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Comment by lp0_on_fire | Hacker News Reader

> This is just my anecdotal observations, but I've seen that military veterans are extremely adept at gaming the system to their benefit. They are able to maximize disability benefits as well as GI Bill benefits. I've known and worked with multiple veterans and each one of them gamed these systems to maximum benefit.

"gamed" is a very loaded term that suggests something untoward is happening as opposed to people just trying to get the benefits they're entitled to as Veterans. Do you have any evidence that the people you've observed are doing something shady or do you just think they're getting more than they deserve?

> It also appeared that they coached each other on how to obtain maximum benefit.

Is it "gaming" the system when I offer my friend advice on how to navigate the byzantine health insurance system in the US?

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Yes, I have anecdotal evidence that people are gaming the system to get more than they deserve. I have directly observed multiple Vietnam Vets gaming the Agent Orange system to get 90-100% disability. The would visit multiple doctors to get the wording they needed to supply evidence that some health issue was related to Agent Orange. Their goal was to get a doctor to write down that a particular health issue "might" be related to Agent Orange. Once they achieved that, they would add that health issue on the list of other health issues. Each one would get them 5-20% disability.

To be be clear, you are not a physician who has examined these Vietnam Vets and have determined that their issues are 100% unrelated to Agent Orange?

(responding to to sibling comment)

No, I'm not a doctor that has examined them. I have been told by these people that they want to maximize their disability payments and they can do that by claiming things are caused by agent orange. I've been told by them that they will shop around the diagnosis until they get something in writing they can use. I have been told by these people that they don't care if it is related to agent orange or not, as long as they can get a doctor to write it down.

So basically getting a second opinion from another doctor is somehow fraudulent behavior? If you have a problem with this, shouldn't it be with the quack doctors making the diagnoses and not the patients?

I was diagnosed with ADHD because I (truthfully) told a doctor I had the symptoms of ADHD. Now I have a prescription for adderall. Did I commit fraud?

getting a second opinion is not fraud. but by the time you're getting the tenth opinion just because the first nine docs didn't give you written justification to draw on public funds, that looks pretty fraudulent.

or put a different way, GP is describing people explicitly admitting that they went to as many doctors as it took to get specific language in a note. they admitted that they didn't care at all about any therapeutic outcomes from all those visits. assuming this isn't a tall tale, does that sound like a good faith use of the system to you?

I understand the (rather obvious) basis for this argument, but at what point does the responsibility shift to the doctor? If you don't have a health condition, and you ask ten doctors to diagnose you with one, then isn't the real issue with the tenth doctor who diagnoses you with one, rather than with yourself - the patient - who genuinely believes (given the benefit of the doubt) that you're suffering from symptoms of some condition the other nine doctors wouldn't diagnose you with? I mean, is it really the responsibility of the patient to moderate the quackiness of doctors that are willing to prescribe whatever medication for whatever illness the patient might have? What's the point of doctors if we can't trust them to gatekeep the drugs (and VA benefits) we put them in charge of disbursing?

I think the reflex to blame patients for this situation is revelatory of the real issue, which is that the entire discipline of mental health is disconnected from any physical reality or real basis upon which a "proper" diagnosis can be based.

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