Monday, May 28, 2007

The Test of a Nation

A Memorial Day thought:
The test of a nation's commitment to its Armed Forces veterans is two-fold: how they are treated during a war, and how they are treated five, ten and twenty years later. With some 60% of Iraq War veterans experiencing some form of PTSD (post-traumatic stress disorder), I have to wonder if we as a nation will abandon the vets as soon as the war winds down, as occured after Vietnam.

I hired many Vietnam vets when I was a builder in the early 1980s, not because they were vets (I didn't ask) but because they were looking for work. A number had psychological problems relating to their service in Vietnam; these problems included extreme withdrawal, outbursts of rage, and inability to concentrate. Others were drifting through their 30s, camping at the beach, while one set of brothers took their Mom with them wherever they found work. I rented a camper on the jobsite for their Mom and paid her a small sum to keep an eye on things. (She was one tough cookie; by her own choice she was armed, as she knew how to handle firearms.)

Would the guys have been troubled even if they hadn't served "a one-year hike through the jungle" (one's apt description of his 'Nam duty as an infantryman)? Perhaps. Would the Veterans Administration facility on Oahu (Honolulu) provided sustained treatment for them? Perhaps. Did they even consider going in for treatment? Perhaps not.

What I do know is that we as a nation shunned these vets, underfunded the VA system, and generally ignored PTSD or "blamed the victim" (aw, those guys are just whiners, etc.). I fear that once hostilities in Iraq wind down (for whatever reasons), the nation will quickly avert its eyes from the individuals who paid the price internally for their service and rush to cut the VA (and military readiness) budgets as the recession bites deeply into tax revenues.

I hope we won't repeat the tragic cycle of postwar denial and abandonment suffered by many Vietnam-era vets, but I am not confident that our nation will choose to spend money to support our vets long after the war is over. I fear the powerful constituencies protecting entitlements (Medicare, etc.) and pork projects will raid the VA budget to protect their own turf. For you see, vets are not politically powerful; those who are suffering often do so privately. And you can be sure the puffed-up pundits who have glorified the war will be the first to forget the vets who actually served.

Continuing on the theme of responsibility: Knowledgeable correspondent Nurse Dorothy offers an "in the trenches" reaction to the May 24 entry on health and healthcare. I believe her comments are extremely important, and speak to issues which are virtually ignored in the mainstream media and the halls of Congress. Here is the chart she refers to:

please go to to view the chart.

"This is in regards to March 24th Health and Bankruptcy article. I know it's a little late in responding, but I just came off of a four day stretch at work. In that article there is a purple circle which says "I want a pill, blame someone else for my ill health". That statement screamed at me because it's so true. I have the perfect example.

This weekend I took care of a 60 year old, overweight women who has an active bleed in her colon. She has been with us for three weeks. She has refused a colonscopy among a few other treatments and tests which are needed to treat this condition. She has also continuously violated our no smoking policy as well as her diabetic diet with the help of her family. You may ask why not just send her home then. We can't because if we do and she dies at home, we will surely be sued as her family has already threatened it. The patient and the family are in no hurry to get her home even though she has no insurance. Why because Medicare pays for part of it and the rest goes unpaid by the family.

Even though we have plenty of documentation of her un-cooperative behavior in everything, we will still be sued and the family will more than likely win the case because our country is adverse to personal responsibility. Although this case is an extreme one, I would say half our patients are not willing to do what is necessary to get themselves back in better health and we as citizens pay for that.

Anyway, I thought I'd share this example with you mainly because I just needed to vent my frustration at our citizen's lack of discipline and responsibilty for their own health care. "

Thank you, Nurse Dorothy, for "plain speaking" to an issue we as a nation refuse to address: personal responsibility. Those of us who know working physicians and/or administrators in the "healthcare delivery systems" (i.e. hospitals and providers) know the medical malpractise system is utterly broken. Yet at the same time, I wonder if a class-action lawsuit might not be the only weapon vets will have to channel funding to the VA when its budget is slashed to protect more politically powerful government-funded fiefdoms.

Responsibility is two-fold: as a nation, we are responsible for the care of those who served, especially those who served in combat. We must keep in mind two things: service is voluntary, and the orders to go to war come from our civilian, elected government, not the Pentagon or senior military officers. Therefore we as a people sent them to war, and we are duty-bound to take care of them, regardless of the war's outcome.

As individuals, we are responsible for our own health. It will come down to this, readers: we can either fund our VA hospital system, or we can pay for irresponsible civilians like Nurse Dorothy's trigger-finger-on-a-lawsuit patient. There won't be enough money for both, and we as a nation will have to choose who gets our support. My vote will always be for full VA funding, above all else--even my own Medicare benefits, should there be any left when I qualify.

Today, and every day, my thoughts are of our friends who are serving in Iraq. Words fail me; just look at this photo.

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