Thursday, January 29, 2015

Hey, Barry, American Idol is lookng for you!







Starting in the United States and starting with some basic questions about the VA.

"How many veterans are being seen? What are they being seen for?".

Very basic questions.

Fundamental, you could argue, to understanding what quality of care the VA is delivering.

But as the Congressional Budget Office's Matthew Goldberg explained to the House VA Subcommittee on Health this morning, in response to Chair Dan Benishek, these basic questions remain unanswered by VA year after year.

And while much has been made (here at this site and elsewhere) about VA and DoD's computers still being unable to link up and 'talk' to one another -- allowing for a seamless electronic medical record to follow a service member from active duty status to veteran's status -- Goldberg noted the reality that the computers for VBA (Veterans Benefits Administration) and VHA (Veterans Health Administration)  can't link up and talk to each other.

These were among the issues discussed in this morning's Subcommittee on Health hearing.  Benishek is the Chair and US House Rep Julia Brownley is the Ranking Member.

The witnesses appearing before the Subcommittee were the Congressional Budget Office's Matthew Goldberg, Paralyzed Veterans of America's Carl Blake, the American Legion's Louis Celli Jr. and the VA's Dr. James Tuchschmidt.

The hearing was about the quality and cost of VA health care and was set in motion by a December 2014 Congressional Budget analysis entitled [PDF format warning] "Comparing the Costs of the Veterans' Health Care System With Private-Sector Costs."

In his opening statement, the American Legion's Celli noted that "if CBO is looking for a baseline by which to estimate the cost of non-VA care, they need look no further than their own library of published reports when in June of 2014, they estimated the cost of outsourcing VA care to exceed $50 billion over 5 years, or roughly $10 billion dollars per year, just to eliminate the backlog of veterans waiting more than 30 days to see a VA doctor. One important point to keep in mind is that this $50 billion represents an additional $10 billion per year to VHA’s already existing $65 billion annual budget, and this measure was only designed to serve less than one percent of VA’s total patient population. After reducing eligibility and constricting payments not to exceed Medicare rates, and a couple of other adjustments, CBO was able to come back with a second score that trimmed about $15 billion from the figure and came in with a second estimate of $35 billion."

Subcommittee Chair Dan Benishek: Mr. Tuchschmidt do you know what the average cost for speciality care for the VA for a routine colonoscopy within the VA versus the private?

James Tuchschmidt: I-I don't have that in my head.  Uh, uhm, we can probably get that information.  Uh, I --

Subcommittee Chair Dan Benishek: I don't think you can.  See, that's the whole point of what we're doing here. We don't know what it costs to do some of the routine things in the VA because we've inquired on this in the past and that's the kind of data that we need to -- we need to have and we need to provide oversight because I agree with these other gentlemen here that VA provides care to our veterans that can't be provided in the prviate sector and yet a lot of things the VA provides can be and in those areas I think a comparison is in order so that we can provide the best speciality care for our veterans.

Pressed by Ranking Member Brownley, the VA's Tuchschmidt tried to spin, "I think that asking what is the cost of care is the wrong question to be asking."

Oh, really?  The VA is above the budget now?


I shouldn't say "now."

As Paul Giblin (Arizona Republic) reported last November, the VA "didn't track its number of unfilled medical positions until June"  and that, in November, the VA learned they had over 31,000 vacant medical positions.

The VA was unanswerable under Bully Boy Bush and it's only become more so under President Barack Obama.

Former VA Secretary Eric Shinseki's tenure (January 2009 through May 2014) was characterized by one scandal after another -- not limited to the backlog, the wait times, the doctored lists to make the wait times disappear,

Shinseki was finally forced to resign in disgrace during the spring of 2014.

Had Congress being doing their job, he could have -- and should  have -- been forced out in the fall of 2009.

The first big scandal he weathered was during that time period.  Veterans going to college on the GI Bill suddenly found themselves with tuition and cost of living expenses but with no check from the VA.

Many had to take out loans.

Many had to beg landlords to be forgiving about rent being late.

Some would still be waiting in December 2009 for their fall 2009 checks.  As a result, some veterans had to postpone Christmas for their children.

And, thing is, when Eric Shinseki took over as Secretary of the VA, he was told that the Post 9/11 GI Bill would not be able to make the college payments in a timely manner in the fall of  2009.  He knew it months ahead of time.  Neither he nor anyone else in the administration made Congress aware of the looming problem.  When the fall semester rolled around in 2009, veterans were planning on those checks.  They took out loans to cover tuition and books, they spent their own money, they did whatever they could to stay afloat and enrolled as they waited and waited on the checks that did not come.   October 14, 2009, he told the House Committee on Veterans Affairs:

Secretary Eric Shinseki: I'm looking at the certificates of eligibility, uh, being processed on 1 May and enrollments 6 July, checks having to flow through August. A very compressed time frame. And in order to do that, we essentially began as I arrived in January, uh, putting together the plan -- reviewing the plan that was there and trying to validate it. I'll be frank, when I arrived, uh, there were a number of people telling me this was simply not executable. It wasn't going to happen. Three August was going to be here before we could have everything in place. Uh, to the credit of the folks in uh VA, I, uh, I consulted an outside consultant, brought in an independent view, same kind of assessment. 'Unless you do some big things here, this is not possible.' To the credit of the folks, the good folks in VBA, they took it on and they went at it hard. We hired 530 people to do this and had to train them. We had a manual system that was computer assisted. Not very helpful but that's what they inherited. And we realized in about May that the 530 were probably a little short so we went and hired 230 more people. So in excess of 700 people were trained to use the tools that were coming together even as certificates were being executed. Uhm, we were short on the assumption of how many people it would take.

When we reported on that hearing, we became the only ones to report on the fact that Shinseki knew months ahead of time that the VA wouldn't be able to issue the checks in a timely manner.

The so-called news outlets wanted to give Eric a pass because he's such a 'good guy.'

I don't care if rainbows and candy corn flow out his ass, his job performance is what matters and he failed at it repeatedly.

A functioning press would've led the charge on that but we don't have a functioning press in the United States, we have a fawning public relations group that latches onto personalities and sells them and their 'life struggle' stories as news -- Lifetime Intimate Portraits passed off as investigative journalism.

And it wasn't just that Shinseki knew months ahead of time that veterans going to college would be screwed over in the fall of 2009.

Let's remember too what the VA did in real time: Blamed veterans.  The VA said the veterans filled out the wrong form or that their schools did.  The VA  stalled and stalled.   The VA didn't suffer.  Christmas bonuses continued at the VA.

The recent scandals were on the mind of the Subcommittee members this morning.

US House Rep Mike Coffman:  We need to know what procedures cost and we don't know that right now.  And we need transparency.  And we don't have that right now in the VA system. And we're talking about a system that --  I mean, we're talking about the quality of care -- that just excluded veterans by virtue of manipulating wait lists -- appointment wait lists, so that people could get cash bonuses.

Tucschmidt was full of nonsense and when he really didn't want to answer a question, he fell back on he wasn't sure if he understood the computer systems and accounting and thought it might date back to, gasp, the 1940s and how was simple him supposed to grasp all that?

The VA is one embarrassment after another and as they continue to play dumb in hearings and refuse to fork over information Congress requests, it's really time for Congress to start censuring them.

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