Saturday, September 21, 2013

Time for a VA Makeover - Part 1

Four and a half years ago we published a pair of posts about restructuring the VA.  In light of recent media revelations of the exorbitant bonuses given to non-performing managers and higher ups in the VA [finally!], perhaps it is time to revisit the VA restructuring.  

We started back then with the following: 

Congress's hands are not clean over the Blue Water Navy issue. They have consistantly passed budgets over the years while the DVA takes appropriations away from Veterans to build new facilities. We refer mainly to costly 'Rural VA Health Centers'.

Consider:


  • The DVA had to have money appropriated in its budget to acquire the land for these centers.

  • Then they had to have money appropriated to construct them.

  • Then they had to have money to staff them.

  • Now they have to have money to keep them running.

  • This is a very costly program.

    Consider the alternatives, however. Not having them forces the Veterans to travel very long distances to receive diagnosis and treatment for any conditions thay have or develop. They have to travel to VA Hospitals...

    OR,

    ...Congress could authorize the issuance of a Veterans Health Care Card, with coverage levels based on DVA Categories of eligibility, and with a payment schedule identical to the one Social Security uses for Medicare. There would be no deductibles or copays for full coverage. The Veterans would use the card at any and all medical facilities they choose, and the medical provider would be barred by law from billing the Veteran for any difference in fees and costs. Prescription coverage would be the same as they have with the DVA, based on categories of eligibility.

    The DVA could then sell those costly Rural Health Centers, applying any moneys realized to the next year's infrastructure maintenance budget to repair and modernize any DVA Hospitals to begin to switch their primary role to that of long term care. Staff reductions will further reduce the budget.

    What could be the advantage of this system?

    Politically, the Democrats will embrace it because it is a step closer to universal health care. The Republicans will embrace it because it shrinks government [hundreds of administrative clerks are far cheaper to pay for than thousands of administrators, doctors, nurses, pharmacists and therapists].

    Medical professionals will embrace it because it does not force many of them to take any experience and training they garnered while serving in the Armed Forces and work within the DVA healthcare system. They can work where they want, and their expertise will be spread throughout the nation and be available to all, not just Veterans.

    Veterans should embrace this plan since it allows them to go to their family doctor for treatment, and their local hospital for emergency and long term services.

    This would reduce instances where Veterans go to DVA Hospitals in an emergency only to find they have no Emergency Room, or to be turned away because of a snafu, or by an under-trained staffer who just doesn't care, forcing the Veteran to seek emergency care at a local facility that is NOT DVA, and then be forced to pay the bill.

    Chances are, the Veterans contemplating suicide will receive better judgement on examination in Emergency Rooms of civililan facilities and not be turned away. They would likely receive better care after admission as well.

    Mostly, though, this would eliminate many of the "cracks" that Veterans fall though in their health care system. Quality of care varies greatly from DVA Medical Facility to Facility, making treatment a hit or miss reality for the Veteran. Many of the staff at DVA facilities are simply overburdened, and have become callous to their patients.

    [New edit: Of course, Congress would need to pass a law setting the Medicare rates as the maximum civilian medical facilities can charge for a procedure, test, or treatment, and making it illegal for the Veteran, or the government, to be charged any amount over that standard.] 

    Positive Results

    Let's get the DVA out of the business of being the ones who treat all of our Veterans and into long term care only, and whatever period of time a wounded warrior needs to transition from the active Military to Veteran status and be ready to go out into the civilian world.

    Finally, by freeing up money in the DVA Budget by stopping the acquisition, construction, staffing and running of DVA Rural Health Centers, and divesting itself of them using the above concept, perhaps the DVA could spend more money, time and effort in paying the benefits to Veterans that they fight so hard to deny. It is time to zero in on the DVA and force massive changes in its thinking, and operations. This is one step, and it starts with Congress.

     

    Time to Start Restructuring the DVA


    Perhaps it is time.

    We would advocate the following, as well:

    Do away with bonuses.  

    Instill in the claims department that their first priority is to the Veteran, not the taxpayer.  It is NOT the VA's job to save the taxpayer money.  Indeed, they try when processing claims and yet somehow none of that money is ever returned to the US Treasury.  Let's make sure it goes to the Veterans, not management bonuses.  

    More to follow!

    VNVets

    ”It is a stain on this nation's honor that the Department of Veterans Affairs has become a deadlier and more difficult adversary to the American veteran than any they have ever faced on a battlefield."-- VNVets

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