Patterico's Pontifications

12/29/2016

Trump Considers Privatizing VA

Filed under: General — Dana @ 10:19 am

[guest post by Dana]

Reportedly, Donald Trump is looking at ways to possibly privatize the Dept. of Veteran’s Affairs:

Mr. Trump is considering changing the department to allow some veterans to bypass the VA heath-care system completely and get care exclusively from private-sector hospitals and clinics, the official said. It is an option that could give veterans full choice over their health care, but which many veterans groups argue is the first step toward privatization and one that will reduce the quality of health care over the long term.

“It’s one of the options on the table,” the transition official said Wednesday. ”Definitely an option on the table to have a system where potentially vets can choose either or, or all private.”

VA bureaucrats see this as problematic. Apparently, the specialized care and guidance that the VA currently provides is so unique that private hospitals would not be able to match it, and the issue of a former member of the military navigating a system on their own might be more than they can handle:

Veterans groups, and the department itself, say a private-sector care program without adequate VA oversight or coordination leaves former members of the military navigating a private system that isn’t necessarily equipped to handle the unique problems veterans face, including post-traumatic stress and injuries sustained on the battlefield.

“Veterans suffer very specific illnesses and injuries that come from the battlefield and that come from service and they tend to be multiple in nature,” VA Secretary Bob McDonald said in an interview on Dec. 13, when asked why the VA needs to remain the coordinating hub of care for veterans. “Veterans want a doctor, or want a provider, who understands these illnesses and these injuries and knows how to deal with them and deals with them every day.”

I suspect that there are any number of families of wounded veterans that might like to weigh in on this issue.

Consider this from Tiffany Smiley:

On an April day in Iraq in 2005, my husband’s world went black.

It came by way of a suicide car bomb. In one second, all the plans we had—for a military career, children and a happy life—seemed to go out the window. Quickly we learned that the federal bureaucracy, including the Department of Veterans Affairs, that would determine so much of our future was not up to the job.

Smiley goes on to lay out the struggles and frustration she and her husband experienced in their efforts to get her husband the help he needed:

My first encounter with the military bureaucracy came days after I arrived at Walter Reed to see Scotty, a West Point graduate, after he’d been flown in from Iraq. This was the other side of the country for me, away from everything and everyone I knew. I was supposed to be on “orders” and receiving a stipend for food, but somewhere along the way someone filled out the form incorrectly. The man I spoke to said that it would be a huge hassle to try to fix it, which seemed ridiculous in light of all that had happened, but I just accepted what he told me.

We got by on Scotty’s first lieutenant pay and the generosity of friends and family. But there has to be a better way for our federal government to make it easier for the spouses, parents and siblings who have to quit their jobs and forfeit their livelihoods to care for an injured veteran.

My next challenge came when we entered the world of rehabilitation for the blind. Scotty was 24-years-old and had his whole life ahead of him. I knew he needed a center that would teach him new things, challenge him and give him the confidence that he would once again be a contributing member of society. We were promised customized care at a blind rehab center. Unfortunately, when we got there, it was clear that no one was ready to rehabilitate post 9-11 warriors.

Here’s an example. We kept asking for computer training because we knew that technology and computers were going to be key to a future of dignity and productivity for Scotty. So imagine how appalled I was when I was informed that computer training came last—behind belt braiding and woodshop. Also, he was given books on cassette. Cassettes!

Smiley and her husband, with the support of friends and family, made it through the many obstacles and frustrations they faced. Smiley also makes several solid points that surely echo untold numbers of military families who have found themselves in the same frustrating boat of difficulties:

In a world where technology is making almost all aspects of life easier, why isn’t there a website, a liaison, or an advocate to fill out government paperwork and get deserving veterans the benefits they were promised and deserved? When I asked for help, someone suggested we hire a lawyer.

Our men and women who have sacrificed on the battlefield deserve better when they come home. So unlike others who worry that our new president is a businessman, this background gives me hope. Because unlike most federal agencies, the VA is primarily about dealing with people—customers. If Donald Trump hopes to make America great again, a good start would be making the VA run more like a business, and giving the customer what the customer needs.

–Dana

29 Responses to “Trump Considers Privatizing VA”

  1. Is it just me, but to bureaucrats seem to consistently underestimate the intelligence of members of the military and their families?

    Dana (d17a61)

  2. Dana, family members like the service men themselves are just numbers to bureaucrats. Widgets to plug in or out as needed. Faceless entities.

    They don’t want things to change because they don’t care and they are making money this way through apathy.

    NJRob (57630d)

  3. Path of least resistance and least effort. That’s the government way.

    NJRob (57630d)

  4. NJRob, that’s really sad. I made my comment at #1 sarcastically because it’s really awful how they maintain control of the masses by eventually wearing them down through overburdening demands and the endless wheel of mind-numbing inefficiency.

    Dana (d17a61)

  5. It’s what they want Dana. Sheep are easier to manage. An ignorant flock is easier to handle. Look at the horrific situation in Venezuela. The people still look to the government for answers even though they created this completely foreseeable disaster.

    NJRob (57630d)

  6. For those things for which the VA is best at, they’ll continue to go to the VA, even if it, while better than what’s otherwise available, isn’t too good either. Nobody’s talking of abolishing the VA. Some people are afraid of losing their jobs. Otherwise who should care if it has 30% or 75% fewer cases? Of course, things can be cut back in such a way so that certain things are handled as well as before, but the idea is not to do that. And it’s true, the more expensive things miht disproportionately remain. Is the VA a money making business, so that it needs to trap customers?

    Tiffany’s story is an illustration of the way a government bureaucracy is not able to deal with new things, (casettes were once mainstream) and also assumes that people are familiar with its processess, just like they were when it was first established.

    Sammy Finkelman (39f7be)

  7. Sweet. I’m sure Trump Brand Veterans’ Hospitals will do a much better job deciding which veterans and which veterans’ families are worthy of medical case.

    Leviticus (efada1)

  8. I’m talking about abolishing the VA Sammy. I’m a wounded, Bronze Star, disabled (not from a war wound though) senior citizen veteran. I’ve never set foot in a VA hospital. I pay for my own private, top rate insurance because I can. Many cannot.

    If we as a nation really, really care about our veterans we would abolish the VA and replace it with nothing. Nothing but a Bio-ID card usable at any doctor, clinic, emergency room dentist and optometrist licensed in the US. The going rate would be calculated by geographic area since a procedure in NYC is more than the same in Scranton, PA. The doctor, hospital or whatever would be reimbursed the standard amount and no more. The patient picks his doctor and his facility. The government who has no business in the medical business nor has any idea how to run a
    hospital would be out. Period. Mission accomplished.

    The object was never to provide care for veterans, it was to provide jobs for voters an a program for voters all to vote for guess who? Just like Social Security.

    Rev. Hoagie® (785e38)

  9. Sweet. I’m sure Trump Brand Veterans’ Hospitals will do a much better job deciding which veterans and which veterans’ families are worthy of medical case.

    Leviticus (efada1) — 12/29/2016 @ 11:36 am

    According to the report, Trump is investigating how to adjust the system so that it would allow a vet to go the hospital of their choosing. This would then put the power in their own hands, rather than the hands of a frequently inefficient and chaotic centralized office of the federal government.

    Dana (d17a61)

  10. I would say that “bureaucrats seem to consistently underestimate the intelligence of” everyone.

    I recently got a 2-page letter from my…I don’t know, drug store HQ?…telling me that since I take thyroid meds, I should talk to my doctor about it and get a test regularly, and they helpfully told me what the meds are for. Where do they think I got it?? From the streets? My doctor prescribed it and told me why!

    Patricia (5fc097)

  11. Mr. Trump will make the good decisions and get the job done

    he’s not a loser like Obama

    I been trying to tell you

    happyfeet (28a91b)

  12. Any hospital, especially one devoted more to a specialized kind of patients will develop special treatments that might be better. There is some exppertise r shold bem with regard to injuries. Because they do not require FDA approval, this is still possible with surgery and some other medical interventions like ulowering body temerature or using widely available items. So I don’t see a reason to close VA hospitals. If some do good jobs for some patients, let them stay open. Although maybe no onger as part of the VA.

    The Bio-ID card probably can work, if the rate is set right, and adjusted as time goes on Right now I think we have the situation where veterans think the VA isn’t too good but se it because it is at no cost to them.

    Sammy Finkelman (39f7be)

  13. @Patricia:I recently got a 2-page letter from my…I don’t know, drug store HQ?

    Yeah, pharmacies have to give this out now. I tried to figure out if this was part of Obamacare, or if this is some new regulatory thing, but no such luck. Anyway, every pharmacy gives you this kind of information now.

    Gabriel Hanna (64d4e1)

  14. @Leviticus: I’m sure Trump Brand Veterans’ Hospitals will do a much better job deciding which veterans and which veterans’ families are worthy of medical case.

    This is a devastating criticism of something that no one has proposed, and has nothing whatever to do with the topic of the post.

    Gabriel Hanna (64d4e1)

  15. Amen Rev!

    Donald (eac13a)

  16. And I would have gotten away with it, if it weren’t for you lousy kids!

    Leviticus (70ca80)

  17. Right now veterans use the VA for all health care, whether or not related to their service in the military. Biggest draw is the cost: it’s generally no cost to them.

    I would keep the VA, but limit its hospitals to care for situations like that of Lt. Smiley: health problems and rehab directly linked to their time in the service. Specialization would inevitably improve it in what ought to be its core functions. For everything else, vets can use whatever insurance and services are available to non veterans in their situation. The fact that a person spent their twenties in the Army should not be a reason to provide them free health care thirty and fourty years later.

    Kishnevi (3bfc26)

  18. The VA has 365k employees. They’re unionized. The VA isn’t going anywhere, veterans be damned.

    Richard Aubrey (472a6f)

  19. I would keep the VA, but limit its hospitals to care for situations like that of Lt. Smiley: health problems and rehab directly linked to their time in the service.

    I’ll tell you why that won’t work, Kishnevi. When you get old many things become a problem that “may be”, “could be”, “can be” related to things that happened 40 years ago. Or not. I was shot once, through. No problem. But I have a shard of mortar about the size of a quarter pressed against my right kidney. So far no problem. But who knows? The idea of “directly linked” becomes ambiguous once a good lawyer enters the picture.

    But if you like that idea, no problem. Dissolve the VA like I said and get the Bio-ID card. You see, only covered illnesses and conditions will be coded on the card. They walk in for an ingrown toenail, too bad.

    Oh and Richard, those 365 fed union employees mean zero to Trump. Maybe less than zero.

    Rev. Hoagie® (785e38)

  20. I too served and was discharged w/a 30% disability. That was 1984…the only thing the VA did for me was to reduce my disability from 30% to 10%…then they lost the paperwork. I have applied and reapplied 9 times in the 32 years since. I have never ever received a dime in my disability payments. Not one red cent. ever.

    I expect that I’ll die before my paper work is ever cleared up and my family will still never get the $$$ that the government owes me. The VA is filled with careerists who don’t give a phlying phuk about the servicemen & women they’re screwing. Too bad there aren’t punishments for incompetence in our government service. If there were, they wouldn’t screw around with people’s lives like they do. I’d like to see 1 in 10…taken out and shot to “Encourager les autres”

    Rich Vail (339dcb)

  21. One of the things that VA defenders say is that there are few, if any, private centers for war wound treatment. The VA has that as a core competence. IF they have lost that due to they general malfeasance of the Obama Administration, then maybe we privatize and hope that private industry can fill the bill.

    Given that agencies like OPM have failed to do the ONE THING they were supposed to do, I’m not shocked that the VA is a cesspool of politically correct bullsh1t.

    Kevin M (25bbee)

  22. “Our men and women who have sacrificed on the battlefield deserve better when they come home.”
    Unfortunately, the VA is led, staffed, and run by progressives. They still see the soldier as a “Baby Killer.’

    Dave F (6adbba)

  23. the VA genuinely hates soldiers with a ferocity that’s really kind of shocking

    happyfeet (28a91b)

  24. Rev. Hoagie. Trump may not care for the 365k VA employees, but their contracts do amount to a hell of an obstacle, along with various labor laws and labor judges.

    Richard Aubrey (472a6f)

  25. I could be wrong, but I have assumed the ton of paper from the drug store is more CYA than anything else,
    They can say that they warned each patient of potential side effects,
    Though I think all of that info without sufficient context is of negligible help and maybe on occasion actually harmful.

    I have been told by someone in on the negotiations that HIPPA was not about patient protection at all, but to clarify how stores and insurance companies could collect data for their own use.

    Besides, what we are really concerned about is the security of our electronic records, and not much is said about that.

    MD in Philly (f9371b)

  26. I would surmise any Healthcare bill that had Ted Kennedy’s sponsorship was not optimum, md

    narciso (d1f714)

  27. This is “turf-protection”. The VA I go to is across the street from the University Hospital. Those Doctors assist at the VA. My eye-care Dr. is a private physician, and sees patients inside the VA certain hours of the week. It’s already a “public/private” institution, but the entrenched bureaucrats are loathe for anyone to see inside its operation. Patients die because of neglect and the responsible administrators are promoted and paid bonuses. The “insiders” sure don’t want anyone “rocking their boat”.

    radioone (113e99)

  28. The people employed by government are not gods; although, with the establishment of the progressive Pro-Choice Church, this may come as a surprise to many. Quality can be measured in outcomes.

    nn (b35206)

  29. Frankly, any time you add the government to a process, you can expect incompetence, delay and added expense. Just get rid of the VA, let veterans use hospitals and doctors like the rest of us. And yes, we owe veterans better than what we’re providing now.

    Rochf (877dba)


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