“That’s Crazy!!!” – More Chronicles from the VA Chapter 8

I-CareI fully admit I got behind in April.  Dear reader, my apology.  I have been whipsawed between emergency room visits, depression, extreme pain, and other issues.  Not offering an excuse but a tiny peek into my world as a disabled veteran.  Luckily, I have maintained employment because my employer allows me to work from home.  My driving privileges are threatened again with removal due to the neurological issues I suffer, and this will dynamically change my life, but this article is not about me, but the continued catastrophe called the Department of Veterans Affairs (VA) and the Inspector General (VA-OIG) reports published.

We begin with a financial efficiency review reported from the inspection of the Durham VAHCS of North Carolina.  I know the jokes write themselves when we discuss any government agency and financial efficiency, but I digress.  This is a head exploding report of leadership failure in the observation and governance of employees who did not perform the functions they were hired to perform.  The VA-OIG found the following from October 1, 2020, through March 31, 2021:

    • The healthcare system had 309 inactive obligations totaling $81.7 million.
    • Of these 309 obligations, 200 (totaling over $74 million) had no activity for 181 days or more.
    • In a subsample of 20 obligations, VA staff had not reviewed 17, as required.
    • Contrary to VA policy, healthcare system staff used purchase cards instead of contracts for 21 of 40 sampled transactions (53 percent), totaling approximately $328,000. These 21 transactions were missing required supporting documentation to verify that the transactions were approved and payments were accurate, resulting in $308,000 in questioned costs.
    • 105 more administrative full-time equivalent staff than the expected number, all not doing their jobs as required under Federal Law!

While not all of the findings, those mentioned are the most egregious and in need of corrective action.  Would the citizens of Durham, North Carolina, please tell me, has this been reported in the local news?  Has anyone lost their jobs as the VAHCS right-sizes the financial department?  I can find no additional information that this problem has been corrected, and I am really curious!VA 3

Oh, the irony is thick; consider the following:

The Department of Veterans Affairs Office of Inspector General Training Act of 2021 would help ensure that VA employees continue to be empowered to assist the OIG in improving VA’s operations and using taxpayer dollars to the greatest effect; helping protect patients and improving their care; and ensuring veterans and others receive services and benefits for which they are eligible.”

The above-quoted material originates from Chris Wilber, who testified to Congress’s HVAC Subcommittee on oversight and investigations.  What is the number one failure on every comprehensive healthcare inspection (CHIP); the lack of staff training, the inadequacy of staff training, or adequately trained staff.  Yet, the statement by the VA-OIG indicates that training has met a threshold for providing adequate training.  Let’s talk about a specific action, “the VA secretary signed a directive in September 2021 mandating that all employees complete a one-time training within one year—an important step in improving VA’s culture of accountability.”  It is now May 2022; the VA-OIG is pushing for training directives to be legislated, not dependent upon any single VA Secretary.  Are you freaking kidding me?  Where is the congressional oversight and scrutiny that allows VA training to continue to be subpar and threaten the lives of veterans?

Long have I wondered how the VA could frustrate VA-OIG actions, investigations, inspections, etc.  Guess what; the answer has become available:

“… there have been instances in which the OIG has been informed that staff have been told that they cannot share information with OIG investigators without first clearing it through supervisors or leaders—contrary to the Inspector General Act of 1978 (the IG Act), as amended.  Under that authority, VA employees at all levels have a duty to cooperate with OIG personnel, including providing information and assistance in a timely manner.”

Employees have been caught lying to the VA-OIG regularly, and what action is taken to remove those employees promptly and efficiently from government service?  From direct observation and employee conversations, it is clear that plans are carefully laid before a scheduled VA-OIG visit to present what the VA-OIG wants, but to gloss over the problems, and nothing ever happened to the managers, supervisors, and employees who lied and misdirected the VA-OIG.  All contrary to established Federal Law!VA 3

Want a specific example of employees intentionally misrepresenting information to the VA-OIG?  Look no further than the statement by Chris Wilber, and this incident was covered as a failure of leadership in a previous article.

Hospital staff at a VA facility in Fayetteville, Arkansas, had concerns about potential substance abuse by the chief of pathology that were not heard and promptly acted on by local management, which allowed him to work while impaired for years.  He misdiagnosed about 3,000 patients with errors resulting in death or serious harm and is currently imprisoned.  The OIG found a culture in which staff did not report serious concerns about the chief pathologist, in part because they assumed that others had reported him, or they were concerned about reprisal.”

From personal experience, I reported problems to the VA-OIG concerning patient abuse, fraud, waste, and other issues.  Never were my concerns acted upon promptly, and I was removed from employment for being a whistleblower.  The culture of corruption at the VA is incredible.  The examples mentioned by the VA-OIG only further sustain the problem with leadership and how sick the VA truly is as an organization!VA 3

We next turn our attention to the VA-OIG report on the inspection of information technology security at the VA Financial Services Center, another head exploding example of leadership failure bordering on criminal!  The findings include:

    • component inventory
    • vulnerability management
    • flaw remediation
    • Identifying 252 vulnerabilities, of which 228 the local IT team could not identify.
    • the VA-OIG team identified access control deficiencies, as 107 of the 278 FSC systems failed to generate or forward audit logs for analysis.
    • the video surveillance system was not fully functional. Ineffective monitoring and recording facility activities supporting information systems minimize the FSC’s incident response capabilities.

How do you spell failure; these findings spell failure to me rather pointedly and dramatically!  Want to laugh; staff training remains a concern, but not a finding, of the VA-OIG inspection team.  Frankly, with this level of incompetence, staff training should have been a finding.VA 3

To be concise and illustrate further the poor leadership, convoluted processes, and brazen noncompliance of VA officials, the following discussion is about two different VA-OIG reports that reached similar conclusions.  First, we have the VA-OIG report on “Noncompliant and Deficient Processes and Oversight of State Licensing Board and National Practitioner Data Bank Reporting Policies by VA Medical Facilities.”  Second is the VA-OIG report on “Concerns with Consistency and Transparency in the Calculation and Disclosure of Patient Wait Time Data.”  Nothing says convoluted processes more than having two written policies, both originating from Washington DC.  The superseded policy does not have an expiration date.  This means that employees have a designed incompetence excuse ready for not adhering to the most current and applicable policy.  Don’t believe me; one of the key findings was, “VHA has presented wait times to the public without clearly and consistently disclosing the basis for their calculations.”  Designed incompetence does not come more blatant than this, and who suffers, the veteran.  Worse, wait time correction and policy clarification has been stalled by COVID-19, the neverending excuse paying dividends to bureaucrats everywhere!Timelines for Wait Time Calculations

However, both reports are substantially summated by the VA-OIG; thus, “The lack of programmatic oversight contributed to the failure of VHA leaders to detect and intervene upon facility noncompliance.”  Meaning that due to COVID-19, the VHA has refused to do their jobs in deference to the pandemic, and since this is a good enough excuse, the VA-OIG has bought the designed incompetence, lock, stock, and barrel.  The VHA leadership is failing; doctors or dentists let go for poor performance were not reported to state and federal boards, so these providers lacking can continue to harm patients.  It is a federal law (42 US Code § 11151, US Department of Health and Human Services, Health Resources and Services Administration Bureau of Health Workforce, NPDB Guidebook, October 2018, chap. A., 8 USC ⸹ 7462(a), 38 USC ⸹ 7401(1), among others) that providers let go for cause must be reported within 7-days to the regulatory boards at the state and federal levels.  Wait times are hidden because they are so bad; the VHA is embarrassed, so the leaders fall back on designed incompetence to shield themselves while looking for another excuse for poor performance!  In both reports, the ramifications of noncompliance are putting people at risk for sentinel events (death, injury, disability, etc.), and the leadership is at best lackadaisical in the performance of their duties.  VA 3

Where are the congressional overseers in ending the abuse?  When will this insanity and bureaucratic inertia end?  How many “sentinel events,” including deaths and permanent injuries, will it take until those tasked with scrutinizing the executive branch finally take committed action and hold people accountable?  When will the elected representatives stop throwing good taxpayer money at problems that money cannot fix?  If these questions are too difficult to answer, please stop running for elected office, for the citizenry is not happy!

We conclude with two related reports so astoundingly obtuse they defy logic and sanity.  The first is the annual CliftonLarsonAllen LLP (CLA) audit of the VA’s information security for 2021.  The second is the continuing failure of the new electronic health record modernization (EHRM) program.  The VA has failed the CLA audit for more than a decade, with many of the hits repeated year-over-year.  In fact, the CLA audit is so bad this year; it has taken my mental breath away and stunned me into a gibbering idiot!  Reading this report was infuriating; describing it as my head exploding is akin to comparing an M-80 to a nuclear bomb.  How in Dante’s Inferno can this level of incompetence be allowed to remain employed?  But, as bad as the CLA audit is, the continued failure of the new electronic health record system pales in comparison.  The new EHRM continues to suffer from reliability weaknesses, which is polite speak from the VA-OIG for the new system fails to do the job.  We are three years from the new extended deadline, we are already past the original deadline, and the system is worthless today than it was a year ago.  With this success rate, the new EHRM will be utterly bereft of value and need replacement before the year’s end.  How many millions (billions, or trillions) of good dollars must chase this ineptitude before the plug is pulled and those involved held accountable?VA 3

Join me in having your head explode:

Additional deficiencies included known tasks not being reflected on schedules, no risk analysis, lack of longer-term actions scheduled, and no complete baseline schedule or overall schedule that fully integrated individual project schedules. VA also did not comply with federal regulations when it paid its contractor for deliverables before accepting them (reviewing compliance with contract requirements).”

Consider this other gem from the VA-OIG report, “$1.95 billion in cost overruns per year” are estimated, meaning the final tab will be significantly higher and compounded year-over-year.  In plain speak, the contractor is being paid for products delivered that fail, the products offered are not usable, there is no schedule of completion, there is no schedule for deliverables, many of the products paid for have never been delivered, and costs are overrunning like a plugged toilet. Worse, no one is being held personally liable for these problems, which were apparent in the last EHRM update from the VA-OIG a year ago!  Like the CLA Audit, I am thrilled the VA agrees with the VA-OIG findings, but what are they DOING to fix the problems?

FYI: the image below is a year old, and comes from the last major update to the EHRM.EHR-VA-OIG

?u=https1.bp.blogspot.com-aqaqk18MHoEWRHHsCi_TyIAAAAAAAAAXc7hY4JQuyylIQHYudoR8sbezGZntic4SSwCLcBs640Betrayal2BSayings2Band2BQuotes2Bwww.mostphrases.blogspot.be.jpg&f=1&nofb=1There is no excuse for behaving like the VA’s bureaucratic legions behave.  Bureaucrats, from the city government (including the school board) to the Federal Government, you hold a sacred trust to act better than you are currently performing.  I refuse you any leeway for acting like pompous overlords when you are paid through forced taxation!  You have trespassed upon my patience and kindness long enough, and the day of reckoning has arrived.  You work for me; you work for every taxpayer and citizen in this country, and you have violated our trust, charged us too much and too often, and if you do not begin to show yourself worthy of the sacred trust, we will force you from your cushy jobs and hold you liable for the monies you have squandered!  The law is on our side; you need to begin showing you honor our trust and investment forthwith!

© Copyright 2022 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the images.  Quoted materials remain the property of the original author.

“That’s Crazy!!!” – More Chronicles from the VA Chapter 7

Oh, how I wish and long for, and am working for, the day when the VA is cleaned up, cleaned out, and corrected completely!  The Department of Veterans Affairs (VA) – Office of Inspector General (VA-OIG) has been busy reporting more on the failures of the VA to act.  Yet, where is Congressional action in scrutinizing the executive branch’s actions?  Honest question, repeated only for emphasis; we elected you to do two jobs, write fair and equal legislation for all citizens, and scrutinize the executive branch; when are you going to do your jobs?

Let’s begin with some softball issues repeated from previous VA-OIG comprehensive healthcare inspections (CHIPs), specifically how employees report feeling morally distressed while working at the VA.  Moral distress is a leadership failure and is widespread enough to reflect the problem is not limited to a single VAMC/VAHCS.  From Virginia to California, Maine to Florida, and Montana to Arizona, too many VA facilities are poorly led, poorly administered, and poorly executed.  The VA is actively abusing the veterans for political gain; some have asked why I consider the VA is actively abusing veterans; let me see if additional disclosure can explain the problem.

VHA Directive 1004.08.  VHA defines an institutional disclosure as “a formal process by which VA medical facility leader(s), together with clinicians and others as appropriate, inform the patient or personal representative that an adverse event has occurred during the patient’s care that resulted in, or is reasonably expected to result in, death or serious injury, and provide specific information about the patient’s rights and recourse.”

The above quote is from the regulations governing VA care.  The VA-OIG quotes this directive, which has been published and is openly available, yet repeatedly the VA-OIG finds directors.  Hospital administrators who are informed and able to repeat this directive.  Who repeatedly refuse to follow this directive or train their staff to follow this directive.  When sentinel events occur (death, permanent injury, non-permanent injury, disability, etc.), the families report having no idea what to do because the disclosures were never provided to the veteran or designated caregiver.  Is this not abuse of the patient?  Is this abuse not driven by ideologues who gain from the harm they cause others?  Should this abuse not be scrutinized until it is eliminated?  Please feel free to read some of these comprehensive healthcare inspection reports from the VA-OIG, see the resulting injuries and problems caused by the failures of government medical providers, and then tell me whether these atrocious actions need more or less scrutiny and qualify for the title abuse.

North Carolinian veterans, VISN 6 is all yours, and would you be shocked to learn that even with newer leadership, moral distress remains a persistent problem in the VA employees throughout VISN 6, which just happens to include Durham, Asheville, Fayetteville, Hampton, Richmond, Salem, and Salisbury North Carolina?  Probably this is not unfamiliar as the patient experience survey scores remain persistently below VA averages, reflecting that new leadership is akin to putting lipstick on a pig.  Interestingly, medical staff credentialing remains a significant concern in North Carolina.

Western New York veterans, especially those receiving patient services in the Buffalo VAHCS, do you agree with the VA-OIG report?  The Buffalo VAHCS includes Buffalo, Batavia, Jamestown, Dunkirk, Niagra Falls, Lockport, West Seneca, and Olean, and the comprehensive report is mystifying to me.  For example, the VA-OIG reports that “Patients generally appeared satisfied with their care.”   At the same time, “Employee survey data revealed opportunities for leaders to improve workplace satisfaction and reduce feelings of moral distress.”  This is a combination not generally found in these CHIP inspection reports.  Something is definitely off, and I would love to know what, especially since the leadership needs significant improvement in identifying and reporting sentinel events.  Do you agree with the VA-OIG findings?  Please let me know your firsthand experiences, for the double-talk in this CHIP report is above what I usually observe.

With almost identical findings and recommendations in the Syracuse NY VAMC’s comprehensive healthcare inspection, covering communities of Syracuse, Auburn, Freeville, Potsdam, Rome, Binghampton, Watertown, and Oswego, NY., I am concerned that the veterans in New York are in as bad or worse shape than Phoenix’s veteran community.  Hence, I have to ask the VA-OIG, has something changed in your measurement and analysis tools to report such disparate findings as “Employee survey data revealed opportunities for leaders to improve servant leadership and decrease employees’ feelings of moral distress.  Patients generally appeared satisfied with the care provided?”  The double-talk level is higher in these CHIPs from NY, which is rarely observed outside of Phoenix and VISN 22.  Two final thoughts on the CHIPs, staff training, continues to be a high-risk finding, and this continues to be a leadership failure for every VAMC/VAHCS/VISN in the VA; why has progress not occurred?  Training is a system, and leadership and organizational risk, system redesign, and improvement is a quality, safety, and value problem of the highest importance; why is action never taken by leadership or the congressional representatives who are expected to scrutinize the executive branch?

28 March 2022, the VA-OIG released their long-awaited annual “Comprehensive Healthcare Inspection Summary Report: Evaluation of Medical Staff Privileging in Veterans Health Administration Facilities, Fiscal Year 2020.”  I have been interested to see what, if anything, the VA had accomplished in improving their medical staff privileging.  If I were a congressional representative, knowing that medical staff continues to harm and kill veterans, I would have been anxiously awaiting to see if the repeated hits from past years had finally been rectified.  Unfortunately, the VA continues to live down to expectations (digging the hole ever deeper), suffers from failed leadership, and the veterans continue to die or suffer abuse.

What did the VA-OIG discover?  Understand, “The OIG conducted detailed inspections at 36 VHA medical facilities to ensure leaders implemented medical staff privileging processes in compliance with requirements.  The OIG subsequently issued six recommendations for improvement to the Under Secretary for Health, in conjunction with Veterans Integrated Service Network directors and facility senior leaders.  The intent is for VHA leaders to use these recommendations to help guide improvements in operations and clinical care at the facility level.  The recommendations address findings that may eventually interfere with the delivery of quality health care.”  The OIG identified deficiencies with focused and ongoing professional practice evaluation, provider exit review, and state licensing board reporting processes.  Specifically:

    • use of minimum criteria for selected specialty licensed independent practitioners’ focused professional practice evaluations
    • inclusion of service-specific criteria in ongoing professional practice evaluations
    • completion of ongoing professional practice evaluations by other providers with similar training and privileges
    • recommendation by executive committees to continue licensed independent practitioners’ privileges based on professional practice evaluation results
    • completion of provider exit review forms within seven business days of licensed independent practitioners’ departure from a medical facility
    • the signing of exit review forms by service chiefs, chiefs of staff, and medical facility directors if licensed healthcare professionals failed to meet generally accepted standards of care
    • initiation of state licensing board reporting within seven business days of supervisors’ signatures on exit review forms to indicate licensed healthcare professionals failed to meet generally accepted standards of care.

The OIG found ongoing issues from the fiscal year 2019 CHIP summary report that warranted repeat recommendations for improvement.  The OIG issued three repeat recommendations related to the following:

    • inclusion of minimum specialty criteria for focused professional practice
      evaluations
    • inclusion of service-specific criteria in ongoing professional practice evaluations
    • recommendation by executive committees of the medical staff in continuing licensed independent practitioners’ privileges based on professional practice evaluation results.

Boiling the findings of the VA-OIG down, essentially, the administrators and leadership are not weeding out poor and horrible practitioners, reporting these underperforming practitioners, and not acting in the best interests of the veterans seeking care at VAMCs and VAHCSs across the country.  I repeat, only for emphasis: Is this not abuse of the patient?  Is this abuse not driven by ideologues who gain from the harm they cause others?  Should this abuse not be scrutinized until it is eliminated?  Please feel free to read some of these comprehensive healthcare inspection reports from the VA-OIG, see the resulting injuries and problems caused by the failures of government medical providers, and then tell me whether these atrocious actions need more or less scrutiny and qualify for the title abuse.  The link to the full report is available; please feel free to make your conclusions and post your thoughts in the comments section.

On a final note for today, consider with me the problems of the Atlanta VAHCS with pallets of unopened mail containing patient health information, community care provider claims needing payment, and a plethora of other unopened mail.  Understand that when community care providers cannot obtain compensation from the VA, they go to the veterans, who then send in correspondence, which is unopened, thus causing more problems, concerns, and issues for an already abused veteran community!  Want your head to explode?  Look at the pictures the VA-OIG helpfully sent along with this VA-OIG report, and ask yourself if any other business or organization could get away with this type of abuse of the customer.

What did the VA-OIG find?  Well, prepare for your head to explode, again:

    • VA Leadership should have established a formal agreement explicitly detailing each office’s responsibilities.
    • VA HCS leaders did not include responsible managers in decision-making discussions and lacked a clear understanding of the volume of mail processing work they were accepting.
    • Atlanta VA HCS did not ensure mailroom staff was adequately prepared or trained to handle or sort the influx of mail. POM (Payment Operations Management) officials were later reluctant to help, citing the verbal agreement.

Buried in the report is this tidbit, “POM is implementing similar transitions at sites across the country; POM and medical facilities need to ensure adequate staff with sufficient training to handle the mail processing workload.  VA concurred with the OIG’s five recommendations.”  Meaning that in a VAMC/VAHCS near you, unopened mail due to verbal agreements will soon add more distress and disgust to the veteran experience.

I have documented in these articles how verbal agreements, verbal standards of work performance, and verbal processes and procedures are the problem and way of life in too many CHIPs and observed practices at the VA.  Yet, these verbal shenanigans are more apparent than in the dilemma Atlanta faces due to unopened mail.  Payment operations to community care providers are on a controlled and fixed timeline.  Failure to process these payments according to the required timeline leaves providers unpaid, which diminishes the community care provider pool of providers.  Talk to a community care provider, and they will discuss the risks of doing business with the VA and the real possibility of not being paid timely enough or being caught in sufficient red tape never to receive payment.

I know of a provider who called me three years after receiving care and was still trying to appeal and correct the paperwork to receive payment.  A provider recently contacted me who wanted to ruin my credit for failing to pay the balance due from care received, and they are charging interest.  Correcting this problem cost me 48 business hours, 20 calls, and frustrations galore.  By the way, the problem still has not been rectified, an appeal is in process, and we have to wait for the VA to make a decision; this incident was caused by the VA changing the process and the paperwork.  The provider told me they are not accepting any more veterans seeking care, the risk is too significant, the timeline to receive payment is too long, and the VA never pays what is charged.  For example, I recently received a declaration declaring payment to a community care provider.  The VA sent me to this provider, which means they knew the prices beforehand and agreed to the fees.  The declaration declared the VA was charged $2,000 and paid $120, not actual amounts, but close enough to communicate the problem.  With inflation, or without inflation, if you were paid less than 1/10th of what you billed (invoiced), would you continue to conduct business with that company or organization?  Now add the unopened mail problem to the mix.  Would you continue to conduct business with this entity?

America, the Department of Veterans Affairs is sick.  All of the other alphabet agencies in the Federal Government are sick.  We continue to elect people who actively refuse to care enough to act according to their mandated duties.  We cannot afford the government we currently have, which is part and parcel of the problem with inflation in America right now!  Debt is entered into to pay for this bloated feckbeast called government; from the city to the federal government, the bloat is too great to be sustained!  Why is the VA able to skirt responsibility, accountability, and improvement?  They can hide behind the size of their convoluted and twisted organizational shield.  Why can the Post Office and the IRS get away with deplorable, at best, customer service?  They are protected by the congress refusing to scrutinize and hold people accountable.  When your head is done exploding, please remember and act in the ballot box to hire better representatives!

© Copyright 2022 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the images.  Quoted materials remain the property of the original author.

Serial Betrayal – More Government Attacks Against Citizens

Angry Wet ChickenGovernment laws, rules, regulations, and the tyrannical thumb of bureaucrats upon the scale of justice mean citizens lose, not gain, freedoms.  Consider the oppression created by the European Union to “protect” wine industries but, in so doing, eradicate competition and lock in prices to which the government gets a portion through taxes, tariffs, and trade.  The cost, though, is to stop the majority of innovation, the role of technology, and the promotion of class warfare.

For example, in reviewing the history of wine, there are several events where a member of the royalty got into a particular product, and the upper classes adopted the same tastes, regardless of costs, and to the detriment of all citizens.  Tea, Port wine, Champagne, and so many other products through history repeat this process, and the government is used to protect the product, to the detriment and cost of all citizens.  Consider this for a moment; similar tactics would be considered protectionist, monopolistic, and highly illegal in any other industry.  Yet, because the government takes these actions, they are allowed to bend the rules, act in a manner disrupting all citizens, and worse, betray the foundational anchors of a society to trust their government.  When trust in government is destroyed, the government has no moral standing to represent its citizens.  Few understand this is a precious commodity, and even fewer, especially in government, will admit to honoring it.This we'll defend. | Defender, Army mom, American flag

A few examples are required to help drive home this truth; please note those specifically named politicians represent the problem, not the only people betraying and using government jargon and bureaucrats to hide and obfuscate the citizenry.  Ridding the body politic of these examples is a small step in the right direction, but the bureaucrats are the primary source of power; thus, reducing the size of government is the answer, not merely replacing the elected heads abusing their office for personal gain and political power.

Senator Mitt Romney finds himself on top of this list of characters not deserving of his office, and who, with his family, should be as investigated as Biden and Clinton.  Sen. Romney recently changed his mind about SCOTUS Nominee Ketanji Brown Jackson.  Because of a supposedly in-depth discussion, the senator now considers the nominee “mainstream.”  Senator, what does “mainstream” mean?  Why should a judge be “mainstream?”  Finally, which stream is “mainstream?”

I have made my mind up on this disastrous nominee based solely upon her non-qualification for a judicial appointment, let alone the ability to sit on the “Court of last resort.”  Her judicial activism, her refusal to use logic and common sense in her decisioning, her flaccid legal mind, and her disastrous leaning toward pro-child pornography are just a few reasons she should NEVER sit on the Supreme Court of this the United States of America.  Good senator, your Yahoo! News article fluff piece does nothing to explain why you changed your mind.  If Judge Jackson was not qualified for a district judgeship, what has changed in the last few weeks to change your mind?  I smell serial betrayal of the citizenry and more mealy-mouthed yellow spinelessness that cost you the US Presidency!

Three state governors also help to elucidate the principle of serial betrayal and deserve removal (in shame) from public office and a transparent investigation.  New Mexico, Utah, and Michigan, your governors Michelle Lujan Grisham, Spencer J. Cox, and Gretchen Whitmer, respectively, are serial betrayers worthy of Benedict Arnold, Doña Marina, or Brutus.  Consider their actions, not their words, and you will find innumerable betrayals made for personal power, political gain, and the demonization of the citizens for the promotion of those who consider themselves elite.  From mask-wearing, mask mandates, government brutality against citizens, and the passing of laws to the destruction of the citizenry, these governors do not deserve janitor’s office, let alone commander-in-chief.

Under the rule of Grisham and through a disastrous legislature, New Mexico became what is termed an“Adult-use Cannabis” state, which means that for recreational use, cannabis can be sold and consumed by adults.  In a state teeming with homelessness, poverty, and already suffering from drug and alcohol abuse problems rampant in the citizenry, the legislature, cheered on by the governor, began to sell cannabis.  The excuse sold to the people, “The state needs to expand its revenue base.”  How does selling an addictive substance to a citizenry already near collapse from the weight of homelessness, illegal immigration, and government regulation improve the tax base?  Simple question, never asked by the cheering media nor answered by the betraying elected leaders proposing another sale of an addictive and harmful substance.Ziad K. Abdelnour Quote: "Trust is earned, respect is given, and loyalty is demonstrated ...

Governor Cox ruled that when the Utah Jazz began awarding scholarships based on race qualifications, as not racist, his colors were evident as a betrayer in deed, not merely by word.  Worse, look to the wording of his first action as governor, what is known as the Utah Compact on Racial Equity, Diversity, and Inclusion: A Declaration on Five Principles and Actions to Create Equal Opportunity.  First, we need to clarify that nothing in this declaration was needed as existing laws are regularly enforced already on the books.  Yet, this new declaration adds some pretty ambiguous wording that is not clarified and will make judicial activism worse, not better.  Leading to the first question, why was this signed into law by the governor who is expected to lead a state?

What does “economic inclusion” mean, and why should all Utahns or any citizens in a direct representative government agree this wording is essential?  What is a “racially equitable state?”  Utah and every other state in America’s union are already racially equitable, only made inequitable by the bureaucrats enforcing the government’s wishes.  Consider the housing projects created by the federal government, supported by state governments, where race is inequitable by design.  Tell me why the government doesn’t just end the housing programs and the racial division they created to have a class of people always ready to riot?25 Quotes on Friendship, Trust, Love and Betrayal

What are “cultures of inclusion?”  The US Constitution already declares in words of soberness, “All men are created equal.”  The Utah State Constitution declares in Section 1 the following:

All men have the inherent and inalienable right to enjoy and defend their lives and liberties; to acquire, possess, and protect property; to worship according to the dictates of their consciences; to assemble peaceably, protest against wrongs, and petition for redress of grievances; to communicate freely their thoughts and opinions, being responsible for the abuse of that right.”

As a point of fact, Section four of the Utah State Constitution remains an even more powerful declaration, more easily understood, supporting equal rights, where equal rights promote a society of inclusion, where cultures of inclusion are grown and sustained.

Further in the declaration on racial equity, diversity, and inclusion, we find another phrase with no meaning and lots of availability for abuse, “… equal opportunity and access to education, employment, housing, and healthcare.”  The recent COVID-Farrago saw healthcare limited based upon race, and Governor Cox did nothing!  The recent COVID-Government sponsored pandemic also saw employment and housing decisions influenced unequally, opportunities to pursue life, liberty, and happiness were restricted, and Governors Cox, Grisham, and Whitmer were leading the pack in cheering and advancing unequal treatment under the law.  Why?  Why is equality something to be turned on and off based upon skin color, obeisance to government mandates, and the cudgel of government used against citizens who have the right to be left alone?Betrayal Sayings and Quotes ~ Best Quotes and Sayings

In reading the five actions you have committed Utahans to follow, Governor Cox, I am left in a mental swamp equivalent to the Okefenokee Swamp.  Racism in America, especially in Utah, only exists because the government is building a disgruntled class of people who can be depended upon to riot explosively anytime their government benefits are threatened.  This is not equality and does not promote life, liberty, and the pursuit of happiness, but you have insisted that all Utahans are racist by default.  I OBJECT!

Action item two declares the need to invest more in creating the perpetually aggrieved class.  More welfare, not less, breeds more discouragement, anger, and racial inequity.  Since the government has created racial problems and supports racial inequality through government action, why do we not reduce government to improve racial justice and inclusion?  The remaining action items do nothing to advance anything but more government top-down actions, which further promote racism as a government action!10 True Quotes About Being Betrayed

30 April 2020, the Michigan State Supreme Court stripped Governor Whitmer of her legal basis of powers for violating the citizen’s rights to representative government.  Yet, Gov. Whitmer was able to continue to abuse, despise, and detest through government actions the rights, liberties, and lives of Michigan’s electorate for the entirety of the government-mandated COVID-Pandemic.  Is there any more glaring example of treason and betrayal by an elected official, let alone a sitting governor, on a massive power grab?  Newsom and Cuomo cannot pale the hubris of this governor, Gov. Whitmer; you deserve to be named beside Benedict Arnold, Doña Marina, or Brutus as the greatest betrayers and traitors in history.

Serial betrayal of the electorate appears to be a game; how much can a politician get away with, remain in power, and be considered honorable?  Hollywood got something right in the Pirates of the Caribbean” movies when Captain Jack Sparrow said, “The deepest circle of hell is reserved for betrayers and mutineers.”  I believe in the rule of law and so wish you your day in court, in front of a jury of your peers, where justice may be served.  I am not your judge, juror, or executioner.  I am a concerned citizen who is fed up with the gamesmanship of politics!

Knowledge Check!America is a Constitutional Republic, a democracy, and a direct representative style of government; thus, I ask, who are you representing?  The demographics of Utah reflect that the governor is not representing the majority of his constituents.  The demographics of New Mexico and Michigan are similar but also reflect that the constituents are not being represented by the governments and governors currently executing the offices held.  On the mayoral level, too many mayors are learning how to deceive, mimic despicableness, and manipulate the media to play the games and achieve elected offices beyond their maximum level of incompetence.  Why is this happening, the gamesmanship of politicians?  The bureaucrats consider themselves to possess lifelong employment in a cushy and “influential” office; they have lists of media heads to call and whisper to and lists of donors and influential people schmooze.

The answer to solving these problems is a more informed electorate and smaller government!

© Copyright 2022 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the images.  Quoted materials remain the property of the original author.

Economic Warfare – Your Liberty, Rights, Freedoms are at Risk!

Bobblehead DollMany pundits have made the following statement, in one form or another, driving a car is the ultimate expression of freedom in America.  Yet, your freedom to drive a vehicle is endangered by the political left and the neo-socialists who want to steal and destroy your freedoms.  Mention economics, and most people’s eyes gloss over, brains disconnect, and they hope the pain will end shortly.  Please, fight this impulse.  I will attempt to make a highly complex topic simple and easily understood.  While I might not get all the specific details correct, I aim to communicate economics to a general audience that is free and empowered to further research the topics for themselves.  My links are reflected in the article for more information.

What is Money?

Money was discussed in a previous article and found here.  In simple terms, money is the tool used to transfer goods from one entity to another, showing a legal purchase was made to change ownership, hence opening the first crucial role of money, legally transferring ownership of goods and services from one person to another.  Unfortunately, legal ownership transference is where the government exercises its first controls, regulating cross-border commerce.  When the government went on a growth spurt in the 1930s, ballooning into the behemoth, we have right now, the government used the excuse of maintaining cross-border commerce to steal products grown by farmers, regulate prices, and set up means and methods to ensure the government was the only winner.TOP 25 QUOTES BY JOAN ROBINSON (of 54) | A-Z Quotes

The 1930 legal battles that wound up in the United States Supreme Court over price controls saw the citizen’s first attempt to reign in the government and failed miserably.  Worse, these first moves by the citizen were the first exchanges in an economic war that has raged ever since—money stores value.  Think of the money found when you do laundry.  You have no idea how long that money was lost, but the value of the money has not changed, you presume, and you celebrate finding the money.  Except, the value of that money has changed through inflation, and the government’s hidden tax (inflation) has robbed you of value.

Let’s say you found $20 in the laundry.  When you first lost that $20 bill, it had more value, e.g., you could purchase more with that money than you can now.  Sure, the value printed on the money still has $20 worth of goods or services, but the cost of those goods and services went up, restricting your ability to purchase.  Hence the economic warfare being waged by your government.  The government essentially said we would not worry about inflation.  Meaning they will devalue the money you hold for their own political purposes.Steve Keen Quote: "Economics is too important to leave to the economists." (12 wallpapers ...

An idea was floated by an economically challenged person to print a $5 trillion bill and use this to pay off the Chinese debt.  The problem is the devaluation of the money printed will capsize American citizens due to the hidden taxes of inflation.  Making that $5 trillion bill or bills would devalue the dollar and crash the American economy.  The stored value in the printed bill would not stand up to and be accepted, as a medium of stored value sufficient to pay the debts incurred.  Is the problem more clear; when money is printed, each dollar, pound, euro, etc., devalues the stored purchasing power of the money you currently hold in hand.Economics Funny Quotes. QuotesGram

Stored value is the second tool for waging economic warfare by the government against its citizens.  Consider all the money printed to pay for the supposed Coronavirus Tax Relief and Economic Impact Payments the world’s governments made to their citizens.  If you had $100,000 in savings when these monies were printed, your savings were devalued by the inflation rate, which is currently at a 40-year high in America.  The government is reporting inflation at 7.9%, so your $100,000 in savings lost the equivalent of $7900.  But, the government does not ever report inflation at the actual level, and the actual level of inflation is ranged between 8% and 45% depending upon the purpose or product you are trying to purchase.  Meaning your $100,000 could have a value of $92,000 to $55,000 in real value.  A hefty tax indeed!

Stored value, the number printed on different bill faces of currency, is static.  The actual value, e.g., the number of goods and services purchasable, is not fixed, and the government allows an annual inflation rate of 2% as “normal and acceptable.”  Thus, your $1 will have a purchasing power of $0.98, which is compounded year-over-year.  Thus, over a decade, that 2% inflation rate is now reducing your $1 to $0.80.  Multiply that for the $100,000 and a decade of saving, receiving interest that does not equal inflation to compensate means your money in your savings account has lost $20,000, just from the government allowing inflation at 2% annual growth.  Let’s say your bank is generous for savings account holders and provides a published interest rate of 3%, subtract the inflation taxes of 2%, and you are only earning 1% interest on your money.  Is this the bank’s fault or the government’s?Amartya Sen quote: Economic growth without investment in human development is unsustainable...

Do you see how the government is robbing you through economics?  Your 5% raise is only 3% once the inflation devaluation has been factored into your budget.  Play the lottery; the taxes alone might kill you, but the devaluation of the money reduces the actual purchasing power of your winnings.  If you do not understand the economic warfare being waged against you by your government, you will lose more than you ever gained in winning the lottery.  Yet another reason why lotteries are a tax on stupid people, for even when you win, you lose!

Cash has another problem beyond inflation, money supply.  The money supply is the technical term for ensuring banks can replace worn-out, ripped, and damaged money.  Money supply plays a role in how much money your local store has on hand to provide change and cashback to customers.  For employers who pay employees in cash, the money supply is a significant problem with extremely high costs.  The government regulates those costs and passes them onto consumers through banks and lending institutions.  Are you struggling to get a loan; this is another by-product of money supply woes.  Paying higher fees to change money to another currency for your trip is another money supply product.  Money supply remains another weapon of the government to affect economic warfare, and many people do not understand this principle, making the government’s policies more effective.Mahatma Gandhi quote: Economics that hurt the moral well-being of an individual or...

Have you noticed the decline in the availability of $10 dollar bills?  I asked for two $10.00 bills when I broke a $20.00 at a Walmart recently, I was denied because Walmart has instituted a policy to only accept $10.00 bills, not give them.  Albertson’s, Staples, the in-store bank in Walmart, and the local credit union, all have a similar policy.  What is the government doing forcing a reduction in $10.00 bills in circulation?  In researching this single policy, I can find no written information on this issue; yet the evidence is clear, there is a manual currency reduction in process and the government needs to explain why.

Before 1980, the basic money supply was measured as the sum of currency in circulation, e.g., cash, traveler’s checks, and checkable deposits.  Currency serves the medium-of-exchange function but denies people any interest earnings.  However, as discussed, interest earnings are not all they are cracked up to be due to inflation.  Cash under a mattress, lost in pockets of clothes, stuck in a book in your library is black money; it is as dead as yesterday’s fish and constantly devalued by inflation.  The money supply tries to regulate the cash on hand to lend as a tool to protect your money from inflation.  Except, the government constantly allows a 2% inflation rate, negating a lot of savings accounts and other interest-earning propositions.

Want a new car, consolidate your credit card debt, or try to buy a house; all of these loan products are an extension of the money supply and the regulation of money supply by the government.  Important to note that your credit cards and bank-issued or employer-issued debit cards are not affected by the money supply, and this is another reason why credit cards and debit cards are so dangerous.  These tools are agreements between you and the issuer, where money is transferred when the tool is used, and the consumer is responsible for all the fees the government insists upon to help pay for the money supply.Economy has frequently nothing whatever to... - Quote

Conclusion

In waging economic warfare, it remains imperative to know about economics, identifying what money is, its role, and the fiduciary controls the government exerts to attack its citizens.  Some may call my language inflammatory, but tell me, do the inflationary costs right now not feel like your taxes have skyrocketed?  Inflation is a hidden tax, a tax fully controlled by the government, and the value of your money decreases yearly because the government says 2% inflation is acceptable.  Who made this decision, an unconstitutional entity called the Federal Reserve Bank.  Since its inception, Congress has tried to obtain transparency and accountability from the Federal Reserve Bank to no avail.  Do you understand why I take umbrage with the Federal Reserve Bank?LIC

The governors of the Federal Reserve Bank decided your money could be taxed at 2% inflation annually as a normal condition of doing business.  These people set the interest rates you pay for your credit cards and are not paid for your savings accounts.  Looking into the history of interest rates since 1900, there is always volatility; the Federal Reserve’s actions have since the 1980s to not allow savings rates over 5%.  When adjusted for inflation, that’s a 3% interest rate for those trying to save money.  What does this mean; fewer people are saving money.  Look where those trying to beat the 3% have invested their money, the stock market, where volatility is a minute-to-minute occurrence, higher risks against less interest, where your money remains subject to taxes, fees hiding other taxes, government fingers, and inflation.

Your government did that to wage economic warfare against you, to empower them to steal your rights, freedoms, and liberties.  There is no other way to describe what is happening globally in all governments.  China plays games with the value of its currency to power trade deficits.  This, in turn, changes prices and increases costs.  These actions are taken to “compete,” when in reality, the activities cover massive debt problems in China.  If the CCP cannot keep the tap turned wide open on trade deficits, their money supply drys up, and debts come due in a bankrupting tsunami!Milton Friedman: The Most Quotable Economist - Capitalism.com - Create the Change

The European Union has never been fiscally sound because the various members of the European Union are taking advantage of the productive members to cover the costs of the fiscally useless members.  France cannot survive as a country without the European Union’s largesse; Greece, Portugal, and several other countries are all in the same boat.  Their governments did this intentionally as political games to stay in power.  When these countries run out of other people’s money, they will be forced to change socially, and the tsunami of debt to the World Bank and other nations will not be pretty.

Knowledge Check!Economics drives these problems mainly due to the lack of knowledge of the lines of congruence between economics and the psychology of governing.  The enemies of freedom understand economics, and this is why these tools have been so successful in waging war and stealing freedom, rights, and liberties through monetary policy.  Until we, the rightful owners of government, understand what is happening, we will all be at the whims of our enemies.

© Copyright 2022 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the images.  Quoted materials remain the property of the original author.

“That’s Crazy!!!” – More Chronicles from the VA Chapter 6

I-CareI promised a follow-up article after Chapter 5; it took me the better part of 48 hours to cool down sufficiently to write coherently to effect an update.  On 18 March 2002, I wrote about an appointment with my Primary Care Provider (PCP) being tardy, unprepared, and bureaucratese in supposedly holding a phone appointment with me.  01 April 2022, not an “April Fools Joke,” at 0731 hours, lasting 9 minutes, my PCP called me to get my approval to have me changed from her PACT team to another provider’s team.  Apparently, in the highly red taped world of PCPs at the El Paso VAHCS, there must be an hour-long handoff call when a provider initiates a change of PACT team.  I have my doubts and smell designed incompetence!

Let me pause here for a moment.  I generally need two hours to write an article after conducting research.  18 March 2002, it took a bit longer to draft that one due to the need to blow off steam with some choice words and choke down the urge to beat a few brick walls with my fists.  I am generally a very controlled person, and the fact that this PCP was so stunningly incompetent, rude, and HIPAA clueless, I admit I lost my cherub-like demeanor!  That the patient advocate was able to get my secure message, upload the comments into the electronic medical record, and contact the provider before the provider had even logged the patient notes, speaks volumes about the ineptitude of the PCP.  Worse, in the call on 01 April, the PCP was still on speakerphone, still disregarding HIPAA security, and quoted lines out of context from my message to the patient advocate.  Speaking volumes about the processes and procedures of the patient advocate’s office to investigate patient claims without breaching confidentiality.  Another topic for another day entirely!PACT_model

28 March 2022, I received the following from the patient advocates office, quoted completely:

We have received your secure message addressing your concerns.  I will be sending a Patient Advocate Tracking notification with your concerns to our Primacy Care Service for review.  They will be contacting you via telephone to discuss your concerns.”

I never heard anything from this mysterious “Primary Care Service” group/team.  01 April 2022 was the first response, and that was from the PCP.  Sourcing the Department of Veterans Affairs (VA) and the Office of Inspector General (VA-OIG), the PCP is the second most important member of the Patient-Aligned Care Teams (PACT) at the VA; the patient is the essential member and an actively engaged and knowledgeable patient is preferred.  I promise the VA-OIG has not even scratched the surface of the problems with recalcitrant, snowflake, and bureaucratic PCPs endangering patient health with the VA.  Not my first run-in with an inept PCP; I sincerely hope it is my last!PACT 3

In returning to the 01 April call, we find another interesting piece of data.  The PCP affirmed that abdominal pain could radiate from, say a hernia, to other parts of the abdomen, but this is for a specialist to diagnose, not a Family Practitioner.  Get that; the PCP is directly reversing all the published documentation by the VA and the VA-OIG by declaring that a specialist is the only person who can adequately decipher and detail why pain is occurring—putting all the PCPs in the VA Health Administration under the bus as merely button pushers and drug dealers.  Then the PCP has the temerity, nay the chutzpah, to suggest a trust deficiency existing between myself and the PCP.  Is it any wonder that people are detested, forlorn, melancholy, madder than a wet chicken with a raging case of hemorrhoids with the care they receive from VA healthcare providers?

Again, I repeat, only for emphasis, when any updates arrive on this issue, I will publish them in their entirety to allow the VA the opportunity to rebut, refute, or explain.  Like the ongoing saga with VISN 22, the Phoenix VAMC, and being arrested and injured three times by the VA Police, I am not holding my breath and awaiting a logical response.  If this were the only problem in the two weeks since the PCP shenanigans, the VA would be in pretty good shape.  Alas, we know, dear readers, that the VA is in dire condition, and the elected leaders need to be scrutinizing the VA a LOT more closely than they are.VA 3

We begin the latest chapter of VA-OIG reports with yet another physician bilking the government:

Robert Clay Smith, a Louisiana physician, pleaded guilty to conspiracy to commit healthcare fraud, wire fraud, and illegal remunerations (taking kickbacks).  According to court documents, the scheme, which ran from 2013 until 2017, involved individuals associated with a medical supply and billing company recruiting Smith to dispense pain creams and patches to his workers’ compensation patients by offering him a split of the profits.  The company acted as the billing agent for Smith, handling all the paperwork and submitting the allegedly fraudulent claims to the US Department of Labor, Office of Workers’ Compensation Programs, and private insurers.  In exchange, the company paid Smith 50 to 55 percent of the profits collected from successfully billing insurers, at markups of 15 to 20 times what the medications cost.”

Plus the following:

Robert Schneiderman of Langhorne, Pennsylvania, admitted to participating in a massive compounded-medication kickback scheme that he and others ran out of a pharmacy in Clifton, New Jersey.  Schneiderman pleaded guilty in federal court to one count of conspiracy to commit healthcare fraud and one count of conspiracy to violate the Anti-Kickback Statute.  From 2014 through 2016, Schneiderman and his coconspirators used Main Avenue Pharmacy, a mail-order pharmacy with a storefront in New Jersey, to run a fraud and kickback scheme involving compounded drugs like scar creams, pain creams, migraine mediation, and vitamins.  Schneiderman was the president of Main Avenue Pharmacy and was a founder and CEO of its corporate parent.  Main Avenue Pharmacy received over $34 million in reimbursements from healthcare benefit programs on compounded medications alone.  Approximately $8 million of that total was paid by federal payers.  Schneiderman himself earned over $400,000 through the course of the scheme.  This case was investigated by the VA OIG, FBI, Department of Defense OIG, Defense Criminal Investigative Service, and Department of Health and Human Services OIG.”

Don’t forget this one:

Dr. Harry Doyle, a psychiatrist from Philadelphia, Pennsylvania, and his wife, Sonya Doyle, have agreed to pay $3 million to resolve alleged violations of the False Claims Act.  The alleged violations include submitting false billing to the US Department of Labor Office of Workers’ Compensation Programs (OWCP) for psychiatric services that were not provided and upcoding and double-billing patient claims.  The Doyles have also agreed to be voluntarily excluded from federal healthcare programs for 25 years as part of the settlement.  This is the largest recovery against a single psychiatrist in the history of the OWCP.  A multiagency investigation of Dr. Doyle’s practice revealed that from January 2013 through April 2021, the Doyles allegedly billed for services not rendered, some of which occurred when they were not physically present in the United States.  This case was investigated by the VA OIG, the Department of Labor OIG, and the United States Postal Service OIG.”

More is coming on this one:

Ten Texas doctors and a healthcare executive have agreed to pay more than $1.68 million to resolve False Claims Act allegations involving illegal remuneration in violation of the Anti-Kickback Statute and Stark Law.  According to a multiagency investigation, from 2015 to 2018, the doctors allegedly received thousands of dollars in illegal remuneration from eight management service organizations (MSOs) in exchange for ordering laboratory tests from Rockdale Hospital doing business as Little River Healthcare, True Health Diagnostics LLC, and Boston Heart Diagnostics Corporation.  Little River funded the illegal remuneration to the doctors in the form of volume-based commissions paid to independent contractor recruiters, who used the MSOs to pay numerous doctors for their referrals.  The MSO payments to the doctors were disguised as investment returns but were based on and offered in exchange for the doctors’ referrals.  As part of their settlements, the defendants have agreed to cooperate with the Department of Justice’s investigations of other parties involved in the alleged law violations.  To date, 17 doctors and two healthcare executives involved in this scheme have agreed on settlements totaling more than $2.7 million.  The civil settlements resulted from a coordinated effort between the VA OIG, Department of Health and Human Services OIG, Defense Criminal Investigative Service, and the US Attorney’s Office for the Eastern District of Texas [emphasis mine].”

Elected officials, the next time you are asked about the incredible amounts of fraud in government-provided healthcare and insurance, do not buy the media talking points that the fraud is minimal, contained, or anything but designed incompetence on the part of the bureaucrats to act as a jobs program for investigators!  The same investigators who are refused sufficient tools to investigate shenanigans by employees in the Federal Government adequately.?u=http2.bp.blogspot.com-fGEUjJsJ2h4VcJgswaisnIAAAAAAAABcsoFqEewPF_E4s1600quote-if-the-freedom-of-speech-is-taken-away-then-dumb-and-silent-we-may-be-led-like-sheep-to-the-george-washington-193690.jpg&f=1&nofb=1

Frankly, all of these cases need the government workers to be held accountable, and the myriad of red tape loopholes CLOSED!  I remember an election; I forget who and the exact when, but a significant election plank in the platform was healthcare reform, promising to clean up the swamp and bring accountability to Washington and the government.  The public is still waiting, and I know enough of you have run on this topic from both parties to repaper the walls (inside and outside) of the White House.

Yet, even if only outside providers and executives were scheming, the VA might not be in too bad a condition.  Except for the employees of the VA, VHA, and VBA, which continue to be caught up in ethics violations at a minimum:

The VA-OIG conducted an administrative investigation that included a congressional request to look into allegations that Charmain Bogue, former executive director of the Veterans Benefits Administration’s Education Service, committed ethical violations arising from her spouse’s consulting work for Veterans Education Success (VES).  VES is a nonprofit advocacy group that regularly had business before the Education Service.  The allegations also pointed to possible incomplete financial disclosures by Ms. Bogue concerning her spouse’s consulting business.  In their work, investigators uncovered evidence of other potential conflicts of interest and related misconduct by Ms. Bogue [emphasis mine].”

VA-OIG finding:

    1. Bogue participated in Education Service matters involving VES without considering whether it raised an apparent conflict of interest and acted contrary to the ethics guidance she received from her supervisors.
    2. Bogue sought résumé feedback from the president of VES to aid in her search for career advancement without considering whether this raised apparent conflict of interest concerns in subsequent VES matters. VES also endorsed Ms. Bogue for presidential nominee positions.
    3. Bogue provided insufficient detail about her spouse’s business in 2019 and 2020 public financial disclosures; VA ethics attorneys had found them compliant. She remedied the subsequently identified deficiency in her 2021 disclosure.
    4. The OIG found that Ms. Bogue refused to cooperate fully in the OIG’s investigation by refusing to complete her follow-up interview. Her husband and VES president also refused to participate in OIG interviews, and the OIG lacks testimonial subpoena authority over individuals who are not VA employees.   Bogue resigned from VA in January 2022.VA 3

UPDATE: 14 April 2022Sen. Grassley was hoodwinked by the VA on this issue and The Daily Signal (linked) has more of this report.  I covered this before, I repeat only for emphasis, when you are discharged from the VA, you lose your ability to be a “whistle-blower.”  As a point of fact, this is how the VA is able to hide a lot of their shenanigans, get rid of the person rocking the boat, invent the paperwork, cover the whole incident over as a “bad-apple” and keep you collective heads down and mouths shut until the VA-OIG investigation concludes.  The VA’s ability to abuse whistle-blowers is further compounded by Federal Attorneys who cherry-pick the cases they know they can win.  Which further protects the VA’s shenanigans and disheartens and mystifies those who have been wrongly terminated.  The Daily Signal reflects this pattern of corruption perfectly citing the records obtained by Empower Oversight.

Some commentators have claimed that blaming elected officials for not scrutinizing or not providing tools to investigate entirely is unduly unfair to the congressional representatives.  Really?!?!?!  The VA-OIG conducts an investigation, the people being investigated refuse to comply, and the VA-OIG is toothless to enforce a full and complete investigation to initiate Attorney General and FBI investigations and actions to recompense the defrauded taxpayer.  Ms. Bogue and the VES have invalidated any trust the taxpayer should have in their respective activities, but this, like so many other investigations into VA employees, will die of apathy before anyone is held accountable.  Even though a congressional representative demanded an investigation, nobody is being held liable.  Nobody is forced to compensate the defrauded taxpayer, yet the taxpayer is still expected to elect the same old representatives to their jobs.  Blaming the congressional representatives (legislative branch) for not scrutinizing the executive branch, one of only two jobs these people have, is somehow unfair?  NO!Exclamation Mark

Remarkably, between the 18 March disaster with the PCP and 01 April’s compounding idiocy, the VA-OIG published an ironically titled investigation report.

Improved Governance Would Help Patient Advocates Better Manage Veterans’ Healthcare Complaints.”

Imagine that, more designed incompetence negatively impacting the veterans seeking care at a VA medical facility, stating the obvious by the investigators.  Who on earth would be responsible for seeing that regulatory agencies had the tools needed to scrutinize and demand corrective action?  Calling all elected officials, did you notice that one of the prima facia tools a veteran has to report problems, conveniently called “patient advocates,” does not have the sufficient authority, adequate oversight, and tools to execute their jobs?  The VA-OIG reports the following:

The Patient Advocacy Program helps advance the Veterans Health Administration’s (VHA) efforts to improve customer service, support veterans’ access to quality care, and provide a mechanism to resolve healthcare issues.  Patient advocates document veterans’ concerns, communicate the resolution, provide follow-up and feedback, and identify trends for potential opportunities to improve medical facilities.  In FY 2020, VHA tracked about 162,000 serious complaints in its patient advocate tracking systems.”

Angry Wet ChickenOn a side topic, VA-OIG, how do you define a “significant complaint” and separate it from other types of complaints?  Honest question, the information was, to quote my PCP, “remarkably” missing from your investigation report!  Would the VA-OIG like to know why so many veterans’ complaints have risen to a “serious” level?  You reported the exact problem:

A complaint is considered resolved when the complainant communicates the outcome, and the record is closed in the tracking system.”

Maybe, the VA-OIG merely overlooked the logic problem, but complaints increase when the solution pushed down the throats of the veterans does not fix the actual situation.  Honest question, no sarcasm involved.  Is a “serious” complaint one where significant harm or death to the patient has occurred?  Is a serious complaint one that breaks federal laws, EMTALA, comes readily to mind??u=https3.bp.blogspot.com-fYRTNk48SCwT8ua0IRDWPIAAAAAAAAFZUpexSmJsN2Kos1600overcoming-adversity-help-yourself-believe-cubby-motivational-1289878102.jpg&f=1&nofb=1

Having had “solutions” forced down my throat, speaking only for myself, I am thoroughly sick of having the patient advocates bureaucratize my complaint, then fail to act, and then compound the problem by quoting policy to me as a reason to close the complaint, when the VHA never have written policies and procedures!  Maybe, you might want to look into the root causes of some of those “closed” complaints and ask root causation questions!

What did the VA-OIG find when they investigated the patient advocates?

    • VHA lacked adequate governance of the Patient Advocacy Program.
    • VHA did not effectively issue and implement adequate policy, monitor complaint practices, and provide guidance to medical facility directors responsible for local program management.
    • Patient advocates did not always enter complaints into the system.
    • Even though complaint records generally appeared to be closed on time, patient advocates did not always document the communication of the outcomes to the complainants.
    • The VA-OIG substantiated an inadequate program policy to identify clear expectations and responsibilities.
    • The VA-OIG found that they (patient advocates) did not always adhere to the documentation requirements to show full complaint resolution.
    • At the local and VISN levels, responsible personnel did not consistently analyze patient advocate tracking system complaints about trends.

Feel free to read the complete abomination of designed incompetence for yourself.  Essentially the VA-OIG concluded that the VHA has been burning taxpayer money in a patient advocacy program, and the designed incompetence is so apparent it can be tracked from L2, where the James Webb telescope is located!  Worse, you won’t need the James Webb telescope to see the designed incompetence!James Webb Space Telescope

Unfortunately, I could have guessed the first three findings without looking.  Every VA program is designed so ineptly, reprehensibly led, criminally incompetent, and with such dastardly deceptive doings that fiction writers’ storylines have to be written better to sell books.  You cannot make this stupidity up and make a profit.  Hollywood would run screaming into the night if they made a true story about the ineptitude found at the VA!

Knowledge Check!Elected officials, where are you?  The VA-OIG presents copies of their findings to you, and I have yet to witness a single one of you holding the VA Leadership criminally responsible for the failures at the VA.  Even when the VA is killing hundreds of veterans, the US Congress refuses even to act upset, let alone scrutinize for a change!  Remember how many veterans were intentionally killed in Phoenix waiting for treatment?  How many VA employees lost their jobs and pensions or were forced in front of a judge for murder?  It is a fair question, where are the elected officials in the legislative branch working to end the criminal “fraud, waste, abuse,” and designed incompetence in the executive branch?

© Copyright 2022 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the images.  Quoted materials remain the property of the original author.

Quis Custodiet Ipsos Custodes? – The Role of the Citizen in Government

Public Service NoteThe links in this article are essential to review.  If you know better resources, please let me know in the comments.  Thank you!

QuestionIn The Satires, VI, Juvenal poses a question of great importance, “Who will watch the watchmen?”  As more and more dirt on a host of politicians comes to the fore, as China expands its heinous reach in the Pacific Ocean, threatening trade and disrupting lives, as the Russia/Ukraine crisis grows, we, the citizens, are left asking this question.  There is only one answer, we, the citizens of representative governments, are charged with watching the watchmen.  A more critical and cogent point has not presented itself in these writings.

Regularly I write about the findings of the Department of Veterans Affairs (VA) – Office of Inspector General (VA-OIG).  As a disabled veteran, a person falsely arrested, injured by VA Police Officers, and flagged fallaciously as a “behavioral problem,” I am a watcher of the watchmen and report on the findings.  Unfortunately, the VA has turned both a blind eye and a deaf ear to the VA-OIG and my summarizations of the VA-OIG’s conclusions.  You, the taxpayer, need to know what the government is doing in your name and with your tax dollars.  We, are the watchmen tasked with watching the watcher (elected political officials), who were hired (elected) to scrutinize the government.  Is our role in the direct representative government of this constitutional republic clear?Apathy

Did you know your neighbors sued the Baltimore Public School system for breach of public trust?  For more than 40 years, the Baltimore Public School system has intellectually abused children and misappropriated public funds through forced taxation.  The unelected school district has done this while tax revenues drop precipitously, students cannot read (yet still pass high school graduation), and the neighborhoods in Baltimore become more unsafe.  Illiteracy is directly tied to crime rates, poverty, and helplessness; yet, the school board in Baltimore cannot even be bothered to allow parents the right of school choice.  What is the role of citizens in Baltimore, the same as it is everywhere else; protect children, scrutinize government, elect different leaders, and watch more closely those elected to protect the rights of all citizens.  “Who will watch the watchmen;” you are the watchers of the watchmen, and you are being lulled to sleep!

In our constitutional republic, we have three co-equal branches of government, the executive, the legislative, and the judicial.  President Biden is reported to be in full swing of destroying the power of the judicial.  Recently the world watched aghast while a wholly unqualified person was measured for a position with the Supreme Court, the court of last resort in American Jurisprudence.  President Biden is on record claiming he would nominate the first black woman to the supreme court; after ensuring that two other more qualified women of color were refused nomination earlier in his career.  Do you sense a hypocrite, liar, and charlatan?  The judge nominated cannot tell the difference between a man and a woman, allows sexual predators to have lighter sentences as she legislated from the bench.  Yet, we, the watchers, are expected to believe she is remarkably qualified and uniquely capable of sitting on the Supreme Court.  I have serious reservations, not because she is a woman or a person of color.  My reservations rest solely upon her record as a judge, which I find detestable at best.Patriotism

Everyone is aware, COVID-19 has plagued the world since late 2019, originating in China, and the costs have been exorbitant and extreme.  Only until the Russia/Ukraine crisis came along did the global media find a new story for wall-to-wall, 24/7 coverage like feckless beasts fighting for a bone.  Repeating only for emphasis, “Where has the opposition party been during COVID-19?”  The watchers, every single one, from the mayor to the US House and Senate, went to sleep and allowed bureaucrats to overcome law and common sense to the detriment of every single citizen.  Where did the watchers go, and why did they leave the citizenry to the incautious, ineffectual, inefficacious, and abortive bureaucrats who fired professionals, broke the law without regard, and still are running free?  Liberties, rights, freedoms, were stolen without consideration, and the opposition party was nowhere to be found.  Indeed, “Who will watch the watchmen?”

The Duty of AmericansOn the topic of China, why is Marco Rubio the only member of the US Congress willing to say aloud what the citizenry is wondering?  2020 closed with China owning $1.9 BILLION or roughly 192,000 acres of prime American farmland.  Want to know where those crops grown on American soil go; I bet you can guess they aren’t traveling to US Supermarkets.  China is still buying prime farmland, and nobody in the US House or Senate is willing to listen to farmers, ranchers, and dairymen about how their land is being purchased by China and they run out of business.  Rep. Dan Newhouse was quoted regarding farmland ownership by Chinese investors as a national security issue.  “The current trend in the United States is leading us toward the creation of a Chinese-owned agricultural land monopoly.  There are currently no federal safeguards against the creation of this monopoly.”  In response to Rep. Dan Newhouse, Rep Grace Meng proclaimed, “Can we honestly say that this Amendment, which singles out one country, won’t have repercussions on Asian-Americans across our country?  Let’s include all of our adversaries.”

Who will watch the watchmen?” An honest and fair question.  I agree that no enemy of America should be allowed to own land inside America.  Not that Saudi Arabia is an enemy to America, but it is important to note not just China is purchasing farms and ranchland in America.  Worse, fresh water in California is regularly purchased to grow alfalfa for shipping to the Saudi Kingdom.  California keeps declaring they are in a drought.  The water crisis continues with or without Saudi purchases through the government’s mismanagement of resources, the need for liquid capital to keep the debt wolves away from the door, and the silly environmental laws.  “Who will watch the watchmen; is apt and very important when discussing national security issues, the acquisitions of foreign entities inside America, and the need to meet citizen needs before foreign markets.quote-mans-inhumanity

On the topic of Biden, specifically the Hunter Biden laptop and the shady deals with China, one has to ask about the timing of China’s massive land purchases ramping up.  At the same time, Joey was Vice President, and Hunter was slipping the “Big Man” money.  The Hunter Biden laptop story has been closely followed since October 2020, and the revelations released in the various news outlets on this story leave me appalled, alarmed, and amazed.  I keep asking myself about the timing, why Joey was so valuable an investment, and the answer lies in his access to Obama.  One of the media pundits discussed how Obama and Clinton are tied into the sale of access by Joey, and not all of the financial analysis is completed even now.  Leaves me asking who got paid and why during the Obama presidency?  A careful records review shows China going on a land purchasing spree simultaneously, and more questions for Secretary of State Clinton need to be addressed immediately!  “Who will watch the watchmen?”Beware of Scam Phone Calls and Emails Disguised as Vendors : The New York City District Council ...

Detective 3The US Constitution, in the 10th Amendment, provides all the authority any citizen needs to demand the watchers scrutinize the government and, if required, replace the watchers.

The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.”

We, the citizens, own the direct representative government in America, and it is time for those elected to fear the citizenry.  Not because we have become violent, but because we are firing them, electing new representatives, and holding those removed from office accountable for their mismanagement while in elected office.  Our country is being sold out from under our feet by those elected to office, and it is time they are held accountable before the bar of justice.  Our national security is a hiss and an insult to them, all while they become enriched, and their children funnel money, and I am sick to death of seeing this nepotism.  We, the watchers of the watchmen, deserve answers from transparent and speedy investigations that conclude with people wearing distinctive clothing and permanently disgraced.

Knowledge Check!How have the watchmen become millionaires while holding public office?  This single question should be the watch cry of every single citizen in America until they are all held accountable and disgraced.  You deserve better watchers.  Our children deserve better watchers.  The world deserves better representatives of the people, by the people, and for the people.  Remember this in November!

© Copyright 2022 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the images.  Quoted materials remain the property of the original author.

Employers and Employees – The Battle is Waged: The Fight is Important

LookEmployers throughout the world, including Disney, American Express, Wells Fargo, and thousands more, have begun to battle their employees.  Unionized shops, the battle has been waged for 50 years and shows no sign of relenting.  Only recently have other employers joined the fray, not to help employees but to rid themselves of employees.  These businesses are fighting employees against their employees for the company’s culture and soul.  Couched in many a buzzword, political stance, and archaic practices, the employers want to rid their workforces of those they despise, and the battle is legal!

Make no mistake, what the employers are doing is immoral, unethical, and disastrous to those employees unfavored, but the actions remain perfectly legal, and this is the point we must understand.  Laws have been changed against the majority for the selectivization and advancement of the minority.  The fight is important because you might be next and never know your termination has been affected, but not enforced until it is too late.  This article intends to raise awareness, not cover every particle in the fight or catalog every avenue an employer might take to attack an employee.  Imperative to know and remember, as long as the actions are against individuals, no laws are being broken, and the employer wins when they can make the situation untenable, and the employee on the out quits or is forced out under a miasma of quasi-legal terms, so it appears that employee was treated fairly.Plato 2

Never forget, a lawyer’s job is to make the illegal appear legal, and the legal appear illegal, so a judge must decide.  Add in judicial activism and legislation from the judicial bench, and the trouble becomes apparent quickly.  Unfortunately, the lawyers’ training has shifted, and the legal mind’s quality has slipped under the weight of many of the topics discussed herein.  The vicious cycle can only be broken when the collective beliefs of the majority are re-established, not to the demise of the minority but the growth of the entire society.

Culture and Politics

As long as people have banded together into organizations, societies, governments, etc., there has been the push and pull of politics.  All of recorded history bears truth to this fact.  People have beliefs.  They express these beliefs through representatives who rise and fall in different leadership positions, and societies change according to the expressed beliefs through which a society is governed (law).  Pick a governing style (Communism, Socialism, Representative, Direct or Indirect Representation, Monarchy, Theocracy, etc.), and you will find the collective beliefs of the people expressed in how long a leader remains in power or the stability of the society so governed.  Politics happens and is best described as the push/pull of collective beliefs expressed by populations.  Economies rise and fall based upon the collective beliefs, expressed in the stability of the society and the government leader’s length of time as leader.Lemmings 1

History has shown when a governing leader is short-lived, it is generally because they refused to follow the collective beliefs of the population, giving rise to the credit ratings of stable governments and societies being higher than for those who are changing leadership every couple of weeks or months.  Those leaders who can tread the waters of public opinion maintain their jobs and, many times in history, their heads by following the collective beliefs in the morals of the people.  The US Dollar’s stability is one of the strongest reasons this currency is one of the world’s benchmark currencies.  Politics did that, and politics are the push/pull collective beliefs expressed by the citizens to their government leaders.  The process is messy and needs to be messy for a reason; only in the expression of two divergent points can a healthy middle ground be established, and society can grow.

Culture is not politics, but politics and politically minded people can influence it.  If politics is a society’s expressed beliefs, then culture is the expressed moral convictions as lived by a community.  For example, many institutions have been built on the law that coveting (envy) is wrong, but the practices of the people living build a culture that accepts graft, bribes, and other incentives that, while violating the law, are accepted.  Make sense?  The closer the culture is to following both the letter of the law and the living of the law provides for a stable and influential culture to invest resources into.?u=http2.bp.blogspot.com-BKwWSo412lIUngTRkmSYwIAAAAAAAARd8GqxDhvovmRgs1600salestaxcartoon.jpg&f=1&nofb=1

How does one change the collective beliefs of a society and the living practices of that society; first, you capture the children.  Bad ideas do not go away, they are either replaced with good ideas, or the bad ideas go into hiding, awaiting the time they can make a new appearance.  Everything modern society is facing has been faced previously, and the difference is that the seeds for the current dilemmas were planted more than 100-years ago, but the bad ideas first captured the children.  Why have these bad ideas advanced so rapidly?  The education of children in social customs, collectively shared beliefs, and individual duty, has been eroded and attacked mercilessly since “progressive education” (the refusal to teach children to read, write, and perform math) began in the late 1800s with Dewey, who called functional illiteracy “Progress!”

One of the first words plasticized, twisted, ripped apart, and then put together to fuel tyranny through modular language was the term progress.  Unfortunately, language has continued to suffer relentless attacks since the late 1800s, and more words have suffered the same fate in the modularization of language.  Consider with me the history of Tea.  Tea plantations in India were ruled by the iron fist of laws drafted in America and marketed with women in distress to the consuming nations geographically distant to where the crops were grown.  The tyranny of slavery is the same tyranny we face with modular language.  Nobody realizes this because to mention this connection is frowned upon by those making money off the tyranny of language.  The tyranny of modular language fueled the oppression of entire populations to fuel an empire.  The language led to actions (afternoon tea) and a host of other practices, words, and social customs to fuel the demand for Tea.  Unfortunately, the tyranny of modular language also fueled hot wars in China, more geographically distant suffering from the population consuming Tea.History of Tea | Dilmah School of Tea

Language – Plastic Terms

Diversity, what is it; what does it mean in practice versus meaning from a dictionary; what value does it have for a business?  Equity, same problem, fewer answers, more confusion.  Inclusion, same problem, confusion, chaos, and eventual destruction.  These are, but a small sample of current buzzwords strung together and causing problems in businesses.  There are entire word classes set apart for plasticization, which sound good to the ear, and that people love to rally behind, but these terms cover a hidden agenda.   They have been weaponized to destroy, not lift and build—tyranny through modular language, plastic words.Plastic Words: The Tyranny of a Modular Language By Uwe Poerksen

American Express is a perfect example of how DE&I efforts (Diversity, Equity, and Inclusion) have been weaponized to pick away, through politics, the non-politically affiliated, those who show up to their employment and merely want to work their job.  The University of Phoenix is another company long captured by, and suffering from, DE&I tyrants.  Both American Express and the University of Phoenix began their DE&I journeys with the best of intentions.  Still, the result remains the same, the minority classes bring politics anathema to good order and discipline into the company, initiating change cloaked in DE&I.  The result has been the discouragement and disenfranchisement of employees.  The DE&I champions crow and cheer for these people leaving as it injects more DE&I hiring, and the new employees realize that unless they are politically affiliated, read that as aligned to a militant tyrant in DE&I, they too will be out of work very shortly.

Language matters, and when terms are plasticized, the only result is destruction and tyranny.  Consider the teachers in the Albuquerque Public Schools System or the employees of the State of New Mexico; both populations stress DE&I initiatives under various names but with the same purpose.  Who are the enemies of DE&I; those who do not wear their politics on their sleeves, acting as emotionally charged smart bombs of the media.  Even if a person holds some of the DE&I beliefs, if they are not militant in their beliefs, they are ostracized by their language, judged, and removed from employment.Political Correctness = Language and Thought Control | Wake Up World

When the patients rule the asylum, the problems for all patients in the asylum double and triple, not improve.  The same result occurs when the vocal minorities of a population gain power that is not theirs, and they make no concerted efforts to rule fairly and justly.  One of the truths about any revolution is that those who initiated the revolution rarely (if ever) get to enjoy the fruits of their rebellion as they are so focused on fixing what they perceive as injustices, they miss that they have become worse in action than those they deposed.

80-20 Rule

The 80/20 Rule is known by many monikers, but always it is the same rule, in different wrapping – 80% of a population will be controlled by 20%.  In standard terms, the minority is setting the culture for the 80% to follow, and they hope you will never realize you are stronger without the vocal minority than with them.  Take the recent changes at Disney.  There is a vocal minority demanding change, couching the changes in diversity, equity, and inclusion, and the Disney business model is about to self-destruct.  The same is true of American Express, where if you are male and white, you are not welcome.  But, if you are one of the members of any number of protected classes, you are welcome.  When politics interferes in professional pursuits, 80% will always suffer under the tyranny of the 20%.  What happens when the vocal minority becomes the majority, they fang themselves to death, and nobody is left to care because that 80% majority has left them to their own devices.Pareto Principle: understanding the 80/20 Rule

It should go without saying, but I will make plain, I am not against diversity.  I do believe that diversity for diversity’s sake is wrong, immoral, unethical, and anathema to good order in a society.  Diversity of thought should be preeminent as the diversity of thought transcends skin color and lifestyle choices.  Diversity of thinking includes the desire to see all succeed on merit, character, and individual action.  I abhor in the strongest terms picking a person solely based on their gender, skin color, religious preferences, disability status, culture, or any variable that supersedes accomplishment, education, and learned skill set.  The same is valid for inclusion and equity; when people cannot compete solely upon achievement, education, and intellectual skill sets, this creates an imbalance in the population.

Hence roadblocks to education must be removed, character-defining and building experiences should be shared and taught, and achievement recognized.  What is missing from schools from K-12 and up; is accomplishment, education, and learned skill sets.  What has replaced these; is DE&I, where the vocal minority is destroying with no thought for what replaces the institutions, societies, corporations, and more.  Iconoclasm in its most destructive form has taken over employers, and these companies are committing suicide to pacify, tranquilize, and placate a small population at the expense of all.Make the 80/20 Rule Work for Your Online Marketing Efforts | WillTan.com

Inherently, change is not bad but growing, productive, and useful change requires inputs from a diverse population.  Inclusion is not inherently a bad thing, but the current demands for inclusion, only for the sake of inclusion, make the activities of the vocal minority lethal to the entire social body.  Equity is a prerequisite for society to grow, develop, and be stable long-term.  This is why societies built on slavery, or those muzzling 50% of the population, are inherently ripe for hostile takeovers.

The actions of the vocal minority in employment right now are precarious at best, suicidal at worst, and permanently immoral and unethical.  The models they promote have no substance and enable unfair, unjust, and unequal systems.  Worse, companies that flout their customer base, which is the largest stakeholder in any business, will find smaller profit margins and higher expenses as employee churn increases.

Knowledge Check!One truth that should give hope to the employees affected is that when the minority becomes the majority in a body and does not have any substance, they destroy themselves.  C-Leaders, are you sure you want to take the company you have been placed in control over down this dangerous path?  On my first day at American Express, new hires were introduced to the rich, proud, and stable company history and core values.  How sad it is to witness how fast this company has fallen!  Who will replace these companies?  Will their replacements learn from the failures of the past?

© Copyright 2022 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the images.  Quoted materials remain the property of the original author.

Sermo Datur Cunctis; Animi Sapientia Paucis – Remind you of Anyone?

Exclamation MarkDistichia Moralia provides with keen wisdom the following, “Speech is given to many; intelligence to few.”  After the European trip of US President Joe Biden, intelligence is in short supply in the White House, the staff, and of course, the US Media!  Would someone please tell me how so many can say so much, yo-yo’ing from one point to another, and still make no sense?  Honest question, the other day someone told me the patients were running the asylum, and I countered no, the clowns took over the circus.  Both sentiments are accurate, but I detest clowns, and mental patients can occasionally do something brilliant.

Now, to be perfectly fair, little Joey Biden has a mental cognition problem that is more than likely some form of senility or Alzheimer’s disease.  I am not entirely blaming little Joey; his spouse and handlers bear the full brunt of the blame and deserve their punishment for not allowing this senile old man to retreat to his beloved basement and finish the rest of his days in solitude and grandchildren.  May little Joey sniff hair and massage shoulders in a creepy fashion after retirement to his heart’s content.  But his handlers, the complicit media, and his spouse need to be hauled in front of a judge for elder person abuse!

From Australia’s Sky News, the BBC, Daily Mail, FOX News, CNN, MSNBC, and Jerusalem News, essentially covering the entire globe, every media channel worth a small moment is complaining about Biden’s European performance.  Not all media channels are created equal, but to have them all complaining about Biden in Europe is pretty phenomenal.  To have Biden walk back his handlers’ “clarification” and then renounce his previous sentiments in the same speech is nothing short of a full-blown communication failure.

To clarify, I do not care what you embrace for your political party.  Any person with half a brain cell can observe what is happening and know instinctively that the elected leaders have no clue and even less intelligence.  Worse, their intellectual ability for self-preservation is running on fumes and day-old flatulence.  Truly, “speech is given to many, and intelligence to few.”  Unfortunately, this is not the tip of the iceberg humanity is headed towards at full speed!If we do not believe in freedom of speech for those we despise we do not believe in it at all ...

Satire is truth wrapped in comic wit and presented for discussion.  Never taken seriously as supported by how many “shock” comedians?  Yet, the Babylon Bee is removed from Twitter because some Twitter employees think they have a special mission from their god CEO Parag Agrawal to silence any voice they deem “hostile.”  More people prove that “speech is given to many; intelligence to few.”  Would someone please tell me how Kathy Griffin can parody cutting off then President Trump’s head, and she can maintain a Twitter account, but the Babylon Bee has their account suspended.  Worse, Kathy Griffin, a fully non-humorous comedienne, got a Netflix special, but Dave Chapelle was hounded mercilessly for weeks because he told the truth and was actually funny.

Kathy Griffin, Dave Chapelle, Biden/Trump, Babylon Bee, Twitter, Facebook, Google, Apple, and others are tied into a Gordian Knot over the topic of controlling speech unconstitutionally.  Whether as perpetrators, victims, or politics, every actor mentioned, especially those not mentioned, as this was NOT a definitive list, all share in the ongoing saga over the First Amendment.Abraham Joshua Heschel quote: Speech has power. Words do not fade. What starts out...

A reminder, the First Amendment states:

Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.”

The perpetrators who are pulling the political strings to hinder and thwart the First Amendment hide, like evil thinking cowards, cower behind the shield, “Congress.” Claiming that since they are not Congress, they only prohibit speech on their private platforms conditional as part of the “User Agreement” or as private citizens or businesses.  Hence, limiting the speech of others is entirely legal, moral, and socially acceptable, intentionally muddying the lines between legal and illegal for entertainment or some other bloviated excuse.  Except, what these perpetrators are doing is stealing freedom from everyone for personal profit.TOP 6 QUOTES BY ZECHARIAH CHAFEE | A-Z Quotes

What is “Hate speech?”  Sure, the lawyers have concocted a definition for court, but in practice, “Hate Speech” is anything any person who thinks they possess a modicum of power deems it to be.  Any tool that limits speech will be used as a weapon to beat people out of their rights and freedoms and steal the same to enslave all.  The Supreme Court regularly hears cases on First Amendment issues, specifically speech.  Of the five freedoms protected and enshrined in the First Amendment (Speech, Religion, Press, Assembly, and Petition the government), speech is the one most often attacked.  The Supreme Court has wisely used the rule of thumb, “Screaming ‘Fire’ in a crowded theater,” as the basis for whether to rule speech as governed under the First Amendment or not.

Why is this a wise rule of thumb?  Because creating panic in a population enclosed in a building should not be protected “free” speech as the consequences are dire indeed.  But does this mean anything else goes; absolutely!  A simple rule exists to explain why, “When you limit the freedoms of a single person in a society, the entire society loses ALL of their freedoms, rights, and liberties.”  Democracy is messy!  A constitutional republic is doubly chaotic!  We, the citizens of either a democracy or a constitutional republic, accept this as a necessity to protect our individual rights, freedoms, and liberties.The Legal Lens: Why Free Speech Matters To You

This means when Twitter declares something as broaching their “User Agreement” and limiting one person’s speech, as a citizen of the United States, every citizen of the United States loses!  When Facebook or LinkedIn practice censorship in the name of “socially acceptable speech,” they are thwarting the US Constitution and decrying they are the wisest of us all and intelligent enough to declare what is and is not “acceptable” speech in a public environment.  When YouTube ends people’s livelihood because they do not like the content in a video, everyone loses their right to produce content free from burdensome oppression.

Chris Rock was free to make a joke about Jada Pinkett-Smith as a point of reference.  Will Smith was perfectly in his right to first laugh at the joke and then choose to become offended.  But, Will Smith’s rights ended when he took action and hit Chris Rock.  Speech is a responsibility, and exercising speech properly means sometimes being held accountable for the speech made.  Unfortunately, modern society has allowed people to make offensive and degrading remarks without accountability for too long, which is a problem.  However, the solution is not to control speech by a business, company, government, non-governmental board/organization, etc.  The solution is to remind people of the accountability inherent in exercising their rights to speech.

Speech is never “Free.”  Free speech means no consequences to what you say, but the reverse is true, and speech has a significant cost!  Ask any disabled veteran about the cost of speech, and let me know if they claim their injuries are free.  Worse, ask any person jailed who made a speech if their speech was free, and tell me if their sufferings, depravations, and sacrifices were without cost.  Chris Rock was entirely in his right to make an offensive joke.  I did not find it funny.  But could Chris Rock have been held accountable for his poor sense of humor without being slapped on international television; absolutely.  But, name me another group of people who abuse the rights, freedoms, and liberties of others without care and concern than Hollywood.  I know of no other industry!

Yet, Hollywood has taken it upon themselves to be the lords and masters over everyone else when they cannot control themselves.  Solidifying the permanence in the principle, “Speech is given to many; intelligence to few.”  How many known victims of Harvey Weinstein?  How many unknown victims are living?  How many dead victims?  How long was Harvey Weinstein abusing his power to subjugate people to whet his appetites and passions?  How many others are currently copy-catting Harvey Weinstein’s example?Speech is power: speech is... | Inspirational Quote by Ralph Waldo Emerson

The government has failed to police Hollywood, and Hollywood refuses to police itself, but how many in Hollywood are willing to insist that Hollywood needs a deep cleansing, an injection of values, morals, and law; not many, if any.  Name another industry so rampant and steeped in villainy, depravity, and disgust that it can escape basic law enforcement.  Hollywood spawned Bollywood and how many other incarnations in countries around the globe, all suffering from the same moral vacuum and creating the same social decay without consequence.  Spoilt children, parading as virtuous adults, demand their rights, liberties, and freedoms, all while denying others the same rights, liberties, and freedoms.  Demanding politicians, the same politicians fawning and feeding the Hollywood monster, to use the powers of government, and big business, to thwart laws for their own profit and gain.

Have you ever heard of a “Casting Couch?”  In business, the military, government, a “casting couch” is sexual harassment, a crime worthy of jail, heavy fines, and social scorn for the perpetrator.  In Hollywood, the “Casting Couch” is regular business for those desiring to be in Hollywood, and the victims, if they speak out, are scorned and unemployable.  The horror stories about the “Casting Couch” are depraved, disgusting, and the victims’ ages run the gamut, all with little to no consequences for those soliciting sexual favors in return for employment in Hollywood.  The case of Harvey Weinstein ripped the scab off the festering wound of Hollywood, but Big Business and Government have helped keep the wound alive and infected, to the shame and horror of the victims.

Knowledge Check!Will Smith, enjoy the spotlight your actions created, and may the consequences fit the crime.  Chris Rock, you’re still not funny.  Wanda Sykes, you lost your funny.  The Oscar’s is not worth my time and energy to scorn, let alone watch.  But, Hollywood, your industry is sick, and the greatest crime is that your infection is spreading faster than a case of Chlamydia in the Playboy Mansion.  Hollywood, you have lost any and all claims to tell anyone else how to live and until you clean up your mess, I will continue to refuse you my money.  You might start by remembering, “Speech is given to many; intelligence to few.”

© Copyright 2022 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the images.  Quoted materials remain the property of the original author.

Continued Inanity from the US Government – Where are the Elected Officials?

Angry Wet ChickenI made the mistake of ranking the various government agencies on how intractable, unintelligent, and irresponsible they are.  I ranked the IRS based upon previous experience more competent than the VA.  That is a mistake I will not repeat any time soon, as the VA and the IRS are in a neck and neck race to the bottom!  Consider how the IRS sends you paper mail notifications; if you have questions, you are referred to a website for answers and provided several customer service numbers.  Except, when the website fails, you call the notifications’ numbers and are told that you need to visit the website for faster service.  The website refers you back to customer service, whose phone queues are always so full you are automatically disconnected after being reminded to use the website for faster service.

As my mind experiences a total meltdown, I begin twitching, and my head eventually explodes; check out this cat picture:Funny Cat Backgrounds, Pictures, ImagesDignified Stray Cat Photos Celebrate Their Unique Beauty

Some will declare this is a one-off incident; surely, the IRS is not this dysfunctional.  Try it for yourself sometime.  I never ask anyone ever to, believe me, experience this for yourself.  Check out the IRS website https://irs.gov.  Try to get solid and reliable information, and see how fast your head wants to explode.  I have been trying to appeal a decision the IRS made arbitrarily since 21 March 2022 and gotten nowhere fast.  Best of all, I have a deadline of 20 May 2022 to register an appeal, yet the website cannot answer my questions and points me back to the phone number on my notification.  The phone number auto-answer assistant refers me back to the website shortly before disconnecting my call.

As a small business owner, I had trouble getting my Tax ID number; the website said to call customer support, the phone number referred me back to the website and then disconnected my call because the queues were too full.  Ad Nauseum Ad Infinitum, but the joke is undoubtedly on me; the IRS proclaims they respect my time and are anxious to resolve the concern.  Can’t you just feel the concern and anxiety emanating from the IRS?  Where are the elected officials who need to be scrutinizing the Executive Branch and demanding better returns on the taxpayer’s investment?

As my mind experiences another total meltdown, I begin twitching, and my head eventually explodes; check out this cat picture:Cats wallpaper - Cats Wallpaper (5194935) - FanpopJust say nope | Grumpy Cat | Know Your Meme

If you’re keeping count, this is the third recent article on the culture of corruption at the Department of Veterans Affairs (VA) in as many weeks.  No, I am not behind; the rate of the frequency of VA – Office of Inspector General (VA-OIG) reports has legitimately been this overwhelming.  Never forget, an indictment is not a conviction, and perpetrators remain innocent until proven guilty in a court of law and the trial and sentencing have been completed.

Hunter Matthew Burroughs and Stephen Keith Andrews were indicted by a federal grand jury in Fort Smith, Arkansas, for their roles in three separate conspiracies to defraud the US government and private workers’ compensation insurers.  Their alleged crimes include a billing and kickback fraud scheme with multiple physicians and medical clinics and separate fraud schemes involving the shipment of medications from Arkansas to two Louisiana physicians, who then distributed those medications from their clinics in violation of Louisiana laws.  Additionally, Burroughs was charged with wire fraud for allegedly falsifying emails he provided in a civil lawsuit involving his sale of the company.”

Not to be outdone:

Robin Calef of Brockton, Massachusetts, was sentenced to one month in prison followed by three years of supervised release after pleading guilty to one count of theft of public funds in November 2021.  She was also ordered to pay restitution of $102,289 to the VA.  In December 2006, Calef’s sister was receiving VA monthly benefits, passed away.  She failed to inform the VA of her sister’s death, and the VA continued to deposit monthly benefits into a joint bank account held by Calef and her sister until September 2017.  Bank records revealed that Calef made monthly withdrawals of approximately the exact amount of VA benefit funds deposited into the joint account.”

And:

Derrick Brewer of Enfield, Connecticut, pleaded guilty to one count of theft of government funds.  In March 2018, Brewer submitted paperwork to the VA offices in Hartford as part of an application for service-connected disability benefits.  Specifically, he submitted form DD-214, which indicated that his discharge from his former service in the US Coast Guard was characterized as “Honorable.” However, the form had been altered before its submission.  According to official Coast Guard records, Brewer’s discharge was characterized as “Other Than Honorable Conditions” following his convictions under the Uniform Code of Military Justice.  There is no record of the discharge characterization ever being upgraded.  As a result of this submission, Brewer collected nearly $70,000 in VA benefits from March 2018 through September 2020.  Sentencing is scheduled for 27 May 2022.”

And:

Sarah Jane Cavanaugh of Warwick, Rhode Island, was arrested on charges of using forged or counterfeited military discharge certificates, wire fraud, and fraudulently holding herself out to be a medal recipient to obtain money and property or another tangible benefit, and aggravated identity theft.  It is alleged that Cavanaugh claimed to be a wounded US Marine Corps veteran and recipient of a Purple Heart and Bronze Star and schemed to collect hundreds of thousands of dollars in veteran benefits and charitable contributions from organizations that provide monetary aid; to veterans in need.”

And:

From 2002 to 2019, Terrie Lynn Christian of Newaygo, Michigan, engaged in a fraudulent scheme that targeted children’s benefits programs administered by VA and the Social Security Administration (SSA).  This scheme, which involved obtaining benefits for two fictitious children, resulted in government losses of over $660,000, including approximately $110,000 for VA.  Christian was sentenced in US District Court to 30 months in prison, three years of supervised release, and restitution of over $660,000.  The VA OIG and SSA OIG investigated this case.”

Do you notice anything odd in these stories of fraud; the documents did not stand up to scrutiny, but fraud was still perpetrated.  I have authentic documents proving service; I have had to present original documents several times and sign affidavits testifying these documents are my documents.  I am a veteran, and under the threat of severe penalties, I swore that I was not attempting to defraud the US Government.  Would someone please explain how these people, and so many others, can commit fraud so frequently?  Would someone please explain how the VHA and the VBA accepted clearly doctored documents and fraud executed?  Finally, where are the VBA and VA employees being held accountable for failing to do their jobs and allowing this fraud to be perpetrated with complicity?Mediocrity Joke

Time after time, I have been denied help, been given the bureaucratic runaround, and refused assistance until my documentation can be certified.  Then after my documents are approved, they are still rejected by bureaucrats who refuse to do their jobs.  Yet, crimes and fraud are perpetrated with the same bureaucratic inertia and complicit behavior.  Elected officials, do you understand why taxpayers are frustrated?

What reignites the explosion of my head is that these are only two of the multiplicity of government agencies.  Nobody knows how much fraud is perpetrated by employees and customers, and worse, even fewer care.  Elected officials, will you please explain why you are not more concerned and avidly involved in ending the fraud?

Let me cast your mind backward to 2005.  United States v. Alvarez, 567 US 709, is a case in which the United States Supreme Court ruled that the Stolen Valor Act of 2005 was unconstitutional.  The Stolen Valor Act of 2005 was a federal law that criminalized false statements about having a military medal.  Elected officials, when the judges legislated from the bench, overstepping their authority, why didn’t you immediately go back to work and redraft legislation to end the theft of valor and penalize people committing fraud?  Instead, you rolled over like a dead, bloated, floating body, and valor theft has worsened!Plato 3

Elected officials, why have you not drafted new legislation to curb government theft?  Why have you consistently refused to act to curb the bureaucrats from abusing taxpayers?  Why do you remain silent on the shrinking morals in America that open the doors for more abuse of the law?  We elected you to the office to take action; what are you doing?  Yes, mayors, city councilors, judges, dog catchers, school board members, county commissioners, and every other single officer elected, you are included in this plea for action!

Dont Tread On MeAgain, I implore you, the voters, to scrutinize your elected officials for their continued employment.  Yes, start today.  I know the elections are months away, but it requires time to evaluate performance, become knowledgeable, and prepare to act on election day.  You deserve a better government, and those in office deserve to be unemployed!

© Copyright 2022 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the images.  Quoted materials remain the property of the original author.

Fed UP! – More Detestable Bureaucratism from the VA.

I-CareI hate being lied to!  More than I hate being lied to, I detest, with every fiber in my being bureaucrats and the inanity they promulgate to excuse their stupidity and throw a wrench into the works.  Today I suffered through yet another call with my VA-appointed primary care provider (PCP).  Not an online conference, but a phone call.  Who was in the office with the provider and why?  How can I guarantee my HIPAA information during a phone call on an unsecured line?  How do I know who I am talking to?  These concerns and more arise when you receive a phone call to discuss important medical information, and my PCP does not care!  My PCP refuses to use the VA’s tools to conduct patient appointments and instead creates workarounds; what an ingenious method for telling lies and spreading falsehoods as bureaucratic inertia; I’m so thrilled!

The PCP continuously claimed all my imaging is “normal” and “unremarkable.”  The pain experienced cannot be related, and the sources are questionable.  In polite speak, the PCP is trying to tell me it’s all in my head; a previous provider from the VA already used this as an excuse for not performing their job.  For more than 10-years, I have been fighting the VAHCS for help in reducing pain and in getting to root causes for the problems experienced.  Yet, today’s call was just more of the same BS wrapped in feel-good words, platitudes, and bureaucratic non-answers.  Honestly, after the third time the doctor related, the imaging was normal and unremarkable; I lost my cherub-like demeanor!  I did not swear until I got off the phone, but I am not anywhere close to a happy patient.

Honest question, does the VAHCS troll medical school for the bottom of the barrel, those people who can barely pass a class, let alone qualify for medical privileges?  I need competence, and I get useless lumps.  I ask questions, and the snowflakes pop out of the woodwork like ticks on a deer or fleas on a dog.  I am thoroughly sick of being treated like a know-nothing inconvenience.  The most important person in the VA marketed PACT Team is the patient who will be active, engaged, and informed.  The second most important member of the VA Marketed PACT team is the Primary Care Provider.VA 3

Since 2002 I have had a problem in my gastro-intestinal system; since 2010, the pain has been debilitating, and four years ago, I was diagnosed with non-alcoholic fatty liver disease.  Today, 22 March 2022, the PCP reviewed the problems area on my electronic health record (EHR), which coincidentally resides at the top of the electronic health record and was mentioned four different times by myself, and noted that non-alcoholic fatty liver disease is not listed.  Tell me, how would that make you feel?  The PCP ordered today’s call before the recent imaging appointment on my abdomen and pelvis, but the provider, who called me almost 30-minutes late, did not even look up my record before calling.  Had not studied the imaging results and formulated a plan of action to move forward, yet as the second most important member of the PACT team, I am supposed to trust this bureaucrat; I think NOT!

Through the miracle of modern technology, I had read and researched the imaging results more than 24 hours before the scheduled appointment to discuss the results.  I came prepared, but the provider could not be bothered to prepare for a call they demanded, then had the sheer effrontery to keep repeating that the imaging is “normal” and “unremarkable.”  Then the provider has the gall to tell me, repeatedly, that I was yelling, when in fact, she only did not like being spoken to with emphasis and insistence that she do her job!  Yes, I called her a bureaucrat and a snowflake, whereupon she threatened to hang up the call, but I disconnected first.  I miss those old rotary phones you leased from AT&T, they had heft, and when slammed, they made you feel better about disconnecting a call.PACT_model

From research, it is abundantly clear that pain from hernias can show up or be felt in areas far removed from the hernia site.  Constipation is both an indicator and a symptom of hernias.  Muscle weakness in the legs, burning sensations, and much more are all indicators of a hernia.  Yet, when I asked about all the other pains and problems experienced in my abdomen, I was told the hernia could not be the root cause, and the imaging is “normal and unremarkable,” but the PCP could not answer why these other symptoms are unrelated when asked.  Where is the research, seeing as “Dr. Google,” is discouraged; Johns Hopkins and the Mayo Clinic, plus I have access to the medical libraries at the University of Phoenix and Grand Canyon University.  With less than five minutes of research, I can locate and read data from reputable sources to form the basis of questions to ask a PCP, which is encouraged of patients by the VA.  Yet, the doctor cannot be trusted to provide any intelligent data, do any preparation, or knowledgeably speak to a symptom list; when will the VA answer why their PCP cannot do their job?PACT 1

If only I were the only person experiencing these problems and issues with the VA.

Former VA cardiologist John Giacomini of Atherton, California, pleaded guilty to one count of felony abusive sexual contact.  In the fall of 2017, Giacomini repeatedly subjected a subordinate electrophysiologist to unwanted and unwelcome sexual contact, including hugging, kissing, and intimate touching while on VA premises.  On 10 November 2017, the victim explicitly told Giacomini she was not interested in a romantic or sexual relationship with him.  Nevertheless, Giacomini continued to subject his subordinate to unwanted sexual advances and touching, culminating on 20 December 2017, when Giacomini turned out the lights in an office, pulled the victim out of her chair, and fondled her until a janitor opened the office door and interrupted the encounter.  The victim later resigned from her position at the VA, citing Giacomini’s behavior as her principal reason for leaving.  Sentencing is scheduled for 12 July 2022.VA 3

Will the VA-OIG troll through this former provider’s employment history seek out the other victims, or will this be swept under the rug not to tarnish the VA?  Having been an employee of the VA, will anyone, EVER, look at how employment law is abused by the leaders in the VA and correct the problems?  This incident should never have occurred, nor should it have taken years of abuse to end this despicable behavior.  Yet, what does the VA do, shut both eyes and pretend it does not occur in consequence of the designed culture at the VA.

Why did the victim have to tell another adult that their behavior was unwanted, and quit their job, before the VA took action?  Will there be an inquiry from congress?  Will any lawyers stand up and demand the VA correct this detestable hole that allows this behavior to promulgate?  I am not holding my breath!

Speaking of electronic medical health records, the VA-OIG has issued three separate reports on this topic, and none of them paint the VA with anything that shows competence.  In the report titled:

Medication Management Deficiencies after the New Electronic Health Record Go-Live at the Mann-Grandstaff VAMC in Spokane, Washington.”  The following findings were related:

Deficiencies in medication data migration and management resulted in patients having inaccurate or incomplete medications in their records or made filling prescriptions accurately more difficult—all of which can affect patient care and safety.  Areas of concern included:

(1) Data migration
(2) Medication formulary availability
(3) Medication order processing
(4) Provider notification and alerts
(5) Controlled substance tracking
(6) Prescription drug monitoring program documentation
(7) Medication reconciliation
(8) Medication list accuracy.”VA 3

As previously stated, I am not as nice and never politically correct.  VA-OIG, please allow me to correct your assertion, “Deficiencies in medication data migration and management resulted in patients having inaccurate or incomplete medications in their records or made filling prescriptions accurately more difficultall of which DO negatively affect patient care and safety.”  Trust is the first casualty in war and in dealing with the VA in ANY form, manner, or method.  When you cannot trust your data to remain confidential, the entire electronic medical record system can only be rated as UNACCEPTABLE!  The upgrading of the electronic medical records system at the VA is a 10-year, multi-billion-dollar fiasco, and as a taxpayer, I am done paying for this system!

Not to be outdone by the medication side of veteran care experiencing failures, the following VA-OIG report was issued:

Care Coordination Deficiencies after the New Electronic Health Record Go-Live at the Mann-Grandstaff VA Medical Center in Spokane, Washington.”

The EHR rollout caused problems in coordinating veterans’ care, ranging from the flags for patients at high risk for suicide not transferring to veterans and their care providers having trouble accessing video appointments and patient portal messaging.  Tracking outcomes were sometimes lost, and disappearing laboratory orders also resulted.  Although the OIG did not identify associated patient deaths, future deployment of the new EHR without resolving identified deficiencies could increase risks to patient safety.”VA 3

Again, the VA-OIG is practicing political correctness instead of being specific, and upfront, the entire EHR is a disaster, the cost is prohibitive, and any fool should see it is time to pull the plug, cut the losses, and hold the leadership accountable!  Yet, what do we see; the EHR is progressing into infinity and beyond at a snail’s pace!

The final nail in the VA’s EHR coffin should be that nobody involved can communicate with the IT helpdesk for the EHR as the IT ticketing system is unreliable!  Form the VA-OIG, we find the following:

Ticket Process Concerns and Underlying Factors after the New Electronic Health Record Go-Live at the Mann-Grandstaff VA Medical Center in Spokane, Washington.”

The failure to process and respond to VHA staff ticketing requests for help or report concerns resulted in reporting, tracking, and resolving problems.  These deficiencies made it difficult for clinicians and administrative staff to serve patients and impeded EHR fixes that can affect future sites.  The inspection team also identified five factors contributing to the deficiencies identified in the two companion reports above: usability, training, interoperability, needed fixes, and problem resolution.”VA 3

Imagine for a moment, you are responsible for a multi-billion-dollar IT project, and one of the first issues discovered by the users is the inability to reach out for IT help; how long would you remain employed?  Would you ever expect to ever work again if any of these problems were your legacy for leading the IT improvement on a multi-billion-dollar project?  As a consultant, I know how fast you would be fired and taken to court for business losses.  Why are these leaders exempt?  Where are the blue-ribbon panels and committees demanding people be held accountable for this fiasco?EHR-VA-OIG

When the VA-OIG casually mentions that PCPs are untrustworthy and not using the current tools correctly, should the providers be issued new tools; NO!  Yet, this is the opposite of what common sense declares.  Are you, dear reader, as a taxpayer, fed UP yet?  My wife reminds me, “These problems happen in civilian hospitals.”  No, in fact, they do not.  If data migrated from one patient’s EHR to another patient’s HER, that hospital would be sued and shut down so fast by congress at the federal and state level, all before the media firestorm would have barely begun.  If a patient were jeopardized because their provider could not track medications, that patient would sue for malpractice and possibly a class-action lawsuit.  If an IT project was occurring in the civilian world, and the users could not contact the IT helpdesk, the project would be overhauled so fast, and people fired, new records would have been set.

Knowledge Check!It is time we end this charade and money pit call the Department of Veterans Affairs, and every other agency of the Federal government bloat!  The government should be leading, not lagging, where operational efficiency and fiscal sanity are concerned.  I repeat, only for emphasis, are you fed UP yet?

© Copyright 2022 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the images.  Quoted materials remain the property of the original author.