Sometimes, You Have to – More Repugnant VA Chronicles

Angry Wet ChickenIn looking back, it has been a long time since I wrote two scathing chronicles about the Department of Veterans Affairs (VA) in a single week.  But, I could not allow these Department of Veterans Affairs – Office of Inspector General (VA-OIG) reports to age any longer in my inbox.  With the Fourth of July fast approaching, as you celebrate, please keep in mind what the VA is purposefully doing to the Veterans, Dependents, and Spouses under their care.  America would not be here without her military, and military service produces veterans.  But, the VA is producing bodies and bureaucracy instead of helping veterans as they are paid and legally charged to do!

When I first left the US Army, I found myself employed in a telemarketing call center and was never paid the correct amount.  18-months later, I was employed with an Internet Service Provider, who bounced multiple paychecks before going bankrupt underneath the employees.  When the VA-OIG reports part-time physicians not being appropriately paid, I can understand the issues this causes.

I-CareThe VA-OIG randomly selected 134 salary agreements for part-time physicians on adjustable work schedules and found 44% of the physicians were either over or underpaid.  One might ask how and why these pay errors occurred.  The answer is extreme designed incompetence, not that the physicians will feel any better that they were either overpaid and owe back monies or underpaid and are now owed a considerable check.

From the VA-OIG report, we find the following as causes for the discrepancies:

This occurred because key management controls were missing or not working. Officials did not make certain that medical facilities complied with policies and procedures. Consequently, the OIG estimated VHA medical facilities had about $8.3 million in questioned costs that year (2019) and an additional $8.3 million in 2020. VHA medical facilities also may have violated the prohibition against voluntary services, and potentially the Antideficiency Act, by not correcting underpayments or by having physicians working above the 1,820-hour cap because their agreements were not properly reconciled” [emphasis mine].VA 3

The government officials’ neglect, malfeasance, and misfeasance might be illegal, as they failed to do their jobs properly.  Yet, the VA-OIG only issued recommendations.  There is potentially $16.6 Million in over or underpayments at stake, plus illegal actions, and people have not been fired or perp-walked into custody.  How can government employees get away with behavior that would have seen class-action lawsuits, criminal investigations, media reporting feeding frenzies if similar had occurred anywhere in the private sector?

IronyYet, the marketing materials produced by the Department of Veterans Affairs – Veterans Health Administration, a division of the VA, claims this is “Defining Excellence in Healthcare in the 21st Century.”  If you believe that, then you must believe that buffalo wings come from flying buffaloes.  Unfortunately, the problems only continue to worsen.

The VA-OIG reports that a doctor had accumulated more than 4000 alerts from the electronic health record (EHR) system.  This means that the computer system notified the doctor that patients needed care, appointments, were seen in the ER, required treatment, pharmacy prescription renewals, and much more.  The alerts, called views, are a built-in measure to help patients not get lost or have “adverse clinical outcomes” while receiving care at the VHA.  The VA-OIG found that the entire medical facility at the Charlie Norwood VAMC in Agusta, Georgia had similar issues.  The doctors were not viewing the patient EHR views as indicated.VA 3

What’s worse, the VA-OIG could not tell if “adverse clinical outcomes” had occurred because once the EHR views are settled, there is no record of the patient or why the view was required.  Talk about accountability, responsibility, and transparency in the patient-aligned care team (PACT).  In reading this VA-OIG report, it looks like when the facility leadership was alerted the VA-OIG was coming, the leadership team did a massive clean-up of the records, knowing they would never get caught and held responsible for any “adverse clinical outcomes.”  As a side note, the VA-OIG report claims the doctor with 4000 views is no longer providing care at this VA facility.  Heaven help his patients wherever this doctor is now!PACT 1

So far in 2020, I have had two different primary care providers assigned, and since moving out of Arizona, I will shortly have a third assigned to me.  My first primary care provider retired, but before doing so, he set up many EHR problems for his replacement to handle.  Including refusing to renew prescriptions, some of which were mine, which caused weeks of not receiving the proper medications.  Upon learning of my impending move, my second primary care provider essentially wiped her hands of my care, leaving me without medications and a clinic to contact for help.  Great job if you can get it; get hired to treat patients, and then not treat patients.  Before you ask, no, knowing I am not alone in this ordeal does not help!

PACT 3Finally, the VA-OIG has completed a full VISN wide comprehensive healthcare inspection (CHIp) for VISN 10.  VISN 10 covering Ohio, Indiana, Michigan and is located in Cincinnati, Ohio.  For all intents and purposes, the CHIp went well; the leaders are competent and knowledgeable.  Thus, I issue my sincerest congratulations to VISN 10 for their success.  The VA-OIG inspected the VISN’s ability to respond to the COVID pandemic appropriately, and the VISN performed well.

VA 3Except, this opens a few questions needing address.  At two VISN 22 and two VISN 17 facilities, I have experienced four utterly different responses to the COVID policy and masking mandates.  None of the facilities have written guidelines that are geographically specific to the patients and weather patterns in those areas.  None of the facilities have documented processes for veterans who cannot wear masks, with an approved policy supported, written statement for accommodating these veterans.  One facility insists that the veterans who cannot wear masks be arrested, cited, and fined.  One facility insists that if you have a letter from your doctor, you are okay.  One facility vacillates wildly from day-to-day and person-to-person, and the fourth facility doesn’t have a clue but is still very helpful, with supervisor approval.Question

Yet, somehow, VISN 10 has all their VAMC’s and VAHCS’ operating to the same sheet of music and behaving similarly.  How is this possible VA-OIG?  Better still, how does this spread out to other VISN’s and facilities?  May I hazard a guess, based solely upon the perceptions of veterans in VISN 10, the masking policy from COVID remains haphazard and improperly applied because Washington, DC, never issued proper guidance in the first place, the VISN leaders never issued written guidance.  The policy process on the local level is a quagmire of egos, bureaucracy, unions, all set into a cesspit of inaction and designed incompetence!  If COVID has taught any lessons, the number one lesson has to be that the leadership at the VISN and local levels remains inadequate to the task they were hired to perform!

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

Did you Hear? – Let’s Have the FULL Conversation

Bird of PreyThe following are several stories where the entire conversation is not being held, information is not being disseminated, and the public is left in the dark.  In the name of having that whole conversation, let us ask tougher questions and demand better answers!  More to the point, I hope these conversations lead to less government control, bureaucratic edict, and bureaucracy fiat.

Medical Mayhem – Socialized Medicine

The Jerusalem Post, 23 June 2021, reports that baby Alta Fixler will be removed from life support.  Following her parent’s wishes to send her to a hospital in Jerusalem due to her parent’s Haredi Orthodox Jewish faith.  The parents petitioned the hospital to release their child, who has been on life support since birth, to travel to the Jerusalem Hospital. Britain’s National Health Service (NHS) took legal action, and now the child is slated to be removed from life support.

Knowledge Check!Make no mistake, this type of parental and patient abuse is alive and well in America.  The face of socialized medicine is a nameless bureaucrat making decisions, running to a judge, and forcing upon parents that which the parents believe is not in the best interest of their child.  If you want to read the heartbreaking story of socialized medicine in America, look no further than the Justina Pelletier case.  The only question never answered in the Justina Pelletier case has been where do parental rights end and hospital bureaucrats begin?  Never answered, and this legal gray area is where socialized medicine thrives!

Baby Alta Fixler is not the first child to die by government fiat in English hospitals by court order.  Justina Pelletier is not the first case of hospitals abusing patients based upon doctor opinions and bureaucracy.  The entire conversation needs to be had.  Each state in America, each voter in America, needs to decide should a nameless, faceless bureaucrat have life and death control over your loved one, or should the family and parents have that control?

US Government – Censors Iranian Websites and Media Outlets

Ziggy on GovernmentReuters, copied on Jerusalem Post, 23 June 2021, reports how the US Government is working to end the social media influence of Iran on America’s political system.  A totally dumb move by the Biden Administration to single out just one state actor pulling America around by the social media noose.  The story includes Russia, China, and North Korea, all investing in websites specifically designed to tout the party line and sway political interests in America.  Yet, the only country singled out for action has been Iran.  Thus, the first question is, why?  Why is Iran singled out?  When will China, North Korea (China’s Hand Puppet), and Russia join the list of censored state actors involved in disinformation?

Now, here is why this is a dumb move; censorship never works!  Censor an idea today, and tomorrow it becomes a living and breathing problem.  For example, Mark Twain’s incredible story of “Huck Finn.”  It was banned in my public library on Monday and Tuesday, the book had a backlog to be checked out, and no copy could be found on any shelf in bookstores.  This all occurred before the Internet, eBay, Amazon.com, the bookstores included used bookstores.  With technology, the problem has only grown.

Knowledge Check!Consider LinkedIn; it continues to censor speech it finds personally repugnant or disagrees with politically.  Facebook does the same; Twitter, Google, and the list of Big Tech censoring grows.  Yet, the ideas they find abhorrent take on a life of their own, continuing to prove that censoring an idea is the worst decision!  Worse, in America, a Constitutional Republic (if we can keep it), demands via the First Amendment that censorship of speech is wrong.  You do not fight bad information with censorship, you fight bad information with good information, allowing the complete discussion based upon the facts, and you respect the Rule of Law!

Why is this concept so difficult to understand?  Before we can shake a stick, there will be lawsuits, charities, and news media with identical talking points trying to push back against the government.  The ACLU will take the case Pro Bono, and the Judicial Branch will again confirm that free speech cannot be censored, making the government look stupid for censoring speech, increasing traffic to these obscure websites from curiosity doing more harm than good to America.  The exact opposite result the government was trying to create by censoring.  Let us have the complete discussion, open free speech, do not censor, and for pity sake stop making legal martyrs out of the enemies of America!

Google Israel, Conversion Therapy, and the LGBTQ+ Community

Question22 June 2021, The Jerusalem Post reports that Google Israel has launched a campaign to fight conversion therapy practices.  After canceling an app to aid in conversion therapy, after an outcry from the LGBTQ+ community.  Since the fallacious claims of the 1960s that sex is love, and love is free, and equality in sex includes changing genders and pushing the full-on homosexual agenda down the throats of a global audience, the LGBTQ+ community has tried to control the conversation on bedroom choices for everyone.  Which in and of itself is a form of censorship.

GLAAD (Gay, Lesbian Alliance Against Defamation) reports conversion therapy is defined as “Any attempt to change a person’s sexual orientation, gender identity, or gender expression.”  Conversion therapists define conversion therapy as, “Conversion therapy is the practice of trying to change an individual’s sexual orientation from homosexual or bisexual to heterosexual using psychological, physical, or spiritual interventions.”  Frankly, it appears to me that both groups are trying to win hearts and minds through the same tactics, just using different politics and purposes.  Here’s the problem, since the LBGTQ+ community continues to use the judicial branch to censor speech, promote their causes, and subjugate laws, the entire conversation is not being had on how people choose to become members of the LGBTQ+ community or if they want to return to heterosexual communities.  This lack of diversity in conversation and the withholding of information is censorship, and censorship is wrong!

Male v. FemaleI repeat myself only for emphasis, “I do not care about your bedroom selections.”  Provided you and your partner are legal and consenting adults, there is no reason for me to be interested.  Your business is YOUR business, with all the consequences of YOUR choices.  I have heard the horror stories of pedophiles grooming young boys to become members of the LGBTQ+ community; I have seen the reports on diseases, physical harm, suicides, rapes, and other problems in this community.  But, by not having both sides of the conversation, how can a person be expected to make a logical choice about their identity if half the conversation is depicted as roses and rainbows, and the other half is never discussed at all?

I am not here to tell you how to live your life.  Make your choices live with your consequences, the same as every other adult.  But, if you are preying on children for homosexual or heterosexual appetite suppression, you are deserving of the full weight of the law!  For example, the North American Man/Boy Love Association (NAMBLA), fighting to decriminalize pedophilia and pederasty, is closely associated with and receives funding from all types of homosexual and LGBTQ+ community supporters.  Yet, what they proclaim and do is groom young boys for homosexual sex.  Worse, the K-12 sexual education programs are an outreach of both NAMBLA and GLAAD and have been since the programs were introduced in K-12 schools.

Question 2Some online sources claim that these targeting groups for pedophiles are defunct, except I do not believe this, as the fluidity of terminology and the plasticization of words are more common among the LGBTQ+ crowd than among politicians.  To date, I have not found a single organized group where women groom young girls into lesbian relationships.  I mention these two items because conversion therapy goes both ways, luring into homosexual relationships and luring into heterosexual relationships.  I have witnessed women practicing witchcraft introduce lesbian lifestyles to their adherents, and I have witnessed several Wiccan groups preach the same lesbian lifestyles to their supporters.  However, I make no judgments or broad aspersions beyond my experience as I do not have enough information on the grooming of women into lesbian lifestyles.

However, the fact remains that the LGBTQ+ community is controlling the conversation.  The volume of disinformation in the LGBTQ+ communities is based on a lot of fear and twisted science, and by preventing the whole discussion from occurring, censorship is hurting people.  All I am asking for is the disinformation and censorship to cease.  If you believe your cause is correct, allow the complete discussion to occur, discuss the pros and cons openly, detail the consequences and potential harm.  We already do this, by forced mandate, for heterosexual relationships; what is there to hide in the homosexual relationships that command all this hatred for telling both sides of the homosexual story?  You, the LGBTQ+ community started this conversation, so let’s have a full and honest discussion.

Knowledge Check!You, as an adult, consenting, can do what you please.  I merely ask that you stop interfering in the transfer of information so young people can have all the facts.  Before they jump into a relationship that can physically, mentally, and emotionally scar them for life, be that relationship hetero or homosexual.  End the censorship!

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

NO MORE BS: Have You Heard?

DutyThe following is a recap of several stories that should have been big news, but since the corporate media is practicing “Biden Behind Covering” (BBC), I doubt this news was heard anywhere.  However, this information is critical, and I have included the links if you want more than my paltry summation of the story.  I encourage you to always hit the links included in the articles I publish, so you know where I get my source materials.

Judge for yourself the importance of the following, but I encourage you to judge wisely, for America is in deep trouble!

Inflation Definition: Formula & How to CalculateFrom the NCSL regarding the future of finance, we find a curious article, “Do State and Local Governments Need to Worry About Inflation?”  The simple answer is absolutely, as the continuing pension crisis will be multiplied as inflations grows.  How much is inflation up, a year ago inflation was 4.2% less than it is today.  But that is a statistic that doesn’t carry the real weight of the problem.  If you owed $100 last year, without interest calculations, you now owe $4.20 more.  That $10.00 steak is now $10.42, before taxes.  That tank of fuel, before all the taxes, is $0.42 more expensive than a year ago, and inflation was already hurting America.  The way inflation works is comparable to running on a freshly waxed floor in your socks, you have to exert more effort to maintain your same spot, forget slowing down, or stopping for that will include falling.  Let me reintroduce you to a term used in the early 1970s, stagflation.  Stagflation occurs when the inflation rate is so out of control, no new jobs are created, employers are looking to cut employees left and right to maintain shareholder profits, and the entire economy grinds to a messy halt.

Inflation may erode PTI's political capital - Newspaper - DAWN.COMRisk managers across the financial system are looking at the government on the Federal, State, and Local levels and are not liking what they see as inflation continues to grow beyond the Federally approved 2% annual allowed rate.  As taxes adjust for increased inflation, it will require more money to pay taxes to maintain current levels, as inflation depletes the value of dollars saved.  Thus, every government is looking at their “Rainy Day” funds, and are watching it depreciate as inflation increases, and this is happening before a penny is even spent.

VaccineFrom SHRM, we find the next astounding piece of news, the “EEOC Gives the Greenlight for Limited Incentives for COVID-19 Vaccinations.”  Mandatory vaccinations are illegal in the United States, currently.  However, incentivizing vaccinations by an employer has now been made acceptable.  Do you see a problem with this EEOC ruling?  Did you notice how slippery the slope is between employers incentivizing vaccinations and mandatory vaccinations?  During periods of higher inflation, how much value is $500, from an employer to vaccinate?  Other employers are allowing employees to sticker their badges showing they vaccinated and can stop wearing a mask in public.  No sticker, you have to keep your mask on.  Slippery slope?  Colleges, K-12 Schools, and other organizations all have a hodgepodge of rules for mingling in a post-COVID government mandated lockdown, as the “New” normal.

Do you see the problems with employers picking winners and losers based upon vaccination status?  How long before those who cannot, or will not, be a guinea pig for a useless vaccine, that is shrouded in mystery, and which has zero long-term studies completed, for a viral disease with a 99.02% chance of survival, are shown the door because of risk averse insurance policies?  I have some concerns with this decision and remain convinced that the EEOC has been bought and paid for by parties unknown.  Their last several decisions have left me seriously concerned.  Watch the bureaucrats, they are sneaky!Plato 2

Virginia Allen, writing for The Daily Signal, provides the next piece of news that should be wall-to-wall with parents marching.  “California Public School Gives Third Graders Assignment About ‘Place on Gender Spectrum.’  Let that sink in for a moment.  9-year-old students are being asked to choose where they place themselves on the “gender spectrum.”  What the heck is a “Gender Spectrum?”  At 9-years old, I was more interested in getting better at little league than I was about anything else, except my paper route.  A quote from the article sums the problem nicely:

The school board is completely indoctrinated. Many teachers are completely indoctrinated. … You cannot change their mind. The only thing you can do is vote them off [the school board] and let them know there are consequences to teaching children inappropriate things for their ages.”

When your politicians are no longer afraid of the citizens they afflict, tyranny has begun to reign!  California is a perfect example of what happens when the populace checks out, the politicians stop fearing the ballot box, and power concentrates under a single party.  Now, ask yourself, is this the America you want for your kids and grandchildren?  I know my answer!Apathy

Cal Thomas also writing for The Daily Signal, presents the scariest topic of all, “Ministry of Truth 2.0.”  Consider for a moment, you make a comment in a grocery store, an off-hand comment to another person, the next day a person from Homeland Security is knocking on your door to discuss your passing of disinformation, who possesses the legal authority to place you under arrest, no evidence needed, and you are guilty until reluctantly allowed to be innocent.  From the article:

Secretary of Homeland Security Alejandro Mayorkas is reportedly considering the development of tools that would help America’s children discern truth from lies and know when they are being fed “disinformation.”

Millstone of Designed IncompetenceIf you have not read, or listened to, George Orwell’s book 1984, you might not recognize “the Ministry of Truth,” which is the propaganda arm of the government who rewrites history to what the government says it is, and not what actually happened.  Would someone please explain to me who appointed the Homeland Security Secretary the harbinger and decider of truth and lies?  When the media cannot even get the truth right, how will a government, senate appointed, person who serves at the pleasure of the current sitting US President know, recognize, or even understand truth?  When the media allow truth to be “subjective to circumstances, environments, and cultures,” how will bureaucrats be able to discern truth?

Tell me, how will the tools be protected from the bias of the tool designers?  One of the biggest issues in modern research is researcher bias; yet somehow the secretary of Homeland Security can magically control bias to protect the tools from the opinions, knowledge, experiences, and politics of the designers.  Exactly how will this occur?  Do you recognize how slippery this slope is, and how dangerous?Why

As a homeowner in a town that is within 50-miles of the southwest border, the continued blind-eye being turned to the southern border infuriates me.  Please, follow this link, and then consider what is being said.  Do not look at the politics of the situation, do not listen to the political leaders and political commenters.  Listen to your heart, your gut, your conscience, and tell me, if the 9-year old girl was your sister, cousin, daughter, what would be your response?  From the article we also find the following:

The cartels are making an ungodly amount of money on a daily basis, somewhere to the tune of $15 to $25 million a day in just the trafficking and smuggling of human beings. That doesn’t include the narcotics. We’re seeing, for example, fentanyl, 5,000% increase in fentanyl coming across the border.”

America Is Crying Digital Art by Deborah VicinoWant to hear the truth about the problem on the southern border, let’s talk about “got-aways.”

Got-aways” are individuals that are crossing the border illegally that don’t want to get caught. They don’t want to go through processing because they are either a gang member, someone on the terrorist watch list, a convicted sex offender, [or] a violent offender. These are people who know that once they are caught, they will get turned right back around because of their record, because they have a record in the United States.”

From January to June, the Border Patrol, through all their efforts, have lost around 200,000 “got-aways.”  These are people seen on cameras, who have eluded apprehension, and are now roaming American streets.  A convicted sex offender was given a small baby to help him cross the border.  Where the parents of this child are, no one knows.  So, even when they get caught, we still have problems getting rid of the vermin mixed into this humanitarian crisis.  How many terrorists from non-South and Central American countries have slipped through as “got-aways?”

Knowledge Check!America is being taken for a ride by the Cartels who run the Southern border!  This is the truth, and anyone trying to tell you something else is selling snake oil and trying to make a buck off the tragedy that is the US Southern Border.  Like all evil and conspiring people through history, the innocent are the shields covering the criminal actions, these children deserve better, but they will never have a future until America becomes a land of laws again, where the Rule of Law is honored.

Child Abuse - New Day Advocacy CenterCan you hear the Statue of Liberty weep at how are laws are being manipulated by the drug cartels, for the glorification of single-party rule and fiscal return on investment?

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

Weep America! – The VA Leadership is Becoming Worse! – Part 2

Angry Wet ChickenOne of the first rules in overseeing junior people working is to make available someone to answer questions, immediately, and render support if needed.  I have had the pleasure of training junior people in a myriad of tasks over the years.  When I read this Department of Veterans Affairs – Office of Inspector General (VA-OIG) report, a plethora of questions arise, and I deeply question the professionalism and competence of the doctor overseeing the work of residents in a VA Hospital who are performing procedures.

  • Ophthalmology Resident Supervision – Important to note, the patient did not experience any long-term loss of sight over this issue. Congratulations to the resident and the other ophthalmology doctors present!  From the VA-OIG report we find the following:

“… The subject ophthalmologist failed to provide adequate resident supervision and entered inaccurate documentation related to supervision for a single patient case.”  Essentially, the doctor charged with overseeing residents was AWOL, and then compounded his error by falsifying patient records.  The VA-OIG report continues by claiming this falsification was the result of an oversight when using pre-recorded notes for patient files.

Draw your own conclusions.  Personally, I think this doctor needs to be released of all duties where overseeing residents is concerned.  I would also question his ethics and morals for falsifying patient records.  You hold a double position of trust, first as a doctor, second as a teacher and leader of residents, and the behavior witnessed should come with steep repercussions professionally!VA 3

Knowledge Check!On the topic of professional duties, and steep repercussions, drug interactions killed a veteran at the Marion VAMC in Illinois.  Before launching into the VA-OIG’s report, please allow me a moment of your attention.  Drug interactions can arise due to vitamin usage, over-the-counter medications, and from illegal and legal but illicit drug use.  Often, I have claimed that people are walking chemistry experiments, and even vaccines need to be carefully evaluated for drug interaction potential.  Foods can cause drug interactions due to the chemicals in the food.  Drug interactions are a growing problem and every medical professional I have spoken to admits drug interactions are becoming worse by the day.  I do not say this lightly, but I do not hold the medical professionals as fully competent in fighting the drug interaction problem due to the amount of chemicals the average person interacts with daily.  The problem is Big-Parma and the continual push towards more specialized medicines, we are going to see more drug interaction issues.  Unfortunately, drug interaction issues come with the risk of death!

From the VA-OIG report we find the following:

The VA-OIG substantiated that high cholesterol contributed to the patient’s death; however, the death certificate indicated that the primary cause of death was accidental acute multi-drug intoxication. The psychiatrist and staff failed to document providing the patient with education during a telephone encounter regarding potential side effects or adverse drug-drug interactions of medication changes. Contrary to clinical guidance, the psychiatrist prescribed long-term benzodiazepine use for a patient diagnosed with posttraumatic stress disorder. The psychiatrist also failed to address the patient’s two negative urine drug screens for a prescribed medication and failed to address a positive urine drug screen for cannabis. Due to COVID-19, the facility failed to launch the Psychotropic Drug Safety Initiative Phase Four Plan. The primary care provider did not comply with facility policy by failing to enter a return-to-clinic order following an appointment but could not determine if this affected the patient. Primary care and behavioral health staff did not comply with facility policy to telephone the patient or send a letter after the patient missed appointments” [emphasis mine].

The lack of staff to follow procedures and do their job, I will certainly hold them accountable for, especially since Cannabis is involved!  Please do not believe that Cannabis is a non-toxic drug, especially when mixed with other drugs, it can be the fatal trigger in a multi-drug intoxication!VA 3

At 18, low those many years ago, I took the EMT-Basic class, but left for US Army Basic Training before I could certify.  Since then, I have received certification as a combat medic and a Journeyman Firefighter (Any industry) which required a lot of hours studying emergency medicine.  I am experienced in drawing blood, starting IVs in difficult circumstances, and handling a myriad of injuries.  I am not a medical professional by any stretch of the imagination, I simply have a healthy desire to learn, and emergency medicine is a fascinating topic I regularly pursue.  I am not a chemist; I rely upon peer reviewed resources and legal and medical websites to stay current on a host of topics.  With this as my qualifier I am going to make several statements and you can judge their merit.  Feel free to comment.

      1. The first rule of medicine is document everything! My first lesson, first day of EMT training, this point was driven home.  If you do not write it down, it never happened!  Yet, what does the VA-OIG find time after time in reviewing cases at the VHA, lack of documentation of steps taken!  Can you say, “Asinine and abysmal behavior by credentialed professionals?” I know I can!
      2. Aspirin and Alcohol can cause a drug interaction that can be deadly. Both chemicals are readily available in the home and over the counter.  Why is spray paint now requiring proper ID, because people are huffing the stuff and getting a multi-drug intoxication.  Oven cleaner and spray pain can cause serious breathing issues and when mixed together can cause a cheap high, as well as a multi-chemical intoxication leading to breathing paralysis and death!
      3. Cannabis continues to be modified, changed, enhanced, and designed to trigger different chemical reactions in the body. Continuing work that began in earnest in the 1960s for the pot-smokers who wanted a more serious high.  Guess what, cannabis and aspirin along with vitamins can cause multi-drug intoxication problems leading to death!
      4. Vitamin D and Vitamin C have both caused serious drug intoxications during COVID-19. People became frightened and took too many of both or just one and wound up in the ER with life-threatening health problems from toxicity of these vitamins.  India has reported a spike in black mould that has caused serious long-term health problems for diabetics after recovering from COVID.  It is currently presumed that the chemicals used to fight COVID allowed for a natural mould to grow in the body, and that became life-threatening.

The VA-OIG conducted another virtual comprehensive healthcare inspection, and found the same problems continue at another VAMC.  Do you know how tired I am of reading these “comprehensive inspection” results and finding the same problems time after time?  When will the VA actually start enforcing some of these VA-OIG recommendations to effect change?  Better, when will the politicians who are charged with scrutinizing the government tire of seeing the same recommendations and not seeing any change?  Bloody frustrating reading these reports and not seeing improvement!VA 3

Broken RobotFinally, we come to what I was hoping to be a great report, where the politician’s heads were going to explode at the inefficiencies, the detestable behavior, and the horrendous responses to legally mandated IT infrastructure changes, and why those changes are not happening at the VA.  I was not disappointed; I was thoroughly disgusted that his report fell on plastic ears speaking plastic words from wax lips!  Statement of Michael Bowman, Office of Inspector General, Department of Veterans Affairs, Director of IT and Security Audits Division, Before the Subcommittee on Technology Modernization, Committee on Veterans’ Affairs, U.S. House of Representatives, Hearing on Cybersecurity and Risk Management at VA: Addressing Ongoing Challenges and Moving Forward May 20, 2021.  Notice something, the failures at the VA in the IT Department are being called “ongoing challenges.”

Millstone of Designed IncompetenceLet me remind you, FISMA was released on 29 April 2021, and I wrote about the abysmal findings of the VA-OIG.  This report is the accountability statement to the Congressional representatives who should have skewered this bureaucrat and roasted him on a spit with onions and peppers, then served him up for public ridicule after firing him!  For the Director of IT and Security Audits Division to make the following statement is flat out beyond comprehension, “The OIG’s conclusions in the FY 2020 FISMA audit are not new or revelatory—rather, they repeat many of the same concerns with VA’s IT security that the OIG has found for many years.”  What incredible chutzpah to make this comment after that scathing report showed just how deplorable the leadership of the IT and Security Audits Division revealed!  Director Bowman then goes on to downplay the band-aid solutions implemented while decrying the time for improvement is too short and there is not enough money.  Do not forget, “Of the 26 recommendations, 21 have been included in every FISMA audit dating back to at least 2017.”  With at least 15 of these recommendations dating back even further.  Want a full list, as well as how old these recommendations are; you will not find it in the Director’s report to Congress!  Is anybody incensed enough to demand a full accounting of just how old these IT recommendations are?

Detective 4The gall of this director to continue to blame legacy systems that were legislated to have been scrapped between 2000 and 2010 continues to highlight the incompetence of the director in conducting business and holding people accountable for failed projects and overspending of taxpayer monies!  The director went further and stated the following, at which time, every single Congressional Representative should have stood and demanded his head.  The “VA does not properly manage and secure their IT investments.”  Tell me director, why should you remain employed if the VA does not properly manage and secure their IT investments?  Is the failure to manage and secure IT investments the root cause for veterans to continue to suffer identity theft from the VA losing their identity?

The director’s next statement puts his other outrageous comments to sleep.  “Security failures also undermine the trust veterans put in VA to protect their sensitive information and can affect their engagement with programs and services” [emphasis mine].  Talk about such an obvious statement, it’s like the sun coming up on a cloudy day, you just cannot miss that sun rise; you also cannot miss the absurdity of making this statement!  Did some intern write his speech?  You are the director of IT Security and you make this type of comment, did you make this comment with a straight face?  I cannot find the video-record of this Congressional hearing so I can only guess he delivered his lines with a straight face!  Most detestable of all, he continued to make outrageous comments, his plan to move the IT security program at the VA forward is weak, lacking firm deadlines, and continues to allow him and his staff to escape accountability and responsibility.VA 3

Angry Grizzly BearAmerica, with these bureaucrats in charge, why shouldn’t we be weeping and wailing, and gnashing our teeth in frustration?  When will we, the owners of this atrocious government, finally scream ENOUGH and demand a full change of heads at the ballot box?  For until the elected representatives are forced out, the bureaucrats abusing us, will only continue!  The VA is sick, but the problem lies in the bureaucrats, administrators, and directors leading the VA at the Federal and VISN levels.  So many other government agencies are just as sick, or worse, and the same problem arises, the leadership refuses to act, but still expects a big titanium parachute when they leave office!  I say it is time to tell them NO!

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

NO MORE BS: The Ugly Face of Government Largess – The Bureaucrat!

Boris & NatashaCharles A. Reich, an American legal and social scholar and an author who was a professor at Yale Law School, in his paper “The New Property,” writes about how government largess created the bureaucrat.  The same bureaucrat who invents rules to exercise authority creates problems to stop work and generally acts like a feudal lord over the taxpayer, to pick winners and losers through government altruism, rather than specific individual bureaucrat’s magnanimity.  Well, the bureaucrat has one thing correct, their enmity is destroying America!

Calvin & Hobbes - EnmityThe bureaucrat’s mind looks for every opportunity to thwart a citizen interacting with the government, that citizens hired through the ballot box, where the bureaucrat can then pick winners and losers in receiving government largess.  Why; enmity, the state or feeling of being actively opposed or hostile to someone or something. Enmity’s legal definition describes the bureaucrat, perfectly; a feeling or condition of hostility; hatred; ill will; animosity; antagonism.

Convoluted ProcessesAmerica has a significant problem with the government. It started in the 1930s when the government took advantage of a catastrophe, which they caused through tariffs and trying to control the stock market to seize power from the citizens.  This problem has only increased over the 100-years since.  The bureaucrat that works in serving the public is an extension of the officers elected through the ballot box.  Thus, I implore; please hold those elected accountable for the drones, the power-hungry, and those who consider their work on the public’s behalf as executing government largess, responsible and, liable.

Ziggy - How Government Should Have to RunNever forget, our Constitutional Republic’s legislative branch has two jobs, write laws that are good for all, and scrutinize government.  Only those elected can positively influence the bureaucrat’s hiding in their cubicles, lording their power over citizens.  Only those elected can be held accountable and responsible for what the workers and staffs do in the name of those elected.  We, the legal citizens of America, are the government we elect, and I advocate the position that I am not a peon, serf, or “huddled mass” beholden to the government.  From the local dog catcher, school board, and judge to the President of the Republic of these United States, the government is beholden to you and me.  Those bureaucrats hiding in offices that make your life so difficult are obligated to us as well.

Non-Sequitur - GovernmentI refuse to be the property of the government, standing like Oliver Twist, begging for slop from fat and repugnant government officials.  America, we deserve a more responsive government; our Constitutional Rights declare that the power over the government is ours to hold, and the government must come to us to ask for more.  Let us use the control we have and demand accountability and responsibility from those elected.  Those elected need to require compliance and keep those working in public service accountable for the abuse and mistreatment the citizen receives at bureaucrats’ hands.

Detective 4Some have told me this is “too idealistic” that our government can never shrink and become more responsive and accountable.  I declare that position is a defeatist position, and I oppose defeatism!  How do we know something cannot be done if we do not first try?  Originally it was believed that a train track could not connect one end of America to the other, yet the train track was laid, and America prospered.  Critics have claimed space flight was too expensive for the private sector, and only the government could put people and machines into space; well, those critics were wrong again.  Defeatists have always taken paths anathema to the doers in American Society, and it is time to put the defeatists to shame again.  We, the citizens of America, can and need to retake our government, using laws and processes established to thwart the bureaucrat and remove the craven and cowardly elected officials!

Ziggy on GovernmentWe, the citizens of America, must embrace a “Liberty FIRST Culture” as a motivation to action and change the government!

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

VISN 22 – The Bureaucrats Operationally Living as Petty Tyrants

Survived the VA23 February 2021:  UPS delivered a letter package containing a single sheet of paper from Dr. Karen MacKichan MD, auto signed, and dated 09 February 2021.  Declaring that the Phoenix VA is absolutely correct in behaving as petty tyrants and denying me medical care, illegally sharing and knowing my HIPAA information with VA Police Officers, breaking EMTALA, and treating me to injuries, all because I cannot safely wear a mask.  My only infraction at the Phoenix VA is not to wear a mask.  Yet, this is considered a “behavioral problem,” and I am wrong for behaving in a manner that insists that my safety comes first!

From June 2020 to date, the charge has been, “Wear a mask or a face shield to receive service in the VA.”  Then, I got arrested while wearing a face shield and told my failure to wear a mask is “disruptive behavior.”  Seriously, not wearing a mask somehow disrupts the entire hospital and keeps it from running efficiently.  Refusing to believe the letter my VA provided Primary Care Provider wrote (August 2020) for my employer regarding my inability to breathe while wearing a mask.  The VA Police have continued to escalate situations to reflect “disruptive behavior patterns.”  Yet, I am the one punished, and I am the one injured; I am the one being denied care.

Literary FiendWhat are petty tyrants?

James Abyad quoted the Urban Dictionary for the definition of petty, which exactly expresses the sentiment of petty.  Urban Dictionary defines petty as “making things, events, or actions normal people dismiss as trivial or insignificant into excuses to be upset, uncooperative, childish, or stubborn.”  It further defines it as “a person who is purposefully childish with the intent of eliciting a reaction,” or “someone who does something in an attempt to hurt another person but makes themselves look stupid.”  Tyrant is a cruel and oppressive ruler, per Webster.  Hence, a Petty Tyrant is a childish, insignificant, oppressive ruler.

Well, Dr. MacKichan, Deputy Chief Medical Officer VISN 22, 300 Oceangate, Suite 700, Long Beach, California, 90802, you are incorrect!  I have followed all written VA directives. Do not assume that it is my fault the Phoenix VAMC leadership cannot write down a COVID Mask Directive and operational policy that supports all veteran health contingencies.  Then train the staff coherently upon written guidelines and directives, and engage in an honest and forthright manner with veterans seeking care.  Where are the written directives governing COVID Mask Wearing?  You claimed to have reviewed all the information; I have asked for these documents and been pointed to a sign.

VA SealOn the topic of written directives, written operational policies, written patient guidelines, and written job descriptions and duties, let’s talk about how the VA Police can injure people and not be held accountable!  The VA Police attacked me on 07 December 2020, violently pushed, then spun into a wall.  My C-and L-Spines did not move, and my T-Spine turned; I dropped like a rock sustaining spinal injuries, knee injuries, and got cut on my right hand and arm.  Worse, being handcuffed with my arms behind my back caused bruised wrists that were jerked by more VA Police officers on 10 December when I sought medical attention.  I am an 80% disabled person with mobility issues, yet your letter claims all the action of the Phoenix VAMC was in accordance with written policies, guidelines, and directives.  Well, I possess a Missouri mindset, “Show ME!”  Show me the written and published policies, guidelines, and procedures that allow VA Police Officers to physically assault patients!  Show me the written and published policies, guidelines, and procedures that allow me to be refused treatment.  Prove through written and accessible documents how the decision for this hodgepodge of ineptitude can label me a “behavioral issue” when my only discretion is not physically and safely wearing a mask!

The Duty of AmericansYou claim to have reviewed the actions of the police officers who routinely have medically protected HIPAA information about people being arrested, joke about this information, act in a manner that brings shame to all Federal Police Officers.  What happens to these unprofessional officers and their despicable commander?  When do my rights to have my HIPAA-protected information withheld from parties who do not need this information?  When do all the other veterans being served and not being served by the Phoenix VAMC become protected under HIPAA?  I am not the only veteran being refused service, denied care, and abused and injured by the VA Police for not wearing a mask, while also not being a “behavioral issue.”

Since your letter proclaims loudly that your review was thorough, independent, and comprehensive, and as the VISN 22 Chief Medical Officer, surely you cannot condone illegal activities being masked by calling a patient a “behavioral issue.”  The Emergency Medical Treatment and Labor Act (EMTALA; 1986), a federal law, requires anyone coming to an emergency department to be stabilized and treated, regardless of their insurance status or ability to pay.  EMTALA was regularly abused at the Albuquerque VAMC, and I reported this issue multiple times. EMTALA’s abuse and illegal activity at the Phoenix, VA Medical Center are worse, and I have reported this issue multiple times.  Twice I have followed my primary care provider’s instructions to report to the VA ER for treatment, and twice I have been refused service.  Thus, what is to be done to correct this obvious deficiency in VISN 22 treatment of veterans, service members, and dependents by VISN 22 emergency medical care providers and the staff, including the VA Police, who should have no influence upon care being received or who should receive care?

Theres moreYour letter discusses “the most effective manner to have the behavioral flag lifted” as “checking-in with the VA Phoenix Police.”  Do you know what that entails?  Did your “thorough, comprehensive, and independent” investigation uncover what happens at this “check-in?”  I was told clearly what happens; I will be evaluated for wearing a mask, found not wearing a mask, arrested, cited, and denied service for not wearing a mask.  Then, I will have a black mark on my behavioral flag record for disorderly conduct!  I am not disorderly in my behavior because I cannot safely wear a mask!  What part of this do you, as a medical doctor, fail to comprehend?

I had my gallbladder removed in a Phoenix hospital (Sept 2020), never had a problem not wearing a mask.  I have had MRIs completed (Aug 2020), never had to wear a mask.  I have been seen three times in an emergency room and never had to wear a mask (Jun 2020, Sept 2020, Jan 2021).  The only medical service provider demanding through compulsion and fear that I wear a mask, which would place my health at risk, is the Phoenix VAMC.  Yet, you as a medical doctor cannot understand this issue, the problems with unwritten policies and directives, leadership failures to train staff properly, and you allow petty authoritarians wearing VA Police Badges to enforce a reign of terror at the VAMC in Phoenix.  Hence, you are part of the problem in failed leadership, poor management, and detestable petty authoritarianism!

InertiaI always interact with the staff at VAMC’s, even when they are wrong, in a respectful manner, knowing that the problems of dumb policies, time-wasting procedures, and bureaucratic inertia are the fault of the leaders hiding in their offices and cubicles.  I have been interacting with the VAMC’s across America, and the inept staff, since I left the service in 2004!  Never having a problem, never having an issue, and never getting injured by or even interacting with VA Police.  This all changed in June 2020.  The VAMC refused to write down a comprehensive directive for COVID Patient Mask Wearing.  I get blamed for following the unwritten policy and directives, then falsely accused of being “disorderly” in my behavior, then falsely accused, again, for being a “behavioral issue!”  I am not in the wrong here!  I am not a “behavior issue!”  I am not disrupting hospital operations, placing other patients at risk, or being violent!  Where are my rights in this farrago and railroading scheme?

Image - Eagle & FlagYour boilerplate response indicates this issue has reached the final point.  I beg to differ!  I will have my name cleared of these false charges.  I will not be blamed for the ineptitude of the leadership at the Phoenix VAMC and VISN 22!  I will not be silent and meek in the corner because you cannot tell the difference between standing for one’s rights against tyranny and compulsion and oppression through bureaucratic fiat!  I have done nothing worthy of these fallacious claims, false accusations, and the Phoenix VAMC and VISN 22 will admit this publicly when I am done cleaning my name of the scum you have thrown upon it!  Make no mistake; I am not angry, but I will have my rights restored, my name clear, and satisfaction from the injuries and treatment I have been made to suffer!

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

NO MORE BS: President Abraham Lincoln on Welfare

The following remains a critical point regarding the government.

“The legitimate powers of government extend to such acts only as are injurious to others. It does me no injury for my neighbor to say there are twenty gods or no god. It neither picks my pocket nor breaks my leg.” – President Thomas Jefferson

Do we understand the principle President Jefferson is trying to convey?  Government actions can only injure.  Governments cannot build, cannot pick winners and losers, and cannot improve the human experience.  Governmental activities, taxes, fees, licenses, regulations, etc., are all designed to injure those governed.  Thus, the need for smaller governments to reduce the potential for injury among the citizenries.

“If you once forfeit the confidence of your fellow citizens, you can never regain their respect and esteem. It is true that you may fool all of the people some of the time; you can even fool some of the people all of the time; but you can’t fool all of the people all of the time. – Speech at Clinton, Illinois, September 8, 1854.” – Abraham Lincoln

Taking President Jefferson’s principle and President Lincoln’s conclusion together, we have reached the problem.  Since the government can only injure and forfeited trust and confidence of the citizens is at stake, we must discuss the principles upon which the Welfare State in America has ballooned.  Back in the late 1980s and through the 1990s, a common theme was found among politicians; there must be a work mandate for receiving government largesse through the Welfare Program.  Unfortunately, the work mandate was never fully adopted by all the states, and the fundamental principles that built the Welfare State were never addressed.

“You cannot help people permanently by doing for them, what they could and should do for themselves.” – President Abraham Lincoln

Yet, this is the exact purpose and goal of the Welfare State, to “permanently do for them what they should be doing for themselves.”  As the first fundamental principle in the Welfare State bureaucracy, we do not help citizens become free but chain them to live as slaves.

The second fundamental principle of the Welfare State is to replace god, gods, and God, with the government.

“It is difficult to make a man miserable while he feels worthy of himself and claims kindred to the great God who made him.” – President Abraham Lincoln

By replacing god, gods, and God with the government, people can be taught to live miserably and never leave the Welfare Plantation, which supplies job security to those who administer welfare programs.  Hence, the Welfare State plantation is a jobs program for government employees, not a helping hand to lift the person to greater achievement. In the Welfare State, the only person greater than the recipient is the government’s bureaucratic gods.

President Abraham Lincoln makes two more connected points where the government’s largesse through the Welfare State bureaucracy and the American Citizen cross.

  • “If this country is ever demoralized, it will come from trying to live without work.”
  • “You cannot build character and courage by taking away people’s initiative and independence.”

Work, the effort applied to a task, where time is traded for money, has redemptive qualities, and builds independence and initiative.  I have traveled through enough government housing projects to know that by not requiring work, the citizenry is demoralized, the people are miserable, and the result is generations of corrupted drones who will not act independently and do not understand the need for individual initiative.  Both of which were stolen from them for a “mess of pottage!”

President Trump was correct. Some people come to America just for Welfare Benefits because living on Welfare in America is better than working back home.

    • “If any man tells you he loves America, yet hates labor, he is a liar. If any man tells you he trusts America, yet fears labor, he is a fool.”
    • “Labor is prior to, and independent of, capital. Capital is only the fruit of labor, and could never have existed if labor had not first existed. Labor is the superior of capital, and deserves much the higher consideration.”
    • “That some should be rich shows that others may become rich, and hence is just encouragement to industry and enterprise. Let not him who is houseless pull down the house of another; but let him labor diligently and build one for himself, thus by example assuring that his own shall be safe from violence built.”

In this instance, labor is the work performed where time is traded for money and the experience of performing work.  Yet, how often is work denigrated and derided by government employees, even as they show up to work at their jobs; too often.  How often is work lamented by Hollywood types who are trying to keep people on the Welfare Plantation; too often.  Why; because the second a person learns initiative and gains independence, that person will curse the time wasted living on the Welfare Plantation, be unsettled about politics, find a god, gods, or God different from government, and exercise their rights and freedoms under the US Constitution.

Government Largess 4In the Welfare State, America’s governmental largesse steals products from growers to give to those who, after the second generation on welfare, no longer understand work or can perform work.  America’s Welfare State is the envy of the lazy people the world over.  I have been bankrupted through decisions I thought were right at the time but were not good at all.  I tried to gain some temporary assistance through the welfare program and was ineligible because I made too much money the year before.

After spending three years rebuilding, I hit a snag.  I tried to apply for welfare again, only to be told that I do not qualify for welfare because I receive money for my disability from military service.  On both visits, the waiting area was full of non-English speaking single mothers with children.  A key point because continuing to have children increases welfare benefits.  One must conclude there must be a male person living in the home to help keep making welfare payments go higher.  Yet, every application has no spouse and no male person residing in residence.

Government Largess 2Hence, welfare leads to promiscuity, moral degradation, and lying.  As an operations manager, I had several hard-working people who hired on as day laborers; I asked them if they wanted to come on full time, and was refused because if these hard workers got a full-time position, their girlfriends’ welfare would be cut.  I was invited into these workers’ homes; their parents owned the home, three younger couples live in the house and the combined children.  Grandma gets welfare for latchkey kids; each mother receives welfare rent assistance, food assistance, clothing assistance, school assistance for themselves and their children, and WIC.  The amount of assistance for the same kids is received by four different people living in the same home.  The grandmother said she was trained on obtaining maximum assistance for welfare and has taught her friends and family how to milk the welfare system.

An isolated incident; not quite.  I have seen versions of this behavior practiced in a number of states, in multiple families, and every time it breaks my heart to see all this potential chained to the Welfare Plantation, but don’t forget the fraud.

President Abraham Lincoln makes two more critical points for consideration.

“You cannot lift the wage earner up by pulling the wage payer down.”

Yet, this is precisely what happens when government vilifies the wage payer to obtain votes.  Look to any election, and you will see rhetoric that vilifies wage payers, but even with all the vitriolic messaging, the wage earner never is raised up.  Remember the $15.00 minimum wage media frenzy, how many states who adopted the $15.00 minimum wage have the same or better employment; none!  Because at the heart of the minimum wage is a government injuring wage payers and interfering with the market.

“You cannot have the right to do what is wrong!”

If ever there was a need for a motto to be chiseled in the stones of every government-run housing development, this is the motto!  The Welfare State breeds dependence, which opens doors for time on a person’s hands.  Time on a person’s hands, who is already dissatisfied, depressed, and disillusioned, equates to violence, riots, looting, crime, drug and alcohol use and abuse, and worse.  All because a government allowed the “right” to commit crimes!

Where did the Welfare State begin?

The Summum Bonum of the roots of Welfare in the United States lies: in the following also from President Abraham Lincoln:

“The philosophy of the schoolroom in one generation is the philosophy of government in the next.”

Why are the professors in college so important; because what they teach today becomes the people’s actions tomorrow.  Therein lies the problem; too many professors know this and continue to preach, teach, and expound upon principles anathema to America’s health, growth, and future.  The colleges get rich on government largesse, turning out the future, full of righteous indignation and no common sense.  Who then proceed to influence government policy, which is emotionally satisfying but ruinous and nonsensical.

“Those who deny freedom to others deserve it not for themselves, and, under a just God cannot retain it.” – President Abraham Lincoln

The professor teaching lies does not deserve the students’ admiration, the pay from the college, or the respect of position.

President Abraham Lincoln also provided the solution to the Welfare State:

“I am a firm believer in the people. If given the truth, they can be depended upon to meet any national crisis. The great point is to bring them the real facts.”

In the current state, America is in, finding the “real facts” is made difficult because of the media, Big Tech, and Hollywood’s complicity and collaboration.  Yet, the truth remains, and the seekers for truth will find absolute truth.  America cannot continue to have the current Welfare State, nor can America long survive having citizens and immigrants, including illegal immigrants, draining the Welfare State, vilifying the wage payers, and causing destruction at the slightest whim or fancy.  Work is an eternal principle that must be re-enthroned as the method and means of qualifying for government assistance.

Government LargessBetter still, return the powers of helping people to religions and non-profit organizations.  Thus, releasing the government from stealing from farmers, illegally and immorally regulating prices, and interfering with the market as injuries to the productive class of citizens to benefit the few who refuse to work.

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

America – Let’s Elect a Few More Bastards

Non est vivere sed valere in vobis …. merentur melius quam tu tibi semper sit.

Finest HourPersonally, I am tired of soft speakers who speak platitudes and inwardly are ravening wolves.  Pres. Obama spoke softly, carried no sticks, drew red lines without consequences, and America is far worse for having had him as a president.  President Clinton also spoke well; but, severely lacked morals, courage, a sense of honor, and America suffered.  Both President’s Bush spoke well but lacked intestinal fortitude, grit, backbone, and ultimately were bad presidents for America.  President Reagan had grit, spoke eloquently, was respected, and was a bastard whose enemies honored him and feared him.  President Trump for all his good qualities is plain and abrupt.  But, inwardly he has a spine of iron, and demands accountability first from himself, and then from those around him.  Recently, I heard President Trump referred to as a “Bastard of a Bully!”  I think we need to elect a few more bastards.  People with grit in their teeth, iron in their spines, tongues that can lash and whip, and hands with calluses from doing actual work.

Anthony Liccione is quoted as saying, “A company of wolves, is better than a company of wolves in sheep’s clothing.”  For too long America has been electing legions of wolves in sheep’s clothing.  People who can utter pleasing words, but lack a spine, morals, convictions, and calluses from doing hard work.  We have elected the political poison we currently suffer because they make a good speech.  I remember an election, in fact, it is the only time I ever voted for Senator John McCain.  His opponent was lackluster, the race was a non-presidential year, and I had heard a couple of speeches and thought Senator McCain was worthy of my vote.  Not two days after McCain’s victory, I witnessed how spineless and useless McCain truly was and my eyes opened.  McCain was a traitor to America, and unfortunately, he had excellent company in the long-term emplaced members of Congress on both sides of the political aisle.  I am glad to say, I never made the mistake of voting for McCain ever again.

Grit is a MarathonAs an independent thinker, armchair historian, and a morally upright citizen, I have been doing more work every election to scrape the shield of whipping cream off the crap sundae the electorate is handed, and know who is being offered for election.  The more I scrape, the more worthless those running for office appear.  Terry Pratchet is quoted as saying, “He was the sort of person who stood on mountaintops during thunderstorms in wet copper armour shouting ‘All the Gods are bastards.’”  That is the type of person America needs in political office.  Not the namby-pamby, wishy-washy, flim-flam artists, but people who insist that the government needs to be smaller, thus consequentially more flexible in crisis.  We need people who have suffered under the rule of bureaucrats and beat the hell out of them to achieve, despite the bureaucracy.  We need more grit!

Grit - DefinedWhat is “Grit” you might ask; well, since America has not seen a lot of grit, please allow me the opportunity to describe this precious commodity. Grit is a positive, cognitive trait based on an individual’s perseverance of effort combined with the passion for a specific long-term goal or end state.  At least, that is what the academics call grit.  Of all the people America remembers who have had a positive and long-lasting influence upon American culture, John Wayne is near the top, and if anyone embodied grit, it was John Wayne who is quoted thusly, “True grit is making a decision and standing by it, doing what must be done.  No moral man can have peace of mind if he leaves undone what he knows they should have done.”  In understanding grit, I have oft called upon T. S. Eliot, “Only those who will risk going too far can possibly find out how far one can go.”

As a child, I once watched the Boston Marathon, it was as interesting to me as watching a dandelion grow, only the finish line really mattered.  As an adult, I saw nonedited pictures of runners during a marathon and understood that which I could not see as a child.  I saw men and women who had bowel movements, torn large pieces of skin away and were bleeding copiously, or thrown up on themselves and still kept running, and I came to understand why grit involves the mindset of living life as a marathon and not a sprint.  Marathon runners are not pretty at the finish line, they know about heartache, failure, blisters, torn muscles, dog bites, shoes failing, weather changes, and so much more.  The marathon is effort incarnate, planning that fails, sorrow, misery, and a finish line.  A marathon is grit embodied, sticking to a plan day in and day out, not for a small period of time days/weeks/months, but months/years/decades, because the goal is worth the effort.

On the Maine coastline, just south of Belfast, is a marina called Bayside.  As a child, I spent time delivering the Bangor Daily News to Bayside homes and got the honor to meet and talk to several of the lobstermen who came and went through Bayside’s docks.  I never expected to see professional lobstermen and fishermen in Bayside.  I was told Bayside was where the rich Boston people had summer homes and playboats.  One very senior lobsterman taught me a lesson one day about grit that I never forgot, “Without grit, pearls are impossible.”  He talked about how small amounts of grit wore down large rocks, that lobsters used grit to clean, and how grit polished.  My grandfather a few summers later taught me how to polish steel until it shined using grit.  I look at President Trump, and for all his faults, I can also see how grit has polished him until he shines.  Maybe a little more grit, that comes with 4-more years as President, can soften more of his abrasive character; but, when I see the growth that the first 4-years has brought, I cheer for President Trump!

PatriotismAmerica, I think it is time we learned a valuable lesson where the selection of politicians is concerned, “Be a good enough person to forgive the losers elected in the past, and smart enough to never trust them again with political office.”  America has lived the words of Soren Kierkegaard, “There are two ways to be fooled.  One is to believe what isn’t true; the other is to refuse to accept what is true.”  It is true, at all levels of government, poor choices have been made, rotten and unintelligent boobs have been placed in power above their ability.  In the military, we called this “being promoted to a person’s maximum level of incompetence.”  Well, this is an election year, and we will have another next year and the year after.  We have been cheated and abused by the smooth-talkers long enough.  Let us elect some true bastards!

Let us elect people who buck the system, who take the bureaucrats on and win.  Let us elect some people who have grit, backbone, and knowledge from experience, not just a degree from a wealthy school and experience as a lobbyist.  We need police officers who know about laws, we need farmers who know about growing things, ranchers, and dairymen who know about long days and short pay because of taxes and dumb decisions made in capitals that kill their businesses.  We need manufacturers who make things, and we need people who do not want to live their lives in the capitals of America feeding off the work of others as a parasite, but who work while elected and long to return to doing what they love.

The Duty of AmericansGeneral George Patton was a bastard; but, he is remembered for being the biggest bastard of them all in WWII, and when the chips were down, he won by being the biggest, grittiest, most hated bastard America had ever sent to war.  I suggest ripping a few pages from General George Patton and Ayn Rand’s book, and electing people who have trod the gristmills of life with bloody feet and callused hands, who live the following: “The question isn’t who’s going to let me; it’s who is going to stop me!”

America, you are the superheroes in your own story, rise!

Thomas Watson said the following about friends, but it applies to politicians desiring to lead just as well, “Don’t make friends who are comfortable to be with.  Make friends who will force you to lever yourself up!”  Politicians should be forcing us to leverage ourselves up, to rely upon ourselves, not the government, and the politicians America needs, know that government is a necessary evil and nothing else!

Lever Up

© Copyright 2020 – 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 pictures.

All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:

https://www.linkedin.com/in/davesalisbury/

Let’s Talk About the VA – The Insanity Must Cease!

I-CareWhen the Department of Veterans Affairs (VA) does something good, I praise them.  The VA recently had a good report come from the Department of Veterans Affairs – Office of Inspector General (VA-OIG), apparently there was progress made in improving performance once policies were written down, training of employees occurred, and over time there has been an improvement, however small and seemingly insignificant.  I offer my sincerest congratulations on making progress and change on this issue.

Carl T. HaydenHowever, I will castigate and deride all abuses of veterans, myself included.  At the Phoenix VA Medical Center, the Carl T. Hayden VA Hospital remains a hotbed of bureaucrats on a power trip weekend from Dante’s first ring.  The abuses at this hospital continue and the leadership needs to be corrected!

For those who do not remember, the Carl T. Hayden VA Hospital in Phoenix, AZ used to be an award-winning hospital, a pillar of good performance, and an example of how VA Hospitals could be run.  Then, the director was changed, the hospital staff changed, awards stopped coming, and veterans started dying.  Leading to the fiasco of dead veterans on paper waiting lists, during Pres. Obama’s reign.  CNN reported on April 30, 2014, that at least 40 United States Armed Forces veterans died while waiting for care at the Phoenix, Arizona, Veterans Health Administration facilities.

On 29 June 2020, I reported to the VA ER sick and in desperate need of assistance.  The assistance was refused because I cannot physically wear a mask.  In my medical records, it is noted that I suffer from shortness of breath and any mask exasperates this problem.  In direct violation of Federal Law that commands all emergency rooms to see whoever walks in, the ER staff refused me service due to the “Mask Policy” as part of their “Covid-19 response.”  No options, no exceptions, no excuses, I as the patient could either endanger my health or find a different hospital ER.

The Emergency Medical Treatment and Labor Act (EMTALA; 1986) is a federal law that requires anyone coming to an emergency department to be stabilized and treated, regardless of their insurance status or ability to pay.  EMATALA also dictates that no person can be refused treatment in any Emergency Room.  The EMTALA is not new and is part of the training from day one for all staff at the VA.  For ER staff, this is the golden ticket and special care is taken to ensure this law is followed to the letter; rather, this law is supposed to be the premier standard from which good health care policy is built for emergency rooms.  Except, the Carl T. Hayden VA Hospital in Phoenix, AZ., and the Raymond G. Murphy VA Hospital in Albuquerque, NM., both appear to be the exception to EMTALA, by order of the staff bureaucrats, who are supported in their illegal and nefarious behavior by the hospital administration collectively, and the hospital leadership specifically.

Raymmond G. MurphyI have written previously of the patient abuse I witnessed, and reported, at the Raymond G. Murphy VA Hospital, in Albuquerque, NM.  I have written about the patients turned away by nurses and other staff because these staff members refused to follow the law.  I reported the risks and problems being run by refusing patients in the ER, and this all fell on deaf ears.  Well, I will not stop raising this illegal practice as a major concern for the hospital leadership all the way to Secretary Wilkie and the elected officials in Congress who refuse to act to improve the toxic culture found in the VA.

You, the bureaucrats in the VA cannot break the law with impunity and your actions are leading to major patient safety concerns, increased hospital operating costs, and putting real people in real harm!  I spent more than an hour in the VA Parking lot trying to calm my breathing down to safely operate a motor vehicle, so as to drive to a different hospital emergency room, where I was treated without ever having to deal with the mask issue.  While in the VA Parking lot, I was attended to by three Federal Police Officers who were willing to try and get me seen at the ER but were stuck trying to force the “Mask Policy,” regardless of my physical inability to wear a mask without causing additional harm and injury.  The Federal Officers were called because the ER staff reported a violent and non-responsive patient had just left the building.  I was both responsive and never violent in the ER.  Regardless of the fact that I was extremely short of breath, unable to walk, and unable to be seen at the VA.  When the officers found me in the parking lot, I could barely breathe and was so weak from lack of oxygen that I was graying out in vision and other major issues; thus, how the ER staff can say I was violent and non-responsive is beyond my comprehension.

The behavior of the ER Staff at the Carl T. Hayden VA Hospital in Phoenix is beyond the pale and bordering on obscene, as well as illegal!  Where is the accountability?  Where is the patient advocate?  Where is the Administrator on Duty who has the power to demand corrective action?  Where is the rightful opposition; well, I know where the rightful opposition is, it is buried with the dead veterans, who died awaiting care at the hands of the VA!

VA SealWhere is the patient advocate in this problem; well, that night after being refused care I reported the problem to the patient advocates office via secure message, and the following morning, the patient advocate replies that “It is VA policy to mandate all people wear masks if they desire treatment.”  Not caring about the federal laws governing ER visits, not even bothering to mention that the treatment by the staff as reported was ludicrous and vile, and not even to bother to ask if I was seen elsewhere.  Just a brief, less than 100-word, statement telling me my concerns for my safety and health are not important and policy must come first.  The perfect bureaucrat, with the most detestable response it has been my displeasure to experience since the last time I visited the DMV.

I am sorry but everyone is required to wear a mask at the VA Facility. I understand you may have shortness of breath but you can wear a mask and undo one side every couple of minutes. This is for your safety and the others around you.

T. C. M. [Name Shortened for Privacy]
Patient Advocate

Will someone please explain how this can occur?  Will an elected official please demand a behavior change at the VA, and remain interested long enough to facilitate the solutions Sec. Wilkie needs to effect change?  How many veterans will have to die needlessly at the hands of the VA before the elected officials decide that veterans’ lives matter and the VA is taking our lives?

I get it, there are a lot of problems in America, and more in the world.  But, the US House of Representatives, instead of passing a budget, which they are statutorily mandated to do, is writing letters, and meddling in Israel’s business.  If the US House has the time to meddle and jump down every rabbit hole on the political landscape, they must have time to assist the veterans and improve the VA.  If the US Senate has the time to meddle, postulate, and pander, then they have the time to review the plethora of VA-OIG reports and begin assisting the VA Secretary in correcting the problems in the VA.

The saga continued this over the first two days of July and forms the bitter cherry on top of the crap sundae the VA is trying to serve the veterans.  I received a call from my primary care provider’s nurse who has the attitude of supreme petty authoritarian to a lesser subject, reminding me several times that the mask policy was political, trying to blame all hospitals in the region of implementing a similar policy (which is fake), and then trying to excuse himself by claiming he was just a messenger and not involved in the policy implementation.  Concluding the call, with the temerity to tell me that I was in the wrong to not follow VA policy.  The patient advocate had the effrontery of sending a message to me stating that I should have asked for a full-face shield instead of a mask.  Seeing as no face shields were offered as a workaround, seeing as the policy enforcers demanding only a mask as the single viable and allowed option, and seeing as I spent more than an hour while in extreme pain trying to be seen to no avail, none of that mattered, the patient was at fault, per the patient advocate.

LinkedIn VA ImageMy cherub-like demeanor has taken a bloody beating over this incident.  Worse, my health has suffered tremendously and I have had to question myself and my advocacy of the VA.  The behavior of the bureaucrats and petty authoritarians of the VA at the Carl T. Hayden VA Hospital in Phoenix, AZ is detestable, and I can only conclude and wonder if I am having these problems, what are less outspoken and less knowledgeable veterans suffering?  I will not be the quiet little mouse in the corner where my safety and the safety of other veterans are being endangered by the politics and illegal actions of Federal Employees.  The policy is wrong and needs immediate revision before more veterans die at the hands of the VA!I-Care

© Copyright 2020 – 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 pictures.

All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:

https://www.linkedin.com/in/davesalisbury/

Symptoms Not Cause – Shifting the Paradigm at the Department of Veterans Affairs

I-CareFor Memorial Day (2020), the National Cemetery, through the directive of the Department of Veterans Affairs (VA), restricted the placing of flags at several national cemeteries, upsetting the plans of Boy Scouts, and angering countless veterans, survivors, dependents, and extended families.  However, the intransigence of the VA on this matter is but a symptom of a larger problem.

ProblemsThe Department of Veterans Affairs – Office of Inspector General (VA-OIG) recently released two additional reports on behavior unbecoming at the VA.  The first report concerns the delays in diagnosis and treatment in dialysis patients, as well as patient transport at the Fayetteville VA Medical Center in North Carolina.  The second is another death of a patient, as well as deficiencies in domiciliary safety and security at the Northeast Ohio Healthcare System in Cleveland.

The VA report from North Carolina includes significant patient issues, especially since two veterans died while in the care of the VA.  Significant issues are generally code words for incredibly lax processes, and procedures that are easily avoided, provided people care enough to do their jobs correctly, succinctly, and thoroughly.  Where patients are concerned a dead patient is pretty significant.  Two dead patients are beyond the comprehension of a reasonable person to not ask, “Who lost their jobs over these incidents?”

Patient A, has leukemia, and from the VA-OIG’s report we find the following responsible parties:

“… A primary care provider failed to act on Patient A’s abnormal laboratory results and pathologists’ recommendations for follow-up testing and hematology consultation. Community Care staff did not process a consult and schedule Patient A’s appointment.

Patient A died from a gastrointestinal bleed while waiting for transport to a hospital from a (VA Contracted) [long-term] care facility.  Patient A’s delays in care led to death in hospital, and the failure of a hospitalist to initiate emergency procedures contributed to the veteran’s passing.  Patient A’s death is a tragical farce of bureaucratic inaction, compounded by the same symptoms as that allowed for Memorial Day (2020) to come and go without the honored dead of America being remembered.  Symptoms not cause.

Patient B, was also in a (VA Contracted) [long-term] care facility, in need of transport back to the hospital, and the administrative staff’s delays had Patient B arrive at the hospital in cardiac failure, where the patient subsequently died.  In the case of both patient’s facility leaders did not initiate comprehensive analyses of events surrounding the patients’ deaths or related processes. But, this is excusable behavior at the VA due to frequent executive leadership changes impeding the resolution of systemic issues.  I have been covering the VA-OIG reports for the better part of a decade and this excuse is always an acceptable excuse for bureaucratic inaction.  Hence, the first question in this madness is to the VA-OIG and it needs to answer, “Why is this an allowable excuse?”  Don’t the people remaining know their positions sufficiently to carry on when the executive team is in flux?  Again, symptoms not cause.

The patient death in Northeast Ohio, started with the domiciliary, on a VA Contract care facility.  Essentially, the patient died because of methadone being provided without first gaining an electrocardiogram.  Oversight of the contracted domiciliary did not include accuracy checks on paperwork, but the VA-OIG found that for the most part, the contracted domiciliary was following VA Contracting guidelines.  From the report, no gross negligence led to the veterans passing, and for the most part risk analysis and other post mortem analysis were conducted properly.  Why is this case mentioned; symptoms not cause.

When I worked at the New Mexico VA Medical Center (NMVAMC) I diagnosed a problem and was told, repeatedly, to not mention the problem as the director would be furious.  The problem is bureaucratic inertia.  Bureaucratic inertia is commonly defined as, “the supposed inevitable tendency of bureaucratic organizations to perpetuate the established procedures and modes, even if they are counterproductive and/or diametrically opposed to established organizational goals.”  Except, the bureaucratic inertia I witnessed daily was not “supposedly inevitable,” it was a real and cogent variable in every single action from most of the employees.

I spent 12 months without proper access to systems, but the process to gain access was convoluted, unknown, ever-changing, and so twisted that unraveling the proper methods to complete the process and gain access was never corrected, and this was a major issue for patient care in an Emergency Department.  Why was the process so bad; bureaucratic inertia.  Obtaining information about the problem took two different assistant directors, two different directors, a senior leader, and the problem was identified that licensing requirements were the sticking point in the problem.

InertiaBureaucratic inertia is the cause of too many issues, problems, and dead veterans, at the Department of Veterans Affairs.  The symptoms include delays in administrative tasks that lead to patients dying for lack of transport to a hospital.  The symptoms include cost overrun on every construction project the VA commences.  The symptoms include abuse of employees, creating a revolving door in human resources where good people come in with enthusiasm, and leave with anger and contempt, generally at the insistence of a leader who refuses to change.  The symptoms include a bureaucrat making a decision that has no logical sense, costs too much and is never held accountable for the harm because the decision-maker can prove they met the byzantine labyrinth of rules, regulations, and policies of the VA.

Veterans are dying at the VA regularly because of bureaucratic inertia.  Hence, as bureaucratic inertia is the problem, and the symptoms are prevalent, it must needs be that a solution is found to eradicate bureaucratic inertia.  While not a full solution, the following will help curb most of the problem, and begin the process for the eradication of bureaucratic inertia.

  1. Give the VA-OIG power to enact change when cause and effect analysis shows a person is “the” problem in that chain of events. Right now, the office of inspector general has the power to make recommendations, that are generally, sometimes, potentially, considered, and possible remediations adopted, provided a different course of action is discovered.
  2. Give the executive committee, of which the head is Secretary Wilkie, legislative power to fire and hold people accountable for not doing the jobs they were hired, and vetted at $110,000+ per employee, to perform. Background checks on new employees cost the taxpayer $110,000+, and the revolving door in human resources is unacceptable.  But worse is when the leaders refuse to perform their jobs and remain employed.
  3. Implement ISO as a quality control system where processes, procedures, and policies are written down. The ability for management to change the rules on a whim costs money, time, patient confidence, trust in leadership and organization, and is a nuisance that permeates the VA absolutely.  The lack of written policies and procedures is the second most common excuse for bureaucratic inertia.  The first being, the ability to blame changing leadership for dead patients!
  4. Eliminate labor union protection. Government employees have negotiated plentiful benefits, conditions, and pay without union representation and the ability for the union to get criminal complaints dropped, and worthless people their jobs back is an ultimate disgrace upon the Magna Charta of the United States of America generally, and upon the seal of the Department of Veterans Affairs specifically.

Leadership CartoonSecretary Wilkie, until you can overcome the bureaucratic inertia prevalent in the ranks of the leadership between the front-line veteran facing employee and your office, lasting change remains improbable.  Real people are dying from bureaucratic inertia.  Real veterans are spending their entire lives in the appeal process for benefits and dying without proper treatment.  Real families are being torn asunder from the stress of untreated veterans because the bureaucratic inertia cannot be overcome from the outside.  I know you need legislative assistance to enact real change and improve the VA.  By way of petition, I write this missive to the American citizen asking for your help in providing Sec. Wilkie the tools he needs to fix the VA.

The VA can be fixed, but the solution will require fundamental change.

Change is possible with proper legislative support!

© Copyright 2020 – 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 pictures.

All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:

https://www.linkedin.com/in/davesalisbury/