Tag Archives: veterans

Science and Other News

Veterans Health Administration Realizes It Should Buy, Not Build, Software

doctor-technologyImagine if you learned a government agency built its own office furniture, HVAC, or telephones. Even if there were a massive amount of corruption in government purchasing, it would be remarkable if a bureaucracy could do a better job building than buying.

Yet, for decades, the Veterans Health Administration has tried to do that with its Electronic Health Record (EHR). I cannot think of another health system that has built its own EHR, rather than buy it from a vendor. It makes as little sense as a health system manufacturing its own MRI machines.

President Trump’s newly appointed VA Secretary has confirmed he will throw in the towel on the VA’s home-brew system, VISTA, and buy a commercial EHR. Continue reading Veterans Health Administration Realizes It Should Buy, Not Build, Software →

Science and Other News

Medicare, Medicaid, Veterans Health At High Risk For Fraud, Waste, Abuse

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InsFormSmallThe Government Accountability Office (GAO) has published its biennial update of federal programs “that it identifies as high risk due to their greater vulnerabilities to fraud, waste, abuse, and mismanagement…”

Healthcare programs feature high on the list. Medicare, the entitlement program for seniors, and Medicaid, the joint state federal welfare program for low-income households, are longstanding members of the list; and the GAO notes that legislation will be required to fix them: “We designated Medicare as a high-risk program in 1990 due to its size, complexity, and susceptibility to mismanagement and improper payments.” “We designated Medicaid as a high-risk program in 2003 due to its size, growth, diversity of programs, and concerns about the adequacy of fiscal oversight.”

So, that would be 27 years for Medicare and 14 years for Medicaid. Seen any progress? Continue reading Medicare, Medicaid, Veterans Health At High Risk For Fraud, Waste, Abuse →

Health Alerts

Veterans Deserve Better Health Care

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man-in-wheelchair(A version of this Health Alert was syndicated by the Tribune News Service.)

President-elect Trump has nominated David Shulkin, MD, to be the next Secretary of Veterans Affairs. In 2015, Doctor Shulkin was nominated by President Obama to be Under Secretary of Health in the VA (the position he currently holds). It is an interesting choice, not only because Mr. Trump is calling on an Obama appointee to take the top job in the VA, but also because it recognizes veterans’ health care is the major pain point in the department. Continue reading Veterans Deserve Better Health Care →

Drugs

Government Price Controls & Drug Addiction

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Variety of Medicine in Pill BottlesIn a recent print issue of National Review, David French has a sobering article describing how the Veterans Health Administration is overdosing veterans on prescription drugs. A veteran himself, French has plenty of anecdotes about his buddies:

They couldn’t sleep, so they had to take Ambien. They were depressed, so they were taking Lexapro. They had chronic neck and back pain after hanging 90 pounds of gear on their frame day after day, month after month, so they took Lortab. They were anxious, so they took Xanax.

It was as if a VA doctor had simply listened to a list of symptoms, located a pill to address each complaint, loaded up the patient with prescriptions, and called it “treating” a soldier with PTSD.

In 2014, an inspector-general report found that the VA was systematically over-medicating its patients – even to the point of death.

Wisconsin’s Senate race is being roiled by a report on the VA facility at Tomah, a place so notorious for freely writing narcotics prescriptions that it gained the nickname “Candyland.”

(David French, “Casualties of the VA,” National Review, Vol. LXVIII, No. 12, July 11, 2016, pp. 20-21.)

Continue reading Government Price Controls & Drug Addiction →

Science and Other News

Billions of Dollars Later, Veterans Health Administration Still Failing

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man-in-wheelchairBack in July 2014, I described how Congress was preparing to reward the Veterans Health Administration for its failure to ensure veterans get timely, adequate care, with a multi-billion dollar bailout.

Because Republicans had taken the majority in both Houses of Congress, the bailout was camouflaged as a method of allowing veterans more choice of healthcare providers, outside the government bureaucracy. The results are pretty bad, according to a report by Dr. Sanjay Gupta: Continue reading Billions of Dollars Later, Veterans Health Administration Still Failing →

Health Care Access

One Year After Veterans Waiting List Scandal, Doctors Only 2,000 of 23,000 New VHA Hires

I hate to bring this up right after Independence Day, but the Veterans Health Administration appears to have devolved from an expensive and failing bureaucracy to an even more expensive and failing bureaucracy.

We have  already discussed that waiting lists have grown one year after the scandal broke. Now, see what they’ve done with the billions of dollars Congress handed them in the wake of the scandal:

o Bonuses at the most troubled VA facilities ran virtually unabated.
o Out of 23,000 new employees added to the employment counts during the scandal, fewer than 2,000 were doctors. Less than 1 in 12 new hires were doctors.
o At the troubled Hines VA in Cook County, IL bonuses leapt to three year highs, but the number of doctors actually decreased.
o Across the system, the VA cut the number of accountability positions: inspector general, auditors, and quality assurance officers.
o There are only 23,768 doctors in the system, but over 338,297 total employees. It’s still an employment farm, not a medical system.
o Yet, the VA increased the Public Relations Directors total salaries by $3,000,000. Painters, Interior Decorators, and Gardeners also increased in headcount and salaries.

(Open the Books, July 4, 2015)

Health Care Access

Veterans’ Waiting Lists Up 50 Percent One Year After Scandal Exposed

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Affordable-Care-ActUnfortunately, our predictive abilities at NCPA’s Health Policy Blog appear to be holding up pretty well. Last July, I wrote that giving billions of dollars to the Veterans Health Administration to “fix” the problems of long waiting lists for treatment would be viewed by the VHA bureaucrats as a “reward,” and they would react accordingly.

That is exactly what has happened:

One year after an explosive Veterans Affairs scandal sparked national outrage, the number of veterans on wait lists to be treated for everything from Hepatitis C to post-traumatic stress is 50 percent higher

Ahead of the House Committee on Veterans Affairs budget hearing scheduled for Thursday, VA leaders also warned that they are facing a $2.6 billion budget shortfall. They said they may have to start a hiring freeze or furloughs unless funding is reallocated for the federal government’s second-largest department. (Emily Wax-Thibodeaux, “One year after VA scandal, the number of veterans waiting for care is up 50 percent,” Washington Post, June 23, 2015)

At what point does a government bureaucracy that fails so badly get put out of business? Not very often, and not soon enough.

NCPA’s CEO, Allen B. West, has also written about this scandal.

Science and Other News

VHA Sitting on Results of 140 Investigations

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We recently noted that the government’s own watchdog has noted that the Veterans Health Administration is at high risk for fraud, waste, and abuse. Unfortunately, the public has little ability to see the evidence. USA Today has discovered that  the Veterans Health Administration has not been very forthcoming about the department’s shortcomings:

The Department of Veterans Affairs’ chief watchdog has not publicly released the findings of 140 health care investigations since 2006, potentially leaving dangerous problems to fester without proper oversight, a USA TODAY analysis of VA documents found.

It is impossible to know how many of the investigations uncovered serious problems without seeing the reports, but all concerned VA medical care provided to veterans or complaints of clinical misconduct.

The VA inspector general declined to provide the reports, say what’s in them or why the contents were kept from the public. (Donovan Slack, USA Today)

Health Care Access

VA to be Rewarded $17 Billion for Failing Vets

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A few days ago, we saw a headline we wished we hadn’t seen, in which a VA official testified to Congress that the VA would need over $17 billion to “fix” the problems that have been denying veterans access to care. Well, it looks like he’s going to get it.

The New York Times reports that a bipartisan bill has been negotiated, that hands $17 billion more dollars to the failed agency. Lawmakers from both sides of the isle hope to pass the bill before the August recess. $10 billion will be allocated to get veterans appointments with private doctors and hospitals when they cannot access the VA system. However, that is not the good news it appears to be.

This looks like it is meant to solve the problem that private providers are increasingly unwilling to see VA patients, because the VA does not pay its bills adequately or timely. So, the solution would be to give vouchers directly to vets, right? No such luck:

Continue reading VA to be Rewarded $17 Billion for Failing Vets →