19
   

VA Scandal

 
 
Frank Apisa
 
  1  
Reply Mon 26 May, 2014 06:01 pm
@ossobuco,
ossobuco wrote:

Re hospitals other than VA - I've been involved in several.

I started at St. John's in Santa Monica (well regarded place then and now, but then it was small). That was my sixteenth birthday, they hired me to take minifilm xrays, after school and weekends. Yes, I wore a lead cloak, while every patient admitted got snapped in a reach to find tuberculosis. I was also, some time later, part of a survey ok'd by the hospital re how useful that all was. It wasn't. But I spent a lot of hours in med records as the researcher. I was still a child in many ways, but an odd child very interested in med history back then.

The head of radiology dictated the film observations to me and so taught me a lot and I wrote it all up, and also looked all the words up, starting my own dictionary in off minutes. I also taught myself to do this left handed when bored. Not good, my left handed writing.

Worked in that hospital seven years, but also worked for an internist as a helper for a couple of years after school. I handled the room, the waiting patients, the pill dispensing, the ekgs... in the hours I was there. My first ekg was on a nun. Picture me and her. Sometimes the phone, which I'd started at too, but usually if I answered I was phone rescue.

UCLA, well described here, many years, I understand a lot about the research and clinic parts.
Also as a patient with wild eye problems, at Jules Stein eye clinic. The resident who first tested me scoffed, and then stopped scoffing (at one point I was tested for syphilis and I showed up 1+. That was a fluoroscopy test so I challenged (I used to do those) and the head of infectious diseases told me what to tell the resident to ask for better testing. Negative.
Anyway, yes, RP.
Back then, as a clinic patient, one day I had something like seventeen people in the room wanting to look at my eyes.

Breast cancer - a conjunction of help from my gyno, the St. John's BC center, and a well regarded surgeon in where I was newly living, northern california.
Lots of stuff, pretty much good. The well regarded surgeon... was actually nationally well regarded. I doubt she is practicing now, but I bet she is still writing.

Eye surgeries. I've had six. One good guy, the one here in Abq. I'd be in love except I could be his mother.

Ambulance after showing up at an urgent care place.
The deal with that is that they tested me up the wazoo for untold amounts of money and creepy stuff for me (I felt fine, but I had to be led to the bathroom for five days). Turned out what I thought it was, the bp pill made me faint. Thousands of dollars, that were not charged to me but medicare and medicaid.

Past my own history, I've read re med history off and on for many decades. But on my own, I've watched and read (please read Atul Gawande, I'll throw in here).
Don't ******* lecture me or EdgarB, Frank.


Don't lecture me then, Ossobuco.

In any case, both the VA hospitals and non-VA hospitals have problems that have to be addressed.

If people like you want to gang up on the VA hospitals...do it. I cannot stop you.

But I will not let someone like you prevent me from saying that they helped me...and that I am grateful.

Sorry that bothers you so much. I pity you for that.
edgarblythe
 
  3  
Reply Mon 26 May, 2014 06:33 pm
@ossobuco,
Other hospitals have other bosses. I don't think it is at all germane to what we are on about here. If the other hospitals are mass murderers or or miracle healers, it has no bearing. They don't answer to the military.
ossobuco
 
  2  
Reply Mon 26 May, 2014 06:40 pm
@Frank Apisa,
Actually, I was talking about really good hospitals, the places I knew other than the local VA were excellent, not perfect, but very good.

My hope is that the VA would be, across the board, that good, and they need backup from the will of the people, thus congress, to do that.

A messed up VA is, in a way, the will of the people - war is fine, don't tell us about the remnants.
ossobuco
 
  2  
Reply Mon 26 May, 2014 06:51 pm
@edgarblythe,
I do.
0 Replies
 
Frank Apisa
 
  1  
Reply Mon 26 May, 2014 07:01 pm
@ossobuco,
ossobuco wrote:

Actually, I was talking about really good hospitals, the places I knew other than the local VA were excellent, not perfect, but very good.

My hope is that the VA would be, across the board, that good, and they need backup from the will of the people, thus congress, to do that.

A messed up VA is, in a way, the will of the people - war is fine, don't tell us about the remnants.


What you were doing was lecturing me not to lecture you.

I responded...as politely as I could.

In any case, I have seen good VA hospitals and good non-VA hospitals...and I suggest, also as politely as I can, that both can use a great deal of work.

We do not have the best medical system in the world here...far from it. Considering our great national wealth, we should be doing better.

I would love to see all people have access to the best medical care possible...vets and non-vets.
0 Replies
 
ossobuco
 
  3  
Reply Mon 26 May, 2014 07:07 pm
That's nice. Why are you screaming?
ossobuco
 
  4  
Reply Mon 26 May, 2014 07:14 pm
Also what it with the quotes? Anyone can see what you said by clicking re what you responded to.

among your annoying traits is that you quote all in creation, we get it if we lift a finger to look on little green words that were said that you are answering.

That plus the loud type is getting tough to read.
Brandon9000
 
  1  
Reply Mon 26 May, 2014 07:58 pm
@ossobuco,
ossobuco wrote:

I agree with being plotzed by all the hidden list stuff. I haven't read enough, but at least at first glance I see it as horrible. I get, I think, how it can happen at first, but not really - and why was all this not railed about?

Smells.



It's worse than horrible. It's criminal. Some people should be arrested and others fired.
ossobuco
 
  2  
Reply Mon 26 May, 2014 08:29 pm
@Brandon9000,
This isn't my first interest in life, re chasing docs, so I'll sit. I gather a lot of this will get interesting to higher ups.
Which of course is not always a good sign.
0 Replies
 
bobsal u1553115
 
  1  
Reply Mon 26 May, 2014 11:27 pm
@revelette2,
Exactly right. The biggest death committee is a Teapublican House.
bobsal u1553115
 
  1  
Reply Mon 26 May, 2014 11:32 pm
@edgarblythe,
Edgar, it also doesn't changethe fact the VA gets a lot more right than wrong. The problems of VA come outof Congress making a political football out of it.

First underfund it and then blame the Administration of incompetence and callousness is how Teapublicans play the game.
0 Replies
 
bobsal u1553115
 
  1  
Reply Mon 26 May, 2014 11:36 pm
@edgarblythe,
And for the most part the service is timely.
0 Replies
 
bobsal u1553115
 
  1  
Reply Mon 26 May, 2014 11:44 pm
@ossobuco,
TheVA wasnever ramped up the way the armed forces were for our little unpaid for wars. At the same time we were invading Iraq and Afghanistan, the Budgets for VA were cut and hospitals were closed, especially here in Texas.

All the while treatment of battle injuries is at the highest quality so that which used to kill is now only maiming. The VA got swamped and nobody gave them the budget the load required. If you're pissed, yell at your Congressman.
0 Replies
 
Walter Hinteler
 
  2  
Reply Mon 26 May, 2014 11:54 pm
@roger,
Thanks, roger!

"Employer's liability insurance coverage" public insurers ("Berufsgenossenschaft") have own hospitals (similar to the military) as well. But anyone can go there. It's really the difference in the structure of medical services which (still) puzzles me.
bobsal u1553115
 
  1  
Reply Tue 27 May, 2014 12:08 am
@Walter Hinteler,
http://www.va.gov/about_va/vahistory.asp

History - VA History

VA History

The United States has the most comprehensive system of assistance for veterans of any nation in the world. This benefits system traces its roots back to 1636, when the Pilgrims of Plymouth Colony were at war with the Pequot Indians. The Pilgrims passed a law which stated that disabled soldiers would be supported by the colony.

The Continental Congress of 1776 encouraged enlistments during the Revolutionary War by providing pensions for soldiers who were disabled. Direct medical and hospital care given to veterans in the early days of the Republic was provided by the individual States and communities. In 1811, the first domiciliary and medical facility for veterans was authorized by the Federal Government. In the 19th century, the Nation's veterans assistance program was expanded to include benefits and pensions not only for veterans, but also their widows and dependents.

After the Civil War, many State veterans homes were established. Since domiciliary care was available at all State veterans homes, incidental medical and hospital treatment was provided for all injuries and diseases, whether or not of service origin. Indigent and disabled veterans of the Civil War, Indian Wars, Spanish-American War, and Mexican Border period as well as discharged regular members of the Armed Forces were cared for at these homes.

Congress established a new system of veterans benefits when the United States entered World War I in 1917. Included were programs for disability compensation, insurance for service persons and veterans, and vocational rehabilitation for the disabled. By the 1920s, the various benefits were administered by three different Federal agencies: the Veterans Bureau, the Bureau of Pensions of the Interior Department, and the National Home for Disabled Volunteer Soldiers.

The establishment of the Veterans Administration came in 1930 when Congress authorized the President to "consolidate and coordinate Government activities affecting war veterans." The three component agencies became bureaus within the Veterans Administration. Brigadier General Frank T. Hines, who directed the Veterans Bureau for seven years, was named as the first Administrator of Veterans Affairs, a job he held until 1945.

The VA health care system has grown from 54 hospitals in 1930, to include 152 hospitals; 800 community based outpatient clinics; 126 nursing home care units; and 35 domiciliaries. VA health care facilities provide a broad spectrum of medical, surgical, and rehabilitative care. The responsibilities and benefits programs of the Veterans Administration grew enormously during the following six decades. World War II resulted in not only a vast increase in the veteran population, but also in large number of new benefits enacted by the Congress for veterans of the war. The World War II GI Bill, signed into law on June 22, 1944, is said to have had more impact on the American way of life than any law since the Homestead Act of 1862. Further educational assistance acts were passed for the benefit of veterans of the Korean Conflict, the Vietnam Era, Persian Gulf War, Iraq and Afghanistan wars.

In 1973, the Veterans Administration assumed another major responsibility when the National Cemetery System (except for Arlington National Cemetery) was transferred to the Veterans Administration from the Department of the Army. The Agency was charged with the operation of the National Cemetery System, including the marking of graves of all persons in national and State cemeteries (and the graves of veterans in private cemeteries, upon request) as well and administering the State Cemetery Grants Program. The Department of Veterans Affairs (VA) was established as a Cabinet-level position on March 15, 1989. President Bush hailed the creation of the new Department saying, "There is only one place for the veterans of America, in the Cabinet Room, at the table with the President of the United States of America."

In 2009, President Obama appointed Secretary Eric K. Shinseki to lead a massive transformation of the VA into a high-performing 21st century organization that can better serve Veterans. Under the leadership of Secretary Shinseki, the VA has adopted three guiding principles to govern the changes underway, namely being people-centric, results-driven, and forward-looking. These principles are reflected in the 16 major initiatives that serve as a platform from which transformation is being executed.

The 16 major initiatives are:

Eliminating Veteran homelessness

Enabling 21st century benefits delivery and services

Automating GI Bill benefits

Creating Virtual Lifetime Electronic Record

Improving Veterans' mental health

Building Veterans Relationship Management capability to enable convenient, seamless interactions

Designing a Veteran-centric health care model to help Veterans navigate the health care delivery system and receive coordinated care

Enhancing the Veteran experience and access to health care

Ensuring preparedness to meet emergent national needs

Developing capabilities and enabling systems to drive performance and outcomes.

Establishing strong VA management infrastructure and integrated operating model
Walter these are from the VA site:
Transforming human capital management

Performing research and development to enhance the long-term health and well-being of Veterans

Optimizing the utilization of VA's Capital portfolio by implementing and executing the Strategic Capital Investment Planning (SCIP) process

Improving the quality of health care while reducing cost

Transforming health care delivery through health informatics

To learn more about these initiatives, consult the VA Strategic Plan.


Also this:

A MESSAGE TO VETERANS FROM THE SECRETARY OF VETERANS AFFAIRS

May 22, 2014

Printable Version
Need Viewer Software?

Fellow Veterans and Family Members,

After 38 years in The Army, I am now honored and privileged to serve as your Secretary of Veterans Affairs (VA). VA remains committed to providing the high quality benefits you have earned and deserve.

Allegations of VA employees’ misconduct have surfaced over the last several weeks, beginning with scheduling delays at the Phoenix VA Health Care System. As I testified before Congress on May 15, I take any allegations about patient safety or employee misconduct very seriously. The reports of Veterans’ negative experiences while seeking VA care are of great personal concern to me. I fully agree with President Obama’s statement on May 21, 2014: “If these allegations prove to be true, it is dishonorable, it is disgraceful . . . .”

In response to these allegations at the Phoenix VA Medical Center and a number of other facilities, the VA Office of Inspector General is conducting a comprehensive, independent review. In addition to the IG’s independent review, I ordered the Veterans Health Administration (VHA) to conduct a nationwide audit of all other major VA healthcare facilities to ensure understanding of, and compliance with, our appointment policy. That audit is being conducted now by more than two hundred senior VHA staff. All teams are independent of the facilities they are visiting. You and your families deserve to have full faith in your VA, and we intend to earn it every day.

As President Obama made clear to the American people May 21, 2014, “Every single day, there are people working in the VA who do outstanding work and put everything they’ve got into making sure that our Veterans get the care, benefits, and services that they need.”

I echo that praise and commend the hard work and dedication of the vast majority of our VA employees, many of whom are Veterans themselves. Every year, dedicated employees are prepared to provide care for over 8.9 million Veterans enrolled in VA healthcare. Every day, VHA conducts approximately 236,000 outpatient healthcare appointments—about 85 million last year.

Since 2009, we have enrolled two million more Veterans in high-quality VA healthcare, reduced Veterans' homelessness by 24 percent, and provided Post-9/11 GI Bill educational benefits to more than one million student Veterans and eligible family members. We have opened up new presumptives for Veterans to receive long overdue care for exposure to Agent Orange, for combat-related PTS-D, and for Gulf War illnesses. And, we have decreased the disability claims backlog by over 50 percent in the last 14 months. We will meet our goal of eliminating the claims backlog in 2015.

Every VA medical facility is accredited by The Joint Commission, an independent, non-profit organization that ensures the quality of U.S. healthcare through intensive evaluation of more than 20,000 healthcare organizations. In 2012, The Joint Commission, recognized 19 VA hospitals as top performers, and that number increased to 32 in 2013.

Since 2004, the American Customer Satisfaction Index (ACSI) survey has consistently shown that, on average, Veterans who use VA healthcare award our hospitals and clinics a higher customer satisfaction score than patients give private sector hospitals. When asked if they would use a VA medical center the next time they need inpatient or outpatient care, 96 percent and 95 percent of Veterans, respectively, indicated they would. Veterans across the Nation are receiving quality care from VA. We must encourage other Veterans to seek it.

Notwithstanding these accomplishments, VA will do even better. If any allegations under review are substantiated, we will act.

As we approach our observance of Memorial Day and its special significance to our Nation, VA is re-doubling its efforts, with integrity and compassion, to earn your trust.

As President Obama said, Veterans have “done their duty, and they ask nothing more than that this country does ours—that we uphold our sacred trust to all who have served.”

And, we will.

###


People wishing to receive e-mail from VA with the latest news releases and updated fact sheets can subscribe to the
VA Office of Public Affairs Distribution List.

Back to News Releases Index
hawkeye10
 
  1  
Reply Tue 27 May, 2014 12:14 am
@Walter Hinteler,
Walter Hinteler wrote:

Thanks, roger!

"Employer's liability insurance coverage" public insurers ("Berufsgenossenschaft") have own hospitals (similar to the military) as well. But anyone can go there. It's really the difference in the structure of medical services which (still) puzzles me.


For a lot of years recruiters and drill sergeants said to damn near every new soldier " the army will provide free healthcare for life"...it is not exactly free anymore but going back on that would be considered a complete breaking of faith even though the promise was not authorized and is not legally binding. Everyone in government knew that the promise was being made, and they let it go, current government feels bound because to disregard it would not be accepted by the people.
roger
 
  3  
Reply Tue 27 May, 2014 12:19 am
@hawkeye10,
VA has eight classes of eligibility. If you have a permanent disability due to having been wounded in combat, it is free. If you are in the eighth level (ME) there is a fifty dollar copay for every visit to the hospital, and fifteen for a visit to the local clinic - if you have one.
0 Replies
 
roger
 
  3  
Reply Tue 27 May, 2014 12:26 am
@Walter Hinteler,
Well Walt, if that's the source of your puzzlement, I can't help you a bit.

On a personal note or two, I enrolled in '95 with that shoulder injury. The standards were lower at that point, and as a Vietnam Era Veteran, I was eligible. Now, Dyslexia didn't get enrolled before some particular cutoff date, so he was never eligible in spite of having been on active duty in Southeast Asia. Funny system, huh?

For what it's worth, service with honorable discharge isn't enough to be an official veteran. That service had to include a certain period of time during some conflict or other. Cold War Veterans received a handshake and the thanks of a grateful nation. In other words, "Sorry Charlie".
roger
 
  1  
Reply Tue 27 May, 2014 12:32 am
@bobsal u1553115,

bobsal u1553115 wrote:

Since 2004, the American Customer Satisfaction Index (ACSI) survey has consistently shown that, on average, Veterans who use VA healthcare award our hospitals and clinics a higher customer satisfaction score than patients give private sector hospitals. When asked if they would use a VA medical center the next time they need inpatient or outpatient care, 96 percent and 95 percent of Veterans, respectively, indicated they would. Veterans across the Nation are receiving quality care from VA. We must encourage other Veterans to seek it.


I wonder how that Customer Satisfaction Index would have worked out if cost to the patient were factored in.
Walter Hinteler
 
  2  
Reply Tue 27 May, 2014 12:48 am
@roger,
roger wrote:
Now, Dyslexia didn't get enrolled before some particular cutoff date, so he was never eligible in spite of having been on active duty in Southeast Asia. Funny system, huh?
I'd discussed that quite often with him, especially since he was in a kind of "picket unit".
 

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