Eric Shinseki is surprised and appalled at the systemic lack of principles among so many in the VA leadership. Obama is to have a ‘serious conversation’ with Shinseki. Veterans are literally dying to see a VA doctor. And the American Taxpayer is footing the bill. Just what in the hell is really going on?
The short answer is, this is what a bureaucratic health care system looks like – a mess.
Shinseki’s protestations and his and the Obama administration’s surprise that hundreds of thousands are languishing on waiting lists is either disingenuous or a sign they are completely out of touch with reality. Or they think we are out of touch with reality and suffer from short term memory loss. What did they think was going to happen when they opened VA enrollment to virtually everyone who ever wore a uniform?
Worse is the feigned outrage that the VA system's administrators are cooking the books. Policies are put in place that state, if you reduce the numbers, you get a bonus. Then fail to implement any oversight or accountability and ignore the complaints and warning signs that all is not as it appears, then pretend shock? With no additional funds or personnel, during sequestration, where did they think all those hundreds of thousands veterans went? Did they really think that suddenly people started doing their jobs and this accounted for the sudden, drastic drop in numbers?
Obama Navigated, Shinseki Rearranged the Deck Chairs
In a 2008 position paper, then candidate Obama said, “When troops serve, they are not divided by income classes or priority groups. Yet, today, the VA is picking and choosing which veterans to serve.” It went on to state that, "...this unfair policy..." of having an income threshold "...has resulted in the VA turning away nearly one million veterans since 2003."
Joe Davis, then national spokesman for Veterans of Foreign Wars said, “It’s going to be difficult because of capacity”. Shinseki’s response was, “It has increased VA’s workload, but we are prepared to accommodate up to 500,000 enrollees, who are being phased in over the next four years.” In other words, even at the outset, only one half of those previously turned away and now eligible would be able to be accommodated.
I wonder, did they account for the then projected two million (currently over 2.7 million) being sent overseas? A large percentage of whom would now qualify for VA care as Priority Group 8 due to the dismal job economy they faced upon return home? I guess they just never thought things would be this bad for this long. I guess it is just another failure to plan with any notion of reality factored in. I guess they figured the iceberg the previous administration was attempting to steer away from wasn't really a threat to the already floundering ship.
It would have been smarter, given Obama’s plans for creating a national healthcare system, if he didn’t open VA eligibility to those without service-connected injuries or illnesses and required them to, as they had been, go on Medicaid. Then, he would have been able to artificially reduce the Medicaid rolls by switching them over to the VA when Obamacare rolled out, bolstering the claim Obamacare was a success. But, that plan would not allow him to position himself as a friend to our military and veterans. Some friend he’s been.
What is Priority Group 8?
In 2003, in recognition of the then existent delays in appointments and overburdening of the system, Priority Group 8 veteran’s enrollment was frozen. It is very important to note what Priority 8 actually means. According to the VA, Priority Group 8 veterans include those who are ”Noncompensable 0% service-connected” and have household incomes above the VA national income threshold who agree to a copay. That copay is significantly less than the cost of private insurance premiums and copays. Is it any wonder hundreds of thousands have opted to enroll in the VA?
Making these veterans are eligible is the cause of both the backlogs and the once dismal now abysmal care those who do have service-connected injuries, disabilities or illnesses receive. It is even worse for those with service-connected issues but have managed to secure jobs and private insurance. They can only get treatment for those specific service-connected issues. For everything else, they have to pay to go to a private doctor. Only if that private doctor can prove a specific aliment is connected to their time in service can the veteran and according to most insurance plans must, go to the VA for care and treatment related to that ailment. That little insurance loophole, by the way, is not closed or even addressed by Obamacare; it is one of the only ‘pre-existing conditions’ insurance carriers are not required to cover.
Looking at the Priority Groups 1-8 as the VA has them listed here is an eye-opener. I admit to having had many erroneous notions about who the VA serves, or more correctly, who is eligible for VA services and how they are triaged. Silly me, I thought that anyone who was injured or ill as a result of their service, or had retired from the military were the only ones eligible. I didn’t know that someone with an “Other than Honorable” discharge could get in line in front of the honorably discharged after twenty years service if they passed a means test.
-As a side note on “Other Than Honorable” discharges, studies have been done showing this group of veterans are at significantly higher risk for unemployment, homelessness, drug and alcohol abuse and are much more likely to end up in jail or prison. Rather than recognize that the reasons for the “Other Than Honorable” status are indicative of that individual’s character, some are calling for the ending of assignment of this form of discharge status, saying it is the status that is causing the veteran to be less than successful in the civilian world. They want the military to have three, and only three options – Honorable, Medical and Dishonorable. What they don’t understand is that many of those currently receiving “Other” discharges do so as part of a plea arrangement; they accept the “Other” status instead of facing Court’s Martial. The military saves a lot of money by not holding trials, but I wonder how much it is then costing in VA healthcare services for individuals who would not have been eligible had they received the Dishonorable Discharge they earned.
I didn’t understand how someone coming home from war today missing limbs or with brains scrambled from multiple concussions had to get in line for care. I didn’t understand what was causing the backlogs to continue to skyrocket. I didn’t understand that Obama, with Shinseki’s full support, had turned the VA into just another form of Medicaid while simultaneously ordering a surge in troops into harm’s way. Granted, Obama didn’t create the priority groups, but he reversed the practice of allowing those uninjured, with illness or ailments not related to their service back into the system while we were more than six years into two wars. The lack of foresight displayed by this strategy is simply staggering. Mind boggling.
For perspective, let's take a look at some of the veterans who are not able to get the care they need because of the backlogs created by this policy:
The guy who blew out his knee in Viet Nam jumping out of an airplane gets that treated by the VA. Years later, because of decades of limping, his hips and back are now shot. Once a private doctor makes that determination, his insurance tells him he has to go to the VA to get those issues addressed. He then has to file, refile, appeal and wait for treatment.
This is a case I know personally - a Gulf War vet got blown up several times. After years of struggling with the effects of multiple concussions, what we now call TBI's, he develops Parkinson's. His insurance now requires him to go to the VA for care because it is ruled service-connected. He then has to file, refile, appeal and wait for treatment.
Another that I know of personally - a guy is in a Humvee that gets blown up. He is injured and medivaced out, but he is the lucky one. Two of his buddies died. He is treated and then medically discharged. He has to get in line, even though he is Priority Group 1, because the system is overloaded. He is unable to work due to a combination of his almost non-functioning leg, Traumatic Brain Injury that has caused severe short-term memory loss and Post Traumatic Stress from having his buddies die in his arms. He is given an appointment five months out. He was a medic, arguably the hardest job in a war zone. He knows that without proper, prompt, continual treatment, his injuries will become life-long disabilities. He can't even get VA disability payments until his case is approved.
What to do, what to do?
There is a very simple solution, one that Obama should be all over.
Now that we have Obamacare and everyone is eligible for insurance, to keep their own doctors if they choose, to never have to worry again about going bankrupt over medical bills, etc., etc., we can allow the VA to go back to doing what it is supposed to do – caring for veterans who are injured, ill or disabled as a result of their service to our country and those who spent more than twenty years in uniform.
There will then be need for only two priority groups -
1-anyone who was injured while in uniform or ill due to their time in uniform, regardless of income. This group would be, as it is now and should be, subdivided and triaged according to their disability rating.
2-anyone who has served not less than twenty years, regardless of health or post-service income.
If those are the only two criteria, the backlog will disappear overnight, not due to creative accounting or secret waiting lists or ‘mysteriously’ lost files. Of course, hundreds of thousands will no longer be eligible, but again, we have the miracle of Obamacare to cover them.
I wonder why our President doesn’t take this route? Admittedly I’m being facetious, but the above basic outline has been proposed – and rejected - by our President. This is a serious question that begs a serious answer.
Ultimately, it doesn't matter to the taxpayer where Priority Group 8 gets medical care - we are paying for it one way or the other. As it stands now, those veterans who deserve the highest level of care and compensation are paying, literally with their lives. This is absolutely Obama's fault. He put this policy in place. Shinseki supported it. And now, they are looking to roll heads because the rank and file of the VA does not have the resources to handle the hundreds of thousands stuffed down their throats under the plans and policies this administration put in place.
Of course, none of this excuses the complete and callous disregard for the lives and well being of our veterans displayed on the institutional level in the VA. But, it does explain where the motivation for artificially lowering the numbers comes from. It comes from the top. I'm not excusing the individual VA leaders who flagrantly violated the trust placed in them, lied about the backlogs and then took the bonuses for coming up with the numbers the administration wanted to see. But, without the pressure to make unworkable policies and numbers work, without the incentive to not just keep their jobs but to receive bonuses, how many veterans would be alive today? Yes, hold every one of them accountable. After the Commander in Chief fires Shinseki.
It will then be up to Shinseki and those who were fired to blow the whistle and produce the memos and directives that motivated the lies and waiting lists. As for Obama, let the chips fall where they may. Let him reap what he has sown.
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