July 9 2014 08:31 AM

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lettersforweb

The wrong diagnosis

Regarding your May 21 editorial about Veterans Affairs hospitals: Obama's demand that all patients be seen within 14 days initiated the current situation, the result of a decree rather than a solution.

It has resulted in a mess, but the current congressional and media frenzy to place blame on the system and put more money and doctors, nurses and personnel into the system is flawed. There's a public perception that the system is turning its back on young, injured war veterans. Nothing could be further from the reality. In point of fact, young vets are generally offered a fast track and serious illness in any vet requiring urgent care is expeditiously provided. I believe we can say with pride that the system provides care equal to any available in the private and academic sector. At the moment, it's just not as fast as it could be, because of well recognized difficulty meeting the demand.

Most of the patients are Vietnam-era with ubiquitous degenerative conditions. Whether it's politically correct to say so or not, much of the hypertension, diabetes, atherosclerotic and arthritic conditions currently overwhelming the system are exacerbated by issues such as obesity and smoking and even by social factors such as secondary gain (such as VA disability claims and other reimbursement schemes essentially paying patients to be ill).

I question the wisdom of making an implicit promise to any and all who ever served any time in the military that subsequent medical conditions in life, no matter their service connection, would be addressed at government expense. Your prediction is correct: This will get worse with time.

What the VA healthcare system needs is a strong definitive eligibility and triage algorithm, not a blanket bottomless promise. The idea that pouring more resources into this system as it currently operates will allow it to eventually catch up with the load is unrealistic and ruinous. The only solution is to correct a national inclination to overmedicalize and a realistic approach to separating the wheat from the chaff and reducing patient load.

Bruce L. Ehni, M.D., Michael E. DeBakey Veterans Affairs Hospital, Houston, Texas


We have our own crazies

Regarding "The pyschos are back" ["Editorial," June 18]: Funny how an offensive by organized crazies on the other side of the world causes so much concern. We have mass shootings happening weekly, an armed posse waiting to battle BLM officers on federal rangeland, guys like Ted Nugent waving military weapons around while calling the president a mongrel and whole parts of legislatures trying to write their version of religious law onto the books. Seems like we have a fairly high level of sectarian conflict here.

Too bad the warmongering wing of the GOP doesn't ever look stateside to see what our own version of the Taliban is up to. But they're only concerned with two goals: maintain the empire that funds their investments and continue to support the biggest scam in modern U.S. history—that Dubya was a functioning American president.

Bill Shaw, Clairemont


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