The Past Present and Future of Veterans Health Care - Research Paper Example

?Running Head: VA MEDICAL SERVICES The past and present practices on veterans' health care and how this suggest the nature of its future University The past and present practices on veterans' health care and how this suggest the nature of its future Introduction veterans' health care has been a benefit that provides those who have served in the armed forces a resource for the continuation of good health. While the benefit is one not enjoyed by all Americans, the veterans' health care system has had its difficulties in providing good health care for those afforded the privilege. In the past there has been many issues with the cleanliness and availability of the services that had been promised. In addition, the issue of veterans' of heath care benefits is often up for both media and political review, threatening the whole system. However, there is evidence to show that the VA health care system is the finest in the United States and with better funding should serve as an example of how government run health care can save an inadequate health care system through privatizing. The biggest problem within the VA is that it is under funded. In a world where volunteering for service is not top on the career moves of most young men and where the draft is no longer being used, maintaining a health care system for those who have dutifully served and may need continuing care afterward is the one of the few ways in which men and women of the service are given proper acknowledgement for the gift that they given to their country. Overview The need for a better health care system for all citizens points to the need for a more approachable system of health care for those in military service. The health care that is provided for veterans' is defined by an as needed basis, but in remembering the nature of illness, one must remember that to wait to get service is to continue to suffer without care. Many appointments are not available for as long as a year, in which the medical issue can be expanded and then require more care than was originally needed had the patient been able to receive care at an earlier time (Gayton & Borden, 2008, p. 7). One advantage to the system is that it is also based on income so that those who have the complication of low income with medical needs can be seen sooner than those with resources from outside of the VA. History Throughout the history of the United States, medical benefits have been supported by the government for those who have fought in the service of the country. After the American Revolution, hospitals were erected by the government to treat soldiers in need of care after fighting for the right to be a country. In 1930, the government formalized veterans' benefits so that law could govern the care of soldiers. The unfortunate history of VA health care benefits is defined by a shortage of resources in which to service all of those who are in need. In 1930 there were 45 veterans' hospitals with 54 regional offices, but by 1948, after the end of World War II there were 125 hospitals with 102,200 beds, but there were still 20,700 soldiers in need of admission, but without the beds to service them (Gayton & Borden, 2008, p. 7). Background Current eligibility for veterans' health care benefits are based upon the: serving in military, navel or air service and being honorably discharged or having been a reservist who was called to active duty and completed the full call-up period. If not, one of the following might be true: the soldier was discharged or separated for medical reasons, the soldier served in combat operations within the last five years, the soldier had a non-pre-existing disability, the soldier was a prisoner of war, received a purple heart, was previously eligible for VA benefits, or receives state Medicaid benefits. After these qualifications are investigated other criteria might be used to situationally determine whether or not benefits are applicable (United States Department of Veteran Affairs, 2011).1 The highest priority for eligibility are those who have been disabled in the line of duty and have low-income, where those with a higher income with no issue that is connected to their military service are of low priority (Holding, 2010, p. 2). In 2010 an appropriation of 48 billion dollars was allotted towards a system that has 150 medical centers, 950 ambulatory care and community based operations, 230 centers for veterans' for mental health care and readjustment, 130 nursing homes, and home rehabilitation and health care services (Holding, 2010, p. 2). In order to improve care, the veterans' Health Care Eligibility Reform Act of 1996 required the veterans' Administration to provide health care to all those with injuries that were directly related to service and to then reach out to provide help to other veterans' when funding was available. All veterans were eligible to enroll and services were assessed on a case by case basis. In addition, ambulatory care began to replace hospitals in order to reduce costs and to utilize funds in a more efficient manner. Outpatient care became the standard, with hospitalization only when necessary. Definition of Terms VA: The veterans' Administration is an extension of the United States government in which veterans' affairs are taken care of and through which the health care system is conducted. NP: A Nurse Practitioner is a nurse who has taken extra education in order to be able to diagnose, order lab-work, and prescribe medicine (Buppert, 2007).2 Statement of Problem Research Questions The following questions will be used in order to frame the research of this study. In answering these questions, the research will be focused and provide context for understanding the outcomes. 1. In reference to the future of veterans' health care, what is the primary concern about maintaining the program. 2. What innovations have provided the most important contributions to creating an effective system and why do those innovations work? How can they be increased in the future? Literature Review VA medical systems are defined by an older population that is the core population in need of services by the administration. The median age of a veteran who uses the service is 62, thus setting the care that will be needed by these valued citizens as being an increasing set of medical problems as they continue to age (Kandel & Adamec, 2009, p. 271).3 However, with the growing number of returning soldiers from Iraq and other theaters of conflict, the needs of those veterans will begin to emerge as necessary obligations to the system. In a medical system that is inadequate to the entire nation, the needs of the veterans will need to be addressed. One of the core problems in the United states in regard to veterans' health care is that overall the nation has a less developed health care system then any other developed nation. Issues that can be attributed to the lower value of health care in this nation include the high expense and the lesser outcomes. Longevity, infant mortality rates, general health assessments, errors in medical treatment all are worse than all other countries that have highly developed health care systems According to Skidmore (2008), “nearly every other country boasts better outcomes from its health care than does the United States” (p. 10). In not providing health care for the masses, the United States is ill-equipped to provide it exclusively for its veterans' as the funds and resources are not available. However, the VA currently has the best medical treatment available to US citizens. In 2003, the New England Journal of Medicine compared eleven criteria within the VA system to private medical systems. The study found that “In every instance…the quality of care in the government institutions was “significantly better” than anywhere else” (Skidmore, 2008, p. 10). According to Leonard (2004) one of the most difficult issues within the VA is that the resources are allocated inequitably. A report given to Senator John McCain indicated that the Senate was investigating a way to allocate resources in such a way as to make health care more uniform throughout the system. Problems such as shifting demographics and the allocation of past funding records as a way of funding future needs. What was needed in one place is not needed in the same place because of shifts in locations of populations of veterans. One of the innovations that have affected the quality of care in veterans' health care systems is the use of NP in order to serve outpatient care and to facilitate a lower cost, but higher quality system. By utilizing NP’s as a primary resource for interaction between the veteran and the needed care, a higher rate of patient care a can be achieved. Because of the utilization of this resource “the VA’s spending per enrollee rose much more slowly than Medicare’s, despite the 1996 expansion of the number of veterans who could access VA services” (Committee, 2010, p. 7). The innovative and effective use of NP services has created a cost savings, while increased care potentials. The use of NP services is represented by the 3,344 that are employed by the VA. This represents 7.7% of the whole NP profession (Sullivan-Marx, 2010, p. 225). In combination with the reports of higher values of health care inside the VA system as opposed to private medical care that is used by most of the rest of the citizens, it suggests that the use of NP services is a way in which to lower health care costs and provide higher levels of care across the entire health care system. Analysis In reviewing the relevant literature on the topic, the needs of the VA are not defined by a lack of good quality care. The needs of the VA are defined by the need for better funding and for an allover better way of allocating funds. The nature of the VA is defined by financial problems. The future of its existence is going to be defined by remedies that provide better resources for the care of patients. Since the improvements of the way in which veterans are addressed from the bill in 1996, the nature of the services have become more accessible. However, it is through funding that the VA will see the best possible outcomes. Because of the outcomes that are appreciated by the government run system, it is possible that providing more resources for the population of the military will create a better overall result for the nation in terms of increasing medical care and resources towards that end. Conclusions The primary concern for the future of veterans’ health care is in the development of appropriate and responsive funding. In creating a system that is not only high quality and accessible in terms of eligibility, but also responsive to current needs of the users of the system, a savings will be appreciated when medical needs to not get worse in the interim between contacting the system and being able to see a medical professional. Because of the lack of equitable allocations to individual venues, the system is not being equally served throughout. Therefore, in creating an integration of the way in which services are available, the system can begin to grow in regard to adequate funding. Through integration, the system can find a way to be a more cooperative and flexible system. The use of NP services should increase greatly, with the expense of doctors being reserved for those times when the complications of the medical care require responses from those with more education and diagnostic expertise. Innovations that restructure the way in which medical care is given should continue to increase the number of people that are being able to receive services. The past increases in performance reveals that continuing this trend of increasing the number of people seen by the VA by using adequate, but lower educational and therefore lower costing medical care will provide a better overall system. In addition, the innovation of switching to a outpatient based system has achieved a similar result. In creating health care that is not bogged down solely through hospital based medical care, the system is creating a lower and effective method of attending to health care needs of those who have served in the military. Recommendations Further research is needed on how to create better and more efficient systems, while finding ways in which to more equitably and deeply fund those systems within the VA medical services. In providing better and more efficient health care in the VA system, it can begin to serve as an example for how the government can better serve all the citizens of the nation. Therefore, studies that compare the quality of the care to the accessibility to the care can close the gap in understanding where the deficits are being realized. Through better research, the funding can increase, therefore providing better overall services. References Buppert, C. (2008). Nurse practitioner's business practice and legal guide. Sudbury, Mass: Jones and Bartlett. Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine. (2010). Future of nursing: Leading change, advancing health. Washington: National Academies Press. Gaytan, P. S., & Borden, M. E. (2008). For service to your country: The insider's guide to veterans' benefits. New York, NY: Kensington Pub. Corp. Holding, H. (2010). Potential costs of veterans' health care. New York: Diane Publishing, Inc. Kandel, J., & Adamec, C. A. (2009). The encyclopedia of elder care. New York, NY: Facts On File. Leonard, Barry. (2004). Veterans' Health Care: Facilities Resource Allocations Could Be More Equitable. Diane Pub Co. Skidmore, M. J. (2008). Securing America's future: A bold plan to preserve and expand social security. Lanham, Md: Rowman & Littlefield Publishers. Sullivan-Marx, E. (2010). Nurse practitioners: The evolution and future of advanced practice. New York: Springer Pub. United States Department of Veteran Affairs. (2011). VA health eligibility home. Veterans’ Administration Website. Retrieved from http://www.va.gov/healtheligibility/ Read More