It’s Past Time to Tear the VA Down by Pat Conrad MD


The VA – as currently conceived – should be torn down, blown up, done away with.

A new study co-authored by the reputable Rand Corporation finds the VA health care system…wanting. There are a lot of vets, many of them aging, who suffer from every conceivable malady including numerous life-threatening or chronic illnesses, and many self-inflicted problems. Many of them have psychiatric diagnoses and issues ranging from BS to severe PTSD, depression, and substance abuse. Before you rip me, know that I am a veteran and am very pro-military and pro-veteran. I do respect that a contract has been made with the members of our armed services and that contract should be honored, whatever your politics. Clear?

Those of you who read my contributions know that I have, to put it charitably, a great antipathy toward the federal government and most of what it does, which it does poorly. I have written to you all for years that the goal of the federal bureaucracy is to make itself ever larger – an instinct really – and that health care is the best way to do it. In the push for nationalized health care that has been active since 1991, and implied since 1965, the VA is frequently thrown up as a template for justifying a sort of universal Medicare. Consider the latest from this study:

  • “The report finds that VA facilities cost twice the normal amount for public facilities.”
  • “The findings also contradict the department’s claim that most patients are satisfied with the care they receive.”
  • “At almost every facility visited, at least one leader interviewed mentioned that risk aversion and a reluctance to ‘speak up’ were a significant issue. . . .”
  • “VHA providers are expected to see between 10 and 12 patients per day. In the typical fee-for-service care model in the private sector, it is common to plan for 24 visits per day.” Author’s note: Seriously folks, how many of you in the mainstream medical machine could get away with and pay the mortgage on seeing twelve patients a day?
  • The VA can no longer deny that its problems, as outlined in this report, are deep-seated and systemic,” the statement continues.
  • The statement added that the agency is “challenged on every level.””

Many if not most of us who have gone through med school and residency have had some involvement with the VA, and we know that they have some very fine people working for them. We also know that they have a lot of lazy-ass parasites on the payroll that are just marking time toward a pension. That is not a surprise characterization of the average federal worker.

The point? We are lying to our veterans just as both major political parties have lied to the voters for years about guaranteeing their health care. An ignorant, mob electorate, a bullying, presumptive media, and an opportunistic political class are pushing us toward being first de facto, and then formally, federal agents. That is and will be bad for patients, and bad for physicians hoping to retain a shred of integrity. The VA is punishing its own, and we’re told we should view it as a success to justify an expansion of government care. Want to fix this VA mess? Institute vouchers for vets to see private physicians, and to go to private hospitals, while dismantling the brick-and-mortar VA system. Maybe some of our veterans will find their way to a Direct Primary Care physician, and get the care they have earned.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  2 comments for “It’s Past Time to Tear the VA Down by Pat Conrad MD

  1. Craig Amnott, DO
    September 30, 2015 at 10:06 am

    I’m a retired vet. 20+ years in the Army. Ten years as an infantry officer. Ten years as a physician. Combat tour to Iraq.

    I moonlighted in the VA (ER and Urgent Care) for 3-4 years while I set up my private medical practice. Here’s my “N of one”.

    1) As a retiree with a disability rating, I am eligible for care at the VA. I currently chose not to receive my care there.

    2) I no longer work for the VA of my own free will. The bureaucracy, top heavy administration, and lack of common sense simply drove me nuts!

    VA modelled healthcare is NOT the answer.

  2. Steve O'
    September 26, 2015 at 9:40 am

    If you want an even more stark contrast, compare DPC and the VA.
    In the mind of the bureaucrat, everybody’s work has the same value. Maximize output by making them busier. The difference between the productivity in the private sector, and the productivity at the VA, is basically measured in the amount of craptime necessary to “do the job.” Probably 5-10 patient visit slots are used up by physicians doing utter crap.
    We also know that they have a lot of lazy-ass parasites on the payroll that are just marking time toward a pension. That is not a surprise characterization of the average federal worker.
    Where do these mutant sloths come from? Sloths don’t just fall out of the trees. Never. (Even when they die. Ewww.) They are created, by several generations of bad management and economic principles.
    Washington understands the Economy in terms of Jobs. The Economy must create Jobs, and Jobs drive the economy forward. If Gran’ MaMa drank too much during pregnancy, and Uncle Ebert is not a rocket surgeon, well, get him a Job! He will contribute to the Economy!
    But Jobs are not the same as Work. Uncle Ebert can show up every day, punch in, sit behind his desk, attend teleconferences and file his quarterlies. That’s what you do at a Job. But he produces nothing.
    It’s why the Eastern Block, and the Soviets, fell apart. It’s like the broken window hypothesis – if you smash your neighbor’s window, he will take idle cash out of the bank to employ someone to fix it, thereby helping to create jobs.
    How many of our friends, neighbors and countrymen….umm…Work? At something that benefits the economy? That doesn’t ask if they drive a Lexus or have a vacation home. What do they “do” exactly?
    The answer to that question lies wide-open and mind-boggling when you look at it. A physician providing direct primary care to a population the size of a VA panel:
    #1) can run her/his own solitary business, doing all the back-office stuff, and
    #2) always have time to get something done.
    Contrariwize, the goal of the Obamaca care is to lower salaries of physicians perhaps 20%, get them to see more patients, and do more crapwork. The end is in sight.
    Which system is more productive? Which system is more easily infested with parasites? Which path will we follow?

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