Panel weighs closing all VA health care — vets' groups raise conflict of interest

[nitpicker]

http://www.militarytimes.com/story/veterans/2016/04/01/panel-weighs-closing-all-va-health-care-vets-groups-raise-conflict-interest/82522000/

Panel weighs closing all VA health care — vets' groups raise conflict of interest

Patricia Kime, Military Times 4:38 p.m. EDT April 1, 2016

A blue-ribbon panel created to evaluate the Veterans Affairs health system is weighing a radical proposal to eliminate all VA medical centers and outpatient facilities in the next 20 years and transition 9 million veterans to the private sector for health care.

A 34-page “strawman document" floated last week by seven of 15 members of the VA Commission on Care calls for giving all veterans immediate access to private health services and closing VA health facilities gradually, starting with those that are obsolete or underutilized in a process similar to a base realignment and closure. VA eventually would become “primarily a payer,” much like Medicare, under the proposal.
(snip)

Commissioner David Blom, president and CEO of the OhioHealth system, is credited as author of the report, with input from the six other members. Blom wrote that the health care needs of veterans are not being met under the current system and that the goal is to "meet the needs of every veteran." “The commission finds the current VA health care system is seriously broken, and because of the breadth and depth of the shortfalls, there is no efficient path to repair it,” Blom and other commission members wrote in the report, created as part of an overall effort to explore VA health reform options.

Under the proposal, veterans would be able to receive care at any provider that accepts VA payments or Medicare. Doctors would be reimbursed at rates 5 percent to 10 percent higher than Medicare rates to encourage them to participate.

The proposal, introduced at the commission’s March meeting, earned immediate condemnation from some veterans organizations as well as VA officials, who say the VA health system performs significantly better on outpatient measures than civilian, Medicare and Medicaid health maintenance organizations.

Eight veterans organizations — including Disabled American Veterans, American Legion, Veterans of Foreign Wars, Vietnam Veterans of America and Iraq and Afghanistan Veterans of America — sent a letter Thursday to Commission Chairwoman Nancy Schlichting denouncing the document.
(snip)

[Ilsa]

1. I'm conflicted over this proposal.

I think that VA facilities should be properly funded so needs of all vets can be met. But the problem is also access for a lot of vets that live in more rural areas or just not in large cities with VA hospitals and clinics, or near military bases.

If a vet could get coverage and see his or her local doctor/specialist with no out of pocket costs, it might be worth it.

[TreasonousBastard]

4. I suspect these guys have an agenda, but ideally...

while we now have Medicare, Medicaid, the VA, the Indian Health Centers, SCHIP, and a whole motley crew of other Federal health plans, it would make sense to merge them into one overall plan.

Fat chance of that, though.

[marble falls]

5. There's more to it than costs: Veterans have issue that are best treated arround vets and by vets...

The VA has around an 85% satisfaction rating, one of the highest in the nation for health care systems.

I love my VA treatment and my Muslim woman primary care physician has saved my life. I can actually get my surgeon on the phone and my treatment is more aggressive and timely than my "Cadillac" plan ever was before the Bush economy blew my personal economy out. Thank G*d for my socialistic health care - the VA! I do not want to part of any profit driven system, especially Ohio's Blue Cross/Blue Shield. which I have had the honor of over paying for and being under served by.

Ilsa, its a shame non veterans can't get an honest look at the really good job it does for 90% of us. And the sad truth is civilian health care systems are significantly worse at dealing with those brothers and sisters who aren't able to deal with what it takes to make the VA work so well. There are a lot better facilities dealing with mental health, agent orange issues, PTSD, homelessness in VA than there is in the real world. VA and veteran groups provide all sorts of programs to get vets to treatment and even pays me mileage for the 100 or so miles I drive to Temple and the 60 or so I drive to Austin for primary care.

Va follows up on me regularly and I am supremely satisfied with it.

[The River]

8. Well Said, Thank You

I feel exactly the same way about the VA. They have provided me with excellent care
since I enrolled 5 years ago. What other hospital system sets up dedicated teams to handle individual primary care or has a web system to contact care givers or re-order prescriptions? What other hospital system is prepared to handle agent orange, TBI's, PTSD and prosthetic limbs like the VA? Short answer: not one!
I've used some world class civilian hospitals before enrolling in the VA system and not a one
of them measured up to the VA care I've gotten.
Those who complain about the VA either have a right wing agenda or are just too simple minded to comprehend what good service is.

The VA does such a good job that I try to "give back" by doing volunteer work for a community based Vet Center in my area.

[marble falls]

11. I am glad that non vets are outraged at the treatment of Vets, I only wish they'd get to see ....

real conditions with VA over all, they'd be surprised.

Have you noticed over the last three or four years how Fox has almost completely disappeared from VA tv's?

[yellowrose45]

15. standing with survivors of Veterans Hospital sexual assault. #doctoredabuse

#UniteAgainstRape UniteWomen.org stands with survivors of Military sexual assault.

Julia Perry's story: "I stand in solidarity with military sex abuse survivors, because I was a proud Sailor, until my pelvis was fractured & didn't heal. I was medically discharged, still needing lots of care for the chronic pain. The Department of Veterans Affairs put a physician on my case who was a liar and sexual predator. He convinced me to undergo unapproved treatment, no nurse present, and I was raped. Continuous patient exploitation pushed me to run out of the state to re-start my life. He located me again and stalked me for months, even taking time off from medical duties & being on medical school clinical faculty to fly out and say to me, "I have done you a grave disservice." Mainly he tried to see if I remembered all I'd been through. Yeah, I do.

There is such a thing as an “Iatrogenic Illness,” which is one resulting from the activity of a health care provider or institution; said of any adverse condition in a patient resulting from treatment by a physician or allied health professional. You know Uncle Sam will not let that term be associated with my life.

Twenty-nine years later, my disability claim JUST got me entitled to appear for a VA evaluation for PTSD and a week later, I received a landmark award, in principle, for benefits. I won a claim under Sec. 1151, Title 38, U.S.C., which is for an injury or illness occurring as a result of VA treatment. However, to retaliate against me, the VA made my "effective date" 22 years later than the 1992 claim documents--I only got retroactive benefits from Jan. 27, 2014 to Mar. 31, 2014. The psychologist PTSD evaluator specifically wrote: "Veteran reported sexual trauma to multiple VAMC providers, but a timely diagnosis and treatment is not evident, the result being that the disability (PTSD) continued to progress.” The Veterans Benefits Administration threw that into “file 13.”

The monetary recovery is a pittance because of the chicanery of ignoring when I filed the claim or when my medical record took notice of it, and substituting the date I wrote a letter asking President Obama not to just look at campus assaults, but those by medical professionals, too. This sick physician had a track record; I got his state license to practice suspended; another violation while he was on probation, for what he did to me, got him turned in by a co-worker, and made his license get revoked for life. In the documents, a matter of public record by Texas State Board of Medical Examiners, the Agreed Order says, "violated the boundaries of the doctor-patient relationship, therefore his conduct constitutes unprofessional and dishonorable conduct that deceived, defrauded and/or injured J.P. and constitutes a deviation from the acceptable standard of care."

You all should know military and veterans facility doctors do not have to carry malpractice coverage The VA won't do anything about it, they're incensed I even expected them to investigate. Congresspersons haven't been able to bring any attention to this plight, either. There are doctors who rape, it's too awful for people to think about. My mother told me I "had better just see to it that it stays out of the newspaper, so don't have to be embarrassed in front of my friends." Veterans (after service) assaulted in VA care need as much a safety net (powerful media presence, legislation, pro bono assistance with taking a legal stand, admission to VA inpatient MST programs, etc.) as those still in uniform."


A VA doctor raped, exploited and stalked me. He admits he did me a grave disservice. Public record in TX: "Deceived, defrauded and/or injured." "Deviation from the acceptable standard of care." Veterans assaulted in VA care need as much of a safety net as those still in uniform.

https://www.facebook.com/UniteWomen/photos/pb.302448176483395.-2207520000.1460227877./940607899334083/?type=3&theater

[Ilsa]

13. I believe every word of what you say.

But I'm concerned about those vets who have difficulty getting to a VA clinic at all. Usually, my cousin needs to take several days off work to drive several hours, stay overnight with relatives or in a hotel, then go in early for fasting labwork, etc. Then drive back home, then take a another day a week or so later to see his dr.

The good part (in addition to your list) also includes their putting him into a special group to receive extra benefits he might be entitled to later if he develops certain illnesses because of where he was stationed. I can't imagine a typical social worker being able to keep up with that. He's had no complaints about his care. It just isn't a quick trip to his local doctor, and it is too far away for emergency care. He got stung pretty hard financially many years ago when he was uninsured and needed emergency care.

Perhaps the best of both worlds would be to offer a medicare-type plan to vets living more than a given number of miles from a comprehensive VA center?

I'm really glad, and proud, that the VA has done tight by you and so many others!

[1939]

2. As long as i can get service from doctorss/hospitals

and the VA pays fr it, they can tear down the VA medical system which has turned into a massive jobs program in which the maintenance of the institution is far more important than providing care.

[marble falls]

6. I so disagree with you on that. VA is too busy to be a "jobs" program. Do you use VA?

[1939]

7. Been there twice and not going back.

The providers are OK, but the large number of clerks and jerks there make it intolerable. It is crowded, but the poor guys being mistreated there do not have other options. I have Medicare with Tricare For Life picking up all the co-pays and deductibles and therefore have the option to ignore VA.

[denbot]

9. I've been getting my care at the West L.A. VA for many years.

The staff is pretty good, and my care is excellent. If you see everyone other then the providers as "clerks & jerks" maybe your expectations are coloring your perceptions?

[marble falls]

10. I just don't have the trouble you have. When I got out I worked at VA in'73 ...

it was a snake pit.

Its certainly not now, not in Temple or Austin,TX.

I look at VA as keeping me from having to do ACA or Medicare.

I'm planning to move to Oregon and Oregon's VA facilities are highly rated. Ironically, the hospital I worked at is now named the Luis B. Stokes Veteran Hospital and is poorly rated.

I have tons of stories about Brecksville VA and Wade Park VA from back in the day that could curl hair.

[TreasonousBastard]

3. I got a notice of a plan to...

expand VA care to any acceptable facility if we didn't live within 35 miles or so of a VA facility.

As it is, we have satellite outpatient centers, but they do less than half of what the main centers do. I get podiatry, bloodwork, and a couple of other things, but I still have to go to the main center for most of my care.

[marble falls]

12. Maybe if we re-opened a bunch of the facilities W shut down, restore funds Teapublicans take ....

out of VA budgets?

[Victor_c3]

14. I would be completely and totally lost without the VA

I'm rated at 100% P&T for PTSD and I've been in and out of all sorts of facilities over the last couple of years. There is a night and day difference between the civilian psychiatric hospitals I've been in and the VA psychiatric hospitals. The VA is so much better funded, the facilities are so superior, the staff is less stressed and better at dealing with the peculiarities of individual patients.

I visit my local VA 4-5 days a week. I have scheduled groups and appointments many of those days, but not all. I hate being home on the weekends (don't get me wrong, I love my wife and kids) I just don't feel at ease when I'm not around other vets or military people. When I'm not in an appointment, I'm usually off playing the piano somewhere in one of the various lobbies. The VA is more like a home to me than my actual home is. Its the only place in a crowded setting that I actually can let my guard down and the only place I feel where I actually belong and I'm not constantly on patrol. I can sit down and start talking with anyone at the VA and have an instant friend. I can't do that in the civilian world. Civilians just look at me like I'm a dangerous over/under medicated freak.

For the most part I hate the civilian world and I have no idea what I'd do without the VA.