VA Code of Integrity

Will New VA Code Of Integrity Help Its Health Care Workers, Veterans?

VA just rebranded its previous ethics requirements into a Code of Integrity for the VA Health Administration to follow.

Every time I tried to write the title of this article, I kept writing “cod” instead of “code;” perhaps a Freudian slip for red herring.

The red herring is a logical fallacy where one party baits the other party with a tempting topic that is not on point with the goal of distracting the argument to win instead of using a better argument.

The history of the red herring logical fallacy is supposedly linked to hunting with dogs. Apparently, pranksters used to use a red herring to cover the path of the fox to throw the dogs off the track.

VA Code Of Integrity

The Code of Integrity is published as a PDF of a PowerPoint presentation that summarizes existing laws and policies as an evolution of the I CARE values pushed by former Secretary Bob McDonald.

“The response by VHA staff in reaffirming our shared values and strengthening our culture is outstanding,” said VA Secretary Robert Wilkie. “We’re proud to help set a standard for other federal departments and agencies to follow.”

“Creating a culture that’s conducive to the highest ethical standards is critical not only to assuring high quality health care, but also to assuring public trust in VA,” Wilkie said.

The Code appears to combine policies with various laws impacting employment. The Code also instructs employees about “efficient use of government resources”.

So, about my obsession with cod, or red herring, noted above.

VA Fetish

VA has a fetish. That fetish centers around ensuring the American public believes the agency is doing everything in its power to provide care, services, and benefits to veterans as envisions by Congress… and, the American public.

Will the VA be able to spin up enough press about its new Code of Integrity help it convince America they are doing everything they can to resolve veteran suicide?

If the agency already has I CARE, why create a new Code of Integrity? Doesn’t the creation of the Code of Integrity suggest the existing ethics laws and I CARE standards are a failure?

The I CARE acronym stands for Integrity, Commitment, Advocacy, Respect, and Excellence.

If VA was following the I CARE standard for integrity, would the creation of the Code of Integrity be necessary?

Will the creation of the Code mean VA employees will suddenly change an unsavory behavior?

Anyway, curious about your thoughts on the Code.

I am curious to see some of the internal documents addressing its creation. Maybe that will be my next FOIA. What do you think?

Will the Code turn things around? Does the timing of this release have anything to do with the three veterans who recently killed themselves at VA facilities?

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42 Comments

  1. Thanks for the replies Old Gator and Rosie, This letter was sent in an email to Senator Merkley and the Federal Employee Health Benefits @ FEHB.gov a few days ago. The person @ FEHB who works with BCBS insurance has made and inquiry into this as well sending me an email thanking me for bringing this to their attention.

    In a subsequent email I sent out about the matter I informed that I publicly raised this issue on August 16, 2017 at a Brookings, Oregon VA town hall meeting when Director Paxton was still the director of the Roseburg VA.
    I and all present were told at that time that Veterans insurances should not be billed for service connected conditions.

    Bringing this matter to Senator Merkley’s attention should be good enough you would think? But it has been my experience in my and other Veterans dealings is that they are able to help Veterans on an individual basis with the VA, treating the same symptoms of the same problems individually. It is seldom that the root causes of the problems, which are often the same issues for many Veterans, are ever addressed. If they would fix the root cause of the problem for one Veteran, they would fix or prevent the same problems from recurring for other Veterans.

    Thanks Rosie for sharing that you have experienced the same problem of having your BCBS insurance being billed for service connected conditions. I had suspected that this problem was not just at the Roseburg VA in Oregon but rather a nationwide problem as VA officials use medicare and other insurances to keep the dollar cost of veterans healthcare lower so they can get bigger performance bonuses. Turning a profit off the insurance as they have clearly done with me and my insurance is even better for them. It’s definitely a screwed up backwards rewards system.

    This over/wrongful billing scheme, if it is nationwide, which I suspect it is, could easily go into the millions of dollars (maybe billions) with regards to insurances and Medicare absorbing these service connected medical costs.
    Just taking into account all of the treatments for all of the health problems derived from Agent Orange exposure alone could do that.

    There are so many problems at the Roseburg VA and within the Roseburg VA Healthcare System I can’t begin to address them in this response. Right now the recurring problem of not staffing the Brookings VA clinic with doctors is again a problem but there are a lot more problems.

    Joel Corcoran from Senator Merkley’s office knows its bad. I’ve been on numerous personal and conference calls with him and the State of Oregon DAV Junior Vice Commander Glenn Turner.

    I am hopeful Ben can dig into and expose this fraudulent VA insurance billing scheme. I’ll be happy to give him what I have.

    Mike Berns

  2. @Mike Berns and OldGator,
    What you have posted about VHA’s deliberate mishandling of private insurance billing is surely egregious on some front, and has gone on for far too long to be considered a “mistake”. This issue has been mentioned by posters on Ben’s blog in the past, although not as extensively as you have explained it.

    Regardless of your personal political leanings, it is always best to reach out to those that may be able to direct one’s issue/situation, toward the attention of someone that can help rectify it for many, rather than (in this case) on an individual basis. A single page letter, pointing out the practice, written to all three of your District/State U.S. Congresspersons will be a good start. Going to “Congress.gov” will give you the contact information for those persons in both The House and Senate, also information of which Committees they are on, and the persons on all of the other Committees including Veteran related. Anyone else out there that is being thusly billed and willing to expose that abuse, might consider the same respectful approach. That in turn will help bring attention to the issue, from those holding the power to fix this problem that has gone on for too many years.

    In some way, the general public has to be made aware of the fact that the VA/VHA/VBA are collectively not utilizing every tax dollar for its intended purpose. Until the non-military related citizens and the non-government contracted business entities are fully informed on the myriad battles that veterans actually go through attaining the Federal benefits promised them, we will be continually left behind to muck through it on our own.

  3. @Michael I have to agree with your post completely. My husband and I also have Blue Cross Blue Shield. We both have service-connected conditions and our insurance is routinely charged for my SC meds, visits etc. I have a lower service-connected percentage than he does, which is why it seems to happen with my charges more frequently than with his. I have repeatedly brought this to the attention of Blue Cross Blue Shield and they have re-billed many of the items back to the VA but this constantly occurs… As a former CPA (and auditor), ethics and accuracy in billing are important to me – both professionally and personally. And this type of so-called billing “inaccuracy” is not an error or omission it is simply fraud and it burns me up. @VA: Hire people that know how to do accounting and stop cheating the taxpayers!

  4. Here is an example of the lack of integrity with regards to the fraudulent insurance billing going on at the Roseburg VA in Oregon. see letter to Senator Merkley below.

    Dear Senator Merkley,

    After receiving two very thick envelopes of statements of benefits from my BC/BS insurance company this week, I realized that the Roseburg VA has fraudulently billed and overbilled Bluecross/Blueshield Insurance for treatment of service connected conditions.

    As you are aware, treatment for veterans service-connected conditions should not be billed to veterans private insurance companies. The VA routinely bills my insurance for treatment of my service-connected conditions and what I recently discovered is that the VA has been overbilling my insurance for a significant profit when my insurance should have never received a bill in the first place.

    Here are just a few examples:

    For treatment I received on 3/27/18, the Roseburg VA billed my BC/BS insurance on 3/30/19 the amount of $705.56. The provider originally billed the VA for these services in the amount of $243.38. The Roseburg VA paid the provider $107.56 and the provider wrote off $135.82. On 4/7/19, BC/BS reimbursed the Roseburg VA $319.48 for a VA profit of $211.92. This treatment was for service-connected conditions.
    For treatment I received on 4/10/18, The Roseburg VA billed my BC/BS insurance on 3/30/19 the amount of $231.70. This provider originally billed the Roseburg VA for this treatment $184.70. The Roseburg VA paid the provider $63.96 and the provider wrote off $120.74. On 4/7/19 BC/BS reimbursed the VA $195.79 for a VA ​profit of $131.83. This treatment was for service connected conditions.
    For treatment I received on 9/27/18, the Roseburg VA billed my BC/BS insurance on 4/2/19 the amount of $439.32. The provider originally billed the Roseburg VA for these services in the amount of $346.56. The Roseburg VA paid the provider $105.79 and the provider wrote off $240.77. On 4/14/2019 the Roseburg VA was reimbursed by BC/BS $414.09 for a VA profit of $308.30. This treatment was for service connected conditions.
    For treatment I received on 12/18/18, the Roseburg VA billed my BC/BS insurance on 4/6/19 the amount of $1,001.68. The provider of this treatment originally billed the VA for these services in the amount of $492.00. The Roseburg VA paid the provider $168.12. The provider wrote off $322.88. On 4/14/19 BC/BS reimbursed the Roseburg VA in the amount of $621.45 for a VA profit of $453.33. This treatment was for service connected conditions.

    Senator Merkley, These are just 4 examples of this VA insurance fraud I can give at least 28 more just from one provider. There are a lot more examples. This is systemic and this affects everyone, the medical providers who have to write off what the VA does not pay, the insurance companies who should not be billed in the first place for service connected conditions but are then billed for hundreds of dollars more than what the VA paid for these services. This results in higher insurance/Medicare premiums for everyone and the VA profits substantially from this fraud.

    Is there anything you can do to stop this?

    Sincerely,

    Michael Berns

    P.S. Joel Corcoran was working on having my VA aqua therapy re-authorized after being denied, even though this was approved by my Roseburg VA Doctor. how is that coming along? Joel said he could help me with this.

  5. There is no integrity in the va. If you want to volunteer and work for free you have t sign aggreement you wont talk to the news media. Goverment tries to limit your freedom of speech

  6. 05/01/2019

    Dear Benjamin Krause,

    It has been Five (5) years since the National Embarrassment and we are now down to 27 days of waiting time at the Phoenix VA from 30 days; and our star rating is still a one after Millions of dollars and man hours were poured into this sink hole.

    Why the creation of the Code of Integrity?—to create with worthiness to stay open.

    Painting the Pig.

    Sincerely,

    Don Karg

  7. Maybe if va just goes to choice it would actually save them money and there no liability because a veteran can just get any lawyer they want were the tort system garbage and its hard to find a lawyer. So the va deny everything when they are completely wrong with the evidence staring them in the face. There no accountability where they just shuffle employees around. Look at Indy VA vet looses leg employee retires sorry about that

  8. Fuck no there office to protect whistle blowers is retaliating. VA patient advocate office retaliation. Mental health nurse in the news being retaliated in the news workers at Nevada va are being retaliated. Smoke and mirrors. Top political leaders in this country and the va directors just need to start going toi the mental health clinics with veterans each week and talk with them if they really want to help. Fix the broken benefits system. Fix the goofy pills they want everyone on

  9. When you run a house like an animal your labeled as an animal house for life. SOP (Standard operating procedures) are made per clinic or hospital by own delusional leaders at millions of dollar’s per year wasted on meetings to further themselves the leadership rather than any Veteran. Less than 2% run the VA as Veteran’s. The low paying jobs are filled at 12-13% with Veteran’s. What/why are non Veteran’s in charge of Veteran’s care. Do you put a marine biologist in charge of a 3 million dollar Gorillas healthcare? Do we hire roofers to fix our highways? The standard operating procedures found anywhere at any VA are man made by the directors over these clinics. Some rules make the employees want to quit. As prior nurse we has to buy medications, gloves, and protective gear working at the Texas VA systems. SOP was to buy your own gear or risk infections plus diseases. At the end of the day good nurses quit each day! What they are left with or convicts who can’t get a job anywhere else or doctors who are criminals before being hired by the VA for half pay. Some doctors and nurses are court ordered to fulfill their criminal conviction and probation served at the VA health care system. The VA is frowned upon by judges, to criminals as a place of prison or jail. 99% of the employees I worked with I wouldn’t trust then with life or wallet for 5 seconds. VA in Texas as nursing community speaks of is called butcher shops on purpose. You go in die they cut your body up and send it to colleges for study. Freezer space for dead bodies of Veterans can’t fit currently through out Texas a memo stating pour bleach over the bodies in the hallways is circulating due to the higher deaths of Veterans than civilians as found in near by hospital’s. Veterans are sent to these VA hospital’s for preparation yet never prepped with respect. Bleach bottles at the Dallas VA hospital is used to cover up the smell of the decaying bodies with no freezer space. SOP is to pour bleach. A five year old runs the VA hospital at Dallas Texas. SOP so stupidly sound that its common through the VA to abuse us on purpose knowing no one can fore them. I remember nurses smoking more on their shifts than actually working. They stroll back in and smack on dorito bags and pounds of M&M’s over smearing food all over the patient records. Records in the trash, records under dorito bags. Yes the Doritos bags get more attention than the patients. The Doritos bags are life at any VA you’ll find these types of medical arrogance. Doritos in surgery. Only place you can eat over an open body and conduct a party above it. How many doctors I met drunk at the VA is best to search who doesn’t drink alcohol during their shifts to save time. I heard from 20 year Nurse that best drugs aren’t in the street. Their found at the VA. That should be scary, and thought provoking. Sugar pills used are a common goal. Which hospital has zero drug use from its dumb arses both civilian or VA? None, all hospitals have this issue yet at the VA I seen is the highest ever in my life towards abuse, property taken, and sugar pulls used. 50% My patients being transferred to another VA hospital were denied. Those 50% who were denied I sent to private hospitals. Knowing they will love their costs at 20-50k in charges and ambulance costs. VA system is a joke to Russia, China, Iraq, Kuwait, and the icing for the terrorists. When any hospital has such disregard for life it’s called a genocide. No one here expect prior VA nurse will say Genocide. Why is genocide happening? Why are soldiers thrown into genocidal order is beyond belief. If we don’t say genocide we are similar to Jews being herded into a cattle carts to our death beds if were lucky die fast, or u lucky and live 110 years with a VA doctor trying their best to snuff that life out then that’s the lucky survivalist. What we face today is genocide. No other word can describe what I see and feel! Genocide people genocide!

  10. Ethics or what’s that other thingy… oath keeping? Integrity? Using ‘da laws/courts.’ Not happening. Ben, you’re site here is well known I’d imagine especially by those in DC or the staffers at least. Agents of doom and destruction, cheerleaders, sure as hell read this site and pass along info. Those quotes from Wilkie (another insider) is a pure joke and shows again how DC to medical boards function and has the fishy odors top to bottom. IF they or any of them cared they would be out here asking questions to guaranteeing our safety, health care, basic human rights and protections instead of allowing all the censoring to retaliations from the VA, official offices, civilian health care, unions, activist, etc., to continue and gain strength against some of us. To be ignored by all those “ethical” or ‘oath keeping’ vets or VSOs or media? Ha. Attacked by the same groups getting on TV stating that “no-one will be left behind combat or no, on the field or in civilian life?” Let me chuckle while they all pass the buck, blow smoke, and sit on Cod filled cushions.

    “Code of Integrity.” When we can’t use the Constitution, HIPPA to so-called protections under the Dis Act of 70 or any lying patient’s rights propaganda? I’m no saint or agent of Oz but if I were Wilkie or some other clown up there I’d be out here gathering some info and demanding to know just what the hell is really happening out here in la la land and of our totally encompassing culture of corruption. But, they already know all about it. I do mean ALL. Then all those at ‘the top’ demand bowing, ring kissing and total respect… no negatives? None of them individually or by groups nor any media types are openly coming out here or FB to question or give support or wanting to change things or get involved. Crickets. To think we can change human behavior, the activist mind-set, the nepotism, any of the corruption, those in charge or shown on TV blowing smoke or paid to propagandize are much sicker or evil than we are?

    “We’re proud to help set a standard for other federal departments and agencies to follow.”

    Who is he trying to BS? Integrity, ethics, truth… no such thing, haven’t experienced it. VA or civilian. No where. Period.

  11. To the OP question:

    Any time there is a “Mission Statement” in any organisation, it is a sign of external friction. Companies do things like change their name (but nothing else), send the minions to training seminars (or nowadays, “webinars”), or pay a consulting company to run around and find something “cultural” they can “fix”, to avoid actually altering the practices causing the friction, because those policies are of direct benefit.

    I’m enjoying the sound of crickets, off to the Right, too.

    1. Yes, Steven, I agree with you. Government is never about meaning, purpose, and recovery. They avoid resolve and solutions. If they never solve and say well it will take 10 years to fix this issue. It keeps the Congress obligated to keep sending them more money than the year before. While they have five years to shift money to eventually no one can track it. Use it all even if it is to paint walls or buy new furniture that they do not need. Just to say they used all their money and while moving it to another facility that ran out before they did. Just more cover up. There are some decent medical professionals in the VA; but, many of them cannot do what is really right by the veterans because the system is not set up to deliver LIFE. This is why many VA employees have poor morale. Their hands are tied. Go along to get along. Remember, big government is about control, power, and greed only. It is only the free market system that will allow LIFE. The free market system is the only economic system that allows choice and freedoms. When the government is removed from different sectors as in President Trump removing many regulations with many more still to be removed, this opens up the economy for growth. This includes the free market which increases competition which ultimately reduces costs. The reduced costs are in medical care too. There are medical professionals who now have discounted payment plans which removes the government and removes the insurance companies totally from the treatment process of the patients which lowers the costs. VA seems to deliver better quality care when the veterans pay full provider costs. Full healthcare professional rates. But, ultimately, the big government is not for the people. I do not care how many code of ethics plans are implemented. The VA will never honor human dignity. Because it is government run healthcare that promotes only sustainabilty. See when the care is about sustainabilty, this type care in itself does not honor or follow any type of Code of Ethics. Following the Code of Ethics would ignite quality in all aspects. See this is how I know the VA is being dishonest. Single payer care goes against the grain of human nature. All people desire the will to live. Honestly, they do. Many find themselves with no way out of their situations which in turn leads to not having a purpose. The VA is a bandaid. That is it. The government does not deliver successes and prosperities. It does not manufacture or build or produce or innovate or grow foods. The only reason why the government exists is from taxpayer funds that come from taxes. If it were not for the profits and revenues from the private sector companies, the VA would not exist. Government forgets this. Notice the VA always honors the fallen in which we should. But, do you ever see them honor LIFE? Never. If they did, they would change the sustainabilty treatment modality hospice care into a treatment modality that catapults the quality care that is necessary for veterans to live their recovery which ultimately means pursuing what they value as their purpose and shares their passion. Of course within the vets limitations. Getting back to the veterans who have fallen or who have died, yes, sometimes the VA has memorial ceremonies to honor them which is good. Though, a front to look good. Ultimately, though, I will say this when a veteran dies, the VA is no where to be found. They disappear from the scene. I thought the VA offered some assistance with burial allowances. Folks, a 100 percent rated veteran who died did not receive a dime from the VA to help pay for the funeral expenses. The funeral cost over 10 thousand dollars. The family had to pay it all. Funeral last November 2018 under President Trump’s watch and Secretary Wilkie’s watch. So with however the VA will screw the veterans, they will. So with what VA Secretary Robert Wilkie is saying, I will never believe in a hundred years. Single payer care being controlled by the government goes against the grain of human nature. So Benjamin here is my take on this Code of Ethics modality. Fake.

  12. I get one every time I see my PC or neurologist and one every 3 months on my mental health practitioner. Haven’t had to put many bad remarks except about the mental health CPT program. It definitely needs revision as does the idea that organic brain problems aren’t a “management problem” instead of a cure problem.

  13. This just came into my inbox: I am scared
    Dear Elaine Ann Knowles,

    The Department of Veterans Affairs is working to consistently deliver the care and services that you deserve and need. I’d like to personally invite you to share your recent VA experience with us. We estimate this survey will take less than a minute. Make sure to submit your feedback to us by May 13, 2019.
    Think about your most recent experience with all the services by the Department of Veterans Affairs (which include healthcare, benefits programs, or memorial services).

    Please tell us how you feel about the following statement:

    I trust VA to fulfill our country’s commitment to Veterans.

    I know this sounds crazy but I haven’t been to the VA for an appt since February 1 so why would they randomly decide to send me a survey today (just now) about my opinion on the VA. This was just the first question on the survey.

    Anybody else getting any surveys like this from the VA in your email?

    1. @ Old gator,

      Yeah, like Lem, I get those after any in-person visit. Remember when you were in the service, and two months was only a long time of it was you reporting to command, not command reporting to you?

      Same thing. To the VA, you were just there.

      I gave up filling them out, but some people stick it out (like Lem).

  14. If they can organize a women’s march on Washington. Surely we can organize a BIGGER & BETTER veterans march (as you suggest Frank), to the White House, Congress & Senate. My Vietnam vet hubby & I are retired but ready to MARCH. Just say when!

  15. What we veterans need to do is have a march to the White House, Congress, and the Senate.

  16. Ethics and Integrity among Gangland criminals? These guys are out banging Veterans everyday.

    It’s easier to put lipstick on a pig. I support the Boycott Idea.

    Get the FOIA ready, Ben…

  17. @junior2/5 remember when all those high school kids walked out of class at precisely the same time one day to protest gun laws or something ?Well maybe we could organize a national boycott where veterans showed up at VA hospitals and held a boycott of our own? I’ve never been to a protest in my entire life so I don’t have a clue as to how to go about something like this. Any ideas?

  18. If it comes from behind the closed doors of the socialist VA it probably does reek of smelly fish. Those behind those closed doors surly must be nose blind. If the VHA was boycotted do you think something might happen…?

    1. VA would jump for joy. Veterans would be gone. But, what they wouldn’t jump for joy for would be if President Trump stripped the VA of their funds in preparation to transition medical care to be managed differently. Free market options. Say similar to auto insurance policies. After all, the auto insurance policies handle uninsured motorists and medical benefits already anyway. They could expand.These could be options for people who do not have medical care insurance supplied by their employers or for people who are in between jobs or for those waiting for disability decisions or for people who may could come off disability should they have come out the other side enough to be retrained for re-entry into the workforce. Best.

      1. Ben, though, I may not be correct. VA Secretary Robert Wilkie really maybe sincere. I am serious. There are happenings leading me to give them the benefit of the doubt. Ben, only time will reveal the truth. TIME reveals all. Best

  19. Sounds like some more VA fake news to me! Or should I say false advertising! That money spent could’ve been spent on better health care for veterans rather than a new ethics CAMPAIGN to make the VA look proactive, when that’s the last thing they are. Ben hit the nail on the head -it’s nothing but a red herring to distract us from the real issue of “poor health care for veterans”…

  20. As you ask Ben, the VA already has ICARE, so why the need for a new Code?
    Long before that the VA had a Veterans Bill of Rights. Why the need for ICARE or a Code unless that too was a failure.
    In fact, I am sure any medical provider in the VA also had some kind of ethics training as a part of their medical training, so why the need for the continued propaganda?

    Does providing this new code suggest all VA employees will suddenly discover they have integrity? Does this mean the VA will suddenly cease every instance of multiple VA employees from intentionally screwing veterans?

    Does this suggest VA employees had no idea what integrity was?

    Imagine the risk millions of veterans took by seeking treatment from VA staff who had no integrity prior to this code being published.

    This is like having to tell a bank teller they should be sure their work is accurate and that they shouldn’t be stuffing Benjamin’s in their pants.

  21. Hey boss does this apply to us ! Management : don’t pay any attention to the Man behind the screen !

    It’s all smoke and mirrors, they said they are doing this just for show. Just keep doing what you been doing.

    This will blow over and no one will be able to do anything about it. What they going to do, to inforce it. Not a dam thing.

    Don’t pay attention to anything being told to you. All you have to do is what I say and if you don’t. Guess what (no) bonus for you.

    You know they make new regulations and laws and they do not mean anything. Just another piece of paper.

    Hell, have you ever, seen anyone held accountable. Of course not. Don’t worry no one and I mean no one is going to tell us how to do our job.

    We, have attorneys to ensure they will find a loop hole. And if by chance someone tells us, that someone has to be held accountable.

    Guess what you just Won a free paid vacation. Don’t worry nephew ! I got your back.

    Those people are so stupid thinking they have any power over us. They can’t press charges against you anyway.

    We, are immune from prosecution !

    Hey are we still going to play Hungry Hippo ! Of course ! Hell, take an hour and a half for break.

    And take tomorrow off. But I don’t have any leave ! No problem, I cover up for you.

    Hey boss, am I going to receive a yearly bonus ?. Of course, that’s automatic. Did you harm any veterans ?.

    Ya, I falsely accused a couple of them of Dis Behavior. You should have seen the look on their dumb ass faces, when they came in and the va police told them they have to be escorted everywhere they go while on va property.

    Well, good for you, for showing those veterans who’s in charge.

    Really, until employees and I mean all employees are held accountable through our justice department.

    Nothing will ever be done. Same old stuff.

    Who or how are they going to enforce any of this. Just ignore and everything will just blow over.

    What about the committee on veterans affairs. Won’t they demand accountability ?.

    No !!!!!!!

  22. Let’s see: Advocacy, that means destroy documents, don’t enter etiology, ignore service connected evidence in favor of trying to pin it on non service incidents, etc.

    And keep a patient on Tegretol for 5 months of complaining that it is making the symptoms worse. Ignore the PDR statement that it is not to be used for the type of seizures you diagnosed. And if you are a later physician support the previous physician’s handling of the patient.

    Advocate for reducing costs by “Delay, Deny, Wait Until They Die”

  23. @jack civilian care is not the answer, making the va perform is the answer. If I care didn’t work, then try this code, if that don’t work then try something else, but, with people like Ben pushing for answers, maybe we’ll get the system we deserve.

    Civilian care? For the 2nd time I was referred to tri-west for a ophthalmology condition where I couldn’t get a va appointment for 3 months. Tri-west made the appointment right at 29 days (less than 30!!). The dr’s office they sent me too was a pig pen. Dirty flloors, boxes stacked in examining rooms, fluorescent ceiling lights that didn’t work, eye instruments that were dirty, examiners who didn’t follow basic sanitary protocols, employees (3) having a personal conversation with the examiner while she was giving me a vision test. I finally said “enough” when she wanted to dilate my eyes w/o washing her hands or putting on gloves.
    I complained to tri-west, they sent me to another that was just as bad. I guess for what the VA pays, only the bottom of the barrel docs participate.

    If the va goes private , that’s what your medical care will look like!! Make the VA do it’s intended job is the answer.

    1. Yes, #29 the VA should not be left off the hook. The answer is to put the VA thru the grind like they have put everyone else thru to include their own employees who wound up leaving the VA because they did not like how the VA was doing business. The answer is not to run. If one does leave, the time is spent building cases or positions to return at later dates to stand up to them to do what is right and ethical.

  24. Yes, I CARE. That is why I’m kicking you out of therapy to commit suicide because I believe you are costing the VA Medical Division too much and that tags on my bonus. If you cost too much my bonus goes down.

    What is needed is to change the bonus program to a health based program instead of a cost based program. If productivity on health care is monitored for bonuses the costs will take care of themselves.

    Mental Health therapists are under pressure to give an “end date” for completion of therapy. Get and look at your health record.

    I have a consult in for the Chief of Psychiatry for the Black Hills VA Medical Facilities but I don’t know if it will do any good. Haven’t received an appointment yet.

    1. Lem, OMG I just met with the director of the mental health clinic at my VA 2weeks ago and he told me that my bipolar disorder would be treated and “my treatment completed in three months”. I’ve been going to this VA for 13 years. They tried to switch me to a diagnosis of ADHD last fall and put me on a stimulant which almost landed me in the psych ward because you don’t put bipolars on stimulants, It makes you CRAZY manic. Any first-year med school student would know this so maybe they were trying to drive me to suicide who knows. When I called my doctor he just said go to the emergency room which would’ve been a direct trip to the psych ward and I won’t even tell you what the horrors of the psych ward at this VA hospital are like. I think they hired correction officers not nurses or doctors to work there. Anyway I took myself off the stimulant medication (probably saved my own life) and I’m seeing my psychiatrist tomorrow. And I want answers because all the director would say is ask your psychiatrist what your diagnosis is. I am wondering how my bipolar of Several decades has suddenly changed into “?????” Whatever it is that I now have —-it can be cured in three months. Tell this to my spouse that knows I get 2-3 hours of sleep a night and they might beg to disagree. My spouse is taking off work and coming with me to the doctors appointment tomorrow. I literally feel like I’m being pushed out of the mental health clinic. Have bipolar disorder (as well as folks that have schizophrenia and whatever other kind of mental illnesses) will now suddenly become cured after a mere three months of magic VA mental health treatment nowadays. I thought those were lifelong illnesses that required care and proper medication management. At least according to the civilian doctors that I had seen in the prior decade and a half before coming to the VA 13 years ago. I was never expecting dismissal from the VA because your Treatment was completed or because they had now come up with some sort of Sham diagnosis that could explain how they could dismiss you as being cured and no longer needing to use the mental health clinic. Oh and I should also mention that this follows on the heels of me no longer having to pay co-pays for my psych meds and my psychiatrist visits because of confirmed MST. Now I don’t get any SC benefits from it but they were obligated to provide psych care for the issue and suddenly they don’t want to treat me for my bipolar anymore interesting timing. And my psychiatrist was forced to resign after reporting the MST and certifying the situation. She wasn’t “fired”. Just forced to resign.

      1. They don’t seem to understand that organic brain syndromes can only be managed not cured. They don’t expect to cure type I diabetes in 3 months, only manage it. as you da WTF

    2. Lem, good luck with the current Black Hills VA system. I always felt lucky to live here, because of the care here. That’s all changed since October!! Just don’t get cancer, one they would rather not tell you, don’t send info out to local provider until day before major surgery, thank God they put a stop on things. Finally a biopsy and saw Dr , oncology, in December, no problems, very small. Sent to local surgeon, take out the whole love, the other spots are metastatic, so palliative care and you have six months to a year. Luckily had a friend with me as witness.. Asked immediately for second opinion, no, you have one already, could I get reference to another VA with more cancer treatment abilities, no. Would you refer me to Denver or Mayo, no. Maybe Minneapolis, they will let me pay my way, but they will do the same thing, surgeon on Tuesday, lobe out Thursday. I want a second opinion, no, no, no all the way up the chain, even Congressional, no answer there. That’s as simple as I can explain it the whole situation, it was/is much more complicated and add in my mental health, well… Bottom line, took my life to Mayo, VATS surgery, home and doing fine on that front. Get too upset to continue right now..

    3. @Lem,

      You are singing my song, brother. The bonus system that exists for supervisory and clinic management level personnel is in direct conflict with providing care, and that is ONE of the most divisive elements of the VA-Veteran relationship.

  25. ?Should be called I don’t care an code of misconduct! Fix the VA or give us civilian health care. When will this substandard healthcare end.

    1. Jack, civilian care is not that much better because the government is involved there to. The difference is private sector physicians can be held accountable for medical errors much quicker with using the civilian court system. American citizens as in the ones who realize this have to even research their physicians in the private sector as well to find credible physicians. Not all private sector physicians are credible. Physicians practicing without license in private sector too. Recent case in South Florida, a physician had been practicing without a license for a good twenty years. Been charged or indicted. I forget which but it was brought to the surface earlier this year. More flexibility in private sector though. Best.

  26. I am surprised that nothing has been said in any veterans blogs about the care provided at the VA/Navy hospital in North Chicago, Illinois. This hospital provides care for the Great Lakes Naval Base and for veterans. In the past six months, there have been two deaths of seaman recruits. The problem has been that the hospital has not been able to provide immediate care for the recruits when they “went down”. The recruits were transferred to a private hospital where they unfortunately passed. Notwithstanding, if the Naval/VA hospital was properly staffed, trained, and funded, such a transfer would not have been necessary. This raises the question of whether the hospital/medical center is sufficient to provide care for veterans even in non-emergency situations.

  27. Problem is, there are too many “little dynasty’s” out there. Being run by “little corporals”, who believe they can do whatever they want. When, and IF, those cancers are removed, the VHA would run much smoother.
    IF these crooked administrators were fired, that would be one way to solve some of the problems.
    IF the physicians were to be in charge of healthcare, instead of the administration, that would be another way of solving some of the problems.
    IF the VA were to hire great healthcare providers, instead of deadbeats and criminals, that would be another way of solving some of the problems.
    IF the top echelon of the VA were to listen to the Veterans concerns, instead of the rank and file incompetent employees, that might take care of some of the problems.

    There’s numerous problems which could easily be fixed IF the the VA’s leadership wanted to fix it. Problem is, in my opinion, “fixing it” would take monies out of their pockets! They’re receiving $220 BILLION TAXPAYERS DOLLARS. They DON’T even want to screw that up!

    1. Well…there it is.

      I don’t know that it’s fair to claim the entire budget as their swag—most of them are just smacking tens of thousands, and only the Directors and the Big Boss are getting millions. Still, there is a point that they actually have a decent budget, if it wasn’t all going to the wrong places—including their pockets.

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