When big government can’t get out of its own way

 

isaksonVA2

Sen. Johnny Isakson (left) and U.S. Rep. Doug Collins at Friday’s hearing in Gainesville.

The shocking news came over a year ago: American veterans were dying by the dozens as they languished on lengthy waiting lists, while Veterans Administration staff falsified records to hide the problem. Almost as shocking, Congress acted within four months of the first news reports about deaths of veterans waiting for care from VA medical facilities in Phoenix.

The result, the Veterans Access, Choice and Accountability Act of 2014, is a classic example of both the need for, and the limitations of, a vast bureaucracy to give people a measure of freedom.

Each point was painfully evident last week during a field hearing of the Senate Veterans Affairs Committee, chaired by Georgia’s Johnny Isakson. Those who spoke at the hearing in Gainesville on Friday demonstrated both how much pent-up demand there was for veterans’ health care beyond the VA’s capacity to deliver it, and how the VA itself has often gotten in the way of meeting that demand.

Central to the 2014 law its requirement that the VA arrange for private care for any veterans who would have to travel at least 40 miles or wait at least 30 days to get care at a VA facility. VA Secretary Robert McDonald, the West Point grad and former Procter & Gamble CEO who took office 13 months ago to right the ship, reported Friday that veterans’ appointments are up by 7 million this year — 4.5 million of them outside the VA system. By that measure, the law is working.

But to hear the litany of problems veterans have had in getting appointments even under the new system is to wonder how many more might have been served, if the bureaucracy were better at letting people out of its grip.

Many veterans eligible for choice programs are unaware of them. Conversely, many veterans who received mailings about the programs aren’t eligible.

Some private physicians are reluctant to sign on with the choice program, a couple of witnesses testified, because the VA has taken up to a year to reimburse them for care in the past. As a result, it sometimes takes veterans more than 30 days to see a private doctor.

When veterans do get an appointment, they don’t always know about it. One veteran who testified Friday, Carlos Chacha, said he missed two appointments with a rheumatologist because he was never told about them. Not surprisingly, no-shows are another reason some providers avoid the program.

Perhaps the most ludicrous exchange came between U.S. Rep. Doug Collins, R-Gainesville, and Donna Hoffmeier, a program manager with a contractor hired to arrange the private appointments, Health Net Federal Services.

Even if the VA has sent Health Net a veteran’s file for use in making the appointment, Hoffmeier said, the firm must first wait for a separate file confirming the veteran’s eligibility.

Collins: “Can VA just send Health Net … any veteran’s file?”

Hoffmeier: “No.”

Collins: “OK. So the reason they would send somebody’s file to Health Net … is because (they) are eligible for the choice program!”

Hoffmeier: “I absolutely agree with you … (but) the contract requires us to wait for that eligibility file.”

They’re both probably correct. And that’s a problem.

It’s not a problem solved by ending the choice program to simplify matters. It’s one solved by continuing to make clear that the VA’s job is to ensure the service is provided, regardless of who does it.

Come to think of it, that’s a lesson a lot of bureaucrats outside the VA could stand to learn, too.

Reader Comments 0

37 comments
PudHead
PudHead

Since the ACA is supposed to cover everybody, including illegal aliens, why do we need the VA or Planned Parenthood?

Wascatlady
Wascatlady

What is still not addressed is how vets are jerked around.  My neighbor has the symptoms of prostate malfunction.  He has been jerked around by the VA for 8 weeks with them 'trying stuff' and finally in 30 more days he will get to see a urologist--12 weeks after obvious symptoms began!

DawgDadII
DawgDadII

If there is an area of priority where the USG needs to open the checkbook and err on the side of enabling fraud and corruption to ensure the people are served, this is it. Virtually across the board USG programs are cesspools of corruption and throwing money at problems, yet our Vets have to jump through hoops to [hopefully] get the services they have earned before their lives are destroyed or otherwise impacted. It is completely shameful, and it is a stain on every politician in Washington that this has not been fixed.


This is a leading barometer of the effectiveness of big government. It simply CANNOT be trusted to operate effectively (putting aside efficiently), certainly not on matters related to health care. This is also a big reason why, even when politicians have received broad voter support, they are held in such low esteem. They've earned our scorn and distrust, repeatedly, day after day, year after year, decade after decade.

JimStarowicz
JimStarowicz

* * Ben Carson: We Don’t Need a Department of Veterans Affairs * *

The VA is Not 'socialized' anything, it's the Responsibility of those served that has never been fully done nor maintained as they ignored or outright denied the so many issues!!
Carson isn't the only so called conservative seeking to bury the agency making it easier for corporate corruptions so it creates more media hyped needed 'scandals' to hasten it, and the government, to privatization for corporate profit and little to no regulation. The military is already way over privatized, thus more costly, for exactly same. Leaving the administration agency personal, smaller government, to easily blame for that created by peoples representatives conservative ideologies and the people served!!!

DeJa-Vu: “With no shared sacrifices being asked of civilians after Sept. 11", Decades and War From, All Over Again!! And that covers much more in the Deficits then just the, grossly under funded and not conservative obstructionists pols concern, VA budgets!!

USN All Shore '67-'71 GMG3 Vietnam In Country '70-'71 - Independent**

FIGMO2
FIGMO2

When I worked in government, my daily mantra was?

It's easier to ask for forgiveness than it is to ask for permission.

I broke every rule at one time or another.

Government workers confuse bad management with destiny.

schnirt

M H Smith
M H Smith

@FIGMO2 

The majority of Americans want an efficient government, no larger than functionally needs be. 

The approach Sen. Isakson is pursuing does exactly what is needed in cut waiting times to see a Doctor. 

FIGMO2
FIGMO2

@m h smith

My comment was made in reference to this:

Even if the VA has sent Health Net a veteran’s file for use in making the appointment, Hoffmeier said, the firm must first wait for a separate file confirming the veteran’s eligibility.

MarkVV
MarkVV

@m h smith @FIGMO2 

"The majority of Americans want an efficient government, no larger than functionally needs be. "

And who is it who knows and decides what size the government "functionally needs to be?" This a a kind of "wise pronouncement" like "people should not steal," one that sounds good and does not really mean or say anything worth saying.

M H Smith
M H Smith

@FIGMO2 @m h smith 

That should never happen. As the adage goes, wait(weight) is what broke the wagon down. As it appears, it broke the VA down too.

Sen Isakson is on the right trek with his idea. When the VA starts with this, "hurry up and wait" routine, that is when the veteran should be able to go directly to the Doctor of their choice - board certified preferably - and send the VA the bill for payment of services rendered.        

RafeHollister
RafeHollister

@MarkVV @m h smith @FIGMO2 Only a proggie would argue for lack of nuance when discussing one of the ten commandments.  I think most folks get it, without adding Clintonian nuance.

M H Smith
M H Smith

@MarkVV @m h smith @FIGMO2 

It is rather self-evident to most people - without any need of pronouncement - when things work efficiently in serving them: Satisfactory service speaks for itself. 

Which is not the case with a number government agencies and programs.

Wascatlady
Wascatlady

My neighbor has been jacked around by this for the last few years, years after he was eligible and years after he needed health care but has refused to pay for a policy (or make the trip to the VA).

McGarnagle
McGarnagle

 Hoffmeier: “I absolutely agree with you … (but) the contract requires us to wait for that eligibility file.”


Is this to prevent fraud?

LogicalDude
LogicalDude

Good article, Kyle.  It seems bureaucracy gets in the way of itself.  Maybe the VA should merge payment programs with the ACA to deliver benefits equally to all Veterans instead of "who is approved" by someone else. I see a few improvements available to veterans that you don't seem to list. 


Expand the choice program. (helps more veterans)

Accelerate payment to doctors. (helps the doctors helping the veterans)

Improve communication to veterans so they know about appointments - like making the appointment at the VA while the veteran is present.  (Helps both doctors and veterans)


Likewise
Likewise

Your "bad government of the day" topic of course is aligned with your Obamacare will ruin the world viewpoint.  That's your point isn't it?  It's not all bad at the VA, is it?  OK, let's privatize the VA and see how well that works.  You may also want to realize that after decades of the US fighting various wars, we have aging veterans who are seeing medical conditions that comes with just plain getting old.  It's called supply and demand. Maybe if we just stop fighting all these wars and save some money then we wouldn't have so many vets needing medical attention.

Kyle_Wingfield
Kyle_Wingfield moderator

@Likewise "let's privatize the VA and see how well that works"

This is explicitly not "privatizing the VA." It is letting veterans get private care when the VA can't provide that care in a convenient or timely manner.

TaxiSmith
TaxiSmith

The business of health care is best operated by private systems. Why not have the government take the money being spent on the VA health system and use it to underwrite veteran care from private health care providers? Too simple?

lvg
lvg

Well written by Kyle. I know someone whose elderly father who had dementia was dumped on an access road to 285 by a VA contractor who was supposed to take him from the VA hospital to a personal care home. Luckily a good samaritan picked him up. It was on channel 5.

LilBarryBailout
LilBarryBailout

@lvg

Good grief.  It seems that the folks who provide rides to and from health care for people on various government medical handout programs are very, very sketchy.  I have heard of similar cases, as well as outright fraud.

RafeHollister
RafeHollister

Why aren't the GOP Congress pursuing their responsibilities of oversight?


Too invested in the status quo and too beholden to their donors who make good money off of government inefficiency and corruption.  The leadership of the GOP is in bed with the bureaucrats in government as much or more than the Dems.  Guys like Perdue and Isaakson are just votes in the pockets of Mitch McConnell.

lvg
lvg

@RafeHollister Response- Teaheads with no intentions of compromising on anything other than reducing spending; backstabbing; grandstanding; fixation on obstructing the President; concerns that GOP monitoring groups will give them failing grades; worshipping at Grover's feet, etc.

Hedley_Lammar
Hedley_Lammar

Wars like the ones in Iraq have consequences. 


But when you think it will be a cakewalk and we will be greeted with Roses and Chocolates you don't prepare for those things.


So you have soldiers who return and cant get the care they need. 

Kyle_Wingfield
Kyle_Wingfield moderator

@Hedley_Lammar Actually, at the moment Vietnam veterans are the ones going through the high-use, high-cost years. That's per McDonald at the hearing.

RafeHollister
RafeHollister

@Kyle_Wingfield @Hedley_Lammar Now Headley needs someone to help him with another Bush to blame talking point.  Obama has had 7 years to bring the VA up to speed, but seems he was more interested in eliminating the Oreo's from school lunches, than take care of our wonderful veterans.

Hedley_Lammar
Hedley_Lammar

@RafeHollister @Kyle_Wingfield @Hedley_Lammar Wow


So Obama is responsible for all those injured in Iraq and in need of care. Talk about deflecting blame.


And FYI Obama got us OUT of Iraq. Otherwise there would be many more veterans in need of care. 


http://www.politifact.com/truth-o-meter/promises/obameter/subjects/veterans/


Also Obama kept most of this campaign promises concerning veterans. Not all no. Are we doing enough no....But if Obama had been President in 2001 i'm betting fewer veterans would need care today. Of that I have no doubt. 

RafeHollister
RafeHollister

@Hedley_Lammar @RafeHollister @Kyle_Wingfield Funny, that you forget Afghanistan where more have been killed and injured under Obama than under Bush.   What about his own casualties?   Barry said while running for President in 2007, he was going to fix the VA.  He didn't do diddly until these problems arose.  He is a failure as a manager of the Fed Gov!

Jefferson1776
Jefferson1776

Instead of giving Israel 6m $ a day, give it to the VA to build hospitals and treat vets. They need the money more.

LilBarryBailout
LilBarryBailout

@Jefferson1776

Obamacare and other handout programs waste much more than that.  Vets and Israelis surrounded by Obama's Islamist comrades need the money more than our own slothful wastes of oxygen.

Stephenson_Billings
Stephenson_Billings

I think this says it all:


The government has no idea how many agencies it has

The U.S. government does not know how many agencies and programs it is asking taxpayers to fund, The Daily Caller has learned.


A spokesperson for the Congressional Budget Office also confirmed to The Daily Caller that the CBO did not have a list of agencies and programs, and instead referred The Daily Caller to the Government Accountability Office (GAO).

A GAO spokesman, in turn, referred The Daily Caller to OMB, stating that no list of programs has existed in the past because of the lack of a consensus within the federal government about what constitutes a program.


http://dailycaller.com/2013/05/03/the-government-has-no-idea-how-many-agencies-it-has/

RafeHollister
RafeHollister

With all the attention, money, and sunshine brought to bear on the VA, the problems are still immense.  It makes you realize what a tremendous mess it must have been, before the problems finally surfaced.  The VA, IRS, DOS, and the EPA, are perfect examples of what happens if the Congress does not vigorously pursue their oversight obligations.  Our bloated, inefficient, corrupt government has outgrown our ability to control it's excesses, and that was before the behemoth Robertscare Insurance company enriching program was created.

GeorgiaRedNeck
GeorgiaRedNeck

@RafeHollister "Congress does not vigorously pursue their oversight obligations." Well, we have that GOP controlled Senate and House. The GOP said they could govern whereas they didn't think the Democrats could govern. Why aren't the GOP Congress pursuing their responsibilities of oversight?