Yesterday was an example of the superior care at VA. It was my first palliative care visit, which was attended by RN, social worker, visiting doc from UCI, and the head doc. The session lasted about an hour and a half, and was concluded only after wifey, son and I had exhausted our questions. They are going to set up visits with psych, etc.

I wish you all had the level of care VA has given me, but the US "free market" profit oriented healthcare prevents that.

 

[gooseberry]

I have to say our care so far has also been exceptional. You are given the time you need and all questions answered. It is caring and compassionate.

 

[Mike in Maine]

The VA has been outstanding for us also, could not find any doctors in Maine that would do the Baclofen Pump. Went to the VA within 2 weeks had the trails and 2 weeks after that I had the pump. While in the hospital for the trail they had everyone come by and visit and they fitted me with all the gear I had a need for (cane, manual wheelchair, plus other) with no hassles. I was so impressed that I wrote both of my Senators commenting on how great the care was.

Mike

 

[cheerleader]

Not only did they supply everything we needed, but the benefits continue for the surviving spouse. (Although there is paperwork and a wait period.). I just received my first survivors monthly check after 3 months AND a rebate on our handicapped van we purchased with MUCH help from them. (If you get a new revamped van you are entitled to over $700 for the air donditioning as a necessity with ALS. Be sure you request it through prosthetics department!). Am still waiting on the burial compensation. The point I'm making is, it certainly doesn't make up for the loss of my beloved husband, but HE can rest peacefully knowing I am continuing to get financial help to make life easier. I suspect all of our veteran PALS want that for their spouse. Donna

 

[Graybeard]

Funny thing, I just read the VA ALS policy posted by Laurie yesterday, and their procedure is like the commercial one - all disciplines in one day. I'm sure glad Long Beach doesn't do that way.

 

[gooseberry]

Tampa did a three to four day inpatient assessment on Steve. They said they do this once per year or as needed. We have VA clinic in a couple of months. Steve is already talking about stopping the usf clinic since the VA seems to help so much more. Usf seems to monitor him.

 

[brienw]

The VA has done wonders for me.

To date they have provided grab bars, a walker, a manual wheelchair, a ramp for egress/ingress, a stairlift, a power wheelchair, a shower bench, a grant for housing and bath modification, a grant for a wheelchair accessible van. a hoist system to transfer me from bed to the power wheelchair. a vpap machine.

Any day now I will receive a shower/commode wheelchair


They provide all medications at no cost-including riluzole

At the time I was very bitter of being drafted. Now, I am Glad I was drafted. I am very happy with the VA policy for ALS veterans.

-Brien

 

[Clearwater AL]

GB, The VA Medical and Medicare are government provided and overseen healthcare. Try and take it away from anyone on it. But... the predominate political sway currently in this country is trying hard and our Supreme Court is about to scuttle Health Care for 9 million people who have 'some' health insurance that they did not have before. I use the VA now.

So, I guess we (VA Med and Medicare recipients) are "Socialists" in the eyes of so many who wish to keep the "For Profit Medical - Insurance without Regulation - Mega Industries" like they were before the ACA. (Both are recording record profits currently... ?)

So, if John Boehners bunch want to call me an "Obama Socialist"... I guess I am.

 

[Atsugi]

Allow me to pile on. VA was fantastic for my PALS wife, and after her death they still take care of me and our kids. ALL medical care could be this good, if only the profit motive weren't in the way.

Signing up for the military, we really had no idea just how deep the sacrifices would go. No notice overseas deployments, back to back sea duty, and a ton of abuse. But at least in this case, the benefits are pretty good.

For one semester, I studied world healthcare systems at the master's level. The US should be ashamed. We need people, especially our politicians, to look at facts instead of believing the lie about "best healthcare in the world." Of course, that would require raising taxes, so...

 

[zoohouse]

My husband was initially diagnosed through the regular medical system, and sent to an ALS clinic in Dallas, who confirmed his diagnosis. They did a lot of blood tests, and then we waited. 6 weeks went by and nothing, finally we made a call to get the results, but no mention of what he should do except get his business in order. About that time I had discovered that he would qualify for care through the VA, and we contacted them. Even though I moved him here to Canada they took very good care of him, although we had to drive the 7 hours to Seattle for each visit. Now that he is ventilator dependant, I found that the rehab department that he had to stay with was not trained or equipped to deal safely with him, so the last time we went was last October, and they nearly did him in. He is followed here by a very capable physiatrist, and we have not heard from the VA since then.
Now I know that I may have a biased opinion about different health care systems, but the time that I have spent in the US with Tim and his different family members did not overly impress me. Atsugi, you talk about having to have your taxes raised to have a better health care system, but I maintain that we pay less for our care. We pay higher taxes, but then we don't have to pay the exorbitant insurance rates. The amount that we pay for our medical insurance is probably 1/5-1/10th of what is paid in the US, and it is based on your income. I'll wager that if you calculated what you pay in taxes as well as medical insurance that we pay less in total, but it is weighted on the tax side. Obamacare is not at all the same as the medical that we get in Canada, and I am not sure that it is even achievable, as most the hospitals in the US are privately owned, so the government would have to build hospitals of their own that are not for profit, and that would be too expensive. The Canadian health care system is very much live the VA system, although medical equipment, medications and dental is not included, that is paid by each person, but many have extended benefits or insurance to cover that which is quite affordable. It is interesting that when Tim first came to Canada 3 specialists saw him, and never did bill us for those consultations, even though he did not have insurance. One wrote us a letter stating that she would continue his follow up Pro-bono until his VA benefits were organized. I am extremely proud to work in this health care system.

 

[frankb]

Roger that, Atsugi.

 

[gooseberry]

All I can add is that our private insurance rarely covers dme without a huge hassle. Then you have to meet a deductible, coinsurance etc. In the end, you essentially pay all but 20%. Medications hmmm....the VA billed my private insurance 2.68 for a med that cvs billed them $168. How is that possible? Dental for us is covered for exams 2x per year because I pay extra for that insurance. Any work that needs to be done is paid on a percentage basis. The VA has provided support and comfort for my husband. There has been a wait while all the paperwork is filled out, submitted, processed, etc but for us, it has been advantageous. As of today, we would have paid an additional $9000 out of pocket for medical bills without VA coverage.

 

[Grumpy'sWife]

We went to one commercial ALS clinic visit as well. When the RT came in he barely glanced at Randy. He went down a list of questions and was told how much trouble he was having breathing especially when laying down. The RT's response was that they would monitor and probably order FVC test the next time around! We were admitted to Cleveland VA for their 2 day eval and that was the first test they did....he was on a Trilogy that afternoon. His FVC was a 27.
I honestly don't know where we would be without the VA. We haven't waited more than a day or two for any piece of equipment we have asked for or needed. We have a home based primary care team that is amazing. I know they are not perfect but we have been lucky and if you ask Grumpy he will tell you he wouldn't be able to stay at home without them.
His progression has been swift and they have helped me to keep a step ahead of the equipment needs the whole time.
So for us they have been a God send.

 

[Atsugi]

Zoohouse, to be sure, I'm impressed by the Canadian system. It's a shame the US can't figure it out. Our nation, and each person in it, spends FAR MORE than any other country on health, yet results--infant mortality, death rates, life expectancy and many others--are nearly the worst in the civilized world. Canada's system gets better results and is less expensive, too.

 

[Graybeard]

Wish we could take a fraction of the money away from the Military Industrial Security Complex and put it toward socialized healthcare for the working stiffs. The poor have socialized welfare, the vets have socialized VA and the old have socialized Mediscare.