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The Mission, Benefits, Scope, Services of the VA Administration is quite vast, and is the 2nd largest funded GOV agency, next to the DOD or Pentagon.I’m not going to discuss all of the History and Mission statement for the VA, as you can just go to it’s own link right here and find out for yourself:U.S. Department of Veterans AffairsThere are approximately 20 Million Veterans (about 7% of the US 325M Population), and at least 50% if not more access the VA Administration for their healthcare and many other associated benefits.My own experience in the PAST, as both Civilian & Military, involved typical, free-standing Civilian Clinic’s, PHS, and Military Hospital’s > of course during my years in service. After my Discharge’s (Army & later Navy), I was notified that I was eligible to receive medical benefits and other awards, BUT, choose not to as I was on a strict 24/7 menu of Hard Work + pursuing a University degree (doctoral), and also felt that there were many other struggling or Homeless Veterans who needed it more than myself. Years later, as a DAV veteran, I have been receiving my health & medical care services, since 2004, in Hawaii … and I’m pretty Happy with my care.Is it Perfect? Hell No … But then I’m not a 1%-er who can purchase a $10 Million dollar MD Concierge Program, with UN-limited Benefits, and Special Riders …The Pro’s about the VA Health Care System, in Hawaii:Our VA CBOC (Community Based Out-Patient Clinic) is in a very modern building, across from the largest state hospital on the island.Our CBOC (pronounced Sea bok’) … THE VIBE - is Very Quiet … serene at times. No Yelling - No loud Chatting on mobile - Baby crying is rare. - - The Demographic’s of our Staff & Veterans on my island - are mostly Asian, or Pacific Islanders, so that may “affect” SOME People that have moved here from the TV show town like “Mayberry, NC” … Just saying … It’s Hawaii … Not Gilligian’s Island!Services include: Primary Care Physicians (Family Practice + Internal Medicine) + Behavioral Health Team ( Psychiatrist’s MD’s) + Behavioral Specialists (PhD’s) / Counselor’s). And/or, a veteran & their family may elect to also use the Veteran’s center, in the same town.Specialty & sub-specialty medical / surgical services - are available from either Oahu or Locally. Staff makes all approval’s, arrangements and notifies the Veteran. There’s also Tele-medicine + Home Visits for eligible Veterans.Some Specialty Referrals to Local, Civilian clinics - Like ‘Audiology’ can be a total Waste Of Time, because their Civilian Providers (& some Staff )… Do Not Know Shiat, Nor, even have a basic Understanding about Exposure to Military trauma, combat environments, 105 howitzers, etc … I have stories to tell … and therefore, you may end up with the WRONG Diagnosis!CBOC - offers Immunizations (Individual schedules) + some Pharmacy + Med Injections, if or when needed.Update - In 2015, there was a New Directive from VA-DC, that all or most CBOC’s, “phase-out” their In-house, Basic to mid-level Acute care (like Abscess I&D, Simple Lacerations, Asthma/ COPD Rescue Inhalation services) , and Pharmacy services. INSTEAD, all CBOC’s have been “directed” to TURF all Veterans … to the nearest Civilian Hospital ER!!!! My immediate question was … WHOSE’s the Moron’s in DC that came up with this brilliant idea of INCREASING the Cost of Services to Veterans???? No answer.Lab & Radiology - the CBOC obtains approval’s and then Faxes the order to the nearest Lab or Xray facility (civilian).GUESS WHAT PEOPLE? In 99% of the time that I have been referred to CIVILIAN Diagnostic or Specialty Facilities, I have always had some Level of Issue or Problem, as someone in the Front or Back Office, will have a different “interpretation” as to what the request is for! AND, now some Moron’s (again) “believe” that ending the VA and “Transferring” into a Corporate HMO … is a Solution!Pharmacy Refill’s + Medical records - may be accessed on your own, personal, secure account, on-line, and much more. Takes 2 minutes for a refill, since it includes your present Menu of meds. Simple …Group Priority Number Assignment - every Veteran, regardless of past medical history, or a service-connected Disability, or a Purple Heart or no awards, is Eligible to receive care, but, ONLY if he or she qualifies under the VA’s Criteria. So there is Priority Group 1, 2, 3 and so on, which also “affects” how high the CBOC jumps on your behalf. This system work’s better if and when you have received a Disability Rating; than without one (I’ve experienced on both sides) … But, is also ‘Location-Dependent’ … Even within the same City, State or Region … as other Veterans have pointed out here …EEOC Governance - Service is provided to eligible members of the military and Veterans, without regard to Gender, Color, Disability, Religion, etc. - THAT makes it about as FAIR as any System … can be in Real World environments. NOT so in Civilian environments …US Military Records Transfers to and from the VA - are conducted by your CBOC.Dishonorable or BCD (Bad Conduct Discharge), or a General Discharge veterans - you may be on your own.Any or all of your VA medical records - copies can be requested anytime, just requires a simple form + signature. Deliver it in-person or by Fax.Appointments - Vary by Provider (PCP, Behavioral health, etc), but most times it’s been only 30 to 45 days out, or you can elect to be on a “call-back”, in case of any Cancellations.Walk-in’s - if you need to be seen (Non_Emergency), you may call -in to get a same day appt or next day. This has NEVER failed me, on a few occasions.Urgent or Emergencies - Call your CBOC 1st, Or Have your GF or Wife or SO, or Family member, then, they will get an Emergency Pre-Apporval for the nearest Hospital ER … And FAX it to the ER. Haven’t had to use this ER service, but that’s the scheme.Quality of my CBOC’s Medical Team - I give them an Absolute 5-Star Rating! Now before you veterans jump up and say that I’m way off … Then, you should also know that our OTHER CBOC here only gets 2-Stars / 5, and I would give it 0, if it wasn’t for 2 staff that work there.Communication - via Phone and email is really good.Appointment Check-in Process - Simple. You flash your VA ID Card in the Reader. Done!Billing or Invoices or statements - ZERO!The Con’s about the VA Health Care System, in Hawaii:A huge, complex, slow-moving Octopus - with the Head in Honolulu.A Government Bureaucracy - by de fault, especially in Honolulu. Things don’t “operate” that Efficiently, there’s a lot of Fubar, Mis-communication daily events, benefit failures, egg-head dipshit’s, etc.Caveat #1 - Every Veteran in each State should check to see if their VA Hospital is FEDERAL or STATE-operated. THERE IS A DIFFERENCE. You’re Welcomed.Caveat #2 - Every State provides “different levels of Additional Benefits” to Veterans. Some are extraordinarily Generous, Others are in the middle level, and some have turned their back on you. You’re Welcomed.Documents - I’ve learned to send any document by Express + Signature-Requirement. They must have a massive File 13 Shredder, that eats any and all documents. Make sure that you have have multiple CERTIFIED COPY’s for each document.Documents 2 - The VA monster Lives and Breathers on “paperwork”, let that be a Warning. Must KNOW each VA-Form’s # … and Specific Request Use.Medical - Health - Behavioral Evaluations in Honolulu - the medical is Ok (C- to B grades), but the “Behavioral jockey’s” was a bunch of amateurs …Travel From Outer Island (akak Inter-island) - is very good, I must point out.The VA Center or Hospital Faculty & Staff - 50& seem to know what they are doing, the other 50% are either Newbie’s, on OJT status, or just don’t give a fuck (just collecting a check). Many CIVILIANS are collecting a check there.The VA Center (Honolulu HQ) - is a A Government Bureaucracy. Yes, it HAS improved in some area’s, and has declined in others.The VA & Military - provide highly-specialized Services, that apply ONLY to the Military and Veterans, that the Civilian World, will NEVER catch up, Nor Deliver … THIS FACT has already been Proven … in the field.Comparisons - I would rank my Best-To-Worst experiences with medical facilities in this order: VA Hawaii >Military Hospital’s > USPHS, and then Regular Civilian facilities.IMO, the biggest problem’s with Civilian healthcare facilities - has always been > a lack of Services Consistency, Office & waiting room Chaos, ETOH/Opiate Drama, SPECIAL Designated favors, Chronic gossip, Rumor Mill’s, Appointment time constraints, Streaming Error’s, MD & Staff turn-over, Disruptive waiting room patients, their “Guests”, etc, etc. THIS IS the purest definition of an UN-controlled Medical Environment …Elite Class Exceptions - the best Civilian health & medical facilities are the ones for the Elite + Wealthy Population … Top-tiered University-based Hospital’s & Clinic’s … like Stanford, UCSF/Berkeley, Seattle, Mayo, Johns Hopkins, Harvard, Yale, etc. That’s where they have the World-class Physicians and Services.A Disaster In The Making - There is some Political “movement” to Change/Move/Transfer the VA Administration Hospital’s, en bloc, to the Civilian Industrial Complex.IMAGINE - HMO’s like Humana, Kaiser, Kaiser-Permanente, Cigna, BC/BS, or worse … Trump Medical Centers, or his Billionaire Krouch Cronies … getting their liver-spotted, scraggly, ‘Gordan Gecko’ Fingerings into the pot … It will / would be nothing but a Barnum-Baily Shit_show of Epic proportions!Converting a FEDERAL Health Care Delivery System - that was especially created for US Veterans … is a System that any 3rd-party Civilian Healthcare System will CHOKE ON & SCREW UP … into a monumental Disaster.Any Veteran that is supporting this shitty 3rd-party CON-version “idea” … needs to leave the VA System, and go get Obama care … Try that for 10 years and then come back and report … Got It?TBC … I’m dam sure of it …