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To silence dissent between veterans groups and VA, the agency released its proposed community care standards that increase access to private care.

About a week ago, VA Secretary Robert Wilkie received great pushback from the veteran community over allegations his agency was freezing out the Big Six veterans groups.

I argued freezing out the Big Six was a mistake as doing so could result in regulatory challenges at the US Court of Appeals for the Federal Circuit that could otherwise be avoided. The Secretary apparently agreed with the rhetoric and published the proposed changes ahead of schedule.

RELATED: The Big Six Complain After Choice Rulemaking Lockout

With an expected effective date in June 2019, the new plans will guarantee greater access to community health care. In order to qualify for access to community options, veterans formerly needed to live outside of 40 miles from a VA clinic or with a 30-day appointment wait time.

Previously, in 2014, VA had a 40-mile “crow flies” policy that kept practically every veteran from using Veterans Choice even if the closest facility was a dental clinic when the veteran needed cancer treatment.

It was a colossal mess that was compounded by agency bickering with government contractors hired to facilitate the process including TriWest and HealthNet. The new proposed changes should increase access, funding, and hopefully cooperation now that other companies have entered the market with HealthNet leaving.

Three Big Changes To Veterans Choice

The three things you need know about the proposed changes, at least as they are now, where the veteran can access community care, if:

  • The veteran lives greater than a 30 minutes drive to a VA medical clinic
  • The wait time for an appointment is more than 20 days (for most appointments)
  • The veteran uses designated providers in the community for Urgent Care appointments and pays a co-pay

If codified following notice and comment around June, these regulatory changes will increase access so long as the agency plays nice with providers that agree to provide medical services in the community.

Publication For Notice And Comment

The proposed guidelines have yet to be published in the Federal Register, but the regulations impacting general access to community care and urgent care will be listed at RIN 2900-AQ46 and RIN 2900-AQ47, respectively.

I encourage everyone here to comment when they are published, and I will be sure to do my part and announce when it happens.

Wilkie On Proposed Veterans Choice Changes

Secretary Wilkie said, “Our medical services must meet our Veterans’ needs and reinforce the trust that forms the basis for every interaction with VA. Our new access standards are a vital part of this effort.

“Most Americans can already choose the health care providers that they trust, and President Trump promised that Veterans would be able to do the same. With VA’s new access standards, the future of the VA health care system will lie in the hands of Veterans – exactly where it should be.”

Wilkie Spins Studies, Supports Choice Expansion

Curiously, Wilkie turned the typical pro-VA health care studies in the recent past on their head. These studies from RAND, Dartmouth, and elsewhere, are normally used to keep veterans in the VA system. Instead, Wilkie cited these studies to buffer pushback against community access expansion.

After referencing the studies in his press announcement, Wilkie continued, “We know that to keep the trust of our Veterans we must continue to deliver…. Our new access standards are a vital part of this effort.”

Lawmakers recently supported a $55 billion reform bill to set up a private network of community care providers to support the VA MISSION Act. The expansion will likely cement in the expansion many in the veteran community sought after the 2014 waitlist fraud shocked the nation.

What do you think of the expansion and how Wilkie turned normal pro-VA spin to support expansion instead of retraction of Veterans Choice?

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39 Comments

  1. Always arbitrary and capricious hurdles to block many veterans from healthcare at non-VA facilities. I am interested in getting cataract surgery outside the VA. According to Mapquest I am 28 minutes from the New City VA clinic which doesn’t provide cataract surgery. How rediculous can they be? There should be no time hurdles for this service at all. I will probably still request community care based on my lack of confidence in VA eye surgeons doing a substandard job. Who wants a trainee resident physician operating on their eyes, with all the risks involved? My senior cataracts are risky to operating on because they are hard—I can wind up blind if this isn’t done by an experienced , board certified eye doctor. The other variable is use of miLOOP, a new development to break up the hard cataract. However, it is new to the industry. The Brooklyn VA has already received some, and the Manhattan is interested in ordering. However, the Bronx VA where I am required to do surgery has not expressed an interest. I received this information from the manufacturer.

    • I agree with you the lack of confidence with the North Korean VA (NKVA,) after all I caught of my Drs, lying to me about kidneys. I also had a few words with the chief of staff, about the lack of care. That lead to being put on the (PRF) list. This puts you into the “RED-FLAG” mode, you are treated like a “PRISONER” when you show up for an appointment you have to get “PRISONER GUSRD” to go to your appointment.

      • Are you saying they reported u as being disruptive ?. Did they advise you, you have been determined disruptive and are punishing you.

        If they did, I know an attorney who is willing to help you and other veterans, such as myself.

        My case is to old for me to file a civil lawsuit against the va, for denying me my civil, human and constitutional rights to a fair trial.

        If you like or any other veterans who have been falsely accused of being disruptive. Write back and I will post the lawyers phone number, who is willing to help us bring a class action lawsuit against the va.

        Concerning the illegal Disruptive Committee.

        Veterans must have been accused and punished within the last year.

    • Hi I will get to the point we have to pay a co pay to see some one and not get the money back right! I am having troubles with that dream of my money and the lack of care at all of the VA. If the people who make us live under such conditions had to use the same kind of system you know it would never happen and they would have world care not just where we can get it. Also I forgot we already paid for our care some more than others but still paid but we have to fight to get it and don’t think or thank the service people like the DAV or any other things that I said it’s fighting for you and your family rights hell I did what my country ask me to do and so they should be doing the same for us okay bye for now Jim Hanrahan

  2. I’m not particularly interested I’m seeing the V.A. privatized. I am for the V.A. through its primary care physicians, clinics and larger facilities using private enterprise where they offer a better solution but not a private contractor not familiar with the veteran, his needs and local alternatives. Every experience I have had with a private contractor has either placed my life at risk or the most recent adventure wanted me to drive over 100 miles one way to see a physical therapist to rate my type II diabetes. I am already 100% and really get annoyed by inadequate service. I never had any issues with the V.A. until the last 18 months and it has yet to be a problem caused by the V.A.

    • Why did you go to someone on the outside, since the va did such a good job. We have said many times the va has (some), good employees.

      But investigators have determined that there are some serious problems with the VA.

      How about the 300 thousand veterans who died waiting for treatment and denied and their claims in the appeals process.

      Now there are 450 thousand veterans in the appeals process. How many of these veterans will die, before they receive treatment.

      Glad you are happy with your care. Many are not.

    • They aren’t talking about privitizing- they are talking about making it possible for folks who live more than 30 minutes from a VA Med Center (not Clinic) to get their medical needs seen to, in a timely manner. However, whereas the Veteran’s Choice Program did NOT require the Vets to pay a co-payment, the NEW program will still be out of reach for many.

  3. I’m 40 minutes from the VA which is in the nearest town where everything else is. Nothing between. Guess that leaves me out. Thanks for the effort.

  4. Maybe these new rules is why the big six were left out. Of course, when has anyone ever watched the VA ever follow the instructions, rules or laws governing them!? Just saying!

  5. We will still have non-payment for outside. The VA acts as if its their money for their taxes and bonuses. They don’t pay out even when they direct you to go to the ER. Over $20,000 and counting for a 3 day stay at a non-VA facility that primary docor from the VA clinic called. So where is the help? Good thing my husband had Medicare. If it was me with CHAMVA and me being under 65 we would be paying all of it.
    The VA is worthless.

    • You are right and they were caught denying these emergency visits, using false information about the regulations concerning outside payments.

      The va promised they would not make veterans pay out of pocket. Yet they lied and continued to do the exact opposite and are denying those claims.

      Non service connected disabilities can be paid but the va is telling veterans if you have any kind of insurance, you are on the hook for anything not paid by the insurance company.

      The va was Told, not to do this and they continued. A new lawsuit has been filed against the va again.

      Yes, the va thinks they can do as they please. The Secretary said ok, we will pay, but expect for costs to skyrocket.

      This is a bunch of bull. This proves that the va intentionally did this, to save money.

      All the va had to do, was go in front of the house or Senate committee on veterans affairs and told them of the need for monies to ensure veterans are not put into this position.

      But no, someone decided to harm veterans by using false information.

      I say it’s time for these employees to be fired and federal charges placed on them for giving false information intentionally to deceive the veterans.

      • There is only one solution which meets all the aforementioned wants:

        Close the VA medical branch. Move their budget into either the the Medicare System. Provide every Veteran with coverage according to their disability rating, ratings to be determined by Medicare. This would NOT be privatization, as Medicare is a federal office, not a private insurer. Veterans would be able to go to the medical providers of their choice who participate in the Medicare program. There would be oversight, there would be leveling of costs, there would be understandable billing and reporting.
        Medicare already has the infrastructure in place, those costs would not need to be duplicated. The existing purchasing contracts held by the VA for prescriptions could be transferred to the Medicare program, benefiting not only Veterans, but all participants.

        The VA is not ‘fixable’, plain and simple. They have too many problems, too much sheltering of terrible employees, lack of quality practitioners, and too many loopholes and hiding places; and when they want to, they just don’t comply with congress. Stop thinking you or anyone else is going to fix it. It can’t be done. It’s time for it to go. They just have to make sure the VA employees aren’t allowed to be hired in the Medicare program.

    • Any time that the VA approves you to go to a private facility and they then do not pay,m you need to file a motion to compel them to pay and go on the warpath to remove the person who denied payment.

      Every Veteran should be allowed a lawyer AT THE BEGINNING OF HIS CLAIM, so that when the VA denies your claim you can file for an immediate, (within 30 days) hearing on the record with your lawyer presenting your case.
      The Appeal Process is a fraud.
      Every veteran should be allowed to “speak softly” and “carry a big stick”, (have a lawyer in his back pocket, ready to pounce)…………………..
      The VA is a prime example of why government controlled medicine for everyone will not work, with bureaucrats controlling the practice of medicine,
      If you are not happy with your private practitioner, you do not get arrested for “acting out”, you just get another practioner, (Doctor).
      The VA is operated using Physicians’ Assistants, not real doctors……………………

  6. The v.a. has demonstrated by their actions and words that the; corrupt, incompetent, disorganized criminals!
    They know without question, that if veterans were actually given a “veterans choice” the vast majority of veterans, including myself and I have been in 7 v.a. medical centers,
    would elect to use doctors outside the so called v.a. medical system.
    As long as the v.a. exists, veterans will suffer and die at the hands of the v.a.!
    The veteran suicide rate of 23 veterans committing suicide everyday is 3 times the kill rate in Vietnam. We veterans have a better chance of being killed by the veterans administration than by the enemy!

    • Christopher Miller,
      We are being killed by an enemy. It’s called the “Veterans Healthcare Deathtrap Administration!”

  7. “The three things you need know about the proposed changes, at least as they are now, where the veteran can access community care, if:
    ⦁ The veteran lives greater than a 30 minutes drive to a VA medical clinic
    (**Are we back to the as the crow flies standards? Does anyone think VA is going to include traffic tie-ups or re-routings, and any host of other travel issues that could retard travel on each and every proposed medical care incident? Of course not! But, some nimrod assumes that minutes vs. miles would be a most efficient solution? FACEPALM!)
    ⦁ The wait time for an appointment is more than 20 days (for most appointments)
    (**And as has been pointed out in prior article posts, outside appointments can often be further out than VHA appointments. I think maybe due to the slow payments by VHA for veteran’s appointments and the added inconvenience put upon long established patients.)
    ⦁ The veteran uses designated providers in the community for Urgent Care appointments and pays a co-pay”
    (**DESIGNATED PROVIDERS… in other words… providers that are willing to be carbon copy VA puppets in theory and in practice. And, will the veteran’s portion of the proposed co-pay continue to be in the neighborhood of 99%? And, is that co-pay also to be forced onto sc patients for sc conditions that turn emergent?)

    “Secretary Wilkie said, “Our medical services must meet our Veterans’ needs and reinforce the trust that forms the basis for every interaction with VA. Our new access standards are a vital part of this effort.”
    Secretary Wilkie,
    It gives none of the bulk of the VA’s enormous patient population a speck of hope that their needs are ever going to be met, when your staff concentrates on visiting the newest facilities in the system. Also, there are thousands of NP’s fully replacing doctor’s and they are given the full authority (as is being told to patients) to provide all primary and/or SPECIALTY care to patients. If a genuine specialist does treat patients within VHA walls, they are handcuffed into providing the most minimal prehistoric methods imaginable and NEVER, EVER diagnose anything! Add to that wherein each facility runs its operations, under its own set of rules/guidelines irrespective of established federal codes and mandates. HIPAA regulations are routinely ignored and patients are victims of anyone looking for prey.
    I respectfully suggest, that you provide a group of staff that will actually make unannounced visits to smaller/older facilities nationwide; and those staffers should posses full powers to access everything related to each facility. I fully guarantee that sc veterans are for the most part, not receiving anything remotely similar to the care received by their family PHYSICIANS prior to service, for even the most routine or mundane issues. But, by golly every version imaginable for cancer testing is forced upon them… with perfect scores… until it reaches stage 4, and “there’s nothing we can do at that stage. Oh, and thanks for your service!” It must also be noted, that there is great disparity in the care/services availed retired veterans and service-connected veterans, regardless of retired military status. An sc veteran is a disposable problem to be politely informed at all times “it’s nothing…” in too many VHA facilities.

    “Most Americans can already choose the health care providers that they trust, and President Trump promised that Veterans would be able to do the same. With VA’s new access standards, the future of the VA health care system will lie in the hands of Veterans – exactly where it should be.”
    The main problem I see in this statement has to do with the fact of the formerly known as Bureau of War Risk Insurance, is still the guiding factor for any care decisions for your medical issues! IMO it is still a glop of political double-speak crap that is always shoved our way throughout the whole VHA system… no one excluded!
    You know that tax form you get every year, yea the one stating you are shielded from paying $xx in fines at your tax filing for not paying for an outside medical insurance policy? It means additional BOHICA time.

    As an aside, several times a day my ears are assaulted with the phrase “Medicare for all!” I caution that one should carefully study those Medicare provisions and lack of coverage, to realize that it is also, another insurance agency that loves to deny necessary care and payments in a timely manner.
    Just be very careful in the wording of what you wish for at all times.

    • The “designated providers” currently are anyone who accepts Medicare patients at the Medicare rates. In other words a movement towards Medicare for all Vets.

    • Thanks Rosie, re: three things… a 30 min. drive, such a variable!… the VA will always rule against the veteran. 20 day appts limit ( for most appts) another VA variable. Use of designated providers, wheres the Choice! And why are the VSO’s even mentioned here, they’re part of the VA deny machine and have never done anything for veterans that I’ve seen, unless maybe you’re a member. And why do I use this venue, does it give me a voice or am I just fartin in the wind?

    • Rosie, spot on it. Odd too is they (all Wilkie/Congress/SES/etc) never mention the devils in the details or generations old issues with the Gov or VA. Let’s include some Medicare fraud too since that is another issue medical boards to local cliques seem to allow to continue on. Mention any wrongs and like the VA the forces that be write us off as an enemy of the establishments and professional classes.

      We are still up against the unions, business types, and backers. Contractors, trying to find civilian care (VA kindred spirits) in some locations that seems impossible for a variety of reasons. Then on to the usual money games and being passed around like a hot potato minus real care to unable to find care for just leaving the VA to being a chronic pain patient then trying to explain that physical therapy (does no good) or some demands to go on anti-depressants for pain is goofy, a waste of time and more money sucking life ruining games. Then on to those unwilling to see vets at VA allowable costs and having to pay extra to see them, if we can get in. The rip-offs wanting things like “new patient fees” and etc. Then the mysteries of file losses or withholding which is reportedly “legal.” There are more laws to time restraints protecting the guilty rather than helping vets or patients in the civvy world even. Is Wilkie and others even mentioning some of the issues that many of us have complained about out here on Ben’s blog and in a wide variety of other agencies or those pretending to be our reps and helps? No. All their claims and rules from “the top” are meaningless as things remain the same and media is not on our side while horror stories continue on and suicides are up but now seemingly a non-issue. Same for some professional ethics and real patient care.

      The entire medical fields and those ‘at the top’ need swift changing instead of the musical chair games. Which I just found out the worse locally that was demoted from PA to a head nurse specialist relocated to head-up an out of state clinic. (!!) And if I bowed to the machine I’d still be left dealing with the same kind of people and having to drive several hundred miles a month for forced care at the VA due to their rules and things remaining the same. Not much real change at all. With or without any kind of claimed “choices.”

      Over the years how many of those concerned at the top, VSOs, reps, have reached out to us out here? Especially those of us out here in the open publically with our asses hanging out to be kicked around and attacked more from every angle out there? I’ll keep “farting in the wind” but I see no change coming as the suicide rates increase, media is silent, misconduct and malpractice must be at epidemic proportions and most of the sheep are silent. And seemingly all this crap is still supported by the public and all those loving people in a oh-so tolerant and caring Kumbaya community/state.

  8. A step in the right direction unless those who have a combined rating of 50% or more are also required to make the co-pay. I would argue against that because 38 CFR states they are not required to make co-pays and 100% coverage is to be provided by the VA.

  9. And just WHY should we have to pay a co-pay? Our treatment from the VA is supposed to be free, so why would anyone who is a Veteran agree to this part? The rest I can live with but not this.

  10. We have a right to life, I went many years and trusted the VA, but they failed to diagnose me because they did not want to pay benefits to a contaminated Armorer. so I was forced to go outside to get properly diagnosed. Turns out a simple blood test would have diagnosed me. So it took six months outside just to have diagnose. Strangely though VA was giving me some of the proper medications for my condition? Wonder how they figured that out when they never diagnosed me? There was things that VA pointed out like my Kidneys failing and having cysts on them, But they did nothing, not one suggestion, same with my liver that suffers from NASH or what VA called Hepatitis! You would think there would be a suggestion. Same with my lungs, found a spot but nothing, same with my spine, found many abnormality but suggested nothing, never did a head scan even though i asked. Called two of my symptoms the wrong medical condition. Suggested I go to zero specialist inside VA. Now to be fair they may have suggested a specialist if they did not know I was a dead man walking from contamination, but why start to replace Liver, Kidney etc… on a man that won’t live long anyway, as one of those conditions and or the incurable Systemic sclerosis will kill him anyway. So best they just treat me and let me die without ever being told about the Benzene,TCE, PCE contamination, it would just cost the Government money. Better to let the Veteran just die blinded to the truth by the system that is supposed to help. so yes I support outside help as it is a huge conflict of interest to have both the VHA and VBA where they can just push each others agenda’s on the other. Must be separated or we end up with thousands if not Hundreds of thousands of Veterans not diagnosed or cared for by people who take away the veterans choice, and life. If you go to a doctor for help they should tell you what is wrong, and if they know why, they should say. Or at least say how in the hell did you get this super rare situation, and by the way the rare disease you have is common with people who was stationed with you, or had same job as you in the military! You will never hear those words at a VA facility!

    • Again: An immediate lawsuit for malpractice when this happens, as well as massive pressure upon the firing of VA employees who usurp their authority.
      We Veterans can control a Presidential election results and can easily control legislation re: health care for veterans, but we are unwilling to amass the power and unleash it upon Congress………………….

  11. It is funny how we get the option to use the “Choice Program” when we are unable to get appointments with the VA within 30 days and now the proposed 20 days.

    Well, I have had several wait times with the the Choice Program in which I did not hear from TriWest for a very long time and received my first appointment 30 days out or greater.

    Seems to me like that defeats the very purpose of the Choice Program!

    I even had it where the Choice Program was unable to provide me with an appointment with a provider under the guidelines that would qualify me for the Choice Program.

    That is pretty poor performance!

  12. “To silence desent between veterans groups and VA” creates a false narrative that doesn’t exist as veterans group (VSO, big six) are part of the VA and don’t care about veterans unless your part of the club. Seek to contact the poor veterans who don’t have transportation and ask them what they think. I went to a VA sponsored so called town hall meeting (that wasn’t widly pulicized) at an Amer. Legion hall. Four veterans showed up and a couple of Audy Murphys that took up a lot of time and some civilians asking if certain Dr.s were still working for VA as ‘I believe’ they had lost friends or loved ones to a va doctor. Four veterans, we were outnumbered by VA employees. But the bar was noisy and full. Did you say “To silence desent…” Ben.? If not it could have been a Freudian Slip by someone at va…

  13. Do not agree with the 3 Changes and feel the same as Rosie and Junior2/5. The change that needs to take place is to give the veteran a “choice”. Nothing more or less.

    The following is just another quagmire used to cause confusion and frustration within the VA system and between the VA and the veteran. Divide and conquer.

    The veteran lives greater than a 30 minutes drive to a VA medical clinic – so 29 miles, too bad for you?
    The wait time for an appointment is more than 20 days (for most appointments) – who chooses what type of appointments and why those appointments?
    The veteran uses designated providers in the community for Urgent Care appointments and pays a co-pay – how are these designated providers selected? And I thought for 100% sc healthcare is provided without charging the veteran.

    My take from this is that only words and numbers have changed but the problem with the system remains the same. And to make matters even worse, as far as know, there isn’t anyone with whom a veteran can place their complaint (don’t get me started with the patient advocate and VA hotline). The veteran is a captive audience. The VA logo should read “VA Healthcare take it or leave but shut the hell up”. LOL

    Peace Out

  14. I am just another pawn of a veteran in this massive system. I am 100 percent service connected and get all my medical care at the Minneapolis VA Hospital. The care is uneven but what is a poor fellow to do. Being from Minnesota where the idea for the Concern Veterans of America was spawned I have always mistrusted this organization. Why do they want to make VA care private and why is private care any better. My wife gets her care sometimes via the Hennepin County Medical System and it seems to be just as screwed up as the VA or worse. She has also been to other private providers which aren’t much better. She is on ChampVa and is treated like a second class system. Why does CVA have so much power and they aren’t even a chartered veterans organization as far as I know. And how many members do they have? Why are the big Veterans organizations being bullied by these guys. Of course, an organization like the American Legion seems to be backing their agenda but they have always sucked up to those in power. Most of the organizations don’t want to get into a pissing contest with the VA. What is the CVA and Koch brothers going to get out of all of this…I imagine money is involved not better care for veterans as they want people to believe. I have been coming to the VA for over 30 years. It has always had its problems. Every administration tries to reinvent the VA it seems. I could go on but who listens or cares what a second class veterans has to say about how he is treated because I have no idea what I am talking about. Just shut up private and follow orders.

  15. First,Once again I think the big issue will be pay to go policies in Congress. I can promise all by now that the VA will blow this budget and need more money like they have in the past when “Choice was tried” Shulkin had to beg for more money to pay bills. We have falled into a trap. Congress will demand that we cut benefits.
    Second, we need to follow priority classificaiton guidelines. Those of us who are service connected should be first eligible. The VA was established for our care and not every veteran.
    Congress screwed this up and refuses to fix it.
    Lets get the VA fixed for those of us it was built for: Service Connected veterans.

  16. Wilkie is not a man, jumps on the coattails of others to feed off the government. The VA has one thing they care about, themselves. What you have now are clinics and non profits pleading to send veterans to them, alone setting up for illegal activity and bribery. The VA holds the carrot for authority and provide the care they say, the diagnosis they say and most places pay doctors and staff lower than the VA, so will be at times laughable. Just more control over other programs for hospital management. Nothing new, been used for years to get away from unions or Walmart working people 30hrs a week. They will also throw problem veterans and veterans taking pain medication using as a second opinion when they choose. This is a huge brick in the ass that will only lead to worse care. The VA say can’t get doctors because can’t pay enough, what about these places? They must pay people who run these programs, adding people in the process they don’t have in the hospital. For the successful places they will run a clinic often with one or two doctors and 4-8 PAs and a couple of nurses. Then will need referrals and tests, back to the VA making the VA the better choice. Until like Medicare where there’s a list to choose who you want and gets paid by the government, this is a shit show where people are going to rake the VA over the coals knowing the system better. A PCP schedules appointments every 15 minutes and the VA every 30. This will only get worse with a small percentage having better. I can’t stand what they have done to me and can’t wait until they start the furnace

    • Different VAMC’s have different resources according to the upline Directors. Got a Cheyenne VA dental appointment in a week for cleaning, check up on a loose to bonding crack and follow up appointments 2 weeks later with the Dentist for the Dental work and a 3 Month appointment for additional cleaning and ? polishing? The polishing is a surprise. Thought only actors and VIPs got polishing. Will post if it really happens.

      • VA doesn’t do dental, at least in my case. Had a tooth knocked out at Parris Island, got some caps and a botched root canal, had to pull the abscessed root. But now I rate no dental from VA…glad you could ,Lem.

      • Did you ever apply for dental service connection for that one tooth? I didn’t apply for dental service connection until a tooth on the fracture line of my service connected facial fracture became loose. The Dental C&P examiner said the loose tooth and the chipped teeth just under it were “more likely than not” service connected. It is in appeal now at the CAVC and is likely a slam dunk for 0% Dental service connection because repair makes my dental condition not disabling as far as eating or anything else other than the repairs necessary.

        If you haven’t applied for SC for your knocked out tooth do so for any further repairs. You’ll have to ask a dentist to identify which tooth it is.

  17. I have felt this “Veterans Choice Program” would eventually actually give us Veterans a “True Choice.” WRONG!
    When I contacted Shady Shulkin about his new “Choice Program” he personally assured me, I would not have to endure 5 hr, multiple transfers, one way transport to attend a Mandatory appointment. This never came to fruition. Patient Advocate, claimed she did her best to get me Choice. Stated 6 Staff personnel made the decision to deny me that Choice, this was with the supposedly Shulkin Choice guidelines. When I finally spoke to VA employee (no longer employed at VA) the comment was made…”make no mistake, there was only 1 person that ran that deny train and he got a nice fat bonus for it! No other reason motivates Administrators, Directors, and Staff MD, PERIOD!”
    This new Urgent Care co-pay is total BS! Urgent Care won’t treat anything, that you can’t look up on Google and meds buy over the counter (they tell you up front, they can’t write prescriptions). Once they start with a “minimal co-pay” it will only go up and the care won’t be worth it. Why aren’t illegals paying co pays? They get Free Health Care!

  18. I’m more worried about:

    “…plays nice”. When does the VA ever “play nice” with anyone, or anything, not paying in on an undisclosed, non-compete, single-source, contract?

    The problem with access and quality of care is not going to be “solved” by privatisation—which IS what Secretary Wilkie is talking about, that’s why he referenced Trump in his statement. Being billionaire beneficiaries of inherited wealth, Trump and Wilkie have never had to worry about paying for anything on the scale of a household budget; and at least as far as Trump is concerned, he doesn’t worry about paying, period.

    The rest of us are not in that club. If you fail to make a co-pay limit of $1,500 per person per anum, which is a pretty good private policy in the wage-earner workplace, you pay the vast majority of the charges (usual and customary is 80% you, 20% your “insurance”) when you have to have a procedure or surgery. You pay $30 per Rx, regardless of what it is or why you take it. No one worries about your “service connection”.

    The only reason for a Veteran Advocate like Ben Krause to be pushing for privatisation is that it makes it easier for “outsider” Lawyers to get their piece of the fat cat cake. If he couldn’t get new business out of it, he would be doing his usual due diligence—even with his pro-Trump bias (which, to be fair, he usually acknowledges). Generally, Krause is a good advocate, but this one may not be a subject he can be objective on.

    Choice was an epic fail. Even as a 100% combat disabled veteran (which puts me almost at the top of the priority list, after POWs), the Choice program was rigged for failure. I wasted nearly six months to see a neurologist about the “residuals” (brachial plexus trauma) from a gsw that are slowly piling up (it was 40 years ago). The Choice physician chosen for me—my choice was not a “programm participant any more, after a cut to the payment amount—was a Resident who had never seen a gsw, a brachial plexus trauma or injury, or much of anything else. The VA sent the “disciplinary flag” and its supporting documentation to his (six pages I’ve never read, btw…) but nothing else. Eighteen years of medical records, and they send six pages of an accusation that I say “f*ck” a lot, and that scared the man who told me he would pray for me as a medical answer (at the VA!).

    So for me, Choice is a two-time bust. I suppose if you read what Mr. Krause would otherwise call “propaganda”, you might think it was giving Veterans served by the VA the opportunity to use their private physicians just like the VA, but that is so far from an accurate portrayal that I’m stunned a guy like Krause could swallow it.

    For those of us who have seen the elephant, this is a business version of Fire & Movement, or what I liked to call “hey, look at this”. Watch the thing your opponent wants you to, and not the roundhouse headed for your face.

    • Or are service connected for dental. I qualify on both counts according to the VA Dentist Office but since the adjudicator didn’t give me service connection on the “more likely than not” assessment by the C&P Dental examiner, I only get it based upon my TDIU 100%. According to the call in appointment scheduler and the Benefits Office clerk and his supervisor I’m not qualified because TDIU is only “paid as 100%” They haven’t read 38 CFR chapter and verse on TDIU or the VA secretary’s handout on the subject. TDIU 100% gets all of the benefits of 100% according to current regulations and directives. It was probably different in the past. My wife is currently also getting CHAMPVA which wouldn’t be the case if the Cheyenne Benefits Office was correct.

  19. “…Would Rather Bleed…” Wrote:

    “provide every Veteran with coverage according to their disability rating, ratings to be determined by Medicare.”

    First, it is a widely-held misconception that the VA provides benefits ONLY for Disabled Veterans. In fact, the VA is tasked to provide health care for any Eligible Veteran who selects VA Care—including Retired service members. Thus, their “Disability Rating” would disqualify them for a service they were promised. Not OK. The VA is already so budget-obsessed that staffing is inadequate for all eligible veterans—even as a Combat Disabled Veteran, I find my appointments moved. So NO.

    Second, who would want to go through ANOTHER C&P hearing? Not me. I spent 15 years fighting the VA to get my Disability Rating, I’ll be damned if I’m doing that again. Sure, SSDI “only” took three years, but I don’t want to do that, either.

    Thirdly, as I and a few others have noted, Medicare/Medicaid (including “For All”) is actually just as bad, if not worse, then VA Medical care. Why any veteran would labour under the illusion that they would get to “see the provider of their choice” under any public health scheme completely escapes my comprehension. You get to see who they will let you see, which is the bottom of the barrel, just as at the VA. Yes, every now and then you’ll come across dedicated, high-quality providers at the VA, or who accept Medicare, but those are few and far between.

    Choice is just another political move…”hey, look over here”. If we are going to get the coverage and benefits we were promised for our service—in combat, or out, hurt or retired—then we are going to have to stop JUST complaining and start ALSO voting for people who follow through on issues important to Veteran Care and Benefits. Yes, they are probably not going to promise to buy you lunch, or turn back time to 1955, but then, those are ;ies Veterans ought to be used to from service. Who never heard the Old Man explaining how great everything was while the whole mission went to shit?

    Forget “single payer”, or Medicare For All, or anything like it. No politician is going to pass it, and no “outsider” will ever have the power or saavy to get it done. The time to dismantle the Health Insurance Industry was 1985, not 2020. Now it is too pervasive and too deeply-entrenched. In fact, if the industry (of probably five companies, maybe three?) can manage to move the VA to “private care”, it will have a dead-lock on the delivery of health care forever—as long as Congresspersons (House and Senate) get their own special health care, anyway.

    You want to fix the system, fix the perquisites that Congress collect. Do this: look at what is required to retire with full and complete benefits—as if you were still employed/serving—in ANY industry. The find out what it takes as a Congressperson. You’ll be surprised.

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