This diary had been brewing in my mind ever since the last presidential debate and I wanted to respond to Bush's claim that there was no problem with the healthcare available to our veterans and active military staff. What a pathetic and frankly inexcusable lie.
I am a urologist (please no need for jokes, I have heard them all...) who has been practicing in Oregon for the past two years. I see a number of family members of active military personnel, and their insurance plan - Tricare - is probably one of the worst that I have encountered. It's comparable to Medicare (and that's not a positive comparison), with some of the WORST reimbursement rates for medical services (often less than half what an average commercial insurance carrier will pay). For this reason, a lot of physicians don't accept this insurance because they end up actually LOSING money when they take care of these patients.
My practice does accept Tricare, mostly because we feel it's the patriotic and moral thing to do, but also because I belong to a larger group practice that can absorb the negative income a little better than some of the solo or smaller practices.
So a lot of these patients inevitably have difficulty finding primary care physicians (PCP), let alone specialists who will take care of them. They all need referrals from their PCP to see specialists (which is no easy task thanks to an endless amount of paperwork) and often times end up traveling long distances for their medical care. In some cases, the patients have to file the claims themselves (again, not an easy thing to do considering the complexity and jargon employed by the insurance companies). It's an absolute travesty that the government should provide such poor insurance for our active military personnel and their families.
In terms of Veterans Hospitals, I can only speak from my own experience as a resident. I had to laugh when Bush talked about how much more money was spent on these hospitals because it just isn't nearly enough. To give you an example, my clinic was always booked solid for about 3 to 4 months in advance and even when these vets managed to get an appointment, they ended up waiting for hours in the waiting room. I remember one day when I was the only physician in our busy clinic, I set a record by single-handedly seeing 52 patients--that's no way to practice good medicine. Any veteran who can afford private insurance would not be caught dead in a VA Hospital. Sure, this is better than not having any insurance, but I really believe that the people who choose to serve our country deserve much much better.