Wednesday, October 21, 2015

Devil in Details on VA Reform Bill

The latest hoopla is on the VA Accountability Act of 2015 and appropriately enough on this day. After all, taking a trip back to the future seems to still be capturing attention.

The product is being sold as accountability for VA employees but there seems to be a lot more to this story than the press wants to even explore. First, none of the problems at the VA are new and this "fix" was pushed before. Frankly, it seems more of a political stunt than anything meaningful.

Fire more employees when they have trouble filling jobs in the first place and more funds go to contractors. Oh, forgot, the press won't talk about them either.

The American people seem to want reform
The 1,000-person survey was conducted by the conservative Tarrance Group. More than 90 percent of respondents called for reforming veterans health care, improving accountability among VA employees and expanding medical care options for veterans outside the department.
But they have no idea how long all this has been going on. None of this is new and frankly, during a time when everyone is getting hunchback from looking at their text messages, they know less than they did a decade ago. Ok, well that isn't totally true. It goes back even longer.

In 2003, just as with every year, the House Veterans Affairs Committee, (you know the guys elected with jurisdiction over the VA) held a hearing on several issues. Why not since they've been doing exactly that since 1946 and you see where all that "hearing" left for veterans to deal with.
The word ‘‘crisis’’ is often overused in this town, but clearly VA health care is in crisis, the funding of VA health care, and it is at a crossroads. Last year I, along with my good friend Lane Evans, offered several bills seeking long-term solutions to VA health care funding problems.
Christopher H. Smith gave the opening statement. You can read the whole thing from the above link but this should sum things up nicely for you.
200,000 veterans are waiting 6 months or longer for their first appointment with a VA doctor, and that estimate doesn’t count those still waiting to enroll in the system. Many of those waiting are 100 percent disabled and paralyzed veterans.
Earlier this month Chairman Buyer and committee staff visited one medical center in Florida and discovered that over 2,700 veterans are waiting to be scheduled to see a VA audiologist, over 4,000 veterans are waiting to see an eye specialist, and almost 700 are waiting to see a cardiologist. More than half of these veterans were high-priority veterans in categories 1 through 7. All reports indicate that a similar situation exists at a majority of VA medical centers throughout the country. Care delayed, I would respectfully submit, is care denied.
At the same time there remain at least 275,000 homeless veterans who—and that is a VA estimate, the VSO has put the number even higher—who desperately need a helping hand, yet VA is unable to fully fund programs that Congress approved less than 2 years ago.
The VA has closed over 1,500 long-term care beds at a time when World War II and Korean War veterans are most in need of assistance. Despite an increase in the number of veterans who have service-connected mental illnesses such as post-traumatic stress disorder, VA is providing less care overall than it did in previous fiscal years.
VA will be short, $1.9 billion in their health care budget for this fiscal year, and that assumes that the VA will receive the full $23.9 billion for health care approved last year by both the House and the Senate Appropriations Committees.
For some, the Secretary’s decision to cut off enrollment of 164,000 category 8 veterans was a solution.
This is from Dr. Robert Roswell, Under Secretary of the VA
VA is currently experiencing an unprecedented demand for health care services. We had nearly 800,000 new enrollees in fiscal year 2002 alone, and currently we have almost 6.6 million veterans enrolled. We currently project that we will provide care to 4.6 million veterans this year. This represents a 70 percent increase since 1996.
I could go on and on and on but the point is, when members of Congress say they have a plan, read the fine print because as always, the devil is in the details.

Just a taste of what else is out there if you search for it.
Where Does the VA Money Go
USAspending.gov, an information resource provided by the federal government, has reported that from 2000 to 2008, the Department of Veterans Affairs spent $61.2 billion on goods and services from private contractors. The lion’s share of the money that was paid to the VA’s 109,436 contractors went for medicines ($22.4 billion), medical and surgical supplies and equipment ($4.9 billion), hospitals maintenance ($1.8 billion), hospitals supplies ($1.7 billion) and nursing home services ($1.5 billion).

The largest recipients of VA contracts were McKesson Corporation and AmerisourceBergen, both of which specialize in distributing medicines and medical supplies from manufacturers to pharmacies, hospitals and other healthcare outlets. They are followed by notable multinational companies such as General Electric and Siemens and defense contractor Northrop Grumman. The full top 10 list of contractors is as follows:
McKesson Corp. $13,011,839,337
AmerisourceBergen Corp. $9,070,950,608
Northrop Grumman $668,978,924
Koninklijke Philips Electronics N.V. $615,019,658
General Electric $592,068,384
Small Business Consolidated Reporting $509,653,195
Cardinal Health, Inc. $506,536,397
Electronic Data Systems $482,386,445
Siemens AG $457,581,698
UCB SA $414,526,637
Examples of VA contracts: EDS, a leading information technology company founded by Texas entrepreneur and former president candidate Ross Perot, has signed several contracts with VHA to help run its computer systems. The latest contract was part of the VA’s eight-company, $1 billion effort to purchase support for the department’s Veterans Health Information Systems Technology and Architecture.

Another IT giant, Unisys Corp., has held VA contracts to improve patient management, billing and collections capabilities for the VHA. In 2003, the company signed a $139 million deal to provide systems integration and consulting services for Flowcast, a commercial, off-the-shelf software from IDX Systems Corp. Flowcast helps with patient access management, patient financials, document imaging and business intelligence.

VHA also contracts with architecture and engineering firms when it comes time to build new medical facilities. In September 2007, VHA announced that a three-party venture to design the replacement VA hospital for New Orleans. The three companies are NBBJ of Columbus, Ohio, Eskew+Dumez+Ripple of New Orleans and Rozas-Ward Architects, also of New Orleans.

Unisys wins VHA patient management, accounting solutions (by Gail Repsher Emery, Washington Technology)

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