VA Scandal

Reply Wed 11 Jun, 2014 07:56 am
@bobsal u1553115,
This is the 2nd time you have had an issue understanding what was said. I said the Dems were using the VA as a selling point for the ACA debates. This was before the ACA was passed. Their claim was that the govt can do health care. Look at the VA. It is such a great system and everyone involved loves the care and attention they get. Look at how efficient and well the VA is run. Look back at the

It was a sham.

Here is a gem from slate.com talking about the success of socialized medicine that is the VA:

Or how about this one from Dick Durbin:
Reply Wed 11 Jun, 2014 08:10 am
Are Vets forced to go to the VA? If not, then there must be some good points. Kind of like everybody complaining about Medicare, but you just try to take it away from older folks, they want to keep it.
bobsal u1553115
Reply Wed 11 Jun, 2014 08:25 am
ACA is not about health care. It's about paying for health care. The VA is a complete single payer system with a complete healthcare system.

Comparing VA to ACA would be comparing a Democratic approach to health care (VA) to a Republican approach to health care(ACA).

And this is one place where I bump against the GOP, I support a single payer system. I also bump against the GOP on privatization of corrections and military.
bobsal u1553115
Reply Wed 11 Jun, 2014 08:28 am
Do you use VA? I do and I love it. The problem with VA isn't VA, its Congress and under funding and politics.
Reply Wed 11 Jun, 2014 08:56 am
Don't change the subject. The claim was that GOP never complained about the VA. Well that is false. We complained about the VA when you guys were using it as an example of how healthcare reform should be done. It was the model that was being pushed. As far as the Dems were concerned the VA was a paragon of health care success.

So the false narrative that the GOP didn't do anything is a lie at best. You lefties thought it was awesome.
Reply Wed 11 Jun, 2014 09:04 am
@bobsal u1553115,
The problem is the administration within the VA. It isn't a matter of funding, they have been carrying forward a surplus for the last several years. I have already provided you the link to the story several times but you have chosen to ignore it because it doesn't fit your narrative.

The funding has been there, the VA just doesn't know how to spend it's money. After the most recent report how can you say the VA is fine? Well over 20 VA locations have now been found to have the same long waiting lists and alternate waiting lists. The VA has been hiding the problem from Congress.
Real Music
Reply Wed 11 Jun, 2014 09:31 am
Ultimately the real problem with the VA is that they don't have enough doctors to keep up with the heavy influx of new veterans from the two wars in the middle-east. The question that should be ask is why haven't the VA hired enough new doctors to keep up with the influx of new war veterans? Second question should be what does the VA have to do to get more new doctors to meet the new demand of this influx of veterans? Basic math. The greater the doctor to patient ratio, the less time you have to wait to schedule an appointment. Yes, I am a Veteran. I've been getting VA care at my local VA for over 20 years. Over the last few years scheduling appointments have taken 1, 2, 3, and in some cases 4 months. It all depended on who my appointment was with and what my appointment was for. Every time I see a VA doctor or any VA support staff, the care I receive is ALWAYS EXCELLENT.
Reply Wed 11 Jun, 2014 09:48 am
Ok, use the surplus to increase the pay of doctors to attract doctors to the VA.
Reply Wed 11 Jun, 2014 09:55 am
I don't have a problem with that. We should also do a little means testing for vets as well. I know a few people who were able to take pre-existing conditions, issues from before they joined the military, and turn them into service related issues. My brother being the first person who comes to mind. He didn't get PTSD from the military he got PTSD from being in our family. We were abused as children and all 3 of us have some issues. He is the only one getting the VA to pay for it. He also has a claim of shoulder issues. These were also from before his military service. People like my brother are cheating the system. Serving in the military doesn't mean you should get free health care for the rest of your life. If you didn't retire from the military and your issues are pre-service related, then get insurance like the rest of us. Don't make the taxpayers pay for it.
Finn dAbuzz
Reply Wed 11 Jun, 2014 10:27 am
@Frank Apisa,
This is a specious argument Frank.

First of all, how do you know that the people who seem to you to think they have all the answers aren't providing these answers to their elected officials?

Secondly, assuming these "answers" have any merit, introducing them to the public sphere either through this forum or other means is a way for them to become known to a wider audience. You, for instance, might read one of these answers and think "Damn! This guy is right." In which case, you might send the "answer" to your elected official or spread it further within the public sphere. And so on, and so on... If it really is a good answer, it will eventually find its way to those who can implement it.

Thirdly, how is there anything "sad" about people voicing their opinions on the problems we face and declaring what they believe to be the answer? My sense is that you only feel this way when you disagree with the answer, but I could be wrong. If I'm not, than your argument distills down to a mere: "Shut up! I don’t want to listen to you."

Finally there is no duty placed upon anyone who thinks they have an answer or a partial answer to a problem, particularly the size of which we are discussing, to join those who have chosen (for numerous reasons of self-interest, as well as some altruism) to take on the responsibility for fixing them. Running for elected office is a long, expensive and often dirty process and there are numerous reasons why even the most civic minded individual would not consider doing it. If you have a duty, it is to vote for people who you believe will be able to effectively work on solving problems, regardless of what they look like, how well they can speak, what movie stars endorse them, and whether or not your friends think they are cool. This implies the further duty to be knowable about the issues and the candidate and not rely on partisan thumbnail sketches or slogans.

You may feel that some or many people oversimplify these problems, and don't appreciate or are too suspicious of the efforts of the people in government who are tasked to solve these problems, but that doesn't invalidate the comments they make.

Real Music
Reply Wed 11 Jun, 2014 10:42 am
@bobsal u1553115,
I also support a single payer health care system. But, the definition of a single payer system is not the same as the VA. The VA is government run healthcare. I am all for a government run healthcare in regard to the VA. I am also in favor of a single payer system which is different. A single payer system is basically providing medicare to every man, woman, and child regardless of age. We all pay into medicare insurance in the form of a tax all of lives, but can't receive the benefits until age 65. Single payer means you start receiving benefits the moment you're born so you don't have to wait until you become 65. The ACA Affordable Care Act is neither private or government run insurance. The ACA is more like a hybrid of combining both government run insurance with private run insurance.
bobsal u1553115
Reply Wed 11 Jun, 2014 11:02 am
You're way too angry. VA and ACA haven't a single comparison short of Federal oversight. When you cool down, lets talk.
Reply Wed 11 Jun, 2014 11:05 am
@bobsal u1553115,
I'm not angry. We can talk but you have to admit some facts first. The Dems were using the VA as a model for health care reform. They were the ones who thought the VA was fixed. Would you agree?
bobsal u1553115
Reply Wed 11 Jun, 2014 11:13 am
I ignore it because those "surpluses" were mandated funds that couldn't be used for anything else. That isn't VA. That's Congress.

Senate Fails to Pass Veteran Benefits Bill | Military.com
Senate Fails to Pass Veteran Benefits Bill. ... The bill would also have extended advance funding to all VA operations. ... making dental care a part of VA health care, and extending the period that Iraq and Afghanistan war vets may seek VA care to 10 years.
[Search domain www.military.com] military.com

IAVA - Congress Fails to Pass MilCon/VA Budget | Iraq and ...
Congress Fails to Pass The MilCon/VA Budget. ... IAVA calls on lawmakers to move swiftly to pass the VA budget so that the men and women who have served our country aren't forced to wait any longer for the ... IAVA's Storm the Hill and Advance Funding; CNN: Paul Rieckhoff on Advanced Funding of ...
[Search domain iava.org] iava.org

U.S. Senate Republicans block veterans' health bill on budget ...
... has nothing to do with the needs of veterans," complained Senate Veterans' Affairs Committee Chairman ... the Senate failed to waive budget rules that ... but was doomed by deep disagreements between Democrats and Republicans that have made this Congress one of the least ...
[Search domain www.reuters.com] reuters.com

[Search domain www.answerl.com] answerl.com
House panel approves advance funding for VA | Federal Times ...
The House Veterans' Affairs Committee approved landmark legislation Wednesday to provide funding for veterans health care programs one year in advance. The hope is to avoid disruption if Congress fails, as usual, to pass a Veterans Affairs Department spending bill in time for the Oct. 1 ...

[Search domain newsmilitary.com] newsmilitary.com
Congress fails to pass funding for VA | www.kilgorenewsherald ...
WASHINGTON (AP) - Congress refused to pass spending bills funding Veterans Affairs and new military construction projects, turning back a last-hours effort by Texas lawmakers Thursday to get the additional money approved. Rep. Chet Edwards, a Democrat, said that decision will leave a large gap in
[Search domain www.kilgorenewsherald.com] kilgorenewsherald.com

I like this last one a lot. If you read it, I'll tell you where it comes from.

Labor Fightback Network

The American public is being bombarded these days with corporate media’s accounts of the VA health care system’s problems. But none of the commentaries goes to the heart of what is basically wrong.

To be sure, many media voices do make reference to the need for more funding. However, none of the references specify where the additional funding will come from.

Start with one basic proposition: The U.S. spent trillions of dollars on the Iraq and Afghanistan wars. But the projected budget for next year for VA health care is only $68 billion, a very small figure by comparison and one that is shockingly inadequate for what is needed.

Of course VA’s problems predate the Iraq and Afghanistan wars. As an example, the Inspector General’s 2001 report found that some VA patients had to wait 730 days to get an appointment. But the problem then, as now, was grossly inadequate funding for VA health care and grossly excessive funding for the Pentagon.

You can’t have both guns and butter. Resources are finite and priorities have to be set. The sacred cow of the U.S. budget has long been money for the military to enable it to help ensure that U.S. corporate investments around the world are protected and expanded.

The VA and Single-Payer Health Care

For decades, supporters of single-payer health care have lauded the Veteran Affairs medical system as an outstanding example of single-payer at work. Was our esteem for the VA centers misguided? Not at all, and even some of its most vociferous critics have acknowledged its virtues.

At the top of the list is the Wall Street Journal, Big Business’ favorite newspaper. In its May 23, 2014 lead editorial, the Journal states:

“The VA operates on a ‘global budget’ that Congress sets each year to provide veterans a guaranteed level of benefits. All veterans are entitled to free preventative screenings, immunizations, lab services and EKGs. Most are required to pay little to nothing out of pocket for medical appointments, hospital care and drugs.”

The same editorial notes “Ah, yes, the VA lacks the evil profit motive.”

Here is what Sam Foote, an internist who was a VA outpatient clinic director for 19 years, said in his article, “Why I Blew the Whistle on the VA”:

“Today’s VA health care system in general does a very good job in providing chronic care, and it excels in things like blood pressure and diabetes control. It has an excellent computerized records system from facility to facility across the nation.” (New York Times, May 24, 2014)

Though there is always room for improvement, VA centers around the country do provide quality care and millions of veterans have high regard for their services.

So what is the problem? Though adequate funding and staffing would make VA care even better, the problem is not primarily in the care but in the scheduling, i.e., the ability to access services when needed.And right-wing forces are exploiting the justified outrage of many veterans and their families over scheduling issues in an attempt to discredit all national attempts to guarantee comprehensive health care for all, with the plundering insurance companies eliminated from the system.

So it should come as no surprise that that same Wall Street Journal editorial cited above calls for privatizing the VA.

The Scheduling Issue

The VA today is overwhelmed with the additional number of patients it is obligated to treat. Two million, eight hundred thousand U.S. troops have served overseas since 9/11 and most of those with stints in Iraqand Afghanistan have returned home. But the rising tide of veterans seeking VA services also includes veterans of Vietnam and earlier wars. There are not nearly enough doctors, nurses, staff, facilities and resources that needed to be ramped up to take care of them, part of the 9.3 million of the nation’s 22 million veterans who are currently enrolled in the VA health care system.

[Regarding doctors, a crash program is needed without delay to vastly increase the nation's number of primary physicians. Financial aid should be provided to low-income and people of color communities, among others, to enable interested persons to become physicians.]

Moreover, at a time when its protocol was to schedule appointments with doctors within 30 days of request, administrators found it difficult if not impossible to comply. So what was the solution? To shorten the time when appointments should be scheduled from 30 days to 14!

This would have been eminently reasonable so long as there were adequate numbers of physicians and support staff to comply with the abbreviated schedule. But given the shortage of personnel, funds and resources, it made a bad situation worse.

Here is how one nurse explained the dilemma that many VA staff members experienced: “Yes it is gaming the system a bit. But you have to know the rules of the game you are playing, and when we exceed the 14-day measure, the front office gets very upset, which doesn’t help us.” (May 24-25 Wall Street Journal ). In other words, either go along or risk losing your job.

Top VA administrators are receiving the brunt of the criticism. It’s no surprise that bad conditions here have bred bad actors and bad actions. Without defending their gaming the system and falsifying the records, we believe it essential to get to the root of the VA crisis and demonstrate where the fault basically lies and who should be held accountable.

To put things in perspective, there were 57,000 homeless veterans and 722,000 unemployed veterans in 2013 and things have not dramatically improved since then. You can’t blame administrators for this sorry state of affairs — as is being done with the VA — so who do you blame?

We say the answer is the federal government and the corporate-run major political parties which control that government. In short, it is the same gang that has allowed the crisis affecting veterans to worsen in so many ways over decades and that tolerates 50 million people living in poverty in the U.S. today. It is the same political establishment that has allowed unemployment compensation to expire for millions of long-term jobless and recently cut food stamp funding by $8.6 billion. It is a heartless and uncaring government which has a long history of underfunding human needs programs, including medical care for veterans, who are treated as cannon fodder and expendable upon returning home .

What Should Be Done?

The Labor Fightback Network endorses the following demands (slightly edited) contained in a statement issued by the Massachusetts Nurses Association:

We urge labor and community forces to join with us in placing these demands:

Put an end to the privatization and outsourcing of necessary medical and support services within the VA. These practices have led to care that is not always top quality , higher costs and allegations of widespread fraud and abuse. We cannot allow our veterans to continue to suffer at the hands of private corporate interests who, the evidence shows, are placing a focus on profits ahead of the interests of veterans.
Streamline access to the full range of medical, mental health and rehabilitative benefits in the transition from military to civilian life. If someone is found to be injured or disabled while in the service, there should be no delay in the delivery of all necessary services while entering the ranks of veterans.
Restore the practice of full access for all veterans to the VA system for all necessary care. While we advocate for comprehensive, quality care for all in our society, veterans cannot wait for that worthy social goal to be achieved.
Provide the funding necessary to expand capacity and hire personnel to provide this full access for all veterans. Cut the war spending that generated so many veterans with so many needs in the first place.
Extend full collective bargaining rights to all employed in this system, those who provide or make possible high standards of care.
Shine a light on the best that this system has traditionally offered, and raise the possibility of expanding this into a national health system, free of profiteering, serving all who dwell within our borders.

The Labor Fightback Network also continues to advocate the formation of labor-community coalitions to promote a program of action that truly reflects the needs and aspirations of the working class majority. Such a program could include redirecting war and military spending to ensure jobs for all; a minimum wage of $15 an hour; single-payer universal health care; an end to deportations; programs to eradicate poverty and end homelessness; defense of public education; rescinding anti-labor legislation and guaranteeing the right to organize; and expanding and improving safety net programs, especially Social Security, Medicare and Medicaid.

Labor cannot go it alone. We must forge stronger ties with our community partners if we are to make significant progress. Together we can mount sizable demonstrations in the streets and be heard.

In the final analysis, we must look elsewhere for political leadership. This means running independent working class/community candidates in support of the kind of program suggested above. It means laying the foundation for a workers party based on the unions and progressive community organizations. which can compete with the corporate parties in the electoral arena. The time to move forward on this front is now.

0 Replies
bobsal u1553115
Reply Wed 11 Jun, 2014 11:24 am
Means testing? Maybe.

But you are wrong about medical treatment.
1. That was the deal. Keep the bargain.

Would you treat the vet differently if his amputation was the result of combat versus a rear area or non combat zone related injury? Who knows how my service related tinnitus affects my driving or my work. Would any injuries driving or working in your mind be treatable or untreatable through VA and my TriCare?

BTW I've never made any claim re: tinnitus.
0 Replies
Finn dAbuzz
Reply Wed 11 Jun, 2014 11:30 am
I'm happy to give credit where credit is due, but obviously a significant problem remains, and it's his responsibility along with congress to fix it. Bringing Bush into the mix is pointless.

As for the list of achievements you've provided, its source is the White House. Sorry but I just don't see that as an entirely credible source for reporting on how well the president is doing. Clearly they are not going to address what has not been done and they take credit for the accomplishments of others and for actions that don't really amount to much; for approving programs for which there is no corresponding evidence of efficacy.

For instance:

On August 31, 2012 President Obama signed an Executive Order that strengthens suicide prevention efforts across the Force and in the veteran community and improves access to mental health services for veterans, service members, and military families members.

This in theory is a very good thing. It's now almost two years since it was signed. How has it worked out?

First Lady Michelle Obama announced on August 22, 2012 that more than 2,000 American companies had answered President Obama's challenge and had hired or trained 125,000 veterans and military spouses in the past year through Joining Forces. This effort, combined with policies and legislation put in place by the President, have resulted in a 20 percent decrease in veteran unemployment compared to the same time last year.

Raising this issue is a very good thing too and to the extent that Mrs. Obama actually had anything to do with convincing companies to "answer President Obama's challenge" she deserves credit, but the real credit belongs not to Mrs. Obama or the President but to the more than 2,000 companies that hired and trained veterans and their spouses.

President Obama signed the Veterans Skills to Jobs Act on July 12, 2012. This legislation will make it easier for veterans to put their skills to work and complements the new partnership launched by the Obama Administration that will make it easier for manufacturing companies to hire thousands of returning service members who have the skills our country needs.

All we can take from this is that he didn't veto it. He didn't write the legislation and we have no idea to what extent the White House was involved in developing it or moving it through congress.

As part of President Obama's broader plan to help millions of Americans refinance and save thousands of dollars a year, support the communities hardest-hit by the housing crisis, and help families avoid foreclosure and stay in their homes, on March 6, 2012 he announced new measures major mortgage servicers will be taking to provide significant relief to thousands of service members and veterans

His plan was to announce the new measures? The mortgage servicers implemented the measures. To what extent was the White House involved?

With Secretary Shinseki, the President will make sure the VA provides veterans the best care possible. This means improved care for poly-trauma, vision impairment, prosthetics, spinal cord injury, aging, and women's health.

This is meaningless

There are some recognizable and potentially meaningful achievements contained within this list which the Administration can take credit for

There seems to be a lot of bullet points devoted to creating online tools to assist vets in finding jobs, but assuming they work a whole better than the Obamacare website, this is a decent accomplishment.

The Joint Virtual Lifetime Electronic Initiative is a good idea, and will bring the VA up to par with private healthcare providers. How is it working though?

It is pretty much of a consensus that Shinseki did a good job addressing and improving the VA's repose to PTSD and homelessness, and if the president is responsible for Shinseki's failures that he should receive credit for his successes.

I have spent the great part of my career working in large corporations with many years at senior executive levels, and I have seen hundreds if not thousands of Powerpoint presentations that try to accomplish what this list is trying to do.

Bullet Binge: Taking credit for each and every effort the executive and his department can draw a connection to; in even the most tenuous of ways.

Weasle Words: The deployment of a plethora of "weasle words," like "worked towards," "facilitated," "encouraged," "challenged" "developed awareness of" etc

Declaring the Race is Won After Leaving the Starting Blocks: Claiming that an accomplished task is by itself an achievement of the desired result.

For those executives and department heads reporting to me these three practices were banned, and anyone who used them was likely to be embarassed before their peers and the senior executive team.

It was fine to report that a task was completed within 6 months of completion but thereafter I insisted on seeing the results - good or bad.

If the executive and departmental staff hadn't actually and concretely done something, I didn't want to hear about it, and I certainly didn't want them to take credit for the efforts of others.

"Weasle words" were pointed out during the presentation.

Requiring the inclusion of projects/tasks that had not been completed or not started.

It didn't take long for these people to get the message and their Powerpoint presentations were trimmed by 50% while telling everyone exactly what had been done and not done, and what was working and what was not. The real benefit was that a lot of time and effort wasn't wasted on things that weren't actually working or resources were focused on making those with promise work better. Accountability, in both a positive and negative sense, was clearer and fairer. Instead of working on how to look good the executives and departments worked on how to be good and solve problems.

People need to view self-serving lists like this with a much more critical eye.
0 Replies
bobsal u1553115
Reply Wed 11 Jun, 2014 11:31 am
@Real Music,
VA is a single payer program. There is a book keeping record made of my treatment and there is a transfer of funds made according to the treatment inside the VA. The Federal government is the single payer. The VA is my single supplier of health care. If, however I have a need for treatment that requires treatment not supplied by VA, like in an emergency or specific treatments, the Fed will pay for it through the VA.

Single payer can exist with the government paying and supplying resource, like VA. Or it can be like the French model: the government pays and the providers are private either or public tothe needs of the patient..
0 Replies
bobsal u1553115
Reply Wed 11 Jun, 2014 11:36 am
1. I am not a Dem.
2. That may be, I don't know care.
3. Why do I have to explain it? The Dems never asked to help craft their argument. Particularly since I don't see the comparison at all. And since I would like to see a single payer system with the health care system pretty much already here in place. I'd like to choose my doctors and hospitals and have a say about my treatments. But everyone gets access.
0 Replies
Frank Apisa
Reply Wed 11 Jun, 2014 11:43 am
@Finn dAbuzz,
Finn dAbuzz wrote:

This is a specious argument Frank.

Actually, it is a schmarmy, sarcastic, in-your-face argument, Finn...not a specious one. And it was intended to be that.

My point was that some people here seem to jump on the "they are doing it all wrong" bandwagon at every opportunity...when in fact, a bit of understanding about how difficult it is to govern might be in order.

Fact is, in just about every major issue now pressing in this country...there is a significant contingent of people pressing for a resolution in one direction...and an equally significant contingent of people pressing for a resolution in the exact opposite direction. And when they are not pressing for opposite solutions, they often are pressing for opposite means to the solutions.

Said another way:

Governing is hard.

Sitting around pissing and moaning about government is EASY.

Finn dAbuzz
Reply Wed 11 Jun, 2014 11:51 am
There are good points. People in this thread have reported personal satisfaction with their VA experiences. You're right that it can't be all bad, and I don't know that there has been a lot of talk about doing away with the VA, but what is bad is very bad and needs to be fixed and not just brayed about to make political points.

There has been a lot of talk about providing veterans with vouchers so they can access healthcare providers outside of the system, if the system is letting them down. This makes a lot of sense to me. It will provide VA officials and employees a much better incentive for providing quality service to the vets, than bonuses based on wait-time records, than can and have been fraudulently manipulated. If VAs aren't using VA hospitals and clinics, these sources should then have to improve their services or lose funding - the people working there...losing their jobs. To avoid a wholesale abandonment of VA facilities, certain limitations can be placed on the vouchers such as they can only be used if the vet can't be seen by a VA facility within a certain time period or if the private doctor certifies a medical emergency. Whatever they are they can be reasonably worked out.If an when the VA sources are cleaned up and vets are using them, I would then favor a return to the bonus plan to maintain a positive incentive.

A potential downside is cost. I don't know how VA healthcare fees stack up against those charged by facilities outside the system. They may not actually charge the vets anything, but surely they could come up with a pro-forma fee schedule that would be necessary to cover their costs. Ultimately if every VA used a voucher outside the system the total cost might be greater than the entire cost of the system, but you get what you pay for. The nation is capable of and willing to spend more on our vets.

I appreciate that VA facilities are at least theoretically better prepared and able to address the sort of health issues that are unique to vets, but that extra expertise is of little value to the vet who can't access it or, worse, who dies waiting for access.

The only good thing about this problem is that it is not unsolvable or overwhelmingly intractable. It can be fixed, if the focus is kept on doing what is right for the vets, and not other interests.

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