I am a veteran of the United States Navy. As an honorably discharged veteran, I am allowed to partake of the VA Medical System. This gives me several advantages that are much to my benefit. And before I go on, I want you to know that I look at VAM System to be much like socialized medical care. I have many complaints about the system.
1) Appointment times to see primary care physicians
While not hard to get if you are willing to wait a month or two, are almost impossible to get in an emergency situation
2) Long waits past appointment times
A normal wait, depending on the clinic can be 0-15 minutes past the appoint time, to the other day when I waited over 2 hours past the appointment time to see the doctor
3) When I need to get in to see a doctor earlier than I am able to make an appointment, I do not get to see a doctor
At the VA, when you have an immediate concern, you go to your clinic where your doctor is when you have an appointment, you will see a PA, but you will never see the doctor. Once the PA has looked you over, you are told to sit in the waiting room until the PA can get with the doctor to discuss your problem. If the doctor is not immediately available, the PA will of course move to the next patient in line. So you have to wait until the free time of the doctor and the PA coincide, and hope it is not while they are at lunch.
4) Some clinics are able to get you in and out fast, which is nice. X-ray is an example of this. They run at least one team of x-ray technicians and readers 24/7. My longest wait for x-ray has been 20 minutes.
5) The ER is consistently busy or backed up
The ER has only 10 beds, the one to which I go. In the overnight shifts there is only one doctor available and he is busier than a one-legged man in an ass-kicking contest. Thankfully for me, I get in almost immediately because when I go it is because of heart problems.
6) Doctors do not seem to talk to one another, nor do the doctors appear to read the evaluation sheets the nurses complete, nor do the doctors seem to read your previous charts before coming to see you.
I feel my time is wasted, as well as the doctors', telling the doctor the same thing I told the nurse which is the same thing I told the person taking my vitals which is the same thing I told the person at the ER desk when I came in, etc.
7) There is rarely any follow up when a doctor says they will call and follow up. I am waiting for the doctor to call me so that it is at his/her convenience, but I never receive the call back, and am told I should have called back. In those cases, I have told them I have and played phone tag with them and so there never was follow up.
There is more, but I will stop there because I know by now you are asking what is the point of my post.
My point is this, the VAM System is a single payer system controlled by the government and by bureaucrats. A doctor who is not seeing enough patients in the time allotted to him/her in a day is not doing his/her job, regardless of the fact that they are overbooked and understaffed. Each doctor to whom I have complained about the long wait times after appointment times have all said the same thing. They are told to schedule in their clinics X number of patients and to see X number of patients. Each doctor wants to spend as much time as necessary with each patient, but the system is not designed for that. It is designed to move people in and out fast and get done what is essential, but allow the doctor the time to evaluate or consider everything.
Can a doctor, who is considered a primary care doctor, really take care of a patient when seeing them once every three or four months? Not even. How distracted is a doctor, when he is with one patient, but thinking about the one previous and the next and so forth? How effective is a doctor that has to continually think about moving on to the next patient so s/he hits his/her quota for the day?
Now, while I do believe the VAM System could use a lot of improvement overall, I do believe it to be a good system in spite of those flaws.
Here is the problem with ObamaCare:
They have a good groundwork laid in the VAM System for a one-payer socialized medical system. It does need improving and could benefit all much by making those improvements.
They are not basing the new system on the VAM System at all. They are completely ignoring that system.
All of the above is beside the point that we do not need a government-funded, government controlled medical system with bureaucrats getting in the way of treating people. But it is definitely something about which to think.