Ed's Blog

"Some people know everything, but that's all they know."

FIXING THE VA HEALTH CARE

VA PHOTO

Why is it that no matter how much national media attention problems at the Veterans Administration receive, serious problems affecting the care of millions of veteran’s health care persist?

Most recently, while long delays in wait times for veterans at VA health care facilities continue, problems mount with the Choice Card, intended to allow veterans to seek private medical care if VA is unable to provide it within a month of being requested, or if there is no VA facility near their homes. The program, opposed by senior people at the VA because they believed it undercut their reputation, is under siege because the VA has not paid millions of dollars to doctors. The result is the hounding of veterans who have used the card by bill collectors.

According to investigative reporter Like Rosiak writing in the Daily Caller, citing the Miami Herald, “A survey of non-VA hospitals in Florida, for example, found VA owed more than $100 million in unpaid claims for services provided to veterans under the Choice Card program. Sixty percent of the hospitals described the problems in getting paid as inexplicable, with their claims mysteriously getting lost. A growing number of doctors across the country are refusing to treat patients using the Choice Card for fear of never being paid.”

What will it take to give veterans the health care they deserve?

They way I see it, three problems are at the root of this scandal. First, is the nature of the federal bureaucracy. Firing incompetent or simply lazy federal employees is an enormous challenge. As a former senior executive in the Department of Defense I can tell you that the time and effort it takes to fire these employees is such a disincentive that most supervisors simply transfer the employee or ignore the problem. The result is a level of incompetence exists in the federal government that is not tolerated in private industry.

Even so, the VA has made progress on this front. According to Government Executive magazine, “The VA has fired 400 more employees this year so far than in 2014, according to Secretary Bob McDonald. McDonald said VA has fired 1,500 employees this calendar year compared to 1,100 people last year – a 36 percent increase. The former head of Procter and Gamble added that 2,280 employees have been terminated since his confirmation as VA secretary in July, and that the department has proposed disciplinary action against 300 workers for ‘manipulating scheduling.’” The VA has a workforce of roughly 330,000 employees. The question is, is this enough?

Second, health care, in and of itself, in the United States is fraught with difficulty. Costs are out of control. The demand for health care is on the rise while the number of doctors available is rapidly decreasing. In the case of the VA, 14 years of war has created a large number of physically and mentally disabled veterans. This compounds the increase in the demand for healthcare by a greying American population. Obamacare has only exacerbated this for Americans in general and driven some veterans to the VA system who otherwise may not have needed VA care.

Third is gross mismanagement by the VA leadership. Even after Congress gave the Secretary of Veterans Affairs the power to fire underperforming senior executives, very few, if any, have been fired. The VA has approximately 400 Senior Executive Service employees, but firing SESs has been difficult. In January and February of 2016, the VA lost three successive personnel decisions under this new authority, leading the VA Secretary to propose shifting the employment jurisdiction governing all VA SESs from Title 5 (Government Organization and Employees) to Title 38 (Veterans Benefits) of the United States Code.

What is the solution? Until all three of these problems are adequately addressed, veteran’s healthcare at the VA will not substantially improve. Perhaps with a new administration more progress is possible. A new National Security Management System introduced by the Bush administration to better rate employees on performance was quickly junked under federal employee union pressure when Obama came to office. Congress and the new president have their work cut out for them.

 

 

Filed under: Healthcare, , , , , , , , ,

THE MEASLES OUTBREAK

measles2-thumb

On the way home in the car this afternoon, listening to Rush Limbaugh, he was talking about the measles outbreak in Southern California. He said he believed the outbreak of this disease, practically irradiated in the U.S., was because of all the un-vaccinated illegal alien children President Obama’s immigration policies have attracted to the U.S. For those of us who are not pleased with President Obama or his immigration policies, it’s tempting to want to believe this. On the other hand I have heard people say it’s the anti-immunization trend, mostly among the more affluent, that is responsible. Proving or disproving this, of course, would be impossible without doing the kind of contact mapping done for the Ebola outbreak. Because measles is rarely life threatening, it’s like the common cold, you can never be sure where or from whom you caught it.

Nevertheless, we know that illegal aliens from Mexico and Central America, where public health policies are not up to U.S. standards, bring many diseases into the country. Rush pointed out that the purpose of Ellis Island, that operated from 1892 to 1954, was to examine immigrants for diseases. It worked. Over the past 100 years, numerous diseases have disappeared in the U.S. Whatever the truth about the measles outbreak in California, is it wise to not do a better job of screening people coming into the United States, legally and illegally, to prevent the reintroduction of diseases thought to be no longer a threat to public health? Given that there no longer are centralized facilities for screening immigrants doing so would require considerable resources. We cannot and should not place that burden on the U.S. Border Patrol; and it’s just one more reason why we need to secure the border. Terrorists, criminals and carriers of infectious diseases must be kept out of the country. For those who cry “racial prejudice” I say nonsense. I don’t want to see any American die from terrorism, crime or disease.

Filed under: Healthcare, Updates, , , , , , , , , , ,

CRIMINAL NEGLIGENCE AT THE VA

 

va

How many veterans that lingered on secret waiting lists at Veterans Affairs hospitals gave their lives so hospital administrators could receive bonuses and promotions? (Read the full column at EWRoss.com)

 

Filed under: Healthcare, Military, , , , , , , , , , , , , , , , , , , , , , , ,

TAKING ADVANTAGE OF THE OBMACARE DEBACLE

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President Obama’s Teflon presidency has been attributable to the mainstream media’s propensity to devote little time to his misstatements and mistakes, the President’s remarkable oratory skills, and his willingness to willfully deceive Americans if it serves the “greater good.” He’s been a superhero-like figure, loved and hated, seemingly immune from slings and arrows of his enemies. All that’s changing, but if Republicans want to exploit this opportunity, they have to do more than throw rocks.  (Read the full column at EWRoss.com)

Filed under: Healthcare, Politics, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

LOOKING BEYOND THE SHUTDOWN

Obama-Boehner

Looking beyond the government shutdown, a skirmish in a larger struggle for the heart and soul of America, will Democrats succeed in transforming the United States into an entitlement state or won’t they, that is the question. All their chips are on the table.  (Read the full column at EWRoss.com)

Filed under: Healthcare, , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

OBAMACARE: AN AVOIDABLE NATIONAL DISASTER

 

obamacare_killing_ecomony

The Affordable Care Act (Obamacare) began as poorly crafted legislation that became a train wreck then turned into a national disaster that will take many years to recover from. Here’s what we should have done and still can do. (Read the full column at EWRoss.com)

Filed under: Healthcare, , , , , , , , , , , , , , , , , , , , ,

OBAMACARE: ONE OF THE BIGGEST POLITICAL MISTAKES IN AMERICAN HISTORY

No matter how the U.S. Supreme Court rules on Obamacare this week, the progressive movement’s massive overreach with healthcare reform likely will go down as one of the biggest political mistakes in American history.  (Read the full column at EWRoss.com)

Filed under: Healthcare, Politics, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

WHAT SHOULD REPLACE OBAMACARE?

With the U.S. Supreme Court poised to overturn the Patient Protection and Affordable Health Care Act (Obamacare) the question arises what to replace it with. Democrats constantly accuse Republicans of having no plan, but Republicans in Congress and conservative think tanks have proposed numerous common sense approaches to health care reform.

Before Obamacare, the laws and regulations that govern the healthcare industry, like state and federal tax codes, were a complex patchwork of legislation and decisions stacked one on another after decades of special interest lobbying, partisan political wrangling, and honest attempts to correct real problems. Both Democrats and Republicans in the United States Congress and state legislatures are responsible for the current situation.

Obamacare only made the problem of health care in the United States much worse with a 2,700 page law that no one who voted on it read before Congress passed it. Even Justice Anthony Scalia said it would be a violation of the Eighth Amendment (cruel and unusual punishment) to be forced to read it.

So what can Congress do to replace Obamacare?

Republicans have put forth numerous serious proposals. None of them get any traction because Democrats control all Senate and the White House.

If a Republican wins the presidential election in November, however, here’s what they can pass to truly reform health care and make it more efficient and affordable for all.

Allow people to buy healthcare insurance across state lines. Currently, employers and employees must choose from a limited number of healthcare insurance plans offered on a state-by-state basis that include coverage for benefits most Americans will never need that drive up policy prices. If people could choose coverage that satisfies their families specific needs from the approximately 1400 plans available nationwide, interstate competition would drive the cost of all healthcare insurance down.

Tort reform. Frivolous malpractice law suits and excessive damage awards by juries force doctors to order unnecessary and duplicative tests and drive up the cost of malpractice insurance. Comprehensive tort reform legislation would contribute greatly to reducing healthcare costs. Trial lawyers are major contributors to the Democratic Party and are the principal obstacle to tort reform.

Low-cost catastrophic coverage. There was a time in the United States when healthcare insurance was called “major medical.” It covered hospitalization and prolonged illness. Millions of young, healthy Americans choose not to buy health insurance because they can’t afford it and don’t believe they need it. Offering them low-cost catastrophic coverage and incentives to buy it, either through their employer or on the open market, would greatly decrease the number of uninsured in this category.

Pre-existing conditions. Forcing insurance companies to cover pre-existing conditions without waiting periods in a non-universal-healthcare environment has its challenges; but they’re not insurmountable. As with auto insurance, government can require healthcare insurance companies to share the risk for people in this category.

Subsidies for the truly needy. A principle of American democracy that the overwhelming majority of Democrats and Republicans agree on is that there must be a safety net for those people not capable taking care of themselves. Federal and state governments should provide subsidies and tax credits for those people to buy private health insurance. There has always been a tug of war over where government should draw the line in defining the truly needy, but this also isn’t difficult.

Filed under: Healthcare

REPLACE THEN REPEAL OBAMACARE: One Step at a Time

Obamacare Chart

Image by Nevada Tumbleweed
via Flickr

On January 5,
Representatives
Michele Bachmann
(R. MN) and Steve
King
(R. IA) introduced H.R. 141 to repeal Obamacare. A
vote on the bill, scheduled for this week, has been postponed
because of the shootings of Representative
Gabrielle Giffords
and others in Arizona. When it does
come up in the House, it will pass; but even if it also passed in
the Senate, the White House has said that President Obama will veto
it. The question then becomes, what can Republicans in Congress do
to thwart the implementation of Obamacare while they work to elect
a Republican president and a Republican Senate in 2012 so they can
repeal it in 2013? (More)

Filed under: Healthcare, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

REDUCING THE DOD BUREAUCRACY: Less is More

Secretary Robert Gates wants to make sweeping budget cuts in overhead at the Department of Defense (DoD). For starters, he has proposed eliminating Joint Forces Command (JFCOM) in Norfolk, Virginia, a 10 percent cut in contractors, the reduction of at least 50 generals and admirals, and the elimination of 150 Senior Executive Service (SES) civilians. I applaud Gates for his initiative. Not only will it save money for the needed modernization of weapons and equipment necessary to maintain our military capabilities, but it will make DoD more efficient and effective. (More)

Filed under: Healthcare, Military, National Security, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

OBAMA’S NUCLEAR WEAPONS STRATEGY

I wasn’t going to write about President Obama’s new nuclear weapons strategy–a central tenet of which is that the US would not authorize a nuclear strike against a nonnuclear country in retaliation for a chemical or biological attack if that country is in compliance with its nonproliferation obligations under the Nuclear Non-proliferation Treaty (NPT).

Then, on Friday, April 9, I listened to Washington Post columnist Sally Quinn tell Laura Ingraham, sitting in for Bill O’Reilly on the Fox News Channel’s The O’Reilly Factor, that people like Sarah Palin who oppose the president’s new strategy (principally conservatives) aren’t smart enough to understand it. (more)

Filed under: Healthcare, Military, , , , , , , , , , , , , , , , , , ,

SUSAN’S FIRST PROTEST

Susan’s first protest.

Filed under: Healthcare, , ,

MARCH 20 PROTEST AT THE CAPITOL BUILDING

I took these pictures myself. I wasn’t near where Speaker Pelosi and other’s walked to the Capitol building and were allegedly spat upon and jeered with the “N” word, and didn’t see what happened. However, I looked for all those posters with “extreme politically incorrect” images and words, but I didn’t see any. This was 30,000 everyday Americans trying to voice their displeasure with Congress.

Filed under: Healthcare, , , ,

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