This ain't Hell, but you can see it from here

Category: Veteran Health Care

  • VA’s BRAC plan

    VA’s BRAC plan

    According to Stars & Stripes, last year Congress asked this CMS Alliance to Modernize Healthcare organization to evaluate the VA Healthcare system and they recommend that the VA “realign” their assets – read that: close some of their facilities.

    Congress should create a governance board to guide the new VA strategy. The board could also reshape the agency’s geographic footprint, moving or closing hospitals to better serve veteran health care needs, similar to the Base Realignment and Closure process, it said.

    Lawmakers and the VA must also decide the agency’s place in the modern era of health care. The 16 members of the review panel wrote a letter to VA Secretary Bob McDonald — included in the review package — suggesting that the agency consider scaling back care to “focus on specific areas of service-related conditions.”

    Yeah, that’s just brilliant. The VA went through a “realignment” process several years ago which closed a lot of facilities and moved the healthcare facilities further from most veterans. That last “realignment” is the reason that the VA has to build new hospitals because that “realignment” realigned service to veterans right out of the picture.

    Last year, Congress and the White House initiated the Veterans’ Choice Program, plowed millions of dollars into the process to help veterans get treatment “on the economy” so to speak, if the lived too far from VA facilities to get responsive treatment in a timely manner. Weeks after sending out the literature and Vet Choice cards to veterans, the White House declared the program broken and raided the funds.

    The CMS Alliance (MITRE Corporation) looked at the problem from a business stand point, so you know that they won’t suggest “realignment” in a way that will benefit veterans. Veterans’ Choice was a simple, common sense solution to the problem, that’s why the White House raped it to fund other things.

    The problem with the VA isn’t geography, the facilities or money – the problem is the culture among the non-medical personnel that stand between veterans and the folks who want to treat them. This discussion about “realignment” is a distraction from the real problem.

    Here’s my experience with the problem; I have lost the use of my feet, so I needed hand controls on a vehicle in order to drive. The VA offered to install those hand controls. That’s fine. But I needed training in order to drive a vehicle with hand controls. The VA’s only driving instructor for the hand controls was in DC (a five-hour round trip) and they wanted me to make the drive there for eight weeks.

    An alternative solution was that I pay for my training out of my pocket for a private instructor that was closer. I found one in Winchester, Virginia (less than an hour away) – so that’s what I did, for four weeks. I drove tractors when I was younger and a number of military vehicles, so the transition wasn’t all that difficult for me. Much less difficult than driving five hours a day for eight weeks. But, the drivers’ training had been “realigned” right out of the Martinsburg, West Virginia VA hospital recently. I could afford to spend the $1200 out-of-pocket expenses, not reimbursable by the VA, by the way, for private driver training, but I’m sure that many elderly veterans can’t. I’m sure there are many who also can’t make the long trip to DC for the training, either. And who wants to take drivers’ training in the Metro DC area anyway?

    But this makes my point about this whole BRAC idea.

    Thanks to Richard for the link.

  • Panel: Tricare is in a death spiral

    The Military Retirement and Compensation Modernization Commission testified before an Armed Services subcommittee and they told the congressmen that Tricare is broken because healthcare costs for retirees are sky rocketing, according to Stars & Stripes;

    “Tricare is a broken system … do not get sucked into the status quo,” Buyer said.

    He said the essential problem with the military’s system is that it has driven down costs by reducing its reimbursements to health care providers below that paid to Medicare, the government subsidized insurance system that functions as a measuring stick for the industry.

    Blah, blah, f’n blah. I only have one thing to say about all of this “death knell for retiree healthcare” bullshit. If it’s such an unsustainable system, and if it’s so costly, why did the Pentagon, with Congress’ approval, raid our Tricare $770 million surplus? (Drops microphone…walks off stage).

  • That 22 veteran suicides everyday number

    I’ll begin by saying that even one veteran suicide death every year is too many for my liking. But 22 everyday has always seemed high to me – high enough that I figured I wouldn’t have any more readers at the end of the year. Chief Tango sends us a link to the Washington Post’s Fact Checker which took a look at how that number was arrived at a few years back;

    This statistic comes from the VA’s 2012 Suicide Data Report, which analyzed death certificates from 21 states, from 1999 to 2011. The report calculated a percentage of suicides identified with veterans out of all suicides in death certificates from the 21 states during the project period, which turned out to be 22 percent. (By point of reference, about 13 percent of U.S. adults are veterans, according to a 2012 Gallup poll.) Then the report applied that percentage against the number of suicides in the U.S. in a given year (approximately 38,000). Divided by number of days in a year, the report came up with 22 veteran suicides a day.

    […]

    To account for uncertainties, researchers gave a range of 18 to 22 veteran suicides a day, which is consistent with previous VA estimates using CDC data. The report does not include some states with the largest veteran population (including California, Texas, Georgia, Arizona and North Carolina), so it is unclear how this would affect the rate.

    They go on to report that average age of a veteran committing suicide is 59.6 years old – kind of outside of the perception that the younger veterans of the most recent wars are suicidal. Add to that, the fact that more than half of the veterans who commit suicide have never deployed, and you have to start wondering why it’s such a big deal these days all of a sudden.

    Between 2001 and 2009, there were 1650 deployed veterans and 7703 non-deployed veteran deaths. Of those, 351 were suicides among deployed veterans and 1517 were suicides among non-deployed veterans. That means over nine years, there was not quite one veteran suicide a day.

    It’s beginning to look to me as a way to make veterans seem like victims, once again. I’m not opposed to measures to prevent suicide, but when I see Richard Blumenthal (the fake Vietnam veteran Senator) and Paul Reickhoff (the phony special forces captain and ED of IAVA) together talking about an issue, I have to wonder if it’s something that we really need. And then we get to read John McCain regurgitating the 22 veterans/day number;

    “According to a study published this month in the ‘Annals of Epidemiology,’ the rate of suicide among veterans from the wars in Iraq and Afghanistan is approximately 50 percent higher than the rate among the general public, and a shocking 22 military veterans commit suicide each day,” McCain said. “Our nation has much work still to do to fulfill its responsibilities for our veterans, and this bill is an important step in improving life-saving mental health care services for the men and women who have served and sacrificed.”

    It just all makes me wonder how much good will really come of a bill (S.167) that mostly calls for more studies and more reports to Congress from the Veterans’ Affairs Department that won’t even mount a hunt for phony POWs and hasn’t been telling Congress the truth for decades.

    Well, at the end of the day, all of the Senators felt better about themselves for passing this bill, whether it does anything good or not. And isn’t that what’s really important?

  • Not balancing the budget on the backs of veterans

    Not balancing the budget on the backs of veterans

    Chief Tango sends us a link to The Blaze which tells about more of Obama’s plan to balance spending (not balancing the budget – that is history) on the backs of veterans. You probably remember last summer when everyone wanted to fix the Veterans’ healthcare system because the VA wasn’t getting it right. So, Congress and the White House hammered out the Veterans’ Choice Program which allowed veterans to get their health care from civilian providers. In an uncharacteristic effort, everyone worked together to get the bill out of Congress and on the street.

    Well, that’s one of the things that the White House wants to cut, while it’s barely six months old;

    …Obama released a budget plan that said he would try to pare it back, and would offer legislation to do so. “In the coming months, the administration will submit legislation to reallocate a portion of Veterans Choice Program funding to support essential investments in VA system priorities in a fiscally-responsible, budget-neutral manner,” the budget said.

    VA Secretary Robert McDonald added that he would propose this chance in order to provide flexibility at the VA, in order to “serve veterans the way they want and deserve to be served.”

    Congress ain’t standing for it…well, for now, anyway;

    “When a near-unanimous Congress worked with President Obama last year to create the choice program, we made a promise to veterans to give them more freedom in their health care decisions,” [House Veterans’ Affairs Committee Chairman Jeff Miller (R-Fla.)] said. “I will not stand idly by while the president attempts to renege on that promise.”

    “It is unacceptable to me that the president would begin to dismantle the Veterans’ Access, Choice and Accountability Act of 2014 that he just signed into law last August by taking the resources allocated to enact this legislation for use elsewhere,” said Senate Veterans’ Affairs Committee Chairman Johnny Isakson (R-Ga.).

    I guess we can take that as a swipe at us veterans for not electing a Democrat Congress for the President. We’re not his constituency, even though he claims to be “everyone’s President”.

  • A Follow Up on that VA “Waiting List” Scandal

    Remember Sharon Helman, former VA employee? She was the director of the VA Medical Center in Phoenix, AZ, when the “secret waiting list” scandal broke.

    After a VA internal investigation, she was fired.  Recently her termination was upheld on appeal. But it probably wasn’t upheld for the reasons you might think.

    Helman was alleged to have engaged in three forms of misconduct: (1) being responsible for delayed veterans healthcare and falsified data regarding medical appointments; (2) retaliation against whistle-blowers; and (3) receiving improper (and unreported) gifts from a former boss-turned-lobbyist.

    As it turns out, only one of those allegations were deemed an acceptable reason for her termination.

    The first allegation – delayed patient care and falsified data – was not accepted by the Administrative Law Judge hearing her case. The judge ruled that the VA had not provided sufficient proof of Helman’s culpability regarding that allegation. And while the judge did find that proof of the second allegation (whistle-blower retaliation) to be sufficient, he also ruled that Helman’s misconduct was not serious enough to warrant being fired.

    However, the third allegation thankfully turned out differently. The judge ruled that at least nine of the twelve (!) allegations against Helman regarding improper acceptance of unreported gifts were fully substantiated. On these grounds, he allowed her termination from the civil service to stand.

    The Arizona Republic/AZ Central site has an article with more details. When I read the article, I found those details fairly disgusting – so if you just ate, maybe you want to wait a while before you read the article.

    Helman was a senior executive at the VA. I’m guessing she was neither the finest nor the worst at her level within the agency.

    With people like this in senior positions, is there any wonder why the VA has serious problems?

  • Pentagon: move retirees to Obamacare

    Pentagon: move retirees to Obamacare

    Yeah, who didn’t see this coming; budget experts at the Pentagon say that the Department of Defense could save butt loads of money if they forced military retirees into Obamacare. We know that, but it’s not keeping faith with veterans who fulfilled their obligations depending on the government to keep their end up. From the Army Times;

    [T]he budget analysts said the Defense Department could realize tremendous savings if it tapped into the resources offered by the general, civilian health care system and coverage available through federal or state exchanges.

    “It’s a little radical, but should we be thinking about how some of the military system might transition some of their people to the Affordable Care Act exchanges, especially in sparsely populated areas of the country?” said Alice Rivlin, former director of the Congressional Budget Office and the Office of Management and Budget who now serves as a senior fellow in economic studies at the Brookings Institution.

    Some of you told me that I was crazy when I warned about this in 2008 before the election. There was a reason that they pumped so much money into the VA, so they could drive us away from Tricare. The Obama Administration claimed that they wanted to make healthcare cheaper for the entire country when they introduced Obamacare – well, everyone except veterans.

    John Mayer, a military health and energy analyst with Booz Allen Hamilton, added the Pentagon should be under no obligation to continue providing “free health” care to those who have retired from military service and have access to health care either through their employers or the Affordable Care Act.

    “Having a program where they can go in and get free health care, and do it as often as they want seems to be a burden that the American public shouldn’t have to bear,” Mayer said, speaking of the military retiree population who uses Tricare.

    I absolutely challenge him to say the same about Medicaid or Medicare. Some of us made life decisions based on promises that the government had no intention to keep.

  • Yet More VA Waste and Abuse?

    Watchdog.org has a new article up today about the VA.  This time, they’re questioning some activities at the 111-bed VA Overton Brooks Medical Center in Shreveport, LA.  At first glance, it certainly seems that the activities in question need questioning.

    Seems the VA Medical Center there has some problems.  The article lists several.  But the one that got my attention most was the fact that it has been running out of things lately.

    What kind of things, you ask?  Well, things like toiletries – toothbrushes, toothpaste, stuff like that – for patients.

    Well, that’s not so bad, you say?  True.  But they’ve been running out of other stuff, too.  Like clean sheets.  And serviceable blankets.  And clean pajamas.

    However, it also seems like the facility has plenty of money.  They recently spent just under $74,500 on flat screen TVs.  No, not new TVs for each of the 115 patient rooms.  New 42″ (and one 50″) flat-screen TVs to be placed in hallways at elevators.  The VA issued a statement saying that these TVs were

    . . . procured to serve as an electronic bulletin board that “offers an easy way to spread information to a wide audience in a short amount of time. It also provides a way to inform … (about) Medical Center activities, future events and specific health-related topics,” . . .

    Hmm.  Yeah, that’s a great way to use our tax money instead using it to support basic facility operations.  I can’t see why anybody would complain.

    They also bought new furniture – at least some of which was made in Canada, not the US – to the tune of just over $134,000.  And they spent $3M on solar cells for the facility.

    Hey, sometimes you need to replace furniture, and the facility was built in 1950.  So maybe the furniture buy was legit – though given employee accounts that much of the furniture previously on hand was in “great shape”, I kinda doubt it.

    I also don’t have any data on the payback period for the solar cells, so I won’t dispute that purchase either.  Based on previous idiocy we’ve seen from this Administration regarding other so-called “green energy” products (like that $24/gallon biodiesel the Navy purchased), I have my doubts.  I’d guess it’s likely a waste, and will never pay for itself.  But maybe not.

    Further:  this hospital is currently sending their soiled items over 100miles to another VA facility to be laundered so that job can be performed by VA employees.  (And no, I’m not joking; that’s really their stated reason for periodically running out of bedding and pajamas.)  So I think I can recommend an easier and simpler way to save even more energy than spending $3M on solar cells – and one that has a real short payback period.

    But the hallway TV procurement for use as an “electronic bulletin board” really bothers the sh!t out of me.

    Why?  Well, for starters:  $74,000 for 24 TVs works out to over $3,080 each.  That probably includes the broadcast source, cabling, and installation.  But still:  close to $3,100 a screen?  Damn, that seems pretty excessive for something used to display the weather, inspirational sayings, quotations from modern poets, and healthy lifestyle exhortations  at the facility’s elevators – which is what one employee says is all that is routinely displayed on them.

    But that’s not what torques me the worst.  What galls me most is that I took a few minutes, looked up a few prices for hospital bedding (here) and blankets (here), and did a little math.  And the results (and implications of same) were, well, disgusting.

    Per those price sources, purchased in case lots (60 each) a set of sheets plus a pillowcase runs somewhere about $20.  A decent cover/blanket runs about the same.  So a set of hospital bedding runs about $40.

    That’s commercial pricing.  I’m guessing the government could negotiate a substantially better price – but let’s use those numbers anyway.

    $74,000 / $40 = 1,850.  That means the money spent on those flat-screen TVs could have bought 1,850 complete sets of bedding for the facility (set of sheets, pillowcase, blanket).

    The facility has 111 beds.  Assuming a daily change of sheets for each bed, that’s over 2 weeks worth of linen for every hospital room in the facility.  Even if each bed needs a 2nd change once a week (due to sickness, accidents, spills, etc . . . ), that’s still nearly 2 weeks worth of linen.  Cut back the furniture buy by about 33% and you’re talking about purchasing around 3 weeks worth.

    Seems to me that 2 weeks is more than enough time to get the laundry done and returned.  And it seems that having a 3-week supply of new bedding on-hand would fix the current problem of periodically running out.  But apparently having those damned TVs and that new furniture was more important than making sure patients had clean linen when needed.

    The basic article goes on to discuss a number of other problems at that VA Medical Center.  Disgusting – there’s really no other word.

    . . .

    I’ve said it before, but I’ll repeat myself here.  IMO, the VA doesn’t have a resource problem.  The VA has a leadership, culture, and priorities problem.

    The new VA Secretary there needs to f**king clean house among his agency’s management.

     

     

     

  • 3000 Troops to fight Ebola

    3000 Troops to fight Ebola

    health-clinic-south-africa

    About ten days ago, we wrote about the President’s intention to send US troops to Africa to help fight the Ebola epidemic there. A few weeks before that, I speculated that would happen, but I never expected that they’d be sending three thousand troops;

    The stepped-up U.S. response includes sending 3,000 troops to the region, including medics and corpsmen for treatment and training, engineers to help build treatment facilities and logistics specialists to assist in patient transportation. Troops would not provide direct care to Ebola patients, White House spokesman Josh Earnest said. A substantial number will be stationed at an intermediate base in Senegal, with others at locations in Liberia, he said.

    Obama also announced that Maj. Gen. Darryl Williams, head of U.S. Army Africa, will head a military command center based in Liberia.

    From AFP;

    Most of the US effort, which will draw heavily on its military medical corps, will be concentrated in impoverished Liberia — the worst hit nation — with plans to build 17 Ebola treatment centres with 100 beds in each.

    […]

    Washington will also send 65 experts from the public health service corps to Liberia to manage and staff a previously announced US military hospital to care for health workers who become sick with Ebola.

    Ebola prevention kits, including disinfectant and advice, will also be supplied to 400,000 of the most vulnerable families in Liberia.

    So we’re raising the costs of veterans’ healthcare while providing free healthcare and building free healthcare facilities in Africa. And, what are the troops who are deploying to Africa going to contract in the various shitholes that they’ll need treatment for in ten or twenty or thirty years from now, when their veterans’ healthcare has been whittled down to nothing?