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I recieved a VA packaged survey in the mail yesterday. Did anyone else get this? It ask a LOT of questions about me, my family and health matters. I'm not sure about this kind of survey as I usually just throw these kind of mailings in the trash. The only reason I haven't is because it came in a VA mailing. Any one?
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I received one about a year ago, answered some of it and returned it. Never heard from them again. I asked and they said it gets sent out to everyone who signs up at the VA med system, whether you get treatment there or not. With all the BS in the News about the VA they are still the largest healthcare provider in the Country, and have a 73% approval rating from Vets that actually use the system. I think the politicians will try to use the 'latest scandal' to attempt ...once again to shutter the VA medical system. It's been pointed out to me, and it makes sense, that the VA med system only works for Veterans who live within a decent commute to a VA medical center. However if they start handing out 'vouchers' aren't we just getting out of the VA line and getting in the Medicare line?
Obviously more than you wanted to know from me, but caffeine is in full control of my knuckles....and having coded for over 20 years...it's on paper before I know I put it there...
Enjoy the fourth...hopefully family is close
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To my knowledge, the "politicians" have no intention to "shutter the VA system." They do however, want to provide vets with reasonable access to quality healthcare and for those who either can't (live too far away from a VA system or are immobile) or don't want VA care (are concerned about the quality of care) that means giving the option of care outside the VA system.
The current "scandal" is about access and VA's attempts to manipulate data on how long it takes to get into the VA system and to get an appointment. The hard evidence is that about 120,000 vets who either tried to get in or requested an appointment were not included on any list used to schedule appointments and more hard evidence shows that VA actively sought to hide that data from not just Congress, but the Vet Service Organizations like the Legion, VFW, VVA etc.
VA has made a habit over the years of when a high ranking employee is identified as a non-performer, of transferring that person to another area. And it gets worse. For example, the director of the a large VA hospital in a SE state was shown to be less than competent. When Congress pressed VA, VA transferred the director out of state for several months and when things cooled off, reassigned that person right back to the director job at the same hospital.
Part of the problem is holding bad performers accountable and civil service rules make it very and I mean VERY hard to remove non-performers. And while that provides protection from bad supervisors, it also creates a feeling of "you can't touch me" among those who should not be trusted - in this case - with providing quality care to vets. And in general, those people are NOT the clerks and worker bees. They are the mid-to-upper level supervisors or in govt terms, members of the Senior Executive Service whose salaries range from $120,749 to $181,500.
Both the House and Senate have bills that would authorize the VA Secretary to summarily fire SES employees for bad performance (the Sec will still not be able to fire for reasons like race, religion, sexual preference, political affiliation and other prohibited personnel practices). That is the same authority that every member of Congress has to remove any member of their staff.
So again, the issue is not whether the VA healthcare system should be "shuttered." it is whether veterans who meet the eligibility criteria have reasonable access to the system. And to those who say VA needs more docs and nurses and facilities, the question that remains is, is VA efficiently using the resources they now have? And the answer is that in many cases they do not. For example, the normal operating hours for most Vet Centers - a source of primary mental health care for combat vets - are 0800- 1630. I wounder how many vets who need some basic mental healthcare are shut out of accessing assistance at the Vet Centers because they work the day shift and would need to take leave to get help.
Anyway, in honor of Independence Day, Happy Birthday to all of us.
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Senators McCain, Burr, Paul, McConnell and others have said, if a veteran can't get a 'needed' appointment within 2 months, or the distance is a factor, then they should be allowed to go to private physician. The VA would pay. Does the money come at a cost to the VA budget? If so then VA facilities would need to downsize. Who makes the call on 'needed' Healthcare? The Veteran? We have just went through a 6 year fight on "affordable health care act". These same people are the ones who said "there aren't enough Doctors, nurses, hospitals to accommodate citizens that can't afford health care. The large majority of VA patients are poor or live in large metro area. The demographic trends in the US is rapidly towards cities, public transportation, internet access, jobs, and commutes. Handing out vouchers, allowing Vets to go to outside doc's etc. would put the VA on a slow path to privatization. Healthcare analysts say the VA system, and Healthcare is the best in the country. The difference being, large population of Veterans receiving overall good Healthcare v hospitals such as Northwestern, Barnes, USC, George Washington, et al is those hospitals treat individuals who can afford high end insurance policies.
So, it is totally correct that it is unfair for veterans to travel many miles for healthcare. It is also unfair to under fund the VA system, blaming 'middle management' is a universal call in the private sector also. A possible solution offered by the politicians listed above would be "credits" to student loans for doctors who work at the VA, or for rural and small practices to also get credit on their student loans. All that being said, interns and residents are paid out of medicare funds. Medicare, in the last 3 congressional budgets proposed by Paul Ryan and unanimously approved by the majority would be privatized.
Perhaps we could force all the Senior Chiefs out of retirement and put them running the VA?
Last of this...sorry, Caffeine is in charge...Mike is much closer to this than I. We both agree that Vets deserve the best care our country can provide, just disagree with the methods...let Mike run the VA and I will STFU
Enjoy your families this 4th..
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I think being able to go to an outside doc would be fine as long as the doc accepts what the VA will give them. One thing on the up side you can get travel pay to go to the VA if you travel any distance... at least it helps with the gas anyway. I know one guy that turns in a paper for travel every time he goes and he only lives 3 miles... it's just $1.32 approx. ... but he does it to piss off the VA and have them pay it.
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This post was updated on .
As always, Paul poses some thoughtful questions. Yes, as I understand some of the current ideas to allow vets to seek care outside the VA system, the funding for that care would come from the appropriation for VA medical care, currently running about $60 Million for FY15 with a bot over $48 Million for direct care costs. The rest goes to pay for O&M costs and other cats and dogs.
VA current spends about $5 to $6 Billion on non-VA care, depending on who is asked the question. Again, that money comes from the medical care account. Paul's other quests about who would decide what is needed care is a good point and to my knowledge, has yet to be decided but I suspect that VA would maintain some degree of authority over an enrollee's care. For example, under the House bill, outside care would be limited to 60 days to accomodate a continuing series of care events when needed.
I doubt that "handing out vouchers" would automatically lead to privatization as Paul is suggesting because there are no alternatives for some vets. For example, he is correct in pointing out that a large number of VA enrollees are indigent. If they were not getting VA care, many of them would be getting care through Medicaid and the number of docs participating in the Medicaid program is shrinking.
In all of this discussion, it is important to remember that we should concentrate on what is good for the veteran and that is not always what is good for VA. Since VA has a monopoly on care for its enrollees who have no other options, VA can decide who treats you and when you get treated and the current scandal has shown VA cannot be trusted to present a true picture, not just to Cangress, but more importantly, to its enrollees. And VA's problems regarding "the whole truth and noting but the truth" are not restricted to its hospital system. For example, several months ago, VA launched a program to process its oldest disability claims. That was a good thing. But to disguuise how long they have had the claim it the system, they allowed claims processors to change the date on the claim to the date they "discovered" the claim which could have been years after submission by the vet. So, when it came time to calculate how long it had been in the processing system, instead of years, the time reflected a few months. While the date change did not affect the amount of money paid to the vet, it did present a false picture to oversight authorities like Congress, GAO and the VA Inspector General.
One final comment regarding the vet who submitted mileage claims for a 3 mile trip wrth $1.32. All that vet is doing is slowing down payments to vets who in some cases are traveling hundreds of miles to get their VA care. I suggest he find another way to show he is pissed at VA that doesn't affect his fellow vets. Better yet, do something positive like volunteering to drive immobile vets to their appointments or becoming a peer counselor at a shelter for homeless vets.
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thanks for the info Mike... one thing to watch, in my opinion..in the 70's congress / senate was composed of over 70% veterans, currently it's dropped to 20% and after the mid-terms we will be around 15% (there are more ex-entertainers, radio talk show hosts etc than vets)..less than 1% of the population now serve in the military, few even know of someone in the military...most American's don't realize we have close to 35,000 troops still in Afghanistan, our longest war yet...
out of site, out of mind...
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Good points Paul regarding the shrinking number of vets. But it is not just in Congress. I believe VA stats show that in 2025, there will be about 18 million vets compared to the 23 million in 2010. And the vet population will continue to decline beyond that date at a steady rate barring some future large scale conflict.
So, in the face of a declining vet population, one of the questions Congress, as representative of not just vets, but all taxpayers, must face is whether the best way to care for vets is to continue building hospitals at a cost of a billion plus dollars each or to spend that billion plus on actual care instead of bricks and mortar. And building hospitals is like building roads; you have to pay not just the construction cost for every mile, but the maintenance cost for each mile for the next 50+ years.
Personally, and I speak only for me, I would rather see our Seawolves have a choice of where to get their care. For those like you who are relatively near a VA facility and like the care they get, continue on. For those far from a VA facility or for some reason prefer their local healthcare network to VA, why would we not give them the choice? We hear every day from veterans who are forced to drive literally hundreds of miles to get care at a VA facility. As those vets age, their ability to drive declines and it is likely alternative transportation is limited at best, especially if family members cannot provide that service. Again, why would we not give them the choice?
So, Mello to the Bulls?
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No "Melo"...maybe "World Peace"....?
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"good reading/info guys,tanks"
..i are, one veteran, who fits in with a lot being said here..so speak'n for myself,..yes there are long drives to care and there are times when i am seen and repaired locally by, dentist, orthodontics, hearing professionals, eye doc's, surgery doc's and others too....so that is on the table for myself, and i use it...by stay'n in touch with VA persons who "get it done"...i've found these hard workers, hard caring VA souls throughout...and yes, those who feel "not the same:"...i've had a few "excited talks" with VA Patient Advocates..."Indeed sir"
..and there is a DAV van i have used to get thar...yet, in the future i may require that DAV van...and in my past i drove that DAV van, talk about sum stories...so it goes for this vet, VA & Outside Care...and i onced walked up to a pay window for "travel-pay" (real volunteers)...now, i fill out paper-work, send in, wait a good thirty days...harder on sum folks.....tell me this..last month VA appt..travel-pay (payed to me, for driving and is signed auto-deposit) $60.75...this month VA appt...travel-pay $52.15..did i miss sum-en here, the distance two and fro ain't changed...petro has not dropped in $....conspiracy, no doubt....yet, i am blessed and do not live in a cardboard box, as is the case with vets i know.....Ya'll take care of yourself's...dagg-nabitt.!!...anything else i was gonna say,..i've forgottern........
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Locked
