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Veteran veterinarian here who recieves her care through the Boston VA in W Rox.

I will state my biases

I love the VA

I have recieved far superior care there than in outside providers

I was told that 70% of American health care providers go through the VA training system at some point. So basically, the VA touch the vast majority of American healthcare workers.

Next...the reason that Congress can whine about the VA is because it has the stats to do so. The VA exhaustively reports in ways no other health care company does or has to.

So your conclusion that VA researchers downplay the awesome that is the VA doesn't surprise me. It is far easier to sell the narrative that "government health care" is terrible or not as good, so they can get more funding.

Does the VA have shortcomings? Sure. But, it is amazing health care with amazing workers.

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This is such a great point. Depending on the issue, there might be an institutional conflict of interest here, one that's unique to the VA. In the private sector, if your data doesn't portray you in a positive light, patients will go elsewhere. But at the VA, if your data doesn't portray you in a positive light, it's evidence of problems in the system that congress may be (or may not be) incentivized to address with additional funding. But problems in the VA system are often cited by policymakers as justification to send veterans into the private sector, so it can go both ways. Obviously there are a lot of complexities here that depend on the issue at hand, ranging from quality of care inside large VA hospitals to access to primary care for veterans living in rural areas.

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"The way we view the world, our ideologies, can impact the questions we ask but may also impact the answers that we find."

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Indeed. This can easily be seen in how the media covers the current Israel/Gaza war. Humans always let their personal biases intrude on almost anything they do.

Always assume that the reason someone does something is to benefit themselves, first, in some way shape or form.

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Our cognitive biases, mental shortcuts, ideologies, etc. can theoretically show up anywhere and impact the way we do things, even in medicine--which is one of the core themes of the Random Acts of Medicine book. But just because our biases and incentives are sitting in the car, I don’t think they’re always in the driver’s seat, so to speak. When everyone’s aware that they’re in the car, though, it’s a bit easier to understand how they might be (or might not be) influencing our words and decisions.

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Universal health coverage vet or no vet

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Get rid of the VAs and turn them into public health facilities for all and care for all folks equally and get universal health care into this mix. Than if you folks like compare individual facilities to each other.

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