Category Archives: Dept. of Veterans Affairs

Seattle VA hospital strands veteran outside ER

Donald Siefken is a 64-year-old Army veteran from Kennewick. Earlier this year he showed up at the Seattle VA Hospital, but couldn't get its staff to help him inside and had to call 911.

Donald Siefken is a 64-year-old Army veteran from Kennewick. Earlier this year he showed up at the Seattle VA Hospital, but couldn’t get its staff to help him inside and had to call 911. Seattle Times Photo

Seattle Times: When Donald Siefken drove up to the Seattle VA hospital emergency room earlier this year with a broken foot, all he asked for was a little help getting inside. Instead, a hospital employee who answered Siefken’s cellphone call told him to call 911 himself, then hung up on him, Siefken said.
Frustrated to tears, the 64-year-old retired truck driver and Army vet from Kennewick placed the emergency call while parked just feet away from the ER entrance. “They won’t come out and get me, do you believe that?” Siefken asked an emergency dispatcher, his voice wavering. “They told me to call 911 and hung up on me.”
In response to inquiries about Siefken’s case, a VA spokesman initially told The Seattle Times the hospital’s response was appropriate. “I know it sounds counterintuitive because someone is just 10 feet away, but it is our policy to do that,” said Chad Hutson, spokesman for the Veteran Affairs Puget Sound Health Care System. “Our policy is no different than Harborview or Swedish or other hospitals in Washington.”
common sense
But that’s not the case. And, after a reporter requested Siefken’s medical file and other records, the hospital changed its story, issuing a written statement earlier this month.
“After a complete review regarding this Veteran’s visit to the VA Puget Sound Seattle campus emergency room, we have determined we did not do the right thing to ensure the Veteran had assistance into the emergency room,” the statement said. It added that ER personnel “should have called the appropriate staff to come and assist the patient, ensuring he made it into the emergency room safely.” The hospital now plans “corrective actions to ensure this does not happen again to one of our Veterans,” the statement said.
On Tuesday, Dr. William Campbell, the hospital’s chief of staff, also met with Siefken to apologize. “He first called me on Friday, and he was all over himself apologizing,” Siefken said, before Tuesday’s meeting. Citing privacy concerns, the VA declined The Times’ request to observe Siefken’s meeting with Campbell.
“Just wouldn’t listen”
Siefken’s odyssey to a formal apology began on the afternoon of Feb. 27.
While getting ready to drive his wife from their Kennewick home to catch a red-eye flight at Seattle-Tacoma International Airport, Siefken “stepped down funny and heard a snap,” he said. During the long drive, his foot started to swell and hurt. “So I dropped my wife off at the airport, and headed right up to the VA.” By the time Siefken arrived, shortly after 3:30 a.m., his foot had swollen to the “size of a football” and was throbbing with pain, he said.
Siefken parked outside the ER on the ambulance roundabout and, because he couldn’t walk, called the front desk for help. The worker who answered “couldn’t for the life of him understand why someone from Kennewick was trying to get treated in Seattle,” Siefken said. “I tried and tried to explain it to him, but he just wouldn’t listen.” After an argument, Siefken said, the employee told him, “ ‘No, we’re not going to come get you. You’re going to have to call 911 and you’ll have to pay for that.’ ”
Siefken dialed 911 at about 3:40 a.m., records show. “They won’t come out and get me in a wheelchair,” he told a dispatcher. “How far away from the building are you?” she asked. “Well, I’m right by the ambulance entrance,” he said.
By 3:47 a.m., a Seattle fire captain and three firefighters manning Engine Company 30 arrived to wheel Siefken into the ER. Staff members examined him, took X-rays, put a boot on his foot and prescribed Hydrocodone for his pain.
Siefken, who declined to take the medication for fear he’d be unsafe to drive, drove back home to Kennewick after the hospital wouldn’t put him up for the night. He arrived four hours later, took a painkiller and crawled into bed.
When The Times asked about the case, Hutson initially said the hospital’s policy — like all other VA and private hospitals — was to call 911 to summon emergency medical responders to handle such a situation. “It has to do with liability and to make sure, like in this case, that the right personnel are there to safely extract the person from the vehicle,” Hutson said. (Hospital personnel aren’t the “right personnel” to safely move a patient?)
He added that the VA employee who talked to Siefken had asked, “ ‘Can you call 911?’ And he said, ‘yes.’ This was not an emergency situation, so we didn’t need to make the call for him.”
But that’s not how it happened, Siefken said. “My pain level was a 10 on a scale of 10,” he said, “and they just hung up on me.”
At least one other hospital and the Washington State Hospital Association noted hospital policies for such situations can vary.
“If we have a person that comes up our ambulance ramp in their personal vehicle and can’t make it in, we will transfer them into the emergency department,” said Susan Gregg, spokeswoman for Harborview Medical Center.
Against federal law
A federal law called the Emergency Medical Treatment and Labor Act (EMTALA) generally requires most hospitals to conduct a medical screening of anyone who shows up seeking emergency treatment. The law’s so-called “250-yard rule” clarifies that hospitals have an “affirmative obligation” to treat patients — whether they make it inside an ER or not — when they arrive on a hospital campus.
“If you are close to the emergency department, they should basically come up and wheel you into the hospital,” said Barbara Tomar, federal affairs director for the Washington, D.C.-based American College of Emergency Physicians.
EMTALA applies primarily to hospitals that accept Medicare and Medicaid patients. The law doesn’t technically apply to VA hospitals, but the VA voluntarily complies with its policies to provide emergency care “to individual patients presenting to the Emergency Department,” the agency’s Emergency Medicine Handbook shows.
Yet, even in its written statement conceding it mishandled the case, Seattle’s VA hospital noted it does not consider Siefken’s situation an emergency. “Policies used to make the recommendation to call 911 for assistance, at the time of the emergency room visit, did not apply to this particular situation due to the non­emergent needs of the Veteran,” the statement said.
Tomar, whose organization represents 33,000 trained emergency doctors, said a broken foot can pose complications and is widely considered an injury that warrants emergency care subject to the federal law.
On Tuesday, while waiting to meet the hospital’s chief of staff, Siefken said his foot has not fully healed. “They said they’re sorry and they’re going to change things so this doesn’t happen again,” Siefken added. “That’s all I really wanted.”
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VA claims living veteran is dead, sends burial check, cuts benefits

tired soldier
Fox News: A North Carolina veteran very much alive is fighting for his life following a clerical error that resulted in his family getting a document from the departments of Veterans Affairs and Defense stating he had died.
The notices, along with the government’s condolences, came with two checks to help pay for burial costs for Robert Pressley — but because the system now says Pressley is deceased, his benefits reportedly have been terminated.
Pressley, who supports a small family and is unable to work due to combat-related injuries, cannot afford to lose his benefits, he told WECT-TV.
To prove that I am alive is just insane and it scares me to death,” he said. “That at a touch of a button or because of someone’s clerical error my whole life can be taken away from me and it is.”
Pressley also claims duplicate letters were sent to his ex-wife, even though he told the VA multiple times he was divorced and has since remarried. “I mean, what do I do?” Pressley asked, according WECT-TV. “I am not getting any answers, I am not getting any help. I am scared.”
Complicating matters is the practice of the Social Security Administration, which does not verify the death reports it receives from multiple sources, including state vital records agencies and seven federal agencies. The VA, the Internal Revenue Service and the Pension Benefit Guaranty Corporation are among the agencies that report deaths to the SSA.
According to a March GAO report, errors forced the SSA to delete nearly 8,200 deaths from its death data between February 2012 and January 2013. Though it’s difficult to determine exactly how many incorrect death notices have been sent via the VA, Pressley’s case does not seem to be unique.
In January, disabled Army veteran James Fales received a similar letter. In it, the VA extended its “deepest sympathy” to his wife Dorothea Fales.
James Fales, who, like Pressley, opened the letter himself, told KFSM –TV, “When you’re pronounced dead, and you are the one opening the letter, it isn’t really a bad thing.”
Fales, a retired sergeant, receives treatment for post-traumatic stress disorder and an ankle injury at the Veterans Health Care System of the Ozarks in Arkansas.  His condolence letter was dated Jan. 8, 2015, but Fales said he got a call from the VA hospital seven days later asking for a follow-up doctor’s appointment.
In Fales’ case, the VA in Arkansas apologized for the error and issued a public statement to veterans that the agency was working on fixing the mistake.
The VA told it is trying to determine what happened in Pressley’s case and correct the error. “(The VA) is committed to providing all eligible veterans, service members and survivors with their earned care and benefits,” Randy Noller, a spokesman for the VA, told “VA also takes seriously its obligation to properly safeguard any personal information within our possession. Without a privacy waiver from the veteran, we are very restricted by privacy laws and policies in what we can provide at this time.”
For a glimpse of the VA’s “commitment”, see also:


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VA Official Paid $288K In ‘Relocation Payments’ To Move 140 Miles

DailyCaller: The director of the Philadelphia VA regional benefits office was paid $288,000 in “relocation payments” to move the 140 miles from Washington, D.C. to her new home last year.
Diana Rubens was tapped last June to take over the Philadelphia regional benefits office, which is one of many VA hospitals and benefits offices currently being investigated over benefits claims.
Rubens, who previously served as the D.C.-based deputy undersecretary for field operations, where she oversaw 57 regional offices, was brought in to help fix the embattled Philadelphia facility.
A breakdown of Rubens’ “relocation payments” was not immediately available, according to the Philadelphia Inquirer, but a VA spokesman said that there was nothing inappropriate with the spending.
Federal regulations allow for the reimbursement of relocation expenses including the “costs of house-hunting, moving, terminating leases, and a per-diem rate for meals and temporary housing for an employee and his or her family,” the spokesman said.
But that hefty repayment is nearly 160 percent of what Rubens earned in base pay all of last year, raising questions over what exactly that money could have gone towards. Rubens was paid more than $181,000 in 2014, according to the website, which maintains a database of federal employee compensation.
“The government shouldn’t be in the business of doling out hundreds of thousands in cash to extremely well-compensated executives just to move less than three hours down the road,” Florida Rep. Jeff Miller, the chairman of the House Committee on Veterans’ Affairs, told the Inquirer.
“For VA to pay such an outrageous amount in relocation expenses at a time when the department is continually telling Congress and taxpayers it needs more money raises questions about VA’s commitment to fiscal responsibility, transparency and true reform.”
Rubens has been mentioned before in articles criticizing other money she’s been paid by the VA. According to the Center for Investigative Reporting, in 2011, she received a bonus of more than $23,000 even though patient backlogs — one area Rubens was in charge of managing — increased by 300,000.
The Washington Examiner reported last year that Rubens received more than $97,000 in bonuses between 2007 and 2011 even though the average time to process veterans’ claims doubled to 325 days on her watch. The ratio of backlogged cases nearly doubled as well, from 37 percent in 2009 to 71 percent in 2013.
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Obama's War on Veterans

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VA wants personal information in exchange for free gun locks

here to help you
Fox News: The Veterans Administration is offering free gun locks to former military members — but wants some key personal information in exchange.
Veterans have received forms recently from the VA with an enticing offer of up to four gun locks. The only catch…they need to return a completed form listing their name, address and the number of guns in the home, according to the Washington Times.
“Dear Veteran, a letter sent from the VA’s Philadelphia office reads, “As your partner in health care, we are committed to keeping you and your family safe. If you own a gun, we hope you will request and use a gun lock. As a Veteran, you already know about the importance of firearm safety.”
The Washington Times spoke with one veteran who received the letter and called it “a gun registry in disguise.”
“Young soldiers are already notoriously reluctant to admit any problems with post-traumatic stress disorder,” the veteran, speaking on condition of anonymity, told the paper. “Imagine the effect if the average 23-year-old private … back from Iraq, already reluctant to ask for help … is now hearing rumors that if he seeks help from the VA for sleeplessness, PTSD, nightmares, etc., Big Brother is going take his guns away? Now young veterans will really avoid asking for help.
According to reports, officials for the VA hospital in Philadelphia have been instructed by the administration not to keep on file any information about veterans who own guns.

You know you're laughing.

You know you’re laughing.

“They have been instructed to offer these gun locks to veterans and family members and to keep no gun registries or other information related to the gun lock distribution,” a spokesperson told The Blaze.
It’s not clear if the directive is a part of any written policy at the VA.
“The NRA is opposed to any and all forms of a gun registry,” NRA spokeswoman Jennifer Baker told “The VA initiative raises concerns because veterans are not offered any written assurances that the information they provide the government regarding their firearms will not be kept on file and used for other purposes.”
The gun locks are distributed under a program started under the Bush Administration in 2008 that was modeled after a similar program called Project ChildSafe. The VA has been distributing the gun locks for the past seven years, but it was not immediately clear if the forms are a recent change in protocol.
According to a 2013 report, it is estimated that 22 veterans take their own lives with a gun every day. The program was started with the hopes of lowering that high suicide rate.
The VA has been distributing the locks in a program with local police departments and a firearms trade group.

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$1+ trillion Congress spending bill keeps Obamacare & funds Obama's invasion of illegals

Late Tuesday, just one month one week after voters handed the Republican Party majority control of both the House and the Senate, Congressional leaders unveiled a massive $1.01 trillion spending bill to keep most of the federal government funded through September 2015.
Instead of defunding or repealing Obamacare, the bill maintains the status quo on Obamacare. It also enables Obama’s amnesty by funding the consequences of Obama’s “border surge.” 
Below are some of the highlights of the spending bill as summarized by Ed O’Keefe for The Washington Post, Dec. 10, 2014. I’ve categorized the bill’s items into two groups:

  • What’s wrong about the bill
  • What’s right about the bill

What’s wrong about the spending bill

1. enable obama’s reckless invasion of illegals

Although the bill funds the Department of Homeland Security (DHS) that oversees most immigration policy only until February, the bill also provides new money for immigration programs at other federal agencies, including:

  • $948 million for the Department of Health and Human Service’s (HHS) unaccompanied children program — an $80 million increase — to provide health and education services to illegal young aliens.
  • $14 million to help school districts absorb new illegal immigrant students.
  • $260 million to the State Department to assist Central American countries from which the illegal immigrant children are coming.

2. keep, instead of defund, Obamacare

The spending bill adopts a passive-aggressive approach to the Affordable Care Act, aka Obamacare:

  • The bill still funds Obamacare.
  • But no new money will be provided for Obamacare, specifically, no new Obamacare-related funding for the Internal Revenue Service and the Centers for Medicare and Medicaid Services, the two agencies most responsible for implementing the law.
  • The budget of the Independent Payment Advisory Board, aka the “death panel,” will be reduced by $10 million.

3. enable big money Campaign donation

The bill would greatly expand the amount of money — 10 times the current amount — that wealthy political donors could inject into the national parties, thereby drastically undercutting the 2002 McCain-Feingold campaign finance overhaul. To illustrate, a donor who gave the maximum $32,400 this year to the Democratic National Committee or Republican National Committee would be able to donate another $291,600 on top of that to the party’s additional arms — a total of $324,000, ten times the current limit. Read more on this here.

What’s right about the bill

1. Abortion

  • The bill once again bans using federal funding to perform most abortions.
  • Blocks the use of local and federal funding for abortions in the District of Columbia.
  • Blocks the use of federal dollars for abortions for federal prisoners.
  • Directs the HHS secretary to ensure that consumers shopping for health-care coverage on the federal exchange can tell whether a plan covers abortion services.

2. IRS

  • The IRS’s budget will be reduced by $345.6 million.
  • The IRS is banned from targeting organizations seeking tax-exempt status based on their ideological beliefs and political partisanship.

3. EPA

  • The agency’s budget will again be reduced — by $60 million to $8.1 billion. (The EPA’s budget has been slashed by $2.2 billion, or 21%, since fiscal 2010.)
  • The reduction in budget means the EPA will have to reduce its staffing to the lowest levels since 1989.

4. Federal employee pay, perks, and pension

Note: The average federal employee makes $35,774 more than the average American, but it’s average Americans who pay the taxes that pay the bloated salaries of government employees.

  • The bill allows a 1% pay raise for federal government workers which was ordered by Obama to take effect in January.
  • Pay freeze for the vice president (Joe Biden) and senior political appointees.
  • Spending for certain conferences, official travel and some employee awards will be banned or limited.
  • Government officials in the Executive Branch, lawmakers and heads of legislative agencies will have to pay or raise the funds for their official portraits.
  • For the first time, the benefits of current retirees could be severely cut, part of an effort to save some of America’s most distressed pension plans. Read more on this here. See also “Thousands of federal retirees get 6-figure pensions.”

5. Military pay

  • Military service members will receive a 1% pay increase next year.
  • But there’s a pay freeze for generals and flag officers.
  • The bill also ends a 5% discount on tobacco and tobacco-related products sold at military exchanges.

6. Veterans

After a year of embarrassing scandals at VA hospitals (see “Veterans die while waiting for MONTHS to see a doctor at VA hospitals” and “Phoenix VA hospital changed records to make patients who’d died waiting for treatment appear alive”), Congress is making good on promises to provide more money and oversight.

  • The spending bill provides a total of $159.1 billion in discretionary and mandatory spending for military veterans, including an added $209 million to address new costs related to the bipartisan veterans’ reform bill passed last summer calling for adding medical staff and expanding dozens of facilities.
  • To specifically addressing the “wait list” scandal, the Department of Veteran Affairs’ inspector general is getting a $5 million budget increase to continue investigating lapses in patient care.

7. Common Core

8. School lunch program

The spending bill takes a hit at Michelle Obama’s school lunch nutritional changes by:

  • Allowing more flexibility to school districts to implement new whole grain nutrition standards “if the school can demonstrate a hardship” when buying whole grain products.
  • Relaxing new sodium standards until they are “supported by additional scientific studies.”

See “Student’s Photo of Skimpy Michelle O School Lunch Sparks Outrage” and “Milwaukee school board president asks who elected Michelle Obama to dictate school lunches“.

9. Food safety

The spending bill increases funding for the Food and Drug Administration by $37 million, to a total of $2.589 billion, including:

  • $27 million in new funding for the Food Safety Modernization Act
  • $1.016 billion for the Food Safety and Inspection Service — an increase of $5 million from last year.

See also “USDA approves import of chicken processed in China despite safety concerns.”

10. Light bulbs

The bill prohibits new standards that would ban the use of incandescent bulbs. In other words, we can continue to buy and use those light bulbs, instead of the more expensive LEDs that environmentalists want to impose on us.

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Empty promise: Michelle Obama's campaign to end veteran homelessness

The thought of so many veterans, who risked their lives for our country, being homeless, just breaks my heart. And at Christmas….
Shame on the Obamas and the Dept. of Veterans Affairs for their empty and broken promise.
Be careful with your charity donations to veterans groups, as you should with any and every charity group (source):
“But as a group, veterans charities are prone to abuse, profiteering and outright fraud, say philanthropy watchdogs. Almost half of the 39 veterans charities rated by the American Institute of Philanthropy in its April/May 2011 report received F grades, largely because they devoted only a small ratio of their expenses to charitable programs, in part due to excessive fundraising expenses…. Fisher House Foundation, the Navy-Marine Corps Relief Society and the National Military Family Association, have been praised for assisting thousands of veterans.”
Before you donate, check with websites like Charity Navigator for an evaluation of charity organizations. Click here.

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Jailed Marine In Mexico Released. No Thanks To Obama.

Hip Hip Hooray!!!!!

This May 3, 2014, photo shows Sgt. Andrew Tahmooressi

This May 3, 2014, photo shows Sgt. Andrew Tahmooressi

SAN DIEGO (AP) — A Mexican judge ordered the immediate release of a jailed U.S. Marine veteran who spent eight months behind bars for crossing the border with loaded guns.

The judge on Friday called for retired Marine Sgt. Andrew Tahmooressi (Tah-mor-EE-si) to be freed because of his mental state and did not make a determination on the illegal arms charges against the Afghanistan veteran diagnosed with post-traumatic stress disorder, according to a Mexican official who had knowledge of the ruling but was not authorized to give his name.

Tahmooressi has said he took a wrong turn on a California freeway that funneled him into a Tijuana port of entry with no way to turn back. His detention brought calls for his freedom from U.S. politicians, veterans groups and social media campaigns.

“It is with an overwhelming and humbling feeling of relief that we confirm that Andrew was released today after spending 214 days in Mexican Jail,” the family said in a statement.

U.S. Republican and Democratic politicians had held talks with Mexican authorities to urge his release. A U.S. congressional committee also held a public hearing to pressure Mexico to free him.

U.S. Rep. Ed Royce, R-Calif., chairman of the House Foreign Affairs Committee, said he was “elated” by the news and that his PTSD will be treated by specialists in the United States. He had met with Tahmooressi in jail and talked to Mexico’s Jesus Murillo Karam about the case.

“As I said after visiting Andrew in the Mexican jail, he needs to come home to the United States to be with his mother Jill and the support network of friends I know to be standing by to help him. He is a hero who served his country bravely on the battlefields of Afghanistan, which is why so many Americans have been focused on getting him home,” Royce said.

Rest Here From AP


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22 military veterans a day commit suicide

Statue of Liberty in tears
22 U.S. military veterans a day committed suicide in calendar year 2010.
That’s the shocking finding in a 2012 report on suicide data by the Department of Veterans Affairs.
Authored by Janet Kemp, RN & PhD, and epidemiologist Robert Bossarte, PhD, the VA study used data collected from 21 states. The study’s other findings include:

  • Suicide rates among veterans in the United States increased since 2007, by about 20%. Whereas the percentage of all suicides identified as Veteran declined between the years 1999-2003 and remained comparatively constant after 2003, beginning in 2007 the number of deaths by suicide increased.
  • A majority of Veteran suicides are among those aged 50 years and older. Veterans who commit suicide are older than non-military Americans who commit suicide. More than 69% of all Veteran suicides were among those aged 50 years and older, compared to approximately 37% among those who were not identified as Veterans.
  • Vets aged 50-59 years are a high suicide risk group.
  • Veterans who died from suicide were more likely to be married, widowed, or divorced.
  • The majority of nonfatal suicide events were the result of an overdose or intentional poisoning. Nearly 11% of non-fatal attempts were made with a firearm.
  • The rate of suicide has increased not just among military vets, but in America in general.

military vets suicides
If you’re a veteran or you know a veteran who is suicidal, help is available!
Call the Veterans Crisis National Lifeline (1-800-273-TALK); push “1” for Veteran services. The Veteran Crisis Line is staffed 24 hours a day, 7 days a week by trained VA employees with backgrounds in mental health services.
H/t CBS DC  and FOTM’s josephbc69

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FBI launches criminal investigation into VA scandal; Senate passes bill to fix problem

Obama's War on Veterans

FBI Director James Comey told the House Judiciary Committee that the FBI has begun a criminal probe of the VA hospital scandal, led out of the Phoenix field office where the shocking discovery of an effective veterans death list first surfaced in the VA hospital in Phoenix, Arizona.

“We’ll follow it wherever the facts take us,” Comey said, declining to discuss it further.

Richard Simon reports for the Los Angeles Times, June 11, 2014, that the VA inspector general has been working with the Justice Department, but lawmakers from both parties have pressed for the FBI to play a bigger role in the investigation.

Their sense of urgency was prompted by two reports showing that the problem is not exclusive to the Phoenix VA hospital, but widespread across America:

  • A report by the inspector general of the Veterans Administration found a systemic nationwide problem in scheduling veterans’ care in a timely manner, including staff falsifying records to cover up long waits.
  • An audit by the Veterans Administration found more than 57,000 veterans have waited at least three months for appointments.

Yesterday, June 11, 2014, by a vote of 93 to 3, the U.S. Senate broke through the usual partisan gridlock to swiftly approve legislation aimed at reducing veterans’ long waits for healthcare.

The 101-page compromise Veterans’ Access to Care through Choice, Accountability and Transparency Act of 2014 (Title III of S. 2450) was written and approved with unusual speed, a reflection of the political importance to both parties of the nearly 6.5 million veterans who use VA’s 1,700 hospitals and clinics.

The bill would:

  • Allow veterans facing long waits at VA facilities to seek care from private doctors
  • Expand the VA secretary’s authority to fire staff for poor performance
  • Authorize the department to lease 26 new health facilities in 17 states, including California and Puerto Rico.
  • Provide $500 million for expedited hiring of new VA doctors and nurses.

Reporting for the Chicago Tribune, Richard Simon noted that a House bill approved Tuesday, H.R. 3230, would eliminate VA bonuses for fiscal 2014 through 2016, while the Senate bill, S. 2450, would eliminate the use of waiting times for determining employee bonuses.

The Senate bill also would extend college education benefits to spouses of service members killed in the line of duty, guarantee in-state tuition for veterans at public colleges and universities and improve access to healthcare for military sexual assault victims.


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Scandal-ridden VA hospitals are template for Obamacare

If you still think Obamacare is wonderful, you should pay attention to the daily scandalous news about the criminally-run Veterans Administration hospital system.


Because VA hospitals, being a “single-payer” government-owned and government-run healthcare system, are the model for the ultimate objective of  Obamacare.

doctors against obamacareNew Obamacare Endgame: the VA for All

By Richard Amerling, M.D.
American Association of Physicians and Surgeons (AAPS)
May 26, 2014

Scandal at the Phoenix Veterans Administration lifted the curtain of secrecy on the VA’s secret waiting lists. The VA lies while patients die.

This is by no means a new phenomenon. The nation’s single-payer system for veterans has long been greatly overloaded. Congress tried to fix it in 1996 by passing a law requiring that any veteran needing care had to be seen within 30 days.

The VA is supposed to have a wonderful electronic medical records system, and the EMR is supposed to be the magic formula for efficiency and quality. The VA gamed the electronic system to hide the waiting lists.

Readers of the British press will be struck by the similarities between fudging waiting lists at VA hospitals and stacking patients in ambulances outside UK hospitals. Finding it impossible to comply with a National Health Service mandate that all patients admitted to an emergency room be seen within four hours, ho spitals kept patients waiting in ambulances outside the ER!

Britain’s NHS and our VA system are both administratively top-heavy, command-and-control bureaucracies. All such systems tend to expand, along with their budgets, as administrators hire more and more people to do what they were supposed to be doing. There is no competition, and virtually no accountability. Every problem is always someone else’s responsibility. Mandates and quotas, rather than incentives, are used to motivate those in the trenches.

Physicians working in the VA system, like the NHS, are mostly salaried employees. There are many fine doctors in both systems, but the incentives in place do not reward them for going the extra mile, seeing the additional patient, or doing another procedure if it means going past their shift. Inevitably, these systems create backlogs and lengthening queues for care.

Americans need to take a close look at the VA—and not only because of their concern about poor treatment of our wounded warriors. It is the prototype for Obamacare. The intent behind Obamacare is to completely centralize control over health care, and thus turn American health care into one huge Veterans’ Administration.

In 2011 I wrote that Obamacare was designed as Medicaid for all. Medicaid expansion is a key component of the law. If Congress wanted to expand coverage to the ten million or so individuals who fall through the cracks of the private/public health system, this could have been accomplished easily by offering them Medicaid or Medicare. These creaky systems could be made to work better simply by eliminating the price controls on physicians and allowing them to balance bill patients for the difference between payment and the cost of providing service. But expanding coverage was not the goal.

The stated goal of government central planners, and of many medical elites, is to abolish traditional fee-for-service medicine. They wrongly blame FFS for out of control health care spending. This is absurd on its face. FFS medicine pre-dates the massive health spending inflation that was largely brought on by Medicare and Medicaid, and the domination by third-party payers. The lack of price transparency and the removal of most disincentives to utilization of health services are what led to the incredible over-spending on health care that we’ve seen since the ‘60s. FFS is the only way to insure the prompt delivery of needed care.

But what central planners want is for all physicians to be salaried employees of either the government or of large hospital systems. Then planners could centrally control care through “payment-for-performance” algorithms built into electronic records. The promptness and quality of care will suffer.

Obamacare is already becoming like the VA. A kidney transplant patient suddenly developed blurred vision. This alarming symptom could signal a brain tumor or other serious diagnosis. I would have arranged for an MRI to be done the same day. Her new Obamacare plan, however, offered a specialist appointment two weeks hence.

The shameful backlog in our VA system could be remedied overnight by either giving veterans vouchers for care in the private, FFS system, or by building incentives into the VA payment structure. Ah, but this would require an acknowledgment that their top-down system has failed.

Richard Amerling, MD is an Associate Professor of Clinical Medicine and a renowned academic nephrologist at the Beth Israel Medical Center in New York City. Dr. Amerling studied medicine at the Catholic University of Louvain in Belgium, graduating cum laude in 1981. He completed a medical residency at the New York Hospital Queens and a nephrology fellowship at the Hospital of the University of Pennsylvania. He has written and lectured extensively on health care issues and is President-elect of the Association of American Physicians and Surgeons. Dr. Amerling is the author of the Physicians’ Declaration of Independence.

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