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The "VA"! Another example of where one word describes it all! "ADMINISTRATION"

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  • The "VA"! Another example of where one word describes it all! "ADMINISTRATION"

    The latest news about the VA, as well as all the previous problems, comes down to the same one word that exemplifies the problems in so many other areas, "Administration"!
    Whether you are talking about the IRS, any other Federal agency or the local school system the current problems and scandals seem to always wind up in the lap of administration! When I was young and in school we had a whole heck of a lot less "administrators"! Yet, the schools seem to function so much smoother and for a lot less money! Hmmm.. I wonder what the percentage of cost was attributed to administration in those days! In Massachusetts children are dying under the supervision of a state agency! It seems much of the reason can be traced back to "administration"! College costs have skyrocketed over the years. Where has much of that money gone? Administration!
    Where the VA is concerned, there is no question that the service providers (Drs, Nurses and etc) care about their patients! They are the ones coming out and exposing the abuses! No, the problem seems to be again, Administration! Maybe this is an area where "de-centralization" may be a better answer. Instead of one big federal agency that needs so much "administration" we should break it all down to the individual services. Instead of closing down and tearing down Naval and Army hospitals, the veterans should be cared for by the service they wore the uniform for. Even though they may have some similar problems in waste and neglect, they have a much better track record. In addition, the individual services have the expertise in treating conditions that are unique to their function. Navy veterans are faced with more lung diseases than Army Veterans. Army and Marine veterans are faced with more TBI (Traumatic Brain Injury) than Navy veterans. The reasons there were separate medical facilities for the different services in the first place was because there were separate needs! Over the years, many medical breakthroughs and advancements came from the military. Things like the invention of MAST trousers were a direct result of treating battle casualties.
    One area that would be greatly enhanced would be "continuity of care"! If a veteran that served in the Navy had an illness related to his service, he would no longer need to prove to another agency the validity of his claim! The service would have him as a life long client!
    So, my question is where and why did we suddenly need all these "Administrators"? Why are they so highly paid for screwing things up so often? How in the heck did everyone get by before without them? Could it be just another symptom of the uncontrollable growth in government? But then, doctors can tell a lot about problems when they know the symptoms! :confu:
    Last edited by SlaterDoc; 21 May 14,, 15:13. Reason: speelling

  • #2
    Doc,

    A real issue here...

    A 43% increase in patient load and only a 9% increase in medical staff.

    And no, the serice should NOT care for the veterans. They are not budgeted and its not their mission. Combat health services (aka Military medicine) is about plugging holes in healthy bodies and returning as many as possible to the fight.

    That is the cold, brutal truth. Care of veterans/retirees is NOT a core competency.

    The massive influx of covered population hit an organization whih has been underfunded and under resourced for decades.

    The VA has become another of the many political footballs punted around these days.

    Using older facilities may seem like a good idea...except buildings wear out and infrastructure cannot handle the newer equipment in use today. Saw this at my wife's hospital...they built an entirely new facility because the older facility no longer could deal with the modern standards of care. Same issues with military hospitals.

    And do you have any idea of how much of a"HAZMAT" site the old Walter Reed is?
    Last edited by Albany Rifles; 21 May 14,, 19:34.
    “Loyalty to country ALWAYS. Loyalty to government, when it deserves it.”
    Mark Twain

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    • #3
      Doc- the DCF situation in Ma is a bit different than the VA, IMO. While on the surface it may appear that the problem is under staffing and not enough money, with the case of Ma, I think that they have funding and could have the staffing, but they waste money on staff for upper level political appointees that could've gone to street level service providers or direct supervision or spot checking of their cases. Ma has a serious problem with political patronage and cronyism. They also have a large case load because many of the cases are nonsense cases like a teacher reporting a child for drawing a picture of a gun at school, or other things that are poor indicators of abuse but are hot button issues and politically useful in the eyes of a political appointee as opposed to a career social worker. Cut upper level management, have professionals run the department and appoint more direct supervision of case workers.

      The VA however, I think is truly overloaded. While there is no doubt bureaucratic waste involved (where isn't there any), look at the demographics and economics of it. The Vietnam era vets, a large demographic group are reaching that age where they are naturally having more health issues, there are the veterans of the Persian Gulf War, and now the War on Terror. Many of the more recent veterans have separated from the service in a difficult economic period and rely on the VA for healthcare and cannot afford any alternatives. Recent court rulings have also allowed larger numbers of veterans to enter claims based on exposure to Agent Orange as well as exposures during the Gulf War. This all has had an effect and the VA hasn't had the funding or staffing to keep up. They have old facilities that are more costly to maintain and it is not as attractive a position for a doctor as working at, say Brigham and Women's or MGH, so they don't have the top 5% of graduating medical classes lining up to work there.

      We have to elect more people who are aware and sensitive to the needs of veterans after their service and keep their toes to the fire. More veterans in our government would be a good thing in my opinion.
      Last edited by DonBelt; 23 May 14,, 03:25.

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      • #4
        P.S. Doc- MAST trousers have fallen out of favor with EMS, although there has been some recent new interest in them, but they saved my mother's life 18 years ago when she had a triple A. Even then though, the medics who worked on her had never used MAST trousers in the field before and complications from it caused the loss of her leg. It was still a required skill when I first got my EMT ticket, but they were never stocked on the ambulance and they are not even on the approved devices list at OEMS anymore.
        But tourniquets have been restored to respectability, maybe MAST will too.

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        • #5
          Have to reassess my prior thoughts regarding VA. I stand by the statement that they are dealing with a much increased workload, but as far as budget goes:
          VA expects to have more medical-care funding than it can spend for the fifth year in a row | Fox News

          Don't know how accurate the report is, but if they are rolling over unused funding for medical care while withholding treatment for vets who need it, there is something most undoubtedly screwed up.

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          • #6
            The funding issue is tied to staffing. They are understaffed and cannot recruit people to come worj for them because the VA cannot offer salaries which allow them to compete with the private sector. So they have the manpower dollars in the budget but can't hire the people they need in many cases.

            Had this discussion with my wife this weekend. She is the Chief Nursing Officer for a hospital here in Virginia. I asked her why does it seem that newly graduated nurses are having a hard time finding jobs. She stated they lack of experience and that hospitals which are run by major corporations do not want to assuhe liability which could come from an inexperienced nurse making a mistake. I said well why don't they go work for the VA. She stated the VA really needs experienced personnel because of the type of patients they deal with. Clinical personnel in the VA also receive additional training on mental health and behavior over and above what is senn in a normal medical setting.

            Here is the issue for you in a nutshell....the entrenched middle managers aren't doing their jobs and the senior managers won't make them. The "fact" that you cannot fire a civil servant is incorrect. I know...I fired 2 this calendar year. But you have to do the due dilligence. You have to do the counseling, talk to the union, develop product improvement plans and stick to them. Yes its laborious but it can be done.

            And as a manager that is why you exist.

            At this point I say bring in the FBI and the DOJ to begin a criminal investigation. Because this is fraud and that is a federal crime.
            “Loyalty to country ALWAYS. Loyalty to government, when it deserves it.”
            Mark Twain

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            • #7
              If they are forging records and falsifying reports, absolutely! Is the staffing strictly medical personnel or are they lacking people to run admissions or manage cases?

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              • #8
                Originally posted by DonBelt View Post
                If they are forging records and falsifying reports, absolutely! Is the staffing strictly medical personnel or are they lacking people to run admissions or manage cases?
                Someone took the job to run those facilities and provide nursery for the veterans. Nothing wrong in investigating why they failed and tear apart their contracts if nothing else.
                No such thing as a good tax - Churchill

                To make mistakes is human. To blame someone else for your mistake, is strategic.

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                • #9
                  Originally posted by Doktor View Post
                  Someone took the job to run those facilities and provide nursery for the veterans. Nothing wrong in investigating why they failed and tear apart their contracts if nothing else.
                  Dok, these are not contracts.

                  These are core civil service.

                  What could help is if the VA was to shed some governemtn core work and contract it out.
                  “Loyalty to country ALWAYS. Loyalty to government, when it deserves it.”
                  Mark Twain

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                  • #10
                    One would guess they'd have a contract for their jobs.
                    No such thing as a good tax - Churchill

                    To make mistakes is human. To blame someone else for your mistake, is strategic.

                    Comment


                    • #11
                      Originally posted by Doktor View Post
                      One would guess they'd have a contract for their jobs.
                      Not permanent core civil service.
                      “Loyalty to country ALWAYS. Loyalty to government, when it deserves it.”
                      Mark Twain

                      Comment


                      • #12
                        http://www.nytimes.com/2014/05/31/us...s-head.html?hp

                        Woot.
                        No such thing as a good tax - Churchill

                        To make mistakes is human. To blame someone else for your mistake, is strategic.

                        Comment


                        • #13
                          How many people on the WAB have used the VA health care system?

                          What are your thoughts on what the problem is and how would you make it better?

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                          • #14
                            Originally posted by Gun Grape View Post
                            How many people on the WAB have used the VA health care system?

                            What are your thoughts on what the problem is and how would you make it better?
                            My father visited the VA for the first time a few days ago, the Captain James A Lovell Federal Health Care Center in Chicago.

                            He was very pleased with the service and said the Corpsman 3rd that did his blood draw was happy to have someone to talk to, I guess the young sailor was bored out of his mind.
                            “Never let yourself be persuaded that any one Great Man, any one leader, is necessary to the salvation of America. When America consists of one leader and 158 million followers, it will no longer be America.”
                            ― Dwight D. Eisenhower

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                            • #15
                              Originally posted by Gun Grape View Post
                              How many people on the WAB have used the VA health care system?

                              What are your thoughts on what the problem is and how would you make it better?
                              I am in the Martinsburg VA Hospital system and had no serious problems. It runs a few satellite clinics in the region where we go for routine check ups twice yearly. I have an assigned doctor who decides on tests and treatments and for those I go to Martinsburg. I've had 2 prostrate biopsies and have another coming up--ouch. The doctor pushes me to get them done. The care is top notch and caring. Prescriptions come by mail pretty fast. All medical records are on a computerized system, and VA personnel anywhere can access them. That's a big plus.

                              I'm lucky because my satellite clinic is 10 minutes away. The hospital is 30 miles away. Some specialties may be located at facilities 75 miles away.

                              People with a long memory will recall that the VA system was once a complete mess. That said, the present system has become overloaded since I first signed up. Wait times for appointments are longer now, which would be a serious problem for people who need immediate attention short of an emergency. It seems to me that the solution is more facilities and more medical personnel.

                              But with a nationwide shortage of doctors, I doubt much will change in the near future. We'll see some window dressing changes as a result of the current scandal, but there's no escaping the fact that the system is overloaded.

                              One thing is for sure, manipulation of reporting has got to stop. It masks the problem.

                              Farming out care to private hospitals might help a little, but with Obamacare pumping new people into the overall healthcare system, I wonder if that's a good short term solution. It would help reduce long drives to VA facilities. Since the number of people in the VA system fluctuates over time, rising during and immediately after military conflicts and falling off during stretches of peace, using private care for the overflow would make sense. Building and staffing a lot of new facilities to meet peak demand could leave the VA with underutilized facilities when demand drops, which could end up being a costly waste.

                              Bottom line, what we promise vets we should deliver as best we can. I read where someone suggested Romney to head up the system. Management is his forte. Sounds like a good idea to me.
                              To be Truly ignorant, Man requires an Education - Plato

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