The back and forth over Veterans Choice as expanded under the Mission Act is just starting to heat up with three major positions.

  1. Those opposed to Choice
  2. Those supporting Choice
  3. Those in the middle, Choice that does not destroy VA

I am personally an advocate of Choice – let veterans choose to stay in the VA system or go outside the VA system. Period. If VA health care quality is as great its proponents assert, then let VA prove it.

The Big Six VSOs are in the other camp. DAV, for example, give the new proposed regulations a thumbs down. Military.com gave them coverage on that platform to spread their position. Rather than repeat DAV’s position, since it is so widely propagated, I took a different approach and reached out to my friends at Veteran Warriors for a pro-choice perspective from a smaller organization.

Below is what my friend Lauren Price had to say…

Veteran Warriors On Choice Expansion

Last June, President Trump signed the “MISSION ACT” into law. This sweeping legislation pertains to a multitude of VA functions and policies, but none have been more hotly debated than the clause which will finally give veterans the right to go to civilian providers if the VA can’t or won’t provide timely care.

The debate over this law change is frankly baffling to many of us who work in the trenches helping those who are being neglected or abused by the very system that is mandated to “…To care for him who shall have borne the battle and for his widow, and his orphan… – Abraham Lincoln”.

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Many of us find this puzzling because the evidence that VA consistently drops the ball in providing “world class healthcare” [sic] is so overwhelming and in many cases, proven to be enterprise-wide.

Many of these cases had a direct impact on the care veterans received (or not) through the VHA. Worse yet, what is not included in those reports, are the numerous cases where a veteran died because of the care (or lack thereof) received due to the VHA misconduct.

There are 256 substantiated investigations by the VA Office of Inspector General (VA-OIG), into every aspect of VHA operations ( OIG Reports ) over the last 5 years. All of the investigations listed in the link above are ones in which the allegations of wrongdoing were substantiated.

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There were 15 such cases during (former) Secretary Shulkin’s twenty-month tenure as the Under Secretary of VHA. This is particularly poignant because his promotion to the Secretary position was on the heels of these unresolved scandals and that promotion brings us to the point of this article.

Three weeks ago, one of the most premier hospitals in the nation was put on “critical” status by the federal regulators after media attention prompted an investigation (take note, the timeline and federal response is important).

“Critical” status means they will lose precious (and very necessary) federal funds on February 23, 2019, if every single deficit is not permanently corrected. The decision to force these corrections on the hospital was not arbitrary or capricious.

They were the result of audits and investigations into every sector of the facility’s work. (Exactly like the VA-OIG has been doing for decades on facilities in the VHA system.) The federal regulators found that this high-profile hospital:

…was cited for not meeting federal rules on infection control, quality improvement, how it hires and manages doctors, and its leadership structure, according to a letter the Centers for Medicare and Medicaid Services sent the hospital Thursday…(the hospital) is now under state agency monitoring until the hospital can correct the issues.  If the issues are not corrected, the agency will not grant the hospital money under Medicare for new patients, starting February 23…” Federal officials threaten All Children’s funding, citing problems | Tampa Bay Times

The irony of this is that the actions, functions, and deficits that prompted this immediate and shocking response by federal regulators are the very same actions that have been “substantiated” repeatedly within the VHA system.

Yet, when the VA-OIG has concluded their investigations: 1) there has NEVER been a threat to cut off funding, 2) there has never been a firing of the bad actors, and 3) there is little to no real accountability for (what in many cases is proven to be) deliberate actions by employees to violate laws, policies and all manner of ethical mandates.

So, it is beyond shocking that any member of Congress or a Veterans Service Organization would even pause at the thought of allowing veterans to have unfettered access to the medical care they earned. What is far more disturbing are the cries that anyone who does support such action is trying to “privatize the VA” – as if that is a sin equivalent to murder.

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Many members of Congress and VSO’s, who fully supported the “MISSION ACT” as it worked its way through the House and Senate, are now quick to dismiss Concerned Veterans of America’s efforts to reform the VHA, as “politically motivated”, going so far as to dismiss their efforts outright because of who is backing them.

There are equally as many members of Congress who will continue to stand with those who will not embrace real VHA reforms Chairman Takano Statement on VA Access Standards | Committee on Veteran’s Affairs, even when the VA is embracing the intent behind the law Trump Administration Issues Guidelines to ‘Revolutionize’ Private Sector Role in Veterans Health Care – Management – GovExec.com.

Why are the American taxpayers not melting their legislators’ phone lines and email servers; demanding that the VHA be subjected to the same level of oversight and accountability as the private sector? Why are so many inside the Beltway already threatening to fight to repeal the “MISSION ACT”? Inquiring minds want to know! What is their motivation?

RELATED: VHA Leaves Veterans Out Of Marijuana Testing

Are veterans not worthy of that same level of accountability that civilians receive? Are our sacrifices being so disregarded that all promises to “…To care for him who shall have borne the battle and for his widow, and his orphan… – Abraham Lincoln”, written in disappearing ink?

After each bad act comes to light, the process is identical.

First, a media outlet gets the story. Then legislators screech that they are “horrified and outraged” and “demand answers”. Next will come yet another perfunctory VA-OIG investigation that at the end, will recommend “more training and increased oversight,” but not one recommendation for prosecution, termination or even demotions.

Then the Congressional hearing will follow, wherein the VHA leadership will be put on the “hot seat” (one that is really just warmed nicely so their rears won’t be cold), and they will be questioned about “how this happened” and “what will they do to make sure it doesn’t happen again.”

The VHA leaders will respond with something very much like this, (in fact, in nearly every VA-OIG investigation we can find about bad things happening at a VHA facility, the words are nearly identical!):

The safety of our patients is our top priority. We are confident that the work we are doing to ensure that our hospital continues to meet the highest standards of care will satisfy any concerns they, our patients, or our community may have. Every day, we deliver world-class care to our patients, and we will continue to do so with distinction and compassion” – All Children’s Hospital spokeswoman Kim Hoppe”.

However, since none of the things that should happen will, the empty promises or reformed processes, behaviors, and attitudes continue.

It is time for everyone to put their party-line rhetoric aside.

It is time everyone admits that VHA health care is NOT “world class” and there are numerous serious, systemic problems. It is time that ALL OF US sit down and collaborate on what our fellow veterans have EARNED and DESERVE from a grateful nation.

Be assured, should our fellow advocates agree, Veteran Warriors will be the first to the table.

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38 COMMENTS

  1. “[Why Do So Many Vehemently Oppose Veterans Leaving VA Health Care?…]”

    Easy: The Cows hardly working at the VA are of the genus “Cash Cow”, and the contracted industrial weight-testing furniture they culture and form their huge asses within are made for the genus ‘Cash Cow’.

    Without Veterans, the VA genus ‘Cash Cow’ would simply dry-up and die because nobody else on earth wants the genus “Cash Cow” on their payroll. Veterans are the ticket to that cookie jar and removing that is like taking crack away from a crack baby.

    Done.

    • namnibor, you took the words out of my mouth.
      “Follow where and to whom the taxpayers money is going!” And you’ll find out why there’s so much opposition of allowing veterans the use of private Healthcare!

  2. I saw the VA sectatry say that thirty percent of VA treatment is through the private sector now.
    So what’s the difference? The VA claims that only VA doctors understand a veterans needs, so how can the VHA not staff its clinics and hospitals? We don’t get to see Drs anymore, just PA’s or NA’s, so the claim by the VA is bogus!

  3. I’m with Ben. Let the Vet choose. Let the VA medical division compete to stay alive. But most importantly, all C&P exams need to be done by SSA examiners because SSA has always done a more complete examination both medically and socially. Granted some SSA examiners guard the entitlements but it is easier to get a second opinion than in the VA. My CAVES report is the most complete evaluation by far in my record. Far more complete than the Navy discharge examination or any of the approximately 10 C&P examinations. All that needs to be added is the environment etiology. Did it happen in the military or some other setting? And most of that is obvious without stating in the CAVES Report. If the CAVES report doesn’t find you totally disabled it recommends rehabilitation lines of endeavor. Never see anything like that even in a VA rehab examination.

  4. Well done, Ben! Well done indeed!

    As in the article above, I have often seen the phrase “timely care” alongside every version of “Choice” care. Too often people will get stuck on a single issue and then judgment can become cloudy over other parts of the total situation that are of equal, if not greater importance within any single issue up for decision. Once the deal is signed, sealed and delivered the lacking parts become glaringly clear, only because the single issue became the greater sole focus of the total situation. This example can be applied to any variety of decisions in life. The power of the people to decide for themselves is being increasingly controlled by other than the individual himself.

    The seemingly central focus of “Choice” care is “timely care”. Let’s pick apart the why. But first, I want to be very clear that all persons receiving VHA care should continue to receive their benefit, I am just attempting to illustrate a possible set of reasons for some issues that I don’t see being evaluated by those holding power to decide human fate. In the mid90’s some standard services provided at VHA facilities disappeared and others were drastically changed while gearing up for the influx of new veterans needing medical care. Accordingly, the staff had to follow stricter guidelines in providing care/services. In a few years it would rightly be decided that deployed NG veterans would be provided VHA care and there was a five year (I think) allowance granted to new veterans for all care. All good stuff but, VHA neglected to plan for having in place the much needed increase in staff throughout the entire VHA facility network/system. That is why a cook will have a calmer experience preparing a meal if they make sure all of the ingredients are measured and prepped before any combining begins. It is simply good strategy! So, how does VHA plan to deal with the under-staffing/too many patients debacle? Well, they just cut out more care/services. Uncle simply promised more than can be delivered and overloaded their collective asses. This is why the specialty clinics are increasingly limited in what care/services they are allowed to provide to the patient. This is for example, why your VHA Podiatry specialty clinic is only allowed to treat diabetic feet and your sc mangled feet will be put to simmer unchecked for years. In other words, it is diabetic necessary busywork that keeps the VHA Podiatry specialty clinics full of less expensive customers. This is why your GI specialty clinic only provides scoping, so to receive university training fees. This is why (unknown by you) the unheard of medication you have been trialling for FDA approval, is removed and replaced by something new to test, after all your liver and kidneys don’t belong to you anymore. This is why VHA NP’s and PA’s have been providing primary care and also have been permanently released from any VHA Physician supervision. BTW, this has recently been made the standard in private practice as well. Plainly, it is all due to poor planning combined with using the patient as a budgeting tool.

    I use the term “Catch-22” only because I’m at a loss for another suitable phrase. The standout issue at hand in all things related to a (fully covered within VHA walls) veteran’s healthcare, actually being paid in full by VHA to a civilian facility, is that just like any other medical insurance provider, the VHA controls the purse and therein lies the “Catch-22” regarding the type/level of care, if any, that the patient will receive and, be fully paid by your VHA medical insurance.

    This goes far beyond only the payment for services rendered. I was with a 100%er (with full VHA medical coverage) in a civvy ER rather recently. I was allowed to read the patient report provided by ROI and it erred by describing the concerned patient as being adversarial. According to the patient, some other information in that document was missing and some also, not quite correct. It appears that the ROI report from VHA of that visit had been modified at some point for VHA records. To my knowledge the patient has still not been able to obtain the often requested civilian facility’s record of that visit. Also, to my knowledge the patient has never been billed for any of the care provided.

    IMO this translates thusly: Private providers of medical care to veterans (fully covered by VHA medical insurance) must provide the same level of NON-care to those patients as would their VHA facility and be willing to wait forever to be paid by VHA for that NON-care service. If the private provider instead chooses to follow HIPAA standard of care rules, then VHA medical insurance can and likely will deny payment for that care. As any other medical insurance provider, the VHA has their own allowed coverages. Unlike other medical insurance providers, VHA is also a medical service provider AND a twig on Uncle’s Executive Branch.

    Be very careful in your decisions.

  5. This whole thing is especially frustrating when you realize that many of us are on Medicare/Medicaid as well as have VA benefits. That means that each one of us has a certain amount of government funding allotted to Medicare/Medicaid, VA healthcare and then a significant amount goes to Choice to have a third party make appointments for us. In essence, we as veterans are fully funded for healthcare through tax dollars for up to four entities that I am aware of. Under Choice and Community Care, I was told repeatedly that it would be the same 3 months, that I would have to wait, to have them get an appointment for me, so I should just stay with the VA. I find this unacceptable considering that they are being paid to get me timely care. Remember, Choice and Community Care is still not a doctor of my choice, but who ever the VA can get who will accept their measly reimbursements and frequently nonpayments. I am an RN with 30 years in civilian healthcare. I have personally experienced the most dangerous, unethical and atrocious acts in the VA that just doesn’t happen in a civilian hospital. I am barely a good enough advocate for myself because of the VA’s systematic shutdown of anyone trying to get quality care. My complaints to the OIG, Medicare/Medicaid centers for fraud and abuse, JACHO and any other organization that the VA is accountable to. Nothing resulted from any of it. If Choice, in any form,is utilized to keep the VA in control of who we see and when, nothing will change. I am able to make appointments for primary care and specialties on my own through Medicare PPO. Many times my insurance doesn’t cover care anyway and it comes out of pockets that are empty, but I would rather go into debt than be a passive patient that allows the VA to dictate when, where and with whom I will see for care. I can get appointments immediately, for any doctor and my wait will only be 2-3 weeks at worse. If I need urgent care, I can go anywhere, at any time. I still have to pay copays for cares and meds and that shouldn’t be the case, considering how much money is allotted to each entity, Medicare and VA for me. Rick Scott made it so that I don’t have access to Medicaid in FL if I am under 65 and I am 54. Veterans forced to go to the VA for care when it is clearly not safe and not in their best interests is the same as asking the enemy to help. You have to be desperate enough to accept anything that they do to you including the abuse. No one, not one person, veteran or civilian, should ever be forced to accept healthcare limited to an entity that has been proven over and over to fail to meet the needs of their patients. In a true capitalist environment, we could go anywhere and any institution that delivers bad care would be directly affected by loss of patronage. Unfortunately, the VA, insurance companies and healthcare organizations have rigged the game. They desperately depend on everything staying just as it is, so that the money being directly funnelled into their bank accounts don’t dry up, no matter how bad a product they serve up. Privatizing VA healthcare will not be any different. What we need is the freedom to go anywhere we feel comfortable and safe for care. By assigning veterans one funding source to access this care, up to 3 other group fundings can be put into increasing the number of medical schools from where we can get a larger number of all medical personnel, pay for our care and medications. We can eliminate the multiple middlemen such as the insurance industry, Choice contracts of any kind and any institutions that receive duplicate and triplicate funding for the same person. We would even be able to maintain Social Security in a viable condition. If this were to happen, there would be a lot of very unhappy millionaires and billionaires around. But they made their money on the illnesses and deaths of US citizens and I don’t feel a damn bit bad about that. The VA doesn’t need to close up shop, but we need to stop enabling the behaviors that endanger all veterans and the honest employees who work there. They can take their financial hits as consequences of their actions and it will be up to them to turn themselves around, but they should be held just as accountable as a civilian healthcare systems are. In general, the US healthcare system needs a complete overhaul. We have millions of veterans and civilians exposed to toxic substances, but nothing exists as a functioning specialty of doctors who assess, diagnose, treat and recover patients. There are tiny groups of researchers, but no patient care for the multitudes that need it. We have known about these contaminates for the last century and the US is almost 50 years behind other countries in legislation that minimizes exposures, treats patients and holds the principle contributors of the pollution responsible. We are missing an entire portion of our healthcare infrastructure that would aggressively take care of exposed patients, instead of denying the existence of the toxic substances. Yet the government has spent billions on failed attempts to remediate land declared Superfund sites. How can our government justify spending massive amounts of money on those properties, directly acknowledging the contaminations, yet continue to deny the same contamination exposures of millions of people. We are killing US citizens daily by not admitting this. Our military alone has killed more of us in peaceful maintenance of military operations by exposure than we have lost in all wars known to mankind. It doesn’t stop at the borders either. We have spread the love to any country that contained a US military base, performed any of the 1500 nuclear testing procedures or conflict theater. We will continue to do so until we are completely transparent in what has been allowed to happen and who, in our US government history, had a hand in both the act of contaminations or the coverups to deny their existence. The chaos of righting this mess is inevitable, but doing nothing and allowing the current form of chaos to continue, is criminal and as far as I am concerned, treason.

    • Megan,
      I too am an RN and have worked at a VAMC–I know what you’re talking about. I agree on everything you’ve said. The sad reality is our Congress continues to fund the living hell we experience. As I look back at it and at my complaints to JCAHO and the VA-OIG the only thing that really comes to mind is the value system behind all of this. Our Government must really hate us as people. Thousands of Veterans letters and complaints – maybe even million of letters have gone in the trash and the Circus continues. I almost think I would rather go to a Veterinarian. Honestly,my dog gets better care and it’s compassionate. The game is rigged and the Vets always lose to the house…Thank you for your words .

  6. There’s more than three positions, Ben. Can’t limit the narratives, are you a dem. socialist or something? VA-VHA is a government run socialist entity that could give a flip about veteran’s health care, only caring about staying in power and controlling the money; and VSO’s are mere appendages of VA-VHA. Divesting myself from contact with them is the best thing I can do for my mental and physical health. So much money could be saved by using hospitals that already exist instead of building, staffing (lol) and supplying them it’s rediculous, but this fact seems to escape all debate. We get obfuscation, platitudes, a warren of beauracracies, and a maze of red tape. All to “delay, deny, hope they die”. VA Mission Act is just more of the same: 40 miles as the crow flies = 40 driven miles = 30 mins drive time; all which disqualifies most, if not all veterans from (a ‘Choice’?) or whatever they call it now. It disqualifies everybody in my neck of the woods. The ,obvious, reason for all the veteran suicides is VA-VHA. I can’t even get a usable pair of glasses, and don’t trust them with cataract surgery. Forced to pay co-pays I can’t afford.
    This is a waste of time, nobody cares. I’m gonna write a book about you mf’s. Maybe I can make some money and pay for my own healthcare. Y’all can fight the next wars, we won’t win another WW.

  7. Oh quandary of quandaries. Status quo fears diminishing slop in their collective trough. The pro Choice crowd are mere minions of Pig Pharma and Pig Med. They can’t wait to get their hands on VA patients and money for yet another carte blanche feast of riches provided by the tax payers. Does anyone who can fog a friggin mirror really believe any of these cork-soakers give a flying flock about veteran health? Please – spare me. The root cause of all things wrong with the VA and public health care systems is institutionalized corruption. Period. The best, if not most gratifying solution would be to line up Pig Med lobbyists, executives, congressional staffers, and their bosses and mow those fuckers down. Not one by one, but in clusters. They are not parasites but treat us as if we are. They are predators. They should be dealt with as such.

    • I may have to give Veteran Warriors a thumbs up, I really did like what Lauren Price had to say. Windguy your right, they are predators. What other species on earth prays upon its own like the VA and the billionaire class does.

    • Wind, You are correct but many of the providers are corrupt too, the VA hires MD/DO/RN’s with questionable pasts not just senators and congressman. Conflicts of interest and with a minimum of medical board complaints I am not even sure if they list on on CV or resume/application. can you say neptunium? or volition of the pharmaceutical sunshine act?
      Also a conflict of interest with the regional Office they are not “straight up” racism and sexism is bad…
      They send out letters without names it just says “regional director” WTF – no name?
      Make it look real good for the congressman and senators have to justify the tax dollars.
      Ben please keep up the good work, it don’t get any better then when someone exposes the VA.
      core values and principles they have none…..

      • Say it. Integrity starts at the top. We needn’t study the dynamics of rank and file. We learned it in a way that the rest of the country didn’t, and doesn’t appear to understand. Rank and file see leadership with their fingers in the till and some decide to shrug their shoulders are simply “get theirs”. That attitude is endemic in modern America. The VA, while near and dear to our hearts, is merely one manifestation of the curse that has befallen our once great nation.

  8. At the Atlanta VA hospital, they have changed their voice mail msg (which we hear repeatedly, before speaking with a person every time) to “This is the Atlanta V A hospital, where exceptional care is given to our Veterans …”, as if repetition will make it so.
    Our President believes in the value of competition. With “Choice”, there will not be the overload of patients or the shortage of staff crippling the VA for decades. Good care givers would love that. Those who are there for “security” or who have their hands in the till, of course, want it to stay the mess that it is.
    When so was at Balboa in San Diago, in 1967-69, the situation was the same – they sat at the desk, doing very little and always had a poor attitude.

  9. This site is always interesting, and it usually offers up some new information and excellent commentary on the “pulse” of those who are either Veterans or professionals who interact with Veteran’s healthcare issues. However, not all healthcare issues of a Veteran can be treated or even given timely care. Some of those issues: The morbidly obese Veteran who is wheeled into a facility, time and time again, demanding a Doctor or an expensive procedure for a return to excellent health. You know who you are, and we’ve all seen you! In those cases, which are frequent in the VA, maybe the Veteran could reflect on how he/she ended up in such a wrecked physical condition. So, reflect on how you got that way! The consumption of a few Pizzas every day for 40 years, little or no exercise, and the multiple visits daily and nightly to the corner Pub? Not exactly service-connected, of course, yet Veterans can and do request care for their own health failures. I’ve used the VA healthcare system often, and Choice as well, but not for health conditions that I have caused. I think it time to also remind some (complaining) Veterans that only so much can be done for them, (if anything at all), and that their condition could have been lessened or even non-existent if the Veteran had chosen a better lifestyle. I’m no nutritionist, medical official, or bleeding heart for the VA system. Still, I’m realistic.

    • @Larry – I’m REALISTIC too;

      VA is jeopardizing the lives of Veterans with non-compliance to VA policies. And many employees are either afraid to speak up about this, or they’re ass-kissers. The loss or failure of health of one Vet by VA’s non-actions is UNACCEPTABLE.

      And the VA doesn’t practice Precision Medicine. Far from it. And stop killing dogs too. Maybe we should use VA employees as guinea pigs instead. You trust them so much are you going to sign up.

      Did you ever think that many VA employees, hiding & riding under the union & Tort law umbrella, makes many Vets sick of the corruption?

      Kiss my ass.

  10. Larry K. likes Jane Fonda too. Come on man … where do you get off telling us pizza is the problem?

    Your statements about what we have all seen is just your own biased vision of reality. Take a look at who goes shopping today. The world is full of buffalo and I don;t mean some place in NY state although I’m sure they have plenty there too and many of them are communists.

    • @Larry – – – While I will be the first to rail against the VA when warranted, it is true and accurate that as we age many veterans choose the ‘good life’ and self-discipline gets chucked right out the window! I could not count the number of times I have had conversations with many guys my age or just a wee bit older who are looking at knee or hip replacements in the very near future.

      The over-riding commonality? They love to eat ‘good'(think chicken-fried steak) food, but have zero time in their lives for the gym.

      I’m a young guy at 63. The miles are getting fewer and slower. But I still currently do a scheduled twenty five mile weekly uphill incline at the gym, plus strength training. This is in addition to whatever walking around my daily business affords me.

      And I can still enjoy a good chicken fried steak on occasion.

      Well said.

  11. For me there’s no way want to leave the VA and I would usually just because of the hatred for so many who work there and don’t care or just suck. I am on a large dosage of opioids and other meds frowned upon because of problems they can cause. Opioids alone is a bad word now and would not get someone to take over with no history with. While I believe the new policies are far better, they don’t touch on the negligence of the VA.

    It’s better for all to take care of an injury and push rehab. The VA even had this posted on myhealthevet, stating short term opioids, rehab to include yoga, water therapy, acupuncture, massage, chiropractic care and what ever missed. The VA has yoga and nothing else to include to be successful because wait times.

    Because of this and pushing off treatment because lack of staff and money in the operating budgets, nothing was ever done. So walking around 25+ years with injuries and altered gait has caused secondary issues making everything worse. So with 2 bulging discs with moderate spurring in my cervical spine, pinched nerve in T5, 5 discs bad in lumbar spine, 3 lesion growths in thoracic spine, both shoulders with impingements and tissue damage, carpel tunnel in both wrists, both hips with impingements arthritis torn labrums and bursitis, too keep short both knees need replacement, one ankle fused and widespread arthritis.

    Who is taking this on? You can’t possibly start rehab or reduce meds until some operations and who wants 5 joint replacements along with multiple spine surgeries? Am I now expected to make the next 15 years of my life surgery and rehab? What is the chance of that happening especially having caused mental health problems? More likely find me in my car eating a carbon monoxide sandwich. So medicate until time to eat.

    The VA can do anything it wants, including writing laws everyone follows except them. So until they let up on opioids you better make sure if leave will be able to live because once leave they won’t want you back.

  12. I empathize with the people that have shared their many unfortunate medical nightmare stories regarding the treatment they have received with VAHC. I have plenty to share also. With that being said I agree with so many of the comments such as, “If the VAHC medical care is superior to others” then enabling veterans’ to have a choice would prove this to be true or not. The comments about vested employees getting a government paycheck and benefits yet their job performance is substandard, and they are not being held accountable, I agree. If the veterans’ go elsewhere for medical treatment because of how they are being treated at the VAHC, then guess what, no VAHC, no job. Holding the VAHC to the same standards that all other private hospitals are expected to uphold, I’m shock that this isn’t already in place. And last but not least, why not have all federal employees use the VAHC such as government employees, senators, governors, presidents, you get the gist of it, if VAHC is such an excellent choice for healthcare that those supporting it say it is, then why isn’t every government employee clamoring to use it?

    I have had some good experiences, when I was younger and only needed a checkup, but when I needed to use it for when I was ill due to the VAHCs error, my experiences have been hit and miss. Mostly I try to stay healthy for fear of having to use my VAHC benefits. As a result, I’m pro Choice. If my medical treatment is good, I have no problem with use VAHC. It is only when I have a problem and would like to have a second opinion or I am being belittled by the staff or physician and for times when I can’t even get the medical treatment I need and deserve, it is for times like these that I would like to have the choice.

    Peace Out

    • To your last paragraph T. I just received a check back from the CAFC for a petition to review a CAVC order cutting short my dispute with the RBA because it is incomplete and needs to be complete for a remand to the BVA for a correct decision.

      So, I’m being denied Due Process. Do I have to go all the way to the Supreme Court or will it be sufficient to send copies to the Washington Post so that the Judges can read my complaints about the Clerks with their morning Coffee.

  13. Larry you’re not realistic, you are a piece of crap. What gives you any right to tell others the way they live are wrong and it you’re opinion. If someone wants to eat pizza and beer every day and makes them happy it’s their business. How many people in perfect health get a disease or a child both with difficulties? Should we push them away because if tested would shown risk and should not have children? You live your life since better than everyone a stfu. Idiot first class

    • Well, Broken … so much for anyone saying anything they please. Pizza, Beer, Happiness ? It was obvious that my comment(s) had nothing to do with happiness but instead HEALTH. Oh well. Your name calling is similar to the pseudonym that you use — meaning, “Broken.”

      • Brave home trying to be a big man. People do this to give their ego abuse, but the world nothing but a chump. Reason use a nickname is because the VA monitors social media and veteran sites. It will kick you in the ass sooner than later chump

  14. Ahhh yet another pussy cat group…Veteran Warriors? From what I see and read it’s just another out reach group with the specialty towards the VA alone, the usual, villages for females only (?), attachments to closed groups, and not much more info. Then spout the ‘we are one’ stuff? What can they do like getting our files from a civvy hospital and others refusing to hand over copies of our med files or playing the same games the VA did? Or refusing things like X-rays over a broken, shattered jaw, that no-one wanted to report on, declined or failed to put/mention in files, or get involved over? Plus much more corruption and covering-up. Oh and they are HIPPA compliant whatever that is. Since HIPPA violations can’t be dealt with in some states like Indiana where evil and corruption on all levels can run rampant and above the laws. If it’s un-ethical, full of professional misconduct all over, censoring, gas-lighting the real victims etc., it’s full steam ahead here. State, DC, med boards, secret societies, all politician party and social justice “warriors” approved and protected. But I’ll check their group out too but my guess is they’ll be like all the rest. To which I’ve managed to piss off every other group, association, medical groups -their unions/family members – cousins – spouses – uncles , media, politician, colleges, state’s AG, med schools, human rights groups, etc., out there so I might as well get a jump on this group too. If more major VSOs and the powerful don’t give a hoot and claim to be powerless over a multitude of issues then this new group will just be like a fart in the wind. Or will they be like the many vet biker groups making claims but also don’t want involved due to corrupt connections and fear of retaliations and upsetting some city council or VA connections… or family work place situations, clubs. Oh all those dastardly connection most do not think about.

    Transparency has been mentioned and is what we really need. Plus the end to all the censoring, banning, and assaults on our free speech or ability to group up with other vets who’ve been harmed by the VA and those in the civvy world. The only ones allowed to group up or speak apparently in most areas are the yes-people and actors claiming all is well and the VA is puuurfect. But without media or real social groups and forums this will never happen. Since attending veteran’s councils to town councils or other events are useless and even dangerous today. So is civilian care today but some claim that to is better or safer. Maybe in some areas but not across the board in reality.

    With Choice I still had to drive hundreds of miles per month even for simple ten minute check ups. The list of why Choice failed in some areas is long. Unable to get the specialist needed locally. Locals not accepting what the VA is willing to pay. A circle of fools that refuse to do what really helps the vet instead of playing the money game and having to visit all their companions or money making co-horts in the money minded only civvy care sectors. To the activist carrying on with the VA and activist styled retaliation for daring to question some AFGE or other union members or staff. Gotta protect the evil ones and their groups and to hell with us and our care. To civvy’s telling us just to go back to the VA or not wanting to wade through the messes of VA files and missing ones. Or not informing us of “in-office communications or notes” that turn us into mortal enemies of many including those in the medical fields or med boards. Then the issue of ‘identity politics” which the hate from that alone prevents much professionalism to actually happen. And to think some new vet group wants and got an all female village? That sure speaks volumes alone or does to me since all the BS I’ve gone through in past years with ‘special interest types,’ mind you years. Every turn. Hell, how about a village for men only that have been black-balled and attacked state wide and community wide for standing up to all the BS? Mainly from all the man haters or Marx-Fems playing VA staffer to secretaries to corrupt nurses having fun with old dudes for fun or to appease the METOO companions. Oops, that’s not PC.

    Then on to the other already mentioned issues like trying to get second opinions, etc. Plus all those who have no business with our med files, info, dealing with suffering vets, or claiming to do their non-investigation investigating. Damn good at attacking us though. Then on to the MDs and others trying to change the entire system of things are silenced but Pig Pharma and mainstreamish AMA med care carries on getting more corrupt than ever before, more controlling too. We are up against a crap storm called America and no end to any of it in sight. I best stop.

    Good stuff Megan and Rosie. I’d want you all in my corner.

  15. This is a SERIOUS mis-statement of fact. Wow.

    Hey, Mr. Krause, with your own law practice (and income therefrom)—I do not know of anyone who would object to your departure from the VA Medical System. You are free to leave the VA Health Care System whenever you want—you HAVE $$.

    What you are ACTUALLY complaining about is that you want to leave without leaving—you want the Federal government to PAY for you to use separate health care.

    Not the same thing. If you read this on some one else’s blog, you’d call it propaganda, at least. I call it stirring the pot.

    The aspect of “Choice” (the program) that I dislike is it’s “privitisation” focus. The more we turn VAHC into “like private insurance”, the more ground gained by the privitisation cabal/group/troika. For those of us who do not have a legal practice or private health insurance, the VA and our pension (and SSDI) are all we have. Dismantling the VA dismantles our health care, full stop.

    I have plenty of experience with the lousy qualities of the VA, and I am not arguing it is great. What I AM arguing is that the fix is NOT the private insurance model—that changes the basis of care from a duty to veterans to making profit; then the people who suffer will be the Veterans who have no $$ to make co-pays, meet deductibles, and so forth.

    What is it you belief Choice offers Veterans, really? Not an actual Choice, because that’s not how it works–I have used the existing Choice program, until it was de-funded by Party R last year (and I’m sure Party D would de-fund it as well). One was the Dr. of my selection, the other was not; in both cases, the actual selection was up to the VA, not me. One worked out, one didn’t. In neither case did the VA get my “electronic” health records to the provider. They sent six pages. Six, dude. The Choice with an actual Dr. went well anyway; the one with brand new Resident was a disaster, and set me back three months (by electing Choice I “forfeited” preference).

    As a way to fix what is broken with the VA, it is more of the same abandonment of responsibility by the Congress that got the VA where it is. If Congress can’t manage the VA, why do you believe it can manage a nation-wide network of disparate hospital ssyems—each with its own bureaucratic maze of slef-protection and profit-making—and private practice physicians, as well as State Medical Boards and state government Bureaucracies?

    I don’t see it. But I’d love to read something about why Choice would be better; that the VA is BAD does not make Choice GOOD.

    • Steven, I agree about the privatization issues giving the civvy side of things today are not much better. Location location.

      There are days I should push away from the pc but I don’t. I also don’t agree totally with dismantling the VA except for the quality of workers, staff and union affiliations or associations. Such change includes Congress and other DC types to the SES and above.

      You hit it. Individually or in a group we were given two choices. Turn our lives over to the VA entirely with signed consent form and contracts or do without health care from them. OR hit the street corners for pain needs. OR, try the civilian sector for health care…”which we at the VA, medical colleges (named), Fed/state agencies (also named like DHS to POTUS) control it all in Indiana. Nice huh? I for one left to go broke again over health care instead of dealing with such scum and playing their retaliation games that did NOT end with leaving the VA. Then count the days, months, till I hit Medicare age to get supplementals to help cover the fleeing from the VA crap. So they have some of us by the gonads, ovaries, whatever the case may be.

      In that group of us for orientation some expressed being stuck and too poor to leave the VA free system of care. I for one do not like intimidation, bullies, games, or threat tactics from some smiling PoS thinking the whole thing funny or cute. Including our issues with the VA he claimed to be so perfect, and he so brilliant and well trained over all. Giving the fact we would be “forced” or “ordered” to take head meds for pain (even if tried before for compliance sake with severe side-effects, stopped.) and do whatever they demand or else lose care? To driving hundreds of miles at midnight if need be for a pain pill count? Told to use the VA only and no using a civvy E-room even in case of an auto accident or something? I was totally out and would rather die first than be treated or talked to that way. Choices? Not in Indiana or the Roudebush VA joke of care there or a CBOC staffed with clowns and cliques.

      With most things we are ripped away from powers/freedoms and one being choices. Or face some consequences. And many out here hate the thoughts of change, freedoms, fear the systems that be, maybe another medical bankruptcy which vet disability is NOT exempt from in this state, etc. Then the big game of trying to find MDs or care givers for quality care. So entire systems and establishments would need a cleansing, total exposure, transparency, investigated, charges made, licensing pulled, etc. Not going to happen.

      Ben, why so many oppose? For one a lot of folks out there I think don’t know what quality care or good bed-side manners really are. Been told as much many times too and by those who have previously had good health or maybe one simple issue to deal with… until later on in life.

      Unions and other cliques, communities, demanding no negatives to be allowed discussed or mentioned. Or else. WE all live in happy global communities enjoying the socialist styled health care brackets don’t we??? Oh and profit driven modern day health care that will not tolerate negativity either.

      The countless stories we may hear about the VA, contractors or connected ones about killing someone off or causing them to lose limbs or something but still praise the VA for whatever reasons. Is it the head dope and VA made Zombie effects???? Can’t even try a conversation with some of those people being so doped up and brain dead. Claiming good care while living in misery but can’t smell the coffee under their nose. To family members not questioning issues at the VA or deaths from a change in meds that once worked to another that caused serious issues and such? Saying they get quality care while using Ace bandages to get a hernia ball in their gut even after mesh surgeries that failed and claim the VA reports can’t be fixed due to scar tissue, but we be getting fine care… and on it goes. Encountered that many times while out in the streets. Now how smart or truthful is that? On top of all the family members and connections they support while working at some VA unit or health care of deceit they don’t want to shine a light on or cause troubles over. Working in med colleges affiliated with the VA and the other corrupted systems. It’s all really endless. We need a proper free chat forum that could try to cover everything going on in “Murica.”

    • 7 Ford, I agree with you in principle except for those of us who don’t have a VA just around the corner. What I’m receiving now is a hybrid. I receive direct mental health care (again as of yesterday) from a VA employee at a Contract facility that has both VA employees and contractor employees. The hybrid is a result of having a clinic only in a very rural setting. 100 mile radius less than 50,000 population located 30 miles from me in a town of 15,000. In this setting there is only one hospital with full service and even then they frequently helicopter patients for definitive care to Denver 300 miles away.

      The problem is as you say, a bad VA. A regional Director who is more interested in the size of his bonus and guarding the peoples taxes from a few malingerers than providing care to the many per his obligation.

      I pay no co-pay when I’m sent to the local hospital for a specialist appointment. Rehab, neurology, etc. I also rate no co-pay for care at Denver or Cheyenne VAMCs. My understanding is that those who have co-pays have the same co-pay that they would have at a VAMC.

      But I do agree, the impetus of the GOP’s cutting of entitlements is to make the co-pays larger and more universal to give the rich boys another tax cut. So we get what we vote for. I voted for Trump believing another budget busting tax cut wouldn’t be possible. But the cuts across the board happened. The VAMCs are also feeing it. Physicians won’t work in a militaristic environment such as the VA unless they are the ones who want to deal out shit.

      Yesterday, my mental health therapist said physicians get mad when they can’t put a patient in a simple box. And with many vets, we don’t fit in a simple box. TBI for example is simply “depression” or anxiety. Everyone’s PTSD residuals are different but the VA has come up with 3 boxes for one size fits all. CPT is working for a lot of PTSD patients but sending far too many out the door to commit suicide.

      Until the wealthy are willing to pay for the privilege of not working on the floors of factories they used to own and learning to speak Russian, Arabic, or Chinese it is going to get worse. They’ll build more fenced compounds with private armies for their security and pay less and less to those that enable them to do that. We’ll find ourselves living in tin shacks or tents or other makeshift shelters and scrounging for food. We’ll have to learn to feed our family of four with that one hamburger we have for lunch for a couple of days. The writing is on the wall as long as we keep electing those who have no concept of what it is to do without basic necessities.

    • @Steven Ford High – I expect the VA to provide timely Precision Medical Care. Its what they preach.

      You that deny that the VA is screwed up are the ones we Vets are concerned about. Traitor!!!

      • I have not written as you allege. Read the posts. I disagree that Choice is the fix. Big difference.

  16. 03/01/2019

    Dear Steven Ford High,

    Good Work. Stir the Beans please, they are burning.

    The more options of health care to the Veterans the better, after this Five Year “national embarrassment” where thousands of our veterans had been killed by the hands of the VA.

    This mentally incompetent organization, due to “management interference,” has little wiggle room left.

    The Phoenix Hacienda Medical Center which has been flagged internationally in the Media is discovering this currently; all the board members are jumping ship into the cold waters of reality, leaving our former Congressman’s wife (Nancy Salmon) speechless [VP of Corporate Communications for Hacienda HealthCare–4 years].

    Lately, many things are on the table—-you can bet Steven Ford High the beans will be burnt.

    Sincerely,

    Don Karg

  17. I want to make one thing really, really clear—VA benefits, including health care, ARE NOT FREE.

    We paid for those benefits. Some of us with body parts, some with peace of mind, all with service that our nation determined was worthy of recompense.

    As to the rest.

    I do not pay a premium or a co-pay for service I receive from the VA—as Lem correctly observed, I have a VAOPC about 20 minutes away—and I am 100% Service-Connected Combat Disabled Veteran. Thus for me, the access issues are a non-starter unless I let myself get talked into “Choice”. The only people ahead of me are former PoWs. But one of the positive residuals of service is an understanding of teamwork and it s value, and of the many strategies employed by outsiders to break up a team—for whatever reason. So I see the issue as one involving veterans, period. Halie Selassie once pointed out the obvious to a group of privledged men who believed they were serving their own best interests:

    “Today it us; tomorrow it will be you”.

    You can read how that turned out if you’ve forgotten.

    I believe there are veterans who feel Choice is the only workable answer to the problems in the VA–judging by Mr. Krause’s continued and uncritical support of it, some Veterans certainly seem to want it. But I am opposed to turning VA health care over to the private sector, and that is what Choice does. I don’t care if you want to go somewhere else, I just don’t want you to screw over guys who don’t have a law practice while you’re doing it.

    It would be great if there were—to paraphrase Lem—a simple “box solution” to the problems in the VA and in VAHC. I don’t believe that is the case. I believe the only solution is hard work, something Congresspersons are traditionally unwilling to take upon themselves, and We The People are unwilling to task them with. Nor are we willing to accept that an unwillingness to make hard choices is not unique to Congresspersons—We The People elect them, after all.

  18. Talked recently again to a DAV liaison type of person. Had a grand meeting with our Congress varmint Rep.Larry Bucshon. Claims there are “only” around “18,000” thousand disabled vet in our state and all are pleased as punch and happy as clams things are so perfect here…with the VA too. Gag. He (Bushy) is the same clown I contacted over some issues including the civvy hospital here playing VA styled games and still will not release my most recent files from them or the secretive insider ‘inner-office’ communications that are said not to be part of medical files for release to the patient. He came out and did a photo-op the following week with the CEOs and thanked them for their high standards of patient care, professionalism and ethics beyond comparison. More gag.

    Seems to me the whole corrupt sheebang are simple fixes if the public would get behind for some support. Giving any or all of us options and choices including VA care or it’s contractors to going all the way civilian if some desire it, unless you’re branded like I am and that hasn’t worked well either. Forcing, trapping, giving some just one choice for care due to playing lab rats or some testing the VA wants to do doesn’t cut it.

    People fight for better animal care and such while allowing the DC cliques, some unions, some city officials and their unions and affiliated fraternal order groups can get it all with their different health care choices or privately used clinics just for them or their families. Vets within that category don’t have to worry about care and don’t give a rat’s butt about the rest of us. They just want some of us to go away, die, or shut up about about the negativity about their community or state. It’s all about the usual big I little U concepts of life. Hell, give me the same respect and care that the Congress critters to the SES can have. That’s pipe dreaming.

    Then at the same time I was reminded by another much younger “un-happy” DAV member about the differences in care in states that may not provide under age 65 Medicare supplementals (yes most know all states are different), are stuck with the basic A/B coverage in this state, and stuck with the VA with no other options and have already gone bankrupt due to health care. While having issues with dis percentage ratings and other issues. And she&and a he can’t get past the games over “unknown environmental illnesses.”

    Of course not many including the trash at the Federal bldg or in front of a Congressman’s office or others are going to care much about one old dude out front with signs on his vehicle and trying to man-handled a couple more large signs in protest. Nope. Antifa, social justice warriors, Metoo groups, the women’s march people and others can make it on the news for media support and to share some info… but not for one old white dude against a very corrupt community and state. Oh and up against all the well connected, billionaires, and upper-class types or “professionals.” Got me a yellow vest, bull horn, and thinking I may have to up-grade to a vagina hat they wear around here. May be that will make me look like a million person march in the streets, I dunno.

    How about it Congress, Senate, House, SES, et al. Give up all your insurance, perks and special health care? Pass it on to us.

  19. Ben and others. Another issue it seems that so many including VSOs to the AMA, the deep rooted self-serving establishments/lobbyist don’t care to see happen or make available. ‘DIRECT PRIMARY CARE.’ Those wanting to provide services minus playing the insurance games and doing the pass around to appease those MDs in their private circles or associations for more $$$$$. Or for more retaliation or covering-up to continue. I’d go that DPC route too since things in this state is so corrupt, fascist, more thuggery or mafia like, and squirrely than true medical professionals.

  20. The VSO’s are full of shit, at least at the corrupted and compromised top, where it COUNTS! They are SOOO on the government take at the top, that it is absolutely PATHETIC! I will bet you that NONE of them use V.A. facilities, but have been provided with secret Congressional medical gold card coverage under the table! Recently, a CT of my heart discovered an enlarged (four centimeters) thoracic aortic artery. That was two MONTHS ago, and private sector doctors claim that at 3.86 cm, I am approaching dangerous (five cm or greater is VERY dangerous) territory for an aortic dissection or rupture. This outcome is almost always fatal, and results in a quick and painful death from shock and the chest cavity filling with blood! Yet, my Sioux Falls V.A. hospital “provider” claims that it is nothing to worry about! Of course not, if you are the “PROVIDER!” It isn’t HIS one heart and one life, IS it!? If this aneurysm were to blow on me, I would be DEAD, and not here to take care of my Jeannette in her nursing home! Meanwhile, not a THING would happen to him, the hospital, the V.A., or the V.H,A.! I am scheduled to see an outside provider on March 27, 2019. However that makes a total of more than three MONTHS, and there is no guarantee that I would last that long. The V.A. hospital in Sioux Falls still has the men’s bathroom open to full view of outsiders passing by in the hall. How many sick and old veterans don’t know this, and pull down their pants (not all wear underwear!) to adjust themselves while not realizing they are being viewed by women in the hall!? I realized this about 10 months ago, when I was standing at the sink, and looked up in the mirror and noticed a 50’s (I am 67) woman watching me in the mirror and smiling! They STILL don’t have a MALE patient advocate for male (the overwhelming majority) patients at the Sioux Falls V.A. hospital, even though many male veterans need to discuss issues of an intimate nature! The flea/male advocate named Beth is a total joke! I have contacted her very politely with return phone number on her V.M. at least four times in the last four years, and she has NEVER returned a phone call. We want PRIVATE VOUCHERS NOW, so we can find high quality private sector care. I have quite a bit of money, so I have had private and V.A. Private is a hundred TIMES better! By the way, I received a notice from V.A. addressed with the title “Evidence” in the envelope window. Turns out that unless cross matching job records turns up job income, you never have to do an employment verification form. If job income IS found, you will be notified.

  21. So…two things.

    The bathroom problem rally doesn’t equate with the Death problem.

    The Death problem is, sadly, very common. Even if one sets aside the idea that the entire establishment is on the take or deliberately trying to kill veterans—as some of us clearly believe—there is too much factual evidence of the delta RL describes. Time and time again, VA providers downplay the seriousness of problems they find, pretty much across the board (younger, newer Drs are not as bad).

    But I still don’t see how private care is a panacea. RL has “quite a bit of money” and has had private care, yet is still having to wait until March to have a potentially fatal condition addressed. How’s that better? That sucks.

    The difference comes down to the model of care—something Mr. Krause refers to when talking about IU, but not about Choice. The VA is a government bureaucracy focused on maintaining itself. It achives goals base on savings, not based on service to veterans, which is what it should do. Private care focuses on generating revenue, not on quality of service. Ever notice the difference between “private payor” and “insurance payor” rates?

    The issue is about focus. If the VAHC were focused on patient care rather than saving money, then our providers would be motivated to treat us, and not to minimise as they have done to RL and to almost all of us. How taking money out of the VA and giving it to private insurance companies achieves that goal still hasn’t been explained.

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