{"id":92009,"date":"2017-12-02T09:37:00","date_gmt":"2017-12-02T09:37:00","guid":{"rendered":""},"modified":"2023-01-06T20:53:51","modified_gmt":"2023-01-06T20:53:51","slug":"the-shape-of-things-to-come-redux","status":"publish","type":"post","link":"https:\/\/cvnextjob.com\/index.php\/2017\/12\/02\/the-shape-of-things-to-come-redux\/","title":{"rendered":"The Shape of Things to Come, Redux"},"content":{"rendered":"<div style=\"margin-top: 0px; margin-bottom: 0px;\" class=\"sharethis-inline-share-buttons\" ><\/div><h3 class=\"post-title entry-title\" itemprop=\"name\"><\/h3>\n<div class=\"post-header\"> <\/div>\n<p><a href=\"http:\/\/formerspook.blogspot.com\/2009\/07\/shape-of-things-to-come.html\">In a recent post<\/a>,  we wondered if the American health care system&#8211;or, at least Barack  Obama&#8217;s vision of it&#8211;would come to resemble that of our military. With  certain exceptions, the armed forces already operate a &#8220;single payer&#8221;  system, featuring limited choices and bureaucratic decisions that govern  the quality of care.<\/p>\n<p>While many military doctors (and hospitals)  are considered excellent, others have a less-than-stellar reputation.  There&#8217;s a standing joke in medical schools that 75% of the graduates are  referred to as &#8220;doctor,&#8221; while the bottom 25% are called &#8220;Captain.&#8221;  Other physicians wind up in the armed forces because of past  difficulties, including an inability to maintain malpractice insurance.  Practicing medicine in uniform, physicians don&#8217;t have to worry about  malpractice coverage and the Feres Doctrine protects them from lawsuits  by military members and their dependents.<\/p>\n<p>But beyond those  concerns, the military health care system faces more basic problems.  Stretched thin by the medical requirements of two wars, at least one of  the services is finding it difficult to provide required services to its  core clientele. According to <em>USA Today<\/em>, the number of Army  medical centers and clinics that provide timely access to routine  medical care has hit a five-year low. As a result, more soldiers and  their families are being sent off-post for treatment, by civilian  doctors.<\/p>\n<p><span style=\"font-size: 85%;\">About 16% of Army patients,  particularly family members, can&#8217;t get appointments with their primary  physicians and are sent to doctors off the installation, according to  the results of a nine-month Army review finished late last year. Some of  those patients end up in emergency rooms or urgent care centers, says  the study, which the Army provided to USA TODAY.<\/span><\/p>\n<p><span style=\"font-size: 85%;\">Army  records show that 26 of its medical centers, hospitals and clinics are  unable to meet the Pentagon standard requiring that 90% of patients get  routine care appointments within seven days. Those are the worst results  since the start of the wars in Iraq and Afghanistan. That&#8217;s a 13%  increase from 2005 in the number of medical facilities unable to meet  the standard. <\/span><\/p>\n<p>To some degree, this problem was  inevitable&#8211;and preventable. Almost eight years into the Afghan conflict  (and six years after the Iraq invasion), the Army knows how many  doctors, nurses and other medical specialists are required to support  deployed operations, and the &#8220;gap&#8221; that creates back home. But according  to the USA Today article, the Army surgeon general has only recently  authorized the hiring of more physicians. <br \/>And, as you might  expect, getting doctors to &#8220;sign on&#8221; with the service (in uniform, or as  civilians) is difficult. As a newly-commissioned officer, military  physicians earn only a fraction of what they could make in private  practice; the same hold true for doctors who accept civil service  positions with the armed forces or the VA. <br \/>So the military winds  up with more doctors that have (ahem) &#8220;fewer career options&#8221; than other  physicians. That, in turn, brings us back to the quality-of-care issues  that have long plagued DoD&#8217;s health care system. <br \/>Thankfully, the  Army still has the option of moving patients into the civilian system,  and the on-going drawdown in Iraq will ease pressure on the service&#8217;s  network of clinics and hospitals. But there is a cautionary tale in the  problems now facing the Army. Creation of a national, government-run  system (the ultimate goal of many Democrats) would result in the same  types of access problems that Army members and their dependents are now  experiencing. <br \/>Consider Great Britain, where 60 years of  socialized medicine have prompted many physicians to opt out of the  system (and work exclusively in the nation&#8217;s small, private health care  network), or seek more lucrative employment in the United States. As a  result, the U.K. has been forced to recruit more doctors from abroad,  creating potential security problems. <a href=\"http:\/\/en.wikipedia.org\/wiki\/2007_Glasgow_International_Airport_attack\">Five of the eight individuals arrested in connection with the 2007 Glasgow Airport terror attack<\/a> were Muslim doctors, recruited to work for Britain&#8217;s National Health System.<br \/>Beyond  security risks, there are the more pressing concerns of access and  quality-of-care. Almost everyone has heard horror stories from the U.K.  and Canada where patients died awaiting their turn for &#8220;rationed&#8221;  procedures, or were denied expensive medications by health care  bureaucrats. <br \/>In our country, military members and their families  can tell similar stories. Getting certain types of medications through  an on-base pharmacy can be difficult&#8211;if not impossible&#8211;because of  cost. Conversely, almost everyone in uniform has a seemingly endless  supply of 800 mg Motrin, the pain-reliever-of-choice in the armed forces  health care system. <br \/>We certainly hope the situation improves for  Army members (and their dependents) who are now having trouble getting  needed health care. Thankfully, the service still has our current hybrid  system to fall back on, allowing it to send patients to physicians and  hospitals off-base. But we wonder how long that option will remain,  given Democrats&#8217; 60-seat majority in the Senate, and the willingness of  House &#8220;Blue Dogs&#8221; to roll over on the issue. <br \/>There&#8217;s also the  matter of past, broken promises on military health care. Military  retirees were once guaranteed access to on-base medical facilities, with  virtually no out-of-pocket expenses. But along came something called  TriCare and more than a decade later, most retired military personnel  and their dependents are in a system that gives them more choices, but  at a higher cost. <br \/>Army families now struggling to see providers  on base should remember this lesson from the TriCare episode: military  promises on health care aren&#8217;t always kept. The same applies to  grandiose promises associated with current efforts to &#8220;fix&#8221; our health  care system.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>In a recent post, we wondered if the American health care system&#8211;or, at least Barack Obama&#8217;s vision of it&#8211;would come to resemble that of our military. With certain exceptions, the armed forces already operate a &#8220;single payer&#8221; system, featuring limited choices and bureaucratic decisions that govern the quality of care. While many military doctors (and [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[1],"tags":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/cvnextjob.com\/index.php\/wp-json\/wp\/v2\/posts\/92009"}],"collection":[{"href":"https:\/\/cvnextjob.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cvnextjob.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cvnextjob.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/cvnextjob.com\/index.php\/wp-json\/wp\/v2\/comments?post=92009"}],"version-history":[{"count":0,"href":"https:\/\/cvnextjob.com\/index.php\/wp-json\/wp\/v2\/posts\/92009\/revisions"}],"wp:attachment":[{"href":"https:\/\/cvnextjob.com\/index.php\/wp-json\/wp\/v2\/media?parent=92009"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cvnextjob.com\/index.php\/wp-json\/wp\/v2\/categories?post=92009"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cvnextjob.com\/index.php\/wp-json\/wp\/v2\/tags?post=92009"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}