Category Archives: Veterans Affairs

Continued VA Cover-Up

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This time with the VA’s IG participating. It’s an unfortunate side effect of having an organization’s inspection/watchdog function be an internal one, even if it works for the organization’s boss and not for anyone further down the totem pole.

Crucial language that the Department of Veterans Affairs Inspector General could not “conclusively” prove that delays in care caused patient deaths at a Phoenix hospital was added to its final report after a draft version was sent to agency administrators for comment….

The single most compelling sentence in the inspector general’s 143-page final report on fraudulent scheduling practices at the Phoenix veterans’ hospital did not appear in the draft version, according to a staff analysis by the House Committee on Veterans’ Affairs.

It was inserted into the final version, the only one that was released to the public, after agency officials had a chance to comment and recommend revisions.

It’s certainly legitimate for IG draft reports to be run by the group just inspected and about whom the report is being written, but that’s to give the inspectees an opportunity to check facts and to suggest corrections to factual errors. Giving the inspectees the ability to “correct” the conclusions themselves is entirely illegitimate.

A separate report, written by the inspectee, is a normal part of the proceeding. Here, the inspectee indicates its concurrence with IG conclusions and its plan of corrective action regarding those conclusions. It’s also in this separate inspectee response report that the inspectee indicates its disagreement with a conclusion and the reasons for that disagreement.

Then the IG responds, again in a separate report, indicating its acceptance of the inspectee’s disagreement or the IG’s overruling of the inspectee, with the original conclusion standing and the inspectee required to take corrective action. All three of these reports are part of the official record.

Notice that: the legitimate course is to disagree with an IG conclusion, in writing, in a separate report, not to rewrite the IG conclusion itself.

And the cover-up of the cover-up:

The House committee obtained the draft version of the report late Thursday, after the [Washington] Examiner published a story that IG had been refusing its release.

Again, I say, it’s time to disband the VA altogether and send the VA’s existing budget and what would have been its future budgets directly to our veterans as voucher checks with which they can be free to seek out their own doctors and their own medical facilities.

A Thought on Government and Enterprise

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This is from The Washington Times.

[T]he Obama administration first received clear notice more than five years ago about the need for an overhaul to reduce patient wait times.

“Excessive wait times are addressed by moving to a resource-based management system,” Veterans Affairs technology officials told the Obama-Biden transition team in a briefing report that included mention of VA’s “schedule replacement” project.

And this [emphasis added]:

“VA has been trying—and failing—to replace its outpatient scheduling system since 2000, wasting nearly $130 million in the process,” Rep. Jeff Miller, Florida Republican and chairman of the House Committee on Veterans’ Affairs, told The Times when asked about the delays.

“Because VA acquisition officials have proven time and again they are simply too inept to guide the development of a new proprietary appointment-scheduling system in an expedient and cost-effective manner, department leaders need to look at adopting commercial technologies that are being used in the private sector….”

It’s easy enough to knock President Barack Obama and his administration over this, and President George Bush’s administration had a hand in this, too. It’s also easy to hammer the Veterans Affairs Department. However, the problem isn’t about any particular President’s failure to deal with a problem, nor is it about the broad failure of the VA to perform.

No, this is an illustration of the general inability of government to do as well as private enterprise anything that private enterprise can do in a competitive market: if private enterprise can do a thing at all, it can within very broad limits do it better than government (national defense and foreign policy come to mind as things better left to the Federal government, but not much else). The Federal government cannot compete with private enterprise on efficiency at all.

In sum, such things should be left to the private sector of our economy, and the government should just stay out. In the particular case, this means that the VA should be disbanded and the VA’s annual budget sent to our veterans as vouchers with which they can find their own doctors, their own medical facilities, their own health plans.

Arrogant in their Failure

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A veteran, a young woman with a son, the mother and veteran the victim of domestic abuse and suffering depression from that abuse, went to the Veterans Affairs office in El Paso seeking help for her depression. A counselor told her she would not be able to see a psychologist: she “looked too nice and put together” for someone depressed.

Of course. How wonderful that the VA can hire folks so skilled that they can diagnose a lack of depression solely on appearance. Still, it’s one way to hold down the wait lists.

The VA has to go, and its budget has to be disbursed to our veterans as vouchers so they can see the doctors of their own choice in medical facilities of their own choice and at times that are actually useful to them.

A Step in the Right Direction

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[A] bill announced Thursday by Senate Veterans Affairs Committee Chairman Bernie Sanders (I, VT) and Senator John McCain (R, AZ) would allow veterans who wait 30 days or more for VA appointments or who live at least 40 miles from a VA hospital or clinic to use private doctors enrolled as providers for Medicare, military TRICARE or other government health care programs.

This is clearly a step in the right direction, but this bill absolutely does not complete the reform of the VA. Why should a veteran have to wait 30 days before he can see a non-VA doctor that he could see tomorrow at urgency or in a few days to a week otherwise?

Why should a veteran have to drive 39 miles to a VA facility, driving past a non-VA doctor’s office just 10 miles away?

Why should a veteran be required to see a government-designated doctor when he could see one that he prefers those 10 miles away?

No. The final way, the complete way, to reform this VA is to disband it and let our veterans see the doctors they choose to see at the medical facility they and their doctor deem appropriate, with the VA’s budget paid to the veterans as vouchers.

The Sanders-McCain bill, it’s claimed

also would let the VA immediately fire as many as 450 senior regional executives and hospital administrators for poor performance.

Again, a useful step, but this cannot be a final one. Disbanding the VA and returning all of the VA’s employees to the private sector clears this problem away, also, and with finality.