Why Did Augustine Convert? Case Study

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VA and Medical Care

One key factor to be taken into account, while evaluating the healthcare structure of the United States (U.S.) Department of Veteran Affairs (VA), is the number of veterans actually availing themselves of VA medical services. Over 9.1 million, out of a total of over 21.6 million, U.S. veterans are registered with the VA healthcare system (Coburn, n.d.). Moreover, every enrollee doesn't necessarily receive medical attention. The Congressional Budget Office (CBO), in 2013, established that terminating enrollment of Priority Group 7 and 8 veterans could aid in reducing the federal deficit. These veteran groups, who gained VA healthcare access only during the mid-90s, include higher income veterans not requiring any service-related medical assistance (Options for Reducing the Deficit, 2013).

History

By the year 2003, VA found it nearly impossible to appropriately cater to the needs of every veteran enrollee, with wait lists for seeking healthcare becoming larger and longer, leading to a cut-off in new enrollments of Priority Group 8 veterans (Coburn, n.d.). A veteran from the Navy died of complications from 4th Stage bladder cancer after awaiting VA medical care for months. He was rushed to a VA emergency facility at Phoenix in September of 2013, only to be sent back home, despite his medical report stating that the situation was a 'critical' one (Coburn, n.d.). Reports state that VA authorities never contacted the family for follow-up on his condition, so the family called several times to schedule an urgent appointment. The veteran's daughter-in-law claims that she contacted authorities daily for months on end, with no fruitful outcomes. After suffering through months of agony and torment, he passed away on 30th November, 2013. She states that they were finally contacted by authorities on the 6th of December, a week after the patient's passing (Coburn, n.d.).

No less than 82 veterans have perished or been inflicted with severe injuries, due to delayed endoscopies or colonoscopies at VA centers, resulting in late diagnosis or care. CNN, after looking into these cases, couldn't find out whether or not any employee in the corresponding VA facilities was fired, or at least suspended for their failure. As a matter of fact, some individuals who are to blame for delay in veteran treatment or care may even have recently received bonuses at work (Coburn, n.d.). Veterans and families are most impacted by this grave issue. Three veterans lost their lives at a Georgia VA center because of delayed medical attention. A total of 5100 veterans (including 340 diagnostic, 2,860 screenings, and 1,300 surveillance endoscopies) who needed gastrointestinal procedures, couldn't access medical consultation in 2011-12 in Georgia (Coburn, n.d.). The VA failed to disclose, or deliberately attempted to bury, information on some of the veterans who lost their lives while awaiting care. No fewer than 40 veterans died while awaiting appointments at Phoenix's VA healthcare facility and, as per a CNN investigation, many of those names could be found on a classified waiting list. A retired healthcare provider who worked 24 years for Phoenix's VA facility asserts that when any veteran in the list passed away, his name was simply taken off the lists. Official records showed no proof that the individual did, in fact, seek medical attention.

Ever since these deaths were disclosed, no less than 18 veteran deaths linked to Phoenix's facility have been confirmed. FBI began criminal investigations looking into VA scheduling procedures on 11th June, 2014, in an attempt to establish whether hospital authorities deliberately lied regarding veteran wait times to receive performance bonuses (Coburn, n.d.). The issue clearly depicts an uneven distribution of money and power between those who need medical assistance and those who have it in their power to grant it. The problem was disclosed to the public through an independent criminal investigation and review, which exposed high mortality and numerous suspicious deaths in Lexington's VA facility in Kentucky (Coburn, n.d.). The VA system failure impacts veterans the most. VA's Inspector General conducted a recent analysis of circumstances associated with a patient's sudden death at Miami's VA facility; the patient was enrolled in Substance Abuse Residential Rehabilitation Treatment Program (SARRTP). The analysis revealed that the facility's healthcare environment wasn't safe enough. As well, techniques for examining SARRTP patients' illicit drug usage could be improved" (Coburn, n.d.).

For the veterans who are serving their country, returning to their homes from long deployment in another country is good news. When they come home, they expect the nation to support them in any way in return to their 'normal lives'.

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However, a lot of veterans suffer financial and medical conditions once they land home. The veterans look forwards to support from the Department of Veteran Affairs for necessities such as medical assistance, education, housing, and healthcare. However, they do not get all the things that they deserve. A lot of veterans have reacted in different ways, such as talking openly about the misconduct of the VA. One veteran, McShan, stated that he has been using VA since 2009 and has been encountering problems with long wait times. He had to wait for a year to get an appointment. A lot of allegations from other veterans have also been reported during the investigations (Gaitan, 2014). Another veteran also pointed out that a single negative experience with VA created a lasting impression on him that destroyed the VA's image.

Organizational Culpability

Previously a physician at Charleston's Huntington VA facility in West Virginia district, Dr. Margaret Moxness claims that while working for the VA facility, her superiors directed her to make delays in providing care, even in case of patients who required immediate mental healthcare. She witnessed no fewer than two patients taking their lives while awaiting therapy between appointments. She is of the view that VA authorities failed to notice the real suffering and pain experienced by veterans, causing them to show hardly any empathy towards these patients. Proper treatment of mental health issues is not possible when patients have to wait 10 months between two consecutive appointments. When Moxness expressed her views to her superiors, that some veterans were in dire need of proper assistance, they ceased talking with her (Coburn, n.d.). At New Hampshire's Manchester VA center, administration made use of clever ploys for covering up the real extent of their backlog.

An official who once served the facility states that performance measures included a condition that veterans seeking treatment at the facility be scheduled for psychiatric appointments within two weeks of their 'desired appointment date'. He identified several factors that made offering veterans the number of appointments essential for meeting their mental health needs impossible. While veterans and their clinicians may agree that a follow-up appointment was necessary in the following week for continuation of therapy, appointments were simply not available. All the same, the facility allegedly met the measure by merely not enabling veterans to provide their desired date. Patients were, instead, 'told' the next available appointment date (which often came weeks or months later), and this date was recorded as the 'desired' date of appointment (Coburn, n.d.)

Southern Nevada's VA facility, which is a one million square feet, $600 million structure packed with sophisticated, advanced technology and offers a central location for various specialized treatments, was acknowledged by national and local leaders as a giant leap towards healthcare delivery in the area. The center is anticipated to improve healthcare quality for veterans, with a capacity to increase its patient base to 60,000 veterans. However, one problem that faces the facility is that there aren't sufficient doctors for handling so many new patients. Nevada has for some time been afflicted with a dearth of healthcare providers, and consistently shows extremely low doctor-patient ratios, as compared nationally (Coburn, n.d.).

Inter-country exchange of services and goods as a response to efficiency criteria is one of the key features of globalization. Unfortunately, such inter-country multilateral agreements often cause further economic harm to less-developed nations. On the other hand, such international trade may also prove beneficial to developing nations (Hodges & Brechat, 2005). There are at least two issues that must be taken into account: 1) the ability of these developments to enhance worldwide healthcare quality (Hodges & Brechat, 2005); and 2) healthcare access and related ethical aspects. Creation of international standards with regards to healthcare delivery and medical education can facilitate healthcare quality improvement. Two questions, however, remain. How sure can one be that creation of global standards which suit the economic, social and cultural contexts of diverse nations is possible? Often, it is assumed that mere demonstration of conformity to quality measures will result in the same outcome, in all countries and for all professionals. But, how sure can one be that, for instance, application of North American (or Asian/African/European) quality standards and procedures to other nations will result in adequate healthcare quality? (Hodges & Brechat, 2005)

After the misconduct of VA was made public, the officials started taking a lot of actions, starting from suspending the officials. VA suspended the assistant director.....

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