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Ask a Vet
Author: TriSec    Date: 03/20/2018 09:44:51

Good Morning.

There appears to be some targets over the V.A. this morning. The clarion call of privatization is sounding ever louder. But of course, it would be a bad idea - this is one of the handful of things in the US that should automatically fall under the guise of the federal government. But of course, these things take money and regulation, things the current administration is vehemently opposed to.

Aaron Hughes, who was deployed to Kuwait and Iraq in 2003 and 2004, now has a serious, very rare lung condition. But he told In These Times he gets "really outstanding care" at the nearby Jesse Brown VA Medical Center. "The doctors are at the top of their class," he said.

Because his condition is so rare, Hughes has been sent to a hospital outside of the Department of Veterans Affairs (VA) for specific tests. And his taste of the private healthcare system has been sour. "As soon as I went there, all hell broke loose," he said said, explaining there were problems with sharing records between the two institutions. "With the VA system, when you do tests, it's all integrated." Every doctor Hughes sees is aware of all the other treatment he gets, from vision to mental health. The private hospitals, on the other hand, often refuse to send the records back to the VA. "The private sector isn't about sharing your information," Hughes explained. "It's not about healthcare, it's about ownership of care."

Hughes thinks these problems could get worse if efforts to fully privatize the VA are successful. President Donald Trump has supported privatizing the system, and has called to make permanent the Veterans Choice Program, an experiment Congress launched in 2014 that gives vouchers to veterans to see private doctors, while cutting other parts of the agency. These developments have provoked concerns that Trump will usher in a full private sector takeover.

"I worry that my care will become a profit motive," Hughes said. "And that means it's not about me anymore, it's about making money."

Now Hughes' organization, About Face: Veterans Against the War, has joined other veterans' groups, unions and healthcare advocates to launch a campaign to stop the privatization of the VA. After several months of building the coalition, the mobilization now includes Veterans for Peace, Service Employees International Union, the American Federation of Government Employees (AFGE) and National Nurses United. Healthcare advocacy groups including the Illinois Single Payer Coalition and the Democratic Socialists of America Healthcare Working Group have also joined the campaign. When the organizations came together on March 1 to hold a panel event in Chicago, more than 100 people showed up.

The combination of unions and veterans' groups is potent. "We as veterans can argue and demand things and raise issues that the unions can't, and the unions can inform us about issues that we don't understand," Hughes said. "We're seeing outside, and they're seeing inside of the system. We're able to have this inside/outside strategy that I think is really a winning strategy."

Organizers believe the time is right to invest in that teamwork now. "It came to our attention last fall that things under the Trump administration have been getting really bad," Roberto Clack, an organizer with the Right to Heal VA Campaign, told In These Times.

"There are problems with the VA, but the VA works," Clack said. "It provides quality care for the people that use it, and it saves lives." A 2016 RAND Corporation analysis found that the VA provides good quality care compared with other health systems, usually in a timely manner. Private providers, on the other hand, could expose veterans to lower-quality care, longer wait times and doctors who aren't familiar with military service.

"We agree that it could be better," Clack said, "but the way to make healthcare better is to have a fully supported VA, funded VA, and staffed VA."

Privatizing the VA wouldn't just risk veteran's healthcare, however. It could also threaten the unionized public sector employees who work for it. AFGE represents more than 700,000 federal workers, 250,000 of whom work at the VA. It would be "a serious death knell for unionization in this country," said Anne Lindgren, president of AFGE Local 789.

Privatization is "absolutely the wrong response," Clack said. "Privatization's not going to make anyone's healthcare better."

This is actually real enough that some veterans are starting to protest in order to save their little corner of the V.A. A small facility in Roseburg, OR has long been the target for shutdown, but of course the locals are having none of it.

A handful of protesters held signs at the Garden Valley Boulevard entrance to the Roseburg Veterans Affairs Medical Center Thursday to express their fear that politicians at the national level are moving to privatize veterans’ health care. These local veterans, members of the Veterans for Peace, believe that would be a disaster for veterans.

Their worry stems from national news reports that VA Secretary David Shulkin may soon be replaced by a proponent of privatizing care provided at VA hospitals like the Roseburg VA.

Reportedly, President Donald Trump is considering Energy Secretary Rick Perry or “Fox and Friends” television personality Pete Hegseth for the role. Hegseth has said on television that he favors moving away from caring for veterans at VA hospitals and instead offering them private care. Hegseth is a former executive director of Concerned Veterans for America, an organization backed by billionaire businessmen Charles and David Koch.

Most veteran groups oppose privatization.

Rick Staggenborg of Roseburg, a retired VA psychiatrist, said corporate interests are behind the push to privatize as much of the VA as they can, but it’s not good for veterans.

Already, he said, the VA’s choice program, which allows veterans to seek community doctors when VA doctors aren’t readily available, is hurting the VA. Forty percent of veteran patient visits are now in the private sector.

“Think of what that money could do in the VA,” he said.

He said even though it’s a big bureaucracy, the VA still offers more service for less money than the private sector would.

He said it’s an integrated system, and when you start “stripping away the parts, the whole thing falls apart.”

Jim McNulty said he attended Thursday’s demonstration because he’s not excited about the idea of privatizing his care.

“I’m afraid the costs would go up for everyone. That’s what always happens with privatization,” he said.

But then I see stories like this next one. There is no excuse for this kind of ineptitude among any healthcare provider. Years ago, I worked in this insurance specialty (called DME, or Durable Medical Equipment). Rules and coverage are different than straight medical, but seven months for a wheelchair fix is ludicrous. I could get an entirely new wheelchair out to someone in something less than 7 hours back in the day.

Disabled veterans had to wait more than two months for the government to fix their wheelchairs, leading to some veterans confined to beds because of mismanagement at the Department of Veterans Affairs, according to a new audit.

The inspector general for Veterans Affairs reported this week on problems at VA medical facilities in its southeast network with its repair system for scooters and wheelchairs. One vet waited as long as 210 days—roughly 7 months—for his power wheelchair to be fixed.

The inspector general initiated the audit after Senate committee chairman Johnny Isakson (R., Ga.) heard of delays at the Atlanta VA. The audit found that the problem was widespread at eight facilities within the Veterans Integrated Service Network (VISN) in the southeast.

The audit revealed 40 percent of repair orders were delayed, taking an average 69 days to complete.

"These delays occurred because staff and Prosthetic Service managers at the respective VISN 7 VA medical facilities did not always effectively manage and monitor repair requests," the inspector general said. "VA medical facility staff, including Prosthetic Service staff, did not always promptly input repair requests in the consult management system so the requests could be properly tracked."

"The [inspector general's] review of veterans' medical records could not confirm that veterans experienced financial hardships due to delayed power wheelchair and scooter repairs, but it did find some veterans experienced physical hardships like confinement to a bed and a missed medical appointment due to the delays," the inspector general said.

The worst offender was the Charlie Norwood VA in Georgia, which took an average 82 days to repair 200 wheelchairs. The William Jennings Bryan Dorn VA in South Carolina took 77 days on average, and the Atlanta VA took 70 days.

In one case, it took 78 days to replace the battery in a veteran's power wheelchair. The inspector general said the purchasing agent did not take initial action until 69 days after the request came in.

Another veteran needed the wheels replaced on his wheelchair and ended up waiting seven months.

"The purchasing agent had the parts delivered to the veteran's home but did not issue another purchase order to have the casters installed," the inspector general said. "Subsequently, Prosthetic Service staff lost track of the repair and did not issue another purchase order to have the casters installed until 163 days after the agent shipped the parts to the veteran."

"Consequently, the veteran waited a total of 210 days to have the repair completed," the inspector general said.

The inspector general faulted the VA for not having a "timeliness standard" for scooter or wheelchair repairs. The inspector general gave itself a 30-day benchmark for wheelchair repairs, and every facility it examined in the network failed to complete repairs in the one-month timeframe.

We'll finish up this morning with a word from an actual veteran. And please take the time to read it all - this one is important.

"Thank you for your service."

I can't tell you how many times I've heard those exact five words while out in public with my husband -- sitting at dinner, heading to a birthday ball, or doing something totally mundane like grocery shopping or getting the oil changed.

It's hard to know what prompts it. Sometimes, it's the haircut. Sometimes, the uniform. Sometimes, the USAA credit card.

Particularly when we travel outside of where he's stationed in Washington, D.C., where military members are a dime a dozen, he attracts a lot of attention from well-meaning civilians. It doesn't hurt that he's a tall, fit, handsome Marine who looks especially dashing in his dress blues.

He's always a little bashful, though, when someone approaches us to thank him. And not just because he's a polite, humble man. It's because the woman right next to him ... his wife ... me ...

I serve, too.

I'm not referring to my role as a military spouse, although that kind of service is also honorable and equally deserving of gratitude. I do hold down the fort when he's away; I put out the fires, kiss the boo-boos, and keep the house (mostly) standing.

But, like him, I also put on a uniform. Like him, I took the oath and signed on the dotted line. I'm married to my husband, and we're both married to Uncle Sam.

"My wife serves as well. She's in the Army."

People always look genuinely surprised.

"Oh! Well thank you for your service, too," they stutter, as an afterthought.

I conclude this reaction is due to one of two reasons: I'm a woman, which is still the exception rather than the rule in the military; or I don't fit the "typical" mold of a female service member.

In the case of the former, I can't really take offense. Women aren't well represented in the military, period.


40 comments (Latest Comment: 03/20/2018 20:42:27 by Mondobubba)
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