THE VETERANS' ADMINISTRATION DEEP STATE

[CCarl]

Yo Vets, Deep Employee Cuts Coming


Here is KAKE-TV in Wichita whining about the VA cutting 80,000 employees:

https://www.kake.com/home/wichita-veteran-reacts-as-va-plans-to-cut-nearly-80-000-jobs/article_b34679de-fa30-11ef-8810-77a541a2607e.html


According to dot-gov websites I found, as of December 2024 the VA boasts a $350 billion budget, and more than 470,000 employees.
According to the most recent report I found on the internet, from a VA website, only 738,212 out of the 9 million veterans who are currently enrolled for veterans' benefits have accessed the VA's healthcare benefits.

Based on the above, here are some numbers:

VA Employees; There are 10 VA employees for every 16 Vets that use the VA medical care. Imagine if your private practice doctor has 300 patients. If he or she had staffing proportional to the VA, the staff would be 187 people!! That should clarify how ludicrously over-staffed the VA is!

VA $$; The VA budget is $38,900.00 for every eligible veteran. BUT only 8.2% of eligible veterans use VA medical care, so it turns out the VA spends $474,000.00 tax dollars for each veteran it cares for. Oh, that isn't a budget for a veteran's lifetime, that is an annual budget! Can anyone begin to imagine that the privately run medical industry has budgets that extreme?? Nope, I didn't think so.

So the VA is being told to lose 80,000 employees, to drop to the 2016 level of, what did KAKE-TV say, 390,000 employees? That would mean 10 VA employees for every 19 veterans. And veterans are whining that they might not have their hand held enough!!

I'm a veteran, so I can have a harsh opinion about this. The VA can survive losing 150,000 employees, and still provide veterans the care they need. If only, the VA would care enough itself. I'll explain that and a solution to the brouhaha in a reply.

[CCarl]

Headline: The Only Rational Solution for the VA's Bloated Budget and Slow-paced Care

The Selective Service sent me a draft notice in September 1969. I opted for four years in the Navy instead of two years in the Army and a one-way ticket to Vietnam. It didn't quite work out that way, but that's another story.

One of the first benefits I heard from the Navy recruiter was the VA would provide me health care if I completed my service with an Honorable Discharge. That was one of recruiting's big features back in the day, or maybe it just seemed big and important to me.

Years later, out of the Navy and through college, it did not hit me that I was eligible for VA care for my emerging health concerns. So paid my medical bills for food allergy diagnosis and treatment in '79 and '80; I paid for Guardia treatment in '90; I paid for four days in the hospital, a spinal tap, and follow-up acupuncture for an L4/L5 herniation in '94 and '95; I paid for diagnosis of Atrial Fibrillation in '05 when I had a heart issue while on a cross-country bicycle ride; I paid for bilateral leg surgery in '06 when my leg veins meandered like the Mississippi River; I paid for three months of osteopathic care for a separated SI joint in '08; and I paid for an echo cardiogram in '09.
In '06, I crossed paths with a guy I had served on board ship with. He was going to the VA, and getting all his medical and dental needs paid for. He'd been a Personnelman in the Navy, and knew all the fine print. He assured me the VA would have paid for all my past medical care, except the acupuncture and osteopathic treatments, and the diagnoses a naturopath made regarding food allergies. He added I'd only get dental care paid for if I had a facial injury of some sort while in the Navy.

Live and learn I guess, but my medical history points out one major flaw in the VA system. The statement that the VA will provide me medical care (with that Hon. Discharge) is an outright lie. THE VA ONLY PROVIDES, OR PAYS FOR, MEDICAL CARE THAT THE FEDERAL GOVERNMENT APPROVES. That is a major step away from the promise made to every recruit.
 
Massive budgets and staffing aside, THAT IS THE VA's BIGGEST FLAW.

I deal with sleep apnea, and refuse to use the primitive CPAP machine. There is an alternative, a mouthpiece that can be worn at night that holds the jaw in a position to provide a positive airway. BUT, the impression for the mouthpiece must be made in a dental clinic, and the mouthpiece is made by a denture company. The VA will not pay for the mouthpiece for me apparently because I did not have a dental related injury during my enlistment. WTF is wrong with the dental industry making a device that alleviates a medical condition? NOTHING, except the VA makes excuses not to pay for the mouthpiece. It makes a cynic wonder who in the VA is getting a kickback to insist on CPAP machines.
I also deal with IBS, aka Leaky Gut Syndrome, and naturopathic medicine deals with it in much more detail from a preventive medicine viewpoint. The closest the VA can come to treatment is have me talk to a VA dietician, and I have more understanding of the illness than they do. The issue is NOT meal planning, the issue is things like gluten, lectins, carbs, the bean family, synthetic chemical-laden foods, probiotics, and unhealthy gut flora. Why doesn't the VA have naturopaths on staff? Other than the fact the allopaths control the VA?

Well, here I am well into page two with no mention of the only Rational Solution, just some bellyaching instead. But the bellyaches have offered a few additional symptoms of the problems that the headline overlooks. Here is the Rational Solution;

Open the community care program to all Veterans, AND phase out the VA hospitals and
CBOTs across the country.

Transition VA personnel into the private sector.

Leave the decision of primary care and specialists completely to the Veteran.

Leave the decision of a treatment plan to the Veteran and his/her medical practitioners.

Now, the Veteran would receive the health care he or she desires, rather than what Uncle Sam dictates and restricts. That's a win. Now the Veteran just deals with the normal scheduling issues of medical practices without the additional burden of bureaucratic delays, SOPs, and a lousy phone messaging network. That's three more wins. Oh, there is one other BIG win;

Transition the VA to a disbursing office to pay for Veterans' choice of health care, just as the US government promised each of us as a condition of our honorable service. The VA simply cuts a check to pay the freight. That's a huge win for everybody!!

Well, everybody but the politicians. The left will scream no centralized oversight or public input. The right will scream not enough structure and obedience through a system of checks and balances. You see, this simple, rational solution has made most politicians unnecessary. Now, just maybe, a constitutionalist or a libertarian will find a way to transition the disbursing office into a military-income funded medical insurance plan just for Veterans.

For that to happen Veterans will need to organize and force the issue. We all know Congress would never voluntarily make such a bold move. Congressional talking heads are owned by special interest groups. If those groups are not the problem then an 'agency' like USAID is always around to steal the money for its own ends. These last statements are all the more reason Veterans need organization to make these changes.

[CCarl]

'Efficient' Bureaucracy Does NOT = Better Health!!

Hey Kansas Vets, Survey says Dole VA is tops in the nation!!

Huh? Tops at what? Vets need to read this gaslighting misrepresentation of good health care & good government;  https://www.va.gov/wichita-health-care/stories/wichita-recognized-as-best-city-in-the-us-for-veterans-health-care/

I'm sure all of us who see a VA Doc as primary care or specialists receive a questionnaire following our appointment. Mine is damn nearly in my email Inbox before I'm home from the appointment. That speed probably counts as 'efficiency' in the "Trajector Medical" study.

For all you readers, here is the format of the questionnaire. How do you rate blah blah? Was your appointment on time? Did you need to wait more than 15 minutes? Was the staff friendly? Were the medical professionals friendly? Were the medical professional professional? Did you receive a timely date for your next appointment? Ad nauseum. For all the meaningless questions, the questionnaire has the same five boxes for the vet to check; [UGH!] [yuk] [meh] [um-hmm] [Yahooo!]

Now, just check one box, please. But, what's missing? How about several lines of space for the vet to provide his/her thoughts on each question? How about several lines of more space for the vet to add his/her personal thoughts/needs/criticisms beyond the administrative questions?

What else is missing? How about questions whether the vet feels his/her health is better & how, the same, or worse & why? How about caring for our health rather than the VA's administrative duties?? Does the VA get that the two do NOT equate? I doubt it.

Here is why the questionnaire is what it is . . . 1) the questionnaire is sold to us as taking just a few minutes, and that's efficient for the vet; 2) the VA will only needs to scan boxes not read comments, and that's time efficiency for the VA; AND 3) the VA doesn't give a shit what we think, it only wants us to check one of Trajector Medical's efficiency rating boxes to accomplish its administrative requirements.

Why is the VA even spending taxpayer dollars for a study of its efficiency? Isn't that an inefficient use of tax dollars?  Who is Trajectory Medical? How many employees have connections to the VA, like all the weapons CEO's connections to the Pentagon? Where is Musk when he's needed? LOL

Be sure to reread these bullet points at the link;

Shortest average wait time in the U.S. for existing patients to see a cardiologist (3.8 days)
Second highest percentage of Veterans able to access routine specialty care when needed (95%)
Second highest access to urgent specialty care (90%)
Third shortest wait time for new patients accessing pulmonology (13.8 days)

Here is one of the tricks of questionnaire interpretation; The VA and Trajector Medical are sure touting that short 3.8-day wait for a cardiologist. They do not want you to ask why the short wait, they want you to think efficiency. But I want you to ask why. How about this for why; the wait is short because the Bob Dole cardiology dept. is so bad that as many vets as possible go elsewhere for heart consultations. That's what I did. I experienced the Dole cardiology dept. ten years ago and went elsewhere after poor care and poor treatment.

I just went back to a Community Care heart doc that I had seen six years ago under the Choice Program. I had to wait 8 months to see him again, because he has such a high patient load because he is a damn good doctor. They day I saw him he had a 3-hour round trip drive to a non-VA health facility, he had at least an hour of set up and close down time, he needed time to eat, AND he had 31, 20-minute appointments that day. The man is serving his clients by committing to a 15 hour day when he travels to rural Kansas.

Now, doesn't the same hypothesis work for the other bulletpoints, i.e., the Dole VA is accessible because the medical care across the board is so lousy that appointments are readily available. Given my wait time for an excellent cardiologist in private practice that 3.8-day wait is nothing to brag about!

Maybe the VA should send out an internal questionnaire to all its medical professionals asking specifically where its medical care is lacking, AND how to fix it. Then release the unedited responses for all vets to absorb and reply to.