Louisville Medicine Volume 63, Issue 8 | Page 28

DOCTORS’ LOUNGE (continued from page 25) long-neglected illnesses. Because of the ACA, funding is available for research into health care delivery and education for NPs, PAs and doctors who will work in medically underserved areas. Because of it, mental health care and treatment for addictions are far more accessible, with parity in copays. Because of it, lifetime limits on treatment have been removed. Because of it, irrational and greedy premium increases have been greatly curtailed, due to mandatory federal review and stiff requirements for justification for such increases. What people seem not to understand is that preventive health care is expensive, but is far more humane than the alternative. Having large cohorts of people die off at 60 saves everybody money but robs the world of grandparents, political leaders, professors, writers, artists, filmmakers, comics, basketball coaches and happiness. In the same vein, sophisticated medical care is extremely expensive, but the cost is doubled when no one is there to receive the discharged patient and try not to let them get that sick again. We don’t have the British system, where everyone is cared for, or the French one, where doctors come to your house to boot; but what we have should be available to all. President Obamacare has made that possible. Gov. Bevin should not dismantle it: it works. IF he can receive federal permission to remodel it along the lines of the Indiana plan, in hopes of saving money and increasing health accountability, that might work out fine. Dismantling it totally with no alternative is a ridiculously expensive, wasteful and inhumane idea. My advice is, when in doubt, raise the tobacco tax. Tripling it would not even bring us close to where we should be and would raise tons of money, in this, the state where someone dies of lung cancer about every three hours. Raise the tax, help the poor, and keep the young from smoking. What’s not to like? Dr. Barry practices Internal Medicine with Norton Community Medical Associates-Barret. She is a clinical associate professor at the University of Louisville School of Medicine, Department of Medicine. DEFENSE OF THE VETERANS ADMINISTRATION Capt. Robert E. Arnold, MD, USNRR Re: Always an Afterthought by Mary Barry, MD, Louisville Medicine, October 2015 I have been a patient in the Veterans Administration system for 20 years and I wish to make it perfectly clear that I do so by choice because I like the care that I have received. I could obtain care in Tricare, civilian providers or military hospitals so there is no financial incentive to remain in the VA. The providers are excellent and the care is timely and appropriate. Waiting times are almost always 15 minutes or less and this includes lab work, X-Rays, etc. The clerks and staff go out of their way to be helpful and one time I asked a man sweeping the floor where a particular service was and he put down his broom and walked me through two long corridors and said “No problem”. Try that at Baptist or Nortons hospitals. Incidentally, they don’t know my rank or that I am a doctor. That being said, there are some common misconceptions about VA that I would like to address. 26 LOUISVILLE MEDICINE At the Separation from Active Duty Orientations, which all service members are required to attend, the VA has a designated time when they clearly explain their function so that everyone can understand it. First of all, VA care is not an entitlement but is an added benefit with very clear guidelines. The VA was made for the benefit of severely wounded veterans who would need almost constant care and it was felt that having this in one place would be advantageous and this concept was proven correct. As this patient population died, the excess VA capacity was opened to all veterans but in ord \