Roseburg VA Death Panel

Roseburg VA Death Panel Rejects Sick Veterans To Rig Performance Ratings

NY Times – The push to improve the performance ranking of Roseburg VA pits doctors and caregivers against facility administrators who put veterans lives at risk to improve ratings.

In the chase for higher bonuses through better performance metrics, Roseburg VA administrators are putting veterans lives at risk while interfering with medical decisions made by staff to provide medical care.

The Department of Veterans Affairs uses an internal rating metric from one star to five stars to evaluate the quality of care and other important factors. While the attempt to rate quality seems vital, but VA administrators have figured out how to rig the game. To evade lower ratings or penalties, they refuse to provide certain treatments or even to admit certain patients when doing so puts their rating at risk.

Administrators at Roseburg VA are no different.

The practice is generally referred to as “unauthorized practice of medicine” and is generally regarded as the practice of medicine without a license. It occurs when someone gives medical advice or treatment without a professional license. It can also occur when a nonlicensed person dictates the medical care a person receives.

At Roseburg VA, one of the poorest rated VA medical centers in the country, veterans lives are put at risk by hospital administrators trying to score points for promotions and bonuses.

These administrators rig the system by denying care using a death panel called a “utilization management team” that dictates who will be admitted based on the likelihood of positive outcome instead of need or ability to provide care. Needed care for very ill veterans is refused or rationed in favor of less costly and less risky procedures to boost positive outcomes while keeping costs down.

While the NY Times stopped short of calling this spade a spade, I did it for them – Roseburg VA Medical Center is overtly engaged in rationing healthcare using a death panel that overrules decisions made by facility medical doctors treating the actual veteran.

Not only is the scheme at the facility unethical, and a form of medical malpractice, it is intentionally refusing health care VA is required by law to provide in an effort to rig the system for improved performance numbers and higher bonuses.

As you read the following excerpt, please note over half Roseburg VA’s beds sit empty and the facility director received a substantial bonus for improving Roseburg’s star rating in 2016.

RELATED: VA Fails To Report 90% Of Bad Doctors

NY Times Case Of Rejected Veteran

According to the NY Times:

An 81-year-old veteran hobbled into the emergency room at the rural Veterans Affairs hospital here in December, malnourished and dehydrated, his skin flecked with ulcers and his ribs broken from a fall at home.

A doctor examining the veteran — a 20-year Air Force mechanic named Walter Savage who had been living alone — decided he was in no shape to care for himself and should be admitted to the hospital. A second doctor running the inpatient ward agreed.

But the hospital administration said no.

Though there were plenty of empty beds, records show that a nurse in charge of enforcing administration restrictions said Mr. Savage was not sick enough to qualify for admission to the hospital. He waited nine hours in the emergency room until, finally, he was sent home.

“The doctors were mad; the nurses were mad,” said Mr. Savage’s son-in-law, Mark Ridimann. “And my dad, he was mad, too. He kept saying, ‘I’ve laid my life on the line, two years in Vietnam, and this is what I get?’”

Savage later sought care from VA but was denied, again. Ultimately, a doctor admitted the man against the will of the facility administrator. Shortly after admission, Savage was transferred off to a nursing home to avoid negative marks in the rating system.

How The Ranking System Works

VA administrators at Roseburg VA cherrypick patients by admitting primarily low-risk cases while turning away veterans who are high risk in an effort to boost numbers:

Fewer patients meant fewer chances of bad outcomes and better scores for a ranking system that grades all veterans hospitals on a scale of one to five stars. In 2016, administrators began cherry-picking cases against the advice of doctors — turning away complicated patients and admitting only the lowest-risk ones in order to improve metrics, according to multiple interviews with doctors and nurses at the hospital and a review of documents.

The act of denying veterans in that manner resulted in the facility climbing from 1 star to 2 stars in 2016. The director, Doug Paxton, earned a bonus of $8,120 as a result.

RELATED: Bad VA Leader Promoted Despite $1 Billion Construction Scandal

Paxton says the veterans benefit by VA turning them away because it allows the agency to focus its resources on the neediest veterans.

“The numbers are indicators of the quality of care for the veterans, so, sure, we’re worried about the numbers,” he said. “But if you improve the care to veterans, in turn your numbers are going to improve. That’s the bottom line.”

RELATED: Bush-era Policy Has VA Hiring Bad Doctors

Whistleblowers Speak Out

These failures were called into question by five whistleblowers, medical doctors at the facility, who wrote to the NY Times to expose the problems plaguing the facility.

All five disagree with what Paxton says. “When we voice concern that a process is dangerous and not good for patient care,” they wrote, “we are met with the response that ‘this is what the director wants.’”

“We cannot express strongly enough how detrimental this process has been for patient care and how unacceptable it would be anywhere else,” the letter noted.

“It’s a numbers game. The leadership has figured out the hospital can actually do better by seeing less patients,” said Dr. Steven Blum, a doctor there who said he has seen patients regularly turned away or transferred to private hospitals. “These numbers show up on the director’s report card, so it is very important they look good.”

RELATED: Dirty Surgical Equipment Results In Delays

Some Strategies To Rig System

The NY Times article also included numerous other strategies VA uses to rig the system.

Congestive Heart Failure Penalty

Misdiagnose veterans with congestive heart failure (CHF) as being hypervolemia. A CHF diagnosis counts against the facility as a sign of poor preventative care. By misdiagnosing that condition as hypervolemia, a condition where too much fluid is in the blood, the misdiagnoses actually hides the problem and results in the veteran not receiving the healthcare they need and not receiving the medical information they are legally entitled to.

Death In Hospital Or 30 Days Post Discharge

To bypass this penalty, hospital administrators encourage forcing veterans to be admitted as “hospice patients”. According to whistleblowers, veterans are sometimes switched to hospice status without knowing.

One whistleblower, Dr. Blum, was pressured to do this.

“It’s extremely unethical, extremely,” Dr. Blum said. “I was asked to do it and so were the emergency department doctors. And we refused, so the administration just did it.”

A Condition “Exclusion List”

To rig the game, Roseburg VA also created an “exclusion list.” This was for conditions administrators deemed too severe for Roseburg VA to treat.

Utilization Management Team (aka Death Panel)

The NY Times also indicated Roseburg VA is making use of a “utilization management team” of administrators to help them decide which patients to admit or to refuse.

Doctors would have to call an off-site nurse to ask permission to admit a patient. Patients with higher risks of death were turned away from VA care to other hospitals or just sent home. Some lower-risk patients would also be sent home such as those with pneumonia who needed inpatient care.

This is a very real death panel that decides who will and will not get healthcare. It is curious that medical doctors are forced to subjugate themselves to an offsite nurse who then gives a thumbs up or thumbs down on who is admitted even if the doctor onsite disagrees with the nurse.

Canada makes use of death panels, a group of government-appointed adjudicators who can make decisions about refusing lifesaving healthcare if they deem it appropriate. Sarah Palin brought this topic to the forefront of political debate in 2009 when she said Obamacare would result in using death panels to ration care.

VA is well-known for using death panels within certain circles, but most journalists and policymakers refuse to call VA’s use of rationing care by offsite administrators as part of a utilization management team as a death panel, but that is exactly what it is.

VA is required to provide all necessary care to qualified veterans in need, but it frequently uses backroom decisionmaking by bean counters to decide who gets the care.

RELATED: VA Adjudication Errors Puts Vets Lives At Risk

Typical VA Denial

VA denies its Roseburg facility engages in manipulations, “All admission decisions are based on the hospital’s ability to provide the care patients require and are made by clinicians, including the facility chief of staff and her clinical chiefs of service — nonclinical administrators have nothing to do with these decisions.”

What are some other ways VA uses death panels to ration healthcare to boost performance numbers while ignoring its fundamental duty to provide for sick or injured veterans?

It never ceases to amaze me how career VA employees fail to connect the dots between VA administrators failing to properly administer healthcare and benefits and the decrease in the likelihood that VA will exist as a healthcare provider in 10 years – at least not in its current form.

How can they be so blind?

VA recently lowered Roseburg VA in its rating system from 2 stars to 1 star.

Whistleblower Letter From Roseburg VA To NY Times

The following is the letter from 5 Roseburg VA doctors to NY Times about the schemes at the facility. It is included in its entirety in italics below:

Mr. Dave Philipps,

U.S. House Representative Peter DeFazio contacted our group of emergency medicine physicians, Emerald Valley Emergency Physicians, and requested we speak with you about concerns regarding patient care at the RVAMC. Therefore, at his request, we write you this summary of matters that are of longstanding concern to our group of emergency medicine physicians. We are all partners and owners of a physician group that has a contract to supply physician coverage to the emergency department at the Roseburg VA Medical Center. The five partners are all Board Certified in Emergency Medicine and continue to additionally work in a busy tertiary care medical center that is a certified stroke, cardiac and trauma center. We also have 12 additional Emergency Medicine Board Certified physicians with vast clinical experience working with us to supply physician services. Five of us have worked at the RVAMC for 7 years.

Over the course of time, worsening over the past 2-3 years, we have seen a very concerning trend of patient care being seriously compromised by the decision making of senior administrative personnel at the RVAMC. The limitations imposed on us and our ability to care for patients is very concerning. As experienced emergency medicine physicians, we understand the complexity of patient needs and have devoted our professional lives to providing the best possible care to our patients. The current processes are being forced onto us by administrative non-practicing physicians, nonphysician positions including nurses and non-clinically trained positions which includes the medical center Director. There has never been any effort to work with us to use our knowledge of emergency medicine patient care to improve care of the veterans. They make patient care decisions without speaking to the patient, without seeing the patient in the ED and without speaking with the physician caring for the patient. The processes are unethical, unsafe and driven by a constant discussion about needing to comply with their misguided efforts to make the “SAIL” report better. Many times, we have been told that the Director demands these artificial processes be used so that certain metrics are met in order to try to increase the “star” rating of the facility. This has gone to such an extreme that there has been an “Exclusion List” created by all these leadership positions that is used to direct how we care for patients in the department. The exclusion list is not one created by nor agreed to by the Board-certified physicians working in the facility.

We have tried every manner possible within the VA system to address these concerns. We have personally met with these people in leadership roles to discuss our concerns. We have made it clear that we hope to be included in any processes that might discuss clinical care within the medical center so we could offer our experience to assist the VA. We are available at all times to meet with and discuss any clinical concerns. We have participated in formal investigative processes conducted by the VA. We have attempted to develop processes to collaborate with leadership. Despite our efforts, we are not involved with nor consulted about clinical decision making. Often when we voice concern that a process is dangerous and not good for patient care, we are met with the response that “this is what the Director wants”. For many months the Chief of Staff, the Chief of Surgery, the medical center Director, the previous Chief of Medicine and a previously employed physician who is part of the “Bed Control Team” who all direct how we should be caring for patients in the ED have been unwilling to discuss these items with us. Of importance is that the RVAMC is a small facility and our group of emergency medicine physicians is by far the largest physician component there. Yet, we are completely excluded from all patient care discussions and our concerns are continually ignored.

Nowhere in a non-VA facility have we ever heard of this type of admission/care process being discussed, suggested as a standard of care, nor forced upon physicians. Physicians within our group hold many high level medical staff positions in a large tertiary care private hospital system and trained at highly respected training programs around the country giving us years of experience and context for our comments. We cannot express strongly enough how detrimental this process has been for patient care and how unacceptable it would be anywhere else. It is in our opinion a gross misuse of positions of power in a complex government hierarchy to allow those people to misrepresent the quality of care being provided to the veterans. Reasons for this process being so adamantly defended by these few in power seem to be desire for promotion, financial compensation and protecting their current salaries and positions.

It has become evident that a driving force behind restrictive processes and compromised care in the RVAMC is an effort to meet a variety of metric measurements, one of which is the SAIL report. The manner in which these metrics are discussed and change is approached differs from any experience we have previously had in non-VA medical centers. Although the metrics are purportedly to be used as a measurement of quality, unfortunately the all-consuming drive to make spreadsheets look better by senior leaders such as the Director Mr. Paxton , the Chief of Staff Dr. Ratnabali Ranjan, the Chief of Surgery Dr. Dinesh Ranjan, other physicians Dr. William Stellar and Dr. Bilal Chaudhry as well as RN staff Mr. Cowan and non-clinical staff Mr. Beiring has created a nepotistic cartel of power that completely prohibits sound clinical decision making by the emergency department staff and hospitalist physicians. Veterans are suffering. Unethical practices are being promoted. We have no recourse within the VA system to try to address these safety issues because every senior position above us refuses to consider perspectives other than their own. It has become clear that the senior positions starting at the Director level do not value the knowledge and experience of the committed, educated, experienced staff physicians and nurses.  

Our group has never before spoken with anyone outside of the VA system about our concerns because we had tried to maintain faith that given time, the process for improvement within the organization would correct these dangerous patient care problems. It has become evident that there is no functioning process within the VA system to improve care for these veterans and subsequently the health and safety of the veterans is compromised. At this point we maintain some hope that speaking out publicly might be the last hope for veterans to get the quality and compassionate care they deserve. We feel we are placing our contract at risk by speaking to you at the request of Mr. DeFazio but at this point it is simply not possible for us to find any other means to address the malfeasance of the senior administrative positions in the RVAMC.

We would have liked to work collegially with the staff and administrators to correct the many issues of concern but there is unfortunately a very antagonistic, unprofessional, unethical and deceitful relationship fostered at the RVAMC.

We hope that by speaking with the New York Times some of these issues might finally be addressed to allow our group of dedicated physicians to provide the quality care that the United States Veterans deserve and were promised for their service to our country.

Thank you for your professional consideration of the information we present to you. To demonstrate how seriously we consider these issues, we are willing to allow these statements to be used by you “on the record” if necessary as well as any other comments in any possible follow up discussion with you that we explicitly discuss in that context.  

Sincerely,

Dr. Christoffer Poulsen, President, Emerald Valley Emergency Physicians
Dr. Charlotte Ransom, Secretary/Treasurer, Emerald Valley Emergency Physicians
Dr. Bradley Anderson, Partner, Emerald Valley Emergency Physicians
Dr. Michael Day, Partner, Emerald Valley Emergency Physicians
Dr. Ann Cooley, Partner, Emerald Valley Emergency Physicians

See: Original Letter To NY Times

Source: https://www.nytimes.com/2018/01/01/us/at-veterans-hospital-in-oregon-a-push-for-better-ratings-puts-patients-at-risk-doctors-say.html

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58 Comments

  1. The VA is broken beyond repair. It has been broken for decades. Every so often someone tries to fix the VA, but the VA simple outlasts their attempts. The only solution is to disband the VA, layoff everyone working there, sell off all it’s assets, and put all Veterans on the same healthcare plan as the President, members of Congress, and US Supreme Court justices.

    1. I’ve been pushing for that for years, and asking so-called leaders or representatives as to why they are above the rest of us when dealing with certain issues. Above the laws too. No change at all, no grand movements in Congress to be like us peons and low-life vets.

      What makes it worse? That local Indiana Democrat ruled government in college towns have adopted the same policies for government/town workers, first responders, political hacks, metro unions, etc. Claiming it all saves the tax payers some money and their want for Obama Care doesn’t affect them like it has working tax serfs. So we shut-up and allow them all to have more special privileges like Congress critters and others have… or be put on their hit-list or black-ball lists for the state activist to know of.

      But then we are expected to give to their charities and support them while we are not part of their clubs or have the same golden parachutes of health care insurance and special clinics and MDs. Countless times I”ve heard the professionals claim or discuss patients being “one of their own” by some nurse or MD, or “gotta go that extra mile for cops, firemen, politicians,” the local country clubbers, the cliques, those in the medical fields, but not for us. Especially if we are listed by many as the enemy.

      I have to agree with those who claim the entire American system is broken. So corrupt it’s beyond repair. Regardless of who sits in some hack political office.

  2. What does Doug Paxton and a prostitute have in common?

    They’ll both fuck you for money.

  3. Matthew Riehl anyone . 4 cops against one . need to know if matt was in his home while situation occurred or not . cant believe ben did not write an article about this. the man was honorable discharged .also man had running mates and a lawyer as well also

  4. I could see this You Tube over-the-top anti-VA skit by Veterans:

    1)Veteran is shot 6 times in their backyard by some drive-by insanity.
    2)The Vet’s buddy takes him to closest non-VA emergency room.
    3)While Vet is bleeding, the non-VA ER contacts a ‘VA Champion’ whom in a window within scene while on phone with ER looks through a HUGE VA book called “The VA Follies”. (‘The VA Follies” are regs. & rules the VA is supposed to follow but don’t, hence name ‘follies’.
    4)’VA Champion’ asks how many times the Vet has been shot? “Was it more than 8 but no less than 7 gunshot wounds…at a non-VA emergency room?” (as “VA Champion’ looks indifferently over large ‘follies’ book).
    5)The non-VA ER Dr. responds, “no, only shot *6* times”.
    6) “VA Champion” repeats from “VA Follies”…”A Veteran may indeed go to a non-VA emergency room if and only if he or she has been shot more than *8* times, but no less than *7* gunshots?”
    7) Veteran’s buddy now takes shot 6 times Vet back out into parking lot and you hear -1- solitary gunshot and them returning to the non-VA ER and…
    8) Non-VA ER Dr. now updates the “VA Champion” on phone that the gunshot count is now at the minimum of 7.
    9) “VA Champion” states that ALL the gunshots must have occurred from the same original location of the SWAT Team. Standby.
    10) MANY gunshots in an audio mayhem resulting from attempting to save a fellow Vets life while fighting the VA Follies.

    (^just a quickie off top of my head, with a very low to nil budget, can only get better^)

  5. I think I’m gonna take off for the rest of the day. Honestly the more I think about it the more convinced I become that Doug Paxton is the one. If you have PTSD you know what the fuck I mean.

    Catch you cats tomorrow.

    WC
    card carrying member of the Green Tribe.
    ONE OF US!

  6. Vet deaths and denial of care = performance bonus. Paxton is a traitor and criminal. The only difference between him and other terrorist is they do it for religion Paxton does it for money. He should be in prison.

  7. this article is a good place to start concerning the problems with the Roseburg VA healthcare system. A pcp not performing required exams and falsifying veterans medical records to say he did. Flawed MRI studies that are fuzzy/inconclusive when compared to MRI studies performed elsewhere (disappearing arthritis, etc.). Non VA radiologist reports are not being accepted by Roseburg’s radiology dept. The VA doesn’t want to make those comparisons. Then there is the doctor who never reviewed my blood labs and never told me I was diabetic (A1c 11.8 at the time) it would be a year before i was informed of those results.
    The Roseburg radiologist who over ruled the VA neurosurgeon and the Chief Radiologist at the VA in Portland as well as a Non-VA pain specialist doctor about the need to perform compression MRI’s of my spine in the sitting position.

    VA Pharmacy Prescriptions- improper, inadequate or missing warnings on prescription bottles. Out of state ghost doctors who treat veterans for high blood pressure, diabetes etc. without ever meeting,talking with or examining/ordering bloodwork.
    Improper dr. dosing instructions on bottles, prescribing gemfibrozil to veterans with gallstones when the drug manufacturer says not to (increases cholesterol in bile)and omitting this information from supplemental drug warning sheets which often do not include FDA boxed warnings, the fine print warnings at the bottom of the label are barely legible, don’t include all of the warnings that you would find on prescriptions from a commercial pharmacy. most of my prescriptions from the VA (i’ve saved all the bottles since 2009) have the labels and fine print warnings folded over.
    I’m just scratching the surface on the multitude of problems with the VA’s prescriptions and this is not just in Roseburg. these problems exist at other VA’s i’ve been treated at in Illinois, White City,OR, Detroit as well. I think its a national problem. you folks who get VA prescriptions would know what I’m talking about. i think the reason they fold these black and white printed labels over is because they can’t cover up who repackaged the drugs. every once in a while i will get a script that was packaged by the VA Pharmacist in the conventional brown bottle with a label that does have the FDA Required Yellow Highlights on certain info on the label but that is seldom.

    Appears to be a nationwide problem. check out your script folks and get back to me here. it would be interesting to see just how many of you are aware of these problems. the FDA doesn’t regulate VA Pharmacies, I called and was told to call Oregon’s state board of pharmacies, they don’t regulate the VA’s Pharmacies either. I spoke with a local pharmacist in town. the only thing wrong with the warnings,labels and drug info sheets is there is not much right with them.

    The VA is regulating itself! let me know what you find out about your scripts. maybe Ben will pick up on this dialogue and bring attention to the problem!

    Mike Berns

    1. I love how the FDA tells you to contact the OR state board. As if a STATE level board has any oversight of a FEDERAL dept. Apparently FedGov is full of people who couldn’t pull the definition of civics out of their asses with both hands, a flashlight and a field manual.

  8. I’m a veteran w/PH, but will not use a vamc. Unlike 80% of all veterans, and McCain, who can afford not to use vamc I have no real healthcare. I eat well, get plenty of exercise, trust God. And will probably live longer; and be happier without trying to deal with getting anything from VA. Would be nice if veterans could get the same consideration from the media as sexually harassed women, illegal aliens, et al. Thanks America, Congress. Hope we don’t have to fight another world war anytime soon.

  9. This article reinforces a concern I have. I am 85 in reasonable good health and am coming up on a Pacer replacement. I have it in my head how easy it is for them to deny this replacement and just let me die. Really worried!

  10. Sorry Ben for parsing the word-smith’s work product, but – I gotta. Your sub-title asks “how much more will the taxpayer allow before pulling the plug?” Well sir, I submit that it is the give-a-shit tax payer that is indeed trying to pull the plug – on Vets. Taxpayers are either too concerned about paying next months rent, or, too busy stuffing their pockets. “Veteran’s whaaa?”

    The only way the VA will get fixed – functionally – is for the Trumperbator to sign an executive order requiring all those in Congress and their families to receive their care from the VA. But – he’d have to give a shit, and it isn’t close enough to the mid-term election. The last guy didn’t give a shit. The guy before him didn’t give a shit. Nobody gives a shit. Hell, I don’t give a shit.

  11. Our group has never before spoken with anyone outside of the VA system about our concerns because we had tried to maintain faith that given time, the process for improvement within the organization would correct these dangerous patient care problems. It has become evident that there is no functioning process within the VA system to improve care for these veterans and subsequently the health and safety of the veterans is compromised. At this point we maintain some hope that speaking out publicly might be the last hope for veterans to get the quality and compassionate care they deserve. We feel we are placing our contract at risk by speaking to you at the request of Mr. DeFazio but at this point it is simply not possible for us to find any other means to address the malfeasance of the senior administrative positions in the RVAMC.

    Upon further reflection this paragraph has me outraged even more. How many of our brothers and sisters in arms have died while this group of “doctors” kept their silence?

    Let me be the first to proclaim 2018 as the year of the gun.

  12. My Senators and Representative told me the only way Veteran Medical Centers to going to change is by have more then 3 Whistleblowers works at a Veterans Medical Centers to change to have a Veteran Medical Centers get a Veteran Medical Center Healthcare system.

    1. So basically what your Sen/rep told you was that they can’t help you. Welcome to the Green Tribe. If FedGov won’t step in to right wrongs then they are immediately divested of power and that power reverts to you. The more people in the Green Tribe the more power the Tribe has.

  13. A sugestion:
    First.

    The problem:We Veterans have NO fucking political teeth, that is not conjecture, it’s fact.

    Solution: We start our own pirate radio station and connect with every Veteran centric source we can find.

    How will this work? Easy, a subscription to either Shoutcast, or Icecast start at 6 dollars per month, then they base that monthly cost, off of the number of people listening, offset by allowing them to place adverts.

    What will it accomplish? It is the fastest way I can think of to network with all Veteran online sources, you want a march? You put out the word and instantly millions of Veterans heard your call to action. Veterans now outnumber citizens, it is time all of us Veterans become the political force we actually are. You don’t want to do right by Veterans? You can kiss your political ass goodbye.

    NEXT!!!!!

    This is a damn good idea and it should be developed asap, before this next election cycle.

    I am not looking for thumbs up……….I am looking for thumbs in eyes of useless politicians, who lie to us year after year after year. We out number the AFGE/SES, it’s time for these politicians to fear the proper group, Veterans, not unions….

    Thats right, I agree with namnibor.
    A fresh 2018 Fuck You AFGE/SES/VA/DOD/DOJ/ and now adding to the list. Fuck You too POTUS.

    1. You may not be looking for a thumbs up but I’mma give you one anyways because your spot the fuck on. Incidentally the cost for a home based broadcast system is not all that expensive. Recording software can be found online that is both robust and free/inexpensive. 300-400 USD can get somebody setup with decent equipment from a place like Guitar Center.

      A broadcast program is absolutely ideal as a first step in getting the voice out. We need a list of all Vet sites of any importance to advertise said program on. A format would have to be hashed out as well as a broadcasting schedule. Daily weekly or monthly. I would like to see lawmakers featured as guests so we can hammer them about the sad state of affairs at the VA.

      Explore this option. If it’s feasible I’m in in whatever diminished capacity I can provide.

      1. WyldeChylde, I looked into the home solution, but the bandwidth would be impossible, for instance, I only have 18mbs coming in, and only 5mbs out, I can only host 2 listeners on a good day. When you subscribe to shoutcast or icecast, your paying for their bandwidth and now you can reach millions of listeners.

        All that is needed is their desktop software, this is free, and people interested to fill dj spots, so we can have a full 24/7 broadcast.

        Ben and his lawyer friends can take up a few hours with their blog articles, and the rest of the time can be filled in with bringing issues to the air, such as those found by Seymore and elf. If your not embarrassed by the sound of your own voice, then anyone can be a dj.

        I use to visit an international chat site, they also had a pirate radio station all their own, manned by dj’s from all over the world. It worked extremely well complete with a rolling squawk box “community chat lobby”
        Listeners could place request for themselves or for others.

        I can see this turning the tide for us, and becoming the beginning of our proper place at the political table.

        When it is all setup, and we have the schedule full of dj’s, then it’s as simple as posting the link to the station on as many Veterans sites as possible.

        Why not Veterans? If everyone else can do these things we can too…..

      2. have you looked into a static format such as youtube. I know it’s not a live format but it could possibly help in keeping subjects/topics on point. Not to piss in the cereal or anything but I’m sure you’ve seen how “eloquent” and focused the average vet tends to be. I suspect a live broadcast would be all over the place initially. Unless your just talking about having guest speakers?

      3. WyldeChylde, for me anyway, it wouldn’t work, I am one of those people who can’t stand to either see or hear myself. I can however work in the background. doing all the medial crap..getting guest speakers, developing skits, etc.

        Know what I mean?

      4. I don’t mind being seen or heard. I just need time to compose myself or I tend to divert and ramble. Both are the kiss of death if you can’t reign them in. So, for me, at least a static format is best. Perhaps a network seeded by vets doing their own thing and linking/supporting each other.

        A thought has just occurred to me while typing this. This is why I get baked. Why not look into getting a veteran PTSD reality show on one of these TV networks? Put this shit right in the living room of every American Citizen once a week. Use the show to drive/fund the rest of the vet network.

        I think if the average person actually got to see what happens in the privacy of a vets mental hell it would be the most effective weapon that could be deployed in the fight.

      5. As to your chat room format, I was actually going to recommend something similar for your broadcast format. It would help field questions for guest speakers. As another aside have you looked into publicly funded radio? Vet issues are of national interest. If it gets out that vets are serially mistreated by the VA then I would submit that parents and potential soldiers would think twice about signing on that line. Hell one could even possibly consider a federal grant to get up and running.

      6. WyldeChylde, yes, that is exactly what I was thinking, a federal grant to a disabled Veteran to operate a radio, and even possibly a cable/free tv, show. There would be no stopping Veterans at that point, remember, the numbers don’t lie, and as we speak there are more Veterans than citizens. We are the largest group of individuals in the country. We need to start claiming what’s ours.

        WE ARE THE TOP OF THE HEEP, LETS START ACTING LIKE IT, BROTHERS AND SISTERS!!!!!

        NOBODY, AND I MEAN NOBODY………….. HAS GREATER NUMBERS THAN WE DO…………

        P
        E
        R
        I
        O
        D

        If we stood on each others shoulders we would reach the damn moon…………

        Okay, I made that shit up. Who knows, if we had a few taller Veterans?????? And one reallly strong OLDMARINE at the bottom holding it all up??? and we didn’t jiggle around any??…..and one Crazy elf, keeping the area free from nay-sayers…???? I bet we just might make it!!!!!

        Let’s make this year, the best year ever……….let’s make this year, the year of the Veterans!!!!!

        Got to go.

        Later Gators -!ii!-

      7. I could see this You Tube anti-VA skit by Veterans:

        1)Veteran is shot 6 times in their backyard by some drive-by insanity.
        2)The Vet’s buddy takes him to closest non-VA emergency room.
        3)While Vet is bleeding, the non-VA ER contacts a ‘VA Champion’ whom in a window within scene while on phone with ER looks through a HUGE VA book called “The VA Follies”. (‘The VA Follies” are regs. & rules the VA is supposed to follow but don’t, hence name ‘follies’.
        4)’VA Champion’ asks how many times the Vet has been shot? “Was it more than 8 but no less than 7 gunshot wounds…at a non-VA emergency room?” (as “VA Champion’ looks indifferently over large ‘follies’ book).
        5)The non-VA ER Dr. responds, “no, only shot *6* times”.
        6) “VA Champion” repeats from “VA Follies”…”A Veteran may indeed go to a non-VA emergency room if and only if he or she has been shot more than *8* times, but no less than *7* gunshots?”
        7) Veteran’s buddy now takes shot 6 times Vet back out into parking lot and you hear -1- solitary gunshot and them returning to the non-VA ER and…
        8) Non-VA ER Dr. now updates the “VA Champion” on phone that the gunshot count is now at the minimum of 7.
        9) “VA Champion” states that ALL the gunshots must have occurred from the same original location of the SWAT Team. Standby.
        10) MANY gunshots in an audio mayhem resulting from attempting to save a fellow Vets life while fighting the VA Follies.

        (^just a quickie off top of my head, with a very low to nil budget, can only get better^) 😀

    2. Maybe a good YouTube channel that has skits like SNL making fun of Dave, Helman , Bob, OIGs Senators…..even a scenario reflecting lazy clerks and healthcare providers.

      1. CorpsmanUp!…….Your talking about VATV!!!!! Hellllllllllllll yeahhhhhhhhhhhhh. and shit!!!! this needs to go from youtube to prime time in your face 24/7 cable.

        Can you just imagine the shit we could come up with? It would be number one for the rest of time…….Whack a mole va directors..

        Okay you Veterans applying for benefits, let’s see what’s behind door number one..ohhhhhhhhhhh it’s the hungry hungry hippos, sorry claim DENIED.

        You get the idea, and the possibilities are endlesssssssssssss….

        Oh, and only Veterans need apply for work……………….Number one, and the advertising dollars coming in could probably fix just about ANY Veterans issues.

        Fuck the VA…

      2. I would think that using the format is fine just don’t expect any serious money from it. I was watching a paladin vid the other day, 13Bravo here, and the guy was mentioning how youtube was shitting on vet channels in some way. Might be something to look into before making decisions based on financing and what not.

  14. The cure for this is to make the local VA responsible for the patient’s outcome no matter where he gets care or doesn’t get care. If he dies at home make it a double wammy against the VA medical center unless the patient is on home hospice care. Get negative reports from the local corner, etc.

    1. I would normally concur with that. However, we all know if that was the case the VA would kick down your door and involuntarily confine you because you sneezed. Anything to keep those gold stars and bonuses…

  15. Doug Paxton puts me in a shooting mood.

    It would seem that it’s perfectly acceptable for a government employee to decide the life cycle of veterans.

    If I where to contact Doug Paxton and offer to stick a gun in his face you can bet I would have multiple armed response units camped outside my front door telling me to come out and play.

    Only FedGov employees get the right to play god. This is a problem.

    Congress passes on it’s responsibilities to reign in the VA. This is a problem.

    When the FedGov shirks its duties and responsibilities. That power, like all power, reverts immediately to the citizenry. This is a solution.

    Maybe Doug Paxton needs to be confronted by a crowd wearing the Green Tribe colors. A rope, a ligh pole or tree branch, problem solved.

    Personally I think he should be pissed on by all assembled before he’s run up by the neck.

  16. What do you think the real function of the DBC is for crying out loud???

    I know full well about Roseburg booting those who bring the numbers down. Here is a cut and paste from my own online VA health record. I had asked Roseburg to restart my mental health care that they had terminated after the press published a damning story about dereliction, deceit, and malfeasance in my case. When I asked to be let back in to mental health care (MH) because my meds had run out they barred me from VA providers. Here is the cut and paste of their response to have another VA MH provider assigned;

    “——Original Message————————
    Sent: 12/14/2016 05:57 PM
    From: VA employee, BRIAN (last name changed out of courtesy)
    To: patient, DENNIS (last name changed out of paranoia)
    Subject: General Inquiry

    I did ask about MH services for you. I was told the VA will pay for you to see a practitioner or psychiatrist in the community. I can start the process if this is what you want.

    Brian VA worker
    LCSW”

    In other words VA refuses to assign me a VA shrink or allow me onsite for VA therapy. Now do you see the insidious way he put the message? If I said “yes” I want Choice then the records would indicate I had asked for this and would not reflect a betrayal of the VA mission. So ask yourself, why wouldn’t I want Choice? Simple.

    They did this three years ago too with me and when I tried to utilize it the national Choice hotline gal told me that without an assigned VA shrink I could not participate. In other words it puts you into an endless loop that cannot be stopped. VA keeps referring, Choice keeps telling you to go back to the local to get it right, VA refers again, cycle repeats and yet on the books it shows you simply to be approved at the local level for your request of Choice Program which they then pass responsibility off to somebody else. It is very clever. It is called limbo and they hope you die before they have to stop.

    Ben, this is not a new thing at Roseburg and in this town it here is even a joke about who has been booted and who will be lolz.

    Honestly though, the entry from my record is their direct denial to perform their duty under the VA mission of caring for each vet as requested and the sole reason is that I brought bad press to them as was reported in the press. I went online yesterday and used the new online app that lets you schedule yourself for a doctor. There is one drug I want to restart from the 13 prescriptions I was on under VA care and that they terminated so for the seventh time in four years I have requested a restart of VA mental health services.

    The reason I obviously qualify at 100% MH for VBA is because I believe that shit like this might work… Wish me luck….

    1. You just eloquently described the Choice Program Crows flying in tight 40 mile circles endlessly. Meanwhile, didn’t the not-so-helpful MH hacks at Roseberg also try to hand-off some prescriptions on the sly on the street outside the VA or was that someone else screwed with by Roseberg and the VA’s DBC?

      Although I have Medicare, I am 100% Svc. Connected and I do want to feel safe and use the VA at some point wherever I may move to and Oregon is a serious contender for that move…am thinking ALL VA’s are a degree of scary and shitty so it’s not like one will stumble-upon “world class healthcare” the VA just LOVES to tout about. Seems there needs to be a 5 turd rating system instead of stars?
      the 1/2 mark would be a turd smear for 1 1/2 turds, for example?

      1. The reason the mental health folks were handing out the drugs out of clinic stashs was because of the leadership at VA Roseburg was driving mental health patients out of care by labelling them disruptive, the like me you couldn’t get meds. The suicide prevention coordinator got a stash of drugs I needed but the wrong dose and put them into an envelope and gave them to me outside of hours.

        I reported this to VA police because it indicated such a horrifically broken system when social workers pass out powerful psycoactive drugs of various dosages just to bypass corrupt leadership. Of course the police report that was generated as a result of my report found multiple stashes of all sorts of drugs – even prescription nicotine patches that the HUDVASH housing folks upstairs were passing out! They also found clonazepam stashed and at last one VA secure prescrtipion drug tablet.

        Do you know what the last paragraph of at police report informs the reader?

        “At the request of the Director the contraband found has been destroyed.”

        If you want the actual police report of it I can forward but let me tell you that a social worker passing out psycoactive drugs of unknown origin to try to save suicidal vets??? my God.

      2. update;
        After forwarding todays blog to the senior reporter who runs multiple regional news sources and who has interviewed me 23 times about VA, she responded within minutes. This letter validates the entire two edition article she published and was critisized for and she plans now to do what a senior reporter does when they can connect all the dots for the public. Ben’s blog caused this ripple and just one of her newpaper outlets over which she is shop forman now has a subscription base of tens of thousands and stretches across Oregon. Ben will impact tens of thousands of people likely over this just by making me aware and which I passed along. I once saw a vet vent upon Ben for not taking action but rather speaking out. Today makes clear that one man taking direct action can move boulders, but one man speaking out and directing action can build pyramids. Each of us are that same man. We are set apart by choice.

        Ben caused action just like each of us can do. Each of us can forward this letter to their local paper then tell them, “…as a vet I want to make a statement for the camera and reporter about how I feel about this betrayal by VA.”

        From experience there will be some reporters that take this up if you too toss them such a softball to swing at. Tell them you are outraged and tell it from the heart. Hold back nothing. Give it a try. This could be the snowball at the top of the hill…

  17. I posted this article to my local V.A. hospitals Fakebook page…..All of them are Broken, Maybe I can shame them to do the right thing, But I kind of Doubt it….LOL

    1. Shame primarily relies on a sense of ethics and without ethics, all that mirror of shame is to these bastards is what a house of mirrors is to a local carny funhouse attraction, a distortion distraction.

  18. And, I’ll bet y’all some of that $2.1 billion dollars for the Choice Program will be handed out for bonuses shortly! IF it hasn’t already!
    If anyone believes this kind of illegal medical care is restricted to Roseburg, I’ve got some “Prime Swamp Land” out in the Nevada desert for sale!

    Here’s something else I’m not too fuckin happy over. A United States Congressperson always says, when confronted with facts of something illegal occurring in the United States of America,
    “If it’s NOT in [his/Her] district, there’s nothing [they] can do!”
    To this I say; “BULLSHIT!”
    They may have been elected in a certain district, YET, they “…serve ALL people of the United States!” Which is WHY they’re called a “United States Congressperson!
    Which means, it’s time for them to get off their lazy, overpaid asses, and start holding ALL the people of VA, NOT only responsible for their misdeeds, also accountable for their crimes against our veterans! Y’all can start with Shulkin!

    Lastly, #President Trump,
    “VA IS LYING AND VETERANS ARE DYING!”
    It’s not anywhere near being “fixed” as you’re reporting! It’s time for you, as our President, to demand the DOJ start indicting those in the VA for crimes against veterans! The DOJ IS responsible TO the President! Which means, the DOJ is mandated to take orders from the President!

    1. I don’t play politics when it comes to taking care of your brother and sister, but if the commander in chief is not doing his job, he has got to go as well!
      The commander in chief in my opinion should have an official military uniform in the presence of military personnel at all times when addressing them.
      All this bad posture, latte salutes and the appearance that the President with a fat ass gut on the premise of passing gas with every step, is a embarrassment to those who served and are serving.
      The talking shit is normal military jargon, and I can deal with that, but being an unsat, fatback is wack!

      1. I would agree with that statement, however. Donnie Bonespurs in a military uniform would probably enrage me even more.

  19. Broken hands on broken ploughs,
    Broken treaties, broken vows,
    Broken pipes, broken tools,
    People bending broken rules
    Hound dog howling, bull frog croaking,
    Everything is broken
    Songwriter: Bob Dylan

    1. I even posted this one to their site
      “https://www.vareview.net/places/united-states/north-carolina/asheville/hospital/charles-george-va-medical-center-asheville-nc/#comment-1476”

  20. Prediction: VA Spokeshack Cashour will disavow this group of Dr.’s as “outlanders”, discredit them and even get other Dr.’s to lie about them, ample AFGE herd of lies about them…and Roseberg will continue doing what ALL THE VA’s have been doing along, picking patients like an obese person squeezing all the chocolates and tossing back in box they don’t like, that’s just how we Veterans are considered…like a box of chocolates… Big Bertha loves the idea of receiving the Veteran/Chocolate/$$$$, but rather just take the $$$$ and discard the Veteran like a vomit cream praline chocolate.

    I’m in a fowl mood this morning so my bonus tips for you fucking VA vultures is the tallest middle finger on each of my hands in a fresh 2018 fuck you, VA.

    1. my bonus tip for the VA would be. Watch yourself when outside the VA walls. You never know when one of us will get through to you…

      1. *bonus tip* – Titanium walker tips, end of cane tips, Rottweiler at end of titanium braided rope teeth tips…

  21. This does not just happen in the V.A.,,,,,IT HAPPENS EVERYWHERE… Doctors,nurses,,Administration will outright lie,,,to make themselves or that facility to ”look good,”….Also they will do thee exact same thing to thee actual patient.They will lie all over patients records,,,to blame the patient,,,for that facility,that doctors,,that nurses,,,screw up,,,,Now a days, it all about denying access to effective medicine to lessen physical pain,,Soo they will falsely label patients as addicts,,to deny them medicine to lessen physical pain,,Also malpractice insurers will give out bonuses,incentives, to hospitals,,who uses less opiates,,ITS SICKENING,CRUEL,TORTURE AND IN SOME CASES GENOCIDE to all who have chronic medical illness thru no faults of their own,,,maryw

  22. It is very important to note that an exclusion list can be construed as a wait list , if the appropriate referral has not been made to treat those on that list.
    The utilization review is equivalent to a DBC ,where illnesses are seen as disruptive to their bonuses.
    The number listed for the person who oversees VHA Directive 1117 is 202-461-1994 , Carolyn Clancy as of 2014.
    So it is safe to say, the policy has never been reviewed since she left that position.
    The Utilization Review at VA is a tragedy to all healthcare providers that are true to their profession.
    I could open up my own Battalion Aid Station and do a lot better than that.
    I am pretty sure if electronic records were not in use, a lot of these patient charts probably were saturated with morning breakfast by VAs elite review boards.
    To all those “Chumleys” in lab coats, (Tennessee Tuxedo ) Fuck you and the box of Hamburger Helper your fat ass was printed on!

    1. **Hungry, Hungry Hippo Helper **…”[your fat ass was printed on!]” 😀 (correction provided by Coalition of Concerned Cash Cows(CCCC). 😀

    2. the exclusion list pertains to medical diagnosis, not individual patients. Electronic record are in use in fact, the VA pioneered electronic records back in the 80’s. It still uses the same dos based system to this day….

  23. MYVA, huh?
    1. Should’ve just put Mr. Savage up in a bed and let him sleep there. Fuck it, he was U.S. soldier dude. Stay there for the night. No biggie. It is Mr Savage’s VA, right? MYVA, huh? Or put him in a hospital room, and let him sleep there, and give him some care there for awhile. Check on him. Then find him a place to stay, and make adjustment for the 81 old vet, Mr Savage later…
    Fuck the policies, and politics and fuck the money…

    2. When I seen this article on the front page of the New York Times today. I pulled the front page of the New York Times off the shelf. I was in a coffee shop. I seen this article right here with Mr. Walter Savage situation. It made me depressed, angry, and upset. For Mr. Walter Savage situation.

    3. There was time when Mr. Walter Savage was strong, young, and made the choice to guard our country. Now he is alone, and vulnerable like so many of us. Mr. Savage should be taken care of and given the best. No, if ands, or buts…

    4. Dumbest fucking people in the world at the VA, getting paid the most in the world at the VA. Sinister and Evil! The Employees at the VA, their labor is NOT worth what they are being paid. There is NOT an equal exchange rate at the VA based on work to dollar ratio. On top of that, many of the employees at the VA are “morarlly bankrupt”, Non Veteran (draft dodgers, anti military, Left of the political spectrum, and of certain religions social networking into the VA for employment) VA money hogs…
    MYVA, huh???

  24. It is really time to stop the “bonus” game with employees at the VA;
    As well I propose a hit team to get rid of these administrators who cause the deaths of veterans and refuse health care to them. WHO IN THE HELL EVER DREAMED UP THIS “BONUS” SYSTEM ANYWAY?!?
    SOMEONE, THOSE RESPONSIBLE FOR THIS SHIT MUST PAY, IN ORDER TO PREVENT OTHER RATS FROM DOING THE SAME THING. wAKE UP VETS, HOW MANY OF YOU WOULD ALLOW YOUR FELLOW FIGHTER TO BE KILLED??

    1. va deathcare is always same crap differant day va deathcare kills vets for the bonous $$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$ va dc hq is a federal rico crime racket congress rats will do nothing for vets that on death panels !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

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