Serial Betrayal – More Government Attacks Against Citizens

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Fed UP! – More Detestable Bureaucratism from the VA.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

“That’s Crazy!!!” – More Chronicles from the VA Chapter 4

Last week, my primary care provider informed me that the VA is no longer responsible for providing my prescriptions as an outside provider that the VA Community Services team sent me to has increased my dosage.  My primary care provider pulled a Pontius Pilot and washed her hands, and I am swinging in the wind with more bureaucracy and less service.  The best part of the news delivered this last week, the fallacious, seditious, and felonious attack on my character, the behavior problem flag, is controlled by the primary care provider.  Boy, I am sick of the bureaucracy of the VA; if only this were the worst of the bureaucratic baloney, the VA is pushing out.

From many VA-OIG reports during COVID, the following, or something close, was a regular statement:

During COVID-19, VHA’s Office of Community Care (OCC) took steps to ensure veterans continued to have expanded access to health care in the community, as required by the VA MISSION Act of 2018.  OCC issued policies to VA facilities to postpone non-urgent appointments and offer alternatives to in-person care, such as telehealth.”

The VA-OIG inspected to see how closely this statement was adhered to during the height of the COVID pandemic.  What surprises no one is how badly the VA managed community care during the pandemic.

Findings:

    • The VA-OIG found that routine community care consults were unscheduled, averaging 42 days, not meeting VHA’s timeliness goal of 30 days.
    • Community care staff faced significant challenges beyond their control that contributed to the scheduling delays, such as the lack of availability of appointments in the community.
    • Some patients were hesitant to schedule appointments during the pandemic, failed to return phone calls, or declined care once it was offered. – While some of this is definitely patient-driven, what is not discussed is the abrupt shift, the lack of trust, and the confusion about the need to pay the community providers, among other things, faced by veterans forced into community care. As a reference point, it has been 24-months, and I am still facing requests to pay several community providers due to the VA not paying the bill due to a technicality.  The VA claims the provider has to “eat the costs,” but I keep getting statements and calls from collection agencies.  Guess the direction of my credit score, the direction of my insurance costs, and how happy I am with community care providers.
    • The VA-OIG found community care providers and staff did not consistently comply with requirements to manage routine consults, and leaders lacked tools to sufficiently monitor program operations that could have identified the problems.
    • Deficiencies emerged in documenting when patients were contacted about scheduling appointments, designating patients eligible for alternative care, and ensuring staff was trained in ways that would address those weaknesses. – Not to mention that pertinent medical records still haven’t been transmitted, received, and alerted the primary care provider. I had gallbladder removal surgery; no records ever made it to the VA.  I have MRIs, CT scans, and ER notes that, even after being hand-delivered, have not been added to my VA electronic health record and presented to the primary care provider to discuss, dating back to 2010.

How’s that community service program working for you?  In any other industry, this performance would represent an abysmal failure; but community care represents a healthy opportunity for improvement at the VA.  The findings listed are a mere drop in the conclusions discussed in the report.  I have a suggestion for the VA, stop overpromising and underdelivering.  How about you under-promise and then over-deliver?

The following VA-OIG inspection report focused on the Veteran Health Administration facility’s adherence to guidelines for medication management, and the following explanation is quoted from the report:

This report describes medication management findings from healthcare inspections initiated at 36 VHA medical facilities from November 4, 2019, through September 21, 2020.  Each inspection involved interviews with facility leaders and staff and clinical and administrative processes reviews.  The results in this report are a snapshot of VHA performance at the time of the fiscal year 2020 OIG reviews.”

Before we get into the findings, let me elaborate on that statement.  The VA-OIG cherry-picked/hand-selected call it what you will, the facilities to inspect.  No criteria discuss how these facilities were selected.  More, the processes chosen for review were also cherry-picked/hand-selected.  Appearing to represent that, the VA-OIG stacked the deck to obtain success, and the VHA still failed, or rather showed weaknesses.

Generally, the VA-OIG rated the VHA facilities as “compliant.”  But “weaknesses” were identified; read that as the VHA cannot follow established guidelines, protocols, and processes, even though they wrote and established these guidelines and medication protocols.  I call this designed incompetence of a criminal nature, but I am not half as lenient and politically astute as the VA-OIG!

Findings:

    • Aberrant behavior risk assessments
    • Concurrent benzodiazepine therapy
    • Urine drug testing
    • Informed consent
    • Patient follow-up
    • Quality measure oversight.

The following, also from the medication’s adherence inspection, remains significant:

“The OIG examined the following indicators of program
oversight and evaluation:

      • Performance of pain management committee activities
      • Monitoring of quality measures
      • Following the quality improvement process”

For the weaknesses represented in the findings to be prevalent, the “Pain Management Committee activities” represent a general failure of the committee to function!  For quality processes to be a finding, monitoring quality signifies that the bureaucrats are NOT doing the jobs they were hired to perform!  A quality process fails when the humans tasked with oversight refuse to engage, and the VA-OIG findings testify to the truth of humans actively refusing to do their jobs individually and collectively!

Having read and written about the VA-OIG reports for almost ten years, I swear sentences containing the following represent a majority stake in why the VA-OIG cannot be trusted.

VA-OIG inspections… underscored the value of independent oversight of care received in these settings to help VA make continuous improvements.”

Really?  Are you sure the VA-OIG inspections provide “independent oversight” and spur “continuous improvement” at the inspected VA facilities?  I have significant doubts the inspections do anything more than highlight the problems as the VA-OIG inspectors have no teeth, and lying has zero repercussions for the humans defrauding the taxpayer!  How do I know this; the VA-OIG reports generally go on to make a claim similar to the following:

The OIG’s findings show that immediate attention is needed in several critical areas….”

Do you, the dear reader, understand better the frustration of veterans and their families?  When the Office of Inspector General (OIG) for the Department of Veterans Affairs (VA) covering the National Cemeteries, Veterans Benefits Administration (VBA), and Veterans Health Administration (VHA), can be deluded, distracted, and duped by conniving and conspiring people, what else can the veterans and their families do BUT become frustrated?  This is behavior unacceptable in every industry.  In fact, legislation overseeing non-government healthcare is strict in outlawing the conduct observed in government-provided healthcare, but somehow the VA is exempt.  Yet, the VA continues to make claims such as the following:

This is how the VA is delivering on its promise to care for the veteran who has borne the battle, his widow, and his children.”

But don’t take my word for it; the VA-OIG conducted several more Comprehensive Healthcare Inspections (CHIPs), resembling cookie-cutter inspections.  Staff training continues to be a major delinquency labeled as “High-Risk.”  Behavior Committee continues to be a central sticking point and inspection problem.  Cleanliness, tagged under “Quality, Safety, and Value,” continues to represent an area for growth and development.  Nurse-to-Nurse communications remain constant as a problem, and electronic medical records are not helping to improve on this problem.  Inter-facility transferring of patients, policy, and documentation also resemble a constant issue.  I feel like I could summarize a CHIPs report with my eyes closed; tell me, when does the “independent oversight” spur “continuous improvement?”

On the topic of “independent oversight” spurring “continuous improvement,” the VA-OIG conducted a VHA inspection of mental health activities for FY 2020.  Declaring:

This report describes mental health-related findings from healthcare inspections initiated at 36 Veterans Health Administration medical facilities from November 4, 2019, through September 21, 2020, and electronic health record review at five additional facilities.  Each inspection involved interviews with facility leaders and staff and clinical and administrative processes.”

Again, how the facilities were selected and the items reviewed appears to have stacked the deck in the VHA’s favor.  The VHA is still failing, showing weakness while generally being compliant.

Findings:

    • Completion of four follow-up visits within the required time frame
    • Appropriate follow-up of veterans with high-risk patient record flags who do not attend mental health appointments
    • Suicide prevention training
    • Completion of five monthly outreach activities.

Under these four categories, recommendations for improvement included:

    • Registered Nurse Credentialling – Source verification of licenses.
    • Staff training on Suicide Prevention
    • Care Coordination – Especially in transferring the patient, form completion, and evaluating transferred patients
    • Medication list transmission during transfers
    • Staff Training
    • Patient notification
    • Attending the Disruptive Behavior Committee

For anyone else keeping record, most of the list above is a repeat from the last several years the mental health inspection has occurred.  Color me shocked that the VA would still have issues remaining year-over-year, and if you cannot hear the sarcasm in that statement, I have some suggestions for you!

I am thoroughly sick to death of the VA failing in its mission, then bragging they are providing “Excellence in Healthcare.”  If the staff is not trained, they cannot perform their jobs, representing a leadership failure.  This is a truth for all industries, occupations, businesses, organizations, etc.  Nobody is exempt from this statement of fact, yet the VA-OIG keeps on swallowing this excuse year-over-year, and NO PROGRESS is EVER made!

America, are you aware of what the various government agencies are doing with your money, on your time, and with your consent?  If your neighbor took your checkbook and wrote checks you are legally responsible for paying, would you want better services rendered?  Elected officials (yes, I am including those at the city, county, state levels of government), why are you NOT scrutinizing the government more effectively and rigorously?  You, the elected officials, are the neighbor writing checks; why are YOU NOT doing the job we hired you to perform?

Elected officials, did you know that VA is not required to maintain records of returned bills, as a matter of policy, but those returned bills mailed to veterans are causing hardship for veterans.  I cannot recount how many times I have changed my address and my spouse’s address with the VA, on the VA-approved websites, and in-person with VA representatives, and still have had mail not delivered for months due to a wrong address in a legacy system.  Yet, the VA is not policy mandated to check returned mail, track that mail to a veteran, and check the different legacy and non-legacy systems for address veracity.

Elected officials, do you read the VA-OIG reports?  Honest question, as the following is directly from a VA-OIG report.

“[VHA primary care] providers did not consistently

        • Identify a surrogate should the patient lose decision-making capacity
        • Address previous advance directives, state-authorized portable orders, and/or life-sustaining treatment plans
        • Address the patient or surrogate’s understanding of the patient’s condition.”

The VA designed the PACT Team to improve care and deliver on the VA’s mission, yet the primary care provider has the following failures weaknesses showing.  The VA-OIG can do nothing to improve this glaring oversight, but you were elected to force change and spur “continuous improvement” in the executive branch officers and employees.  Well, where are you?  The VA-OIG substantiated that a failure in the PACT team led to a delay in a cancer diagnosis, causing increased pain, problems, and resource loss for a veteran; where are the elected officials, and the media for that matter, in raising a holy rhubarb on the PACT Team failing this veteran?

Elected officials, did you catch that statement in the VA-OIG report on the cancer diagnosis?

Facility leaders have an unwritten expectation that primary care providers conduct a thorough historical review of the patient’s electronic health record starting with the most recent annual note; however, the OIG found that not all of the patient’s providers conducted historical reviews, but instead focused on current issues and problems identified by the patient.”

Having transferred between PACT teams inside the VHA and state-to-state, I can affirm this is exactly what is transpiring in the PACT team; the second most important player, behind the patient, is the primary care provider.  When the primary care doctor fails in their job, like dominoes falling, the care of the patients rapidly cascades into a dynamic failure of healthcare in a VHA facility.  What are YOU doing to stop this madness and demand accountability?

The electronic health record has a section near the top of the record for “Problem List.”  Guess what; when providers fail to keep this section updated, current, and accurate, the healthcare of the patient borders on malpractice requiring only a slight push to arrive with a dead veteran.  The VA-OIG found providers and nursing staff failures to update the problems list accurately, keep the problems list current, and regularly discuss the problems list with the most critical member of the PACT team, the patient!  Providers failed to comply with sound science, good business practices, and act appropriately for the patient’s health; do you think this might be a slight problem in the PACT team?

I have offered the VA several suggestions for plotting a path forward.  Yet, the VA cannot and will not take advice without stern and reproachful measures taken by Congress.  Elected officials, it is time for you to act and groundswell the changes needed in every government agency, even if it means reducing the size of government!

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

Flashes – First World Nation Problems

Bobblehead DollSince Russia invaded Ukraine, no longer is the truth able to hide; America has been pursuing easy things, making America weak!  Several years ago, I was in a used book store and found “Flashes from the Eternal Semaphore” by Leo J. Muir.  I count myself extremely blessed to have found and purchased this treasured book!  Mr. Muir explains that a semaphore is a means of using flags to send messages, and people have been using flags to send messages for a lot of the earth’s recorded history.  The author declared that regardless of religion, certain truths are timeless, ageless, and failure to learn and live these truths brings destruction to civilization.

The first flash/truth is that pursuing easy things makes people weak.  Consider for a moment a German proverb, “The hard is the good.”  Work is an eternal principle; it does not change if you believe, or do not believe in, God, god, or gods.  The need to work, to pursue difficult tasks makes boys into Men, girls into Women, and at the end of life reflects honor and dignity in a life well-lived.  Yet, what do we find daily as the life to pursue, playing games, rest, recreation, and all the waste this involves.Work Quotes With Pictures | Labor Day Quotes | Marketing Artfully

I know not the source, but as a kid, I heard someone complain that the hardest and most difficult job in the world is being a person of leisure.  As a kid, I had worked my fingers to the bone every day, going to bed bone-weary and mind tired.  To hear this man talk blew my mind, for I would have given anything to have less work to do.  Yet, during periods of unemployment, I have wept in frustration for not having a job that tasked my mind and body.  In employment right now, I often look around and ask what else is there to do, for I feel like I am cheating my employer.  Some call this a work ethic, I call is being responsible, professional, and honest in my dealings with my fellow-man.

A friend informed me that most people do not think similarly, and I wonder why.  My friend said it was a “First-World Nation Problem.”  He explained that in first-world nations, you have to go a long distance to find anyone who works like I do and thinks work is necessary.  Mr. Muir reminds us, “There is no immunity from the penalty of indolence and irresponsibility.”  Think of that, too much idleness, too many video games, not enough personal responsibility builds weak people, and there is no social or personal immunity, no vaccination, from the consequences.

40 Motivational & Inspirational Quotes About Hard WorkWhat’s worse, First-World nations are passing this malady around the globe.  We are sick from the disease of not working, akin to catching polio, leprosy, or a fatal case of pneumonia; the disease can be treated, but the effects are life-changing.  You cannot achieve for your ability is curtailed.  We have forgotten that “There is NO excellence WITHOUT labor” [emphasis added].  I remember assignments from K-12 that left me physically drained from the mental exertions, and I remember lazing my way through lessons; in both situations, the grade I earned was of my own creation!  Believe me, my parents were exercised to see my low grades, and I had my school and home work increased to new levels to achieve learning that one lesson, “There is NO excellence WITHOUT labor.”

What do we see today?  Students are allowed to graduate who cannot read, do simple math, and write their names.  We see lowering standards for scholastic performance in K-12, which produces a slug of a student who expects to graduate college.  Woefully unprepared people who were abused and allowed to abuse themselves during K-12 due to their skin color, economic situation, or English as a second language.  What teachers do you remember from school, those who allowed you to slide, or those who believed in you, challenged you, setting high standards, and then teaching you how to meet those high standards?

I told my friend, and dear reader, I am telling you, the principle of work should not be sacrificed to “Leave no child behind.”  If a person sets out to leave no one behind, they get to know their charges, work their charges, set high standards, teach how to reach those high standards, and then urge them on to new growth opportunities.  Why did the school boards lower standards; they believe in growing a class of citizenry that can be controlled!  Since the late 1800s, this has been the government’s intentional actions in America.  Some will use their weakened minds and claim this is the dastardly work of a single political party, but the reality is that both political parties are neck-deep in the responsibility they have shirked and promoted by lower standards, and they call this “helping.”50 Famous Quotes About Success And Hard Work - Dreams Quote

No, do not for one second believe that this is a “First-World nation problem,” it is a problem made by conspiring men (and women) for the overthrow and destruction of freedom.  They have been carefully creating a class of people who can be counted on to be controlled for personal political gain.  Independent people, strong-bodied and minded people, scare those who desire to be a ruling class.  Consider Putin in Russia; he wanted to rule, he has planned, crafted, killed, lied, and cajoled to rule, and he is a strong person ruling a weak people who have gotten sick on the pursuit of easy things.117 Best Hard Work Quotes That Everybody Must See

Look at Cuba and North Korea; the people have had to be beaten and starved to weaken them into submission and keep them dependent on a strong leader.  Yet, how quickly could those strong people throw off their oppressive governments if they had even 1/100th of the opportunities their poorest neighbors enjoy.  What happens in countries oppressed, the leaders become weak pursuing easy things, the people get stronger, and then the government is backed against a wall, and either the people overthrow the government, or the government is killed.  Then the cycle begins again until the population is consumed by a neighbor (Ukraine being consumed by Russia) or democracy and capitalism are tried and found to be valuable.  But democracy is only powerful if the law is held sacrosanct!  Capitalism is only useful and helpful when the society employing it has morals, values, and is educated.

26 WORK Quotes About Hardships And Cooperation At Workplace | Brainy ReadersWhat is weakening every oppressive regime around the globe; is a failure to honor the rule of law.  The leaders pursuing easy things become weak, and their choices inevitably lead them into problems with the law.  Think back a couple of years to the Chinese baby food or dog food scandals.  The Chinese Communist Party (CCP) blamed mid-level leaders for their roles in the scandals, but were these people really to blame or merely useful tools to help deflect blame from the flagrant and profligate rule-breaking of someone higher?

Pursuing easy things makes people weak!  There is no escaping the damage pursuing easy things does to an individual and a society.  Yet, how big are the entertainment industries?  How expansive has the lure of taking it easy become?  How prevalent have games become?  An entire new technological industry sprung up to feed the appetites of those pursuing games?  For a truth, Muir quotes Franklin for the following flash, “Laziness travels slowly and is soon overtaken by poverty.”  How expensive have cellular phones become?  How soon do those phones wear out and need to be replaced?  Worse, how many politicians, Hollywood “influencers,” and hundreds of other sources exemplify not working, hide behind a “work-life balance,” or employ social media to display a life of plenty and ease without working?  The only way to keep the American dream alive is through hard work!

Knowledge Check!King Solomon provided the only instruction that offers a modicum of relief and is quoted as the final flash, “In all, they getting, get understanding.”  I know many people’s childhood was full of abusive relationships.  From parents to teachers, to peers and government officials, you have been robbed, plundered, and the abuse is real.  For all that, you remain an eternal being suffering a mortal existence.  Thus, you have the choice to get understanding.  You possess the power to throw off the abusers.  Learn to learn.  Learn to read.  Learn math.  Learn how to write.  You hold the power, choose to exercise that power, and you will bless your life and the lives of those around you!

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


New Year – Same Ol’ Disaster at the VA! – Are You Disgusted yet?

Angry Wet ChickenWords fail to describe how much I detest seeing the same abuses week-after-week, month-after-month, and year-over-year.  To witness the disaster known colloquially as The Department of Veterans Affairs (VA), as told from the Office of Inspector General (VA-OIG).  Not merely witnessing but also being abused by the VA leaves such a bitter taste in my mouth.

Matthew C. McPherson of Olathe, Kansas, was sentenced to two years and four months in federal prison without parole for defrauding the government.  From September 2009 to March 2018, McPherson participated in a conspiracy to obtain contracts set aside by the federal government for award to small businesses owned and controlled by veterans, service-disabled veterans, and certified minorities.  McPherson, who is neither a certified minority nor a veteran, owned and operated construction companies that used the veteran or minority status of coconspirators to obtain federal contracts to which the companies would otherwise not be entitled.  The companies received approximately $346 million in federal contracts.  On June 3, 2019, McPherson pleaded guilty to one count of conspiracy to commit wire fraud and major program fraud.  In addition to his prison sentence, McPherson has forfeited to the government more than $5.5 million, which represents his share of the fraud proceeds.”

Honest question, how is this fraud any different from an elected official using insider trading to profit off the stock market?  On another note, does this sound like a plea deal?  If so, what was the deal, and who is being targeted?  Plea deals used to be rare; now, they are cropping up anytime the government has a shaky case.  Could Mr. McPherson have beaten the entire crime by using a better lawyer or connecting with a more powerful politician; of course, and that is disgusting!

I have applied for these government contracts, and the paperwork burden is immense, the bureaucrats authoritative and disreputable.  When will the bureaucrats face criminal charges for abuse of power in allowing for the defrauding of government?  Simple question, yet one to which no elected official will address.VA 3

Speaking of fraud and the need for bureaucrats needing to be held accountable:

“Dr. David Bellamah, a vascular surgeon who operates vein and surgery centers in Missoula and Kalispell, Montana, has agreed to pay the federal government $3.7 million to settle alleged False Claims Act violations.  According to the civil complaint, from January 1, 2015, to March 31, 2017, Bellamah performed medically unnecessary surgeries based on improper techniques and submitted fraudulent bills for payment to four federal healthcare programs, including Medicare, Medicaid, TRICARE, and CHAMPVA.  The settlement agreement between Bellamah and the US Attorney’s Office for the District of Montana, Department of Health and Human Services OIG, Defense Health Agency, VA, and a third party directs Bellamah to pay approximately $1.9 million in restitution and $1.8 million in additional damages.”

The article link is missing from the VA.gov website, reason unknown as of this writing.  I received an email about this story, which is why I know of it, but cannot link someone else to it.  Still, the questions remain, someone in the VA legion of bureaucrats had to have known and contributed to facilitating this fraud, and they are not being held accountable.  Why?

  • Patsy Truglia of Parkland, Florida, was sentenced to 15 years in federal prison for his role in two consecutive conspiracies to commit healthcare fraud.  According to a multiagency investigation, from January 2018 to April 2019, Truglia and his coconspirators generated medically unnecessary physicians’ orders via a telemarketing operation for durable medical equipment (DME).”
  • Ramón Julbe-Rosa pleaded guilty to 12 counts including theft of government property and introducing unapproved new drugs into the United States.  His multiple fraud schemes included defrauding the Social Security Administration and Medicare by receiving Social Security Disability Insurance benefit payments while working; fraudulently receiving unemployability benefits from VA; and falsely stating that his primary residence—purported to be in Morovis, Puerto Rico—was damaged by Hurricane Maria, leading to the fraudulent approval of a Small Business Administration Disaster loan.”
  • Wayne Bowen of Jacksonville, Florida, has pleaded guilty to aggravated identity theft for using his estranged identical twin brother’s name, Social Security card, and military discharge papers to apply for federally subsidized housing benefits.  Due to his fraudulent use of his twin’s identity.”
  • Matthew Smith of Palm Beach, Florida, has pleaded guilty to his role in a compounding pharmacy scheme that defrauded the Department of Defense’s Tricare and VA’s CHAMPVA benefit programs of approximately $88 million.  Smith admitted to his role in fraudulently billing the two insurance providers for expensive, medically unnecessary compound drugs.  To further the scheme, Smith and his coconspirators paid approximately $40 million in kickbacks to patients, patient recruiters, and doctors in exchange for them ordering expensive pain creams, scar creams, and vitamins without regard to the patients’ medical needs.”
  • Seven Texas doctors have agreed to pay more than $1.1 million to resolve False Claims Act allegations involving illegal remuneration in violation of the Anti-Kickback Statute and Stark Law.  According to a multiagency investigation, from 2015 to 2018, the doctors allegedly received thousands of dollars in illegal remuneration from eight management service organizations (MSOs) in exchange for ordering laboratory tests from Rockdale Hospital doing business as Little River Healthcare, True Health Diagnostics LLC, and Boston Heart Diagnostics Corporation.  Little River funded the illegal remuneration to the doctors in the form of volume-based commissions paid to independent contractor recruiters, who used the MSOs to pay numerous doctors for their referrals.”

?u=http3.bp.blogspot.com-CIl2VSm-mmgTZ0wMvH5UGIAAAAAAAAB20QA9_IiyVhYss1600showme_board3.jpg&f=1&nofb=1Take a moment, read the full articles reporting these crimes, and ask yourself, have ALL the guilty parties been held accountable before the law, or are some parties noticeably missing?  If you reach different conclusions, please note this in the comments, and let’s discuss.  Show me your thinking, I want to learn!

Fraud, to succeed, requires willing people in positions of authority not to do their jobs properly.  Yet, for all the rules, mandates, political attention, and legislation, the fraud continues.  Why; because if you are the approving authority and have a plausible excuse, you are never held accountable!  The situation is untenable; the maze of red tape regulations preclude honest people from participating and opens the doors for nefarious actors to swindle, cheat, steal, and profit.  Simple question, when will those legally responsible for not allowing fraudulent activities be held accountable?VA 3

The VA-OIG conducted a Comprehensive Healthcare Inspection (CHIPs) of the Charles George VAMC in Asheville, North Carolina.  Want to understand more about the quagmire of the VA personally?  Read one of these CHIP reports.  Long have I wondered how leadership could be fully measured when the leader of the hospital leadership team has been in their position for two (2) days.  The VA-OIG couches this by claiming the associate director had been in the role for 18-years.  Do you see a problem?VA 3

Where and how are veterans being abused, staff training, and the “Disruptive behavior committee.”  Some might ask, how is staff training an abuse to veterans?  What do you consider “disruptive behavior?”  Did you know if you ask a doctor questions, that doctor can report you as presenting disruptive behavior to the Federal VA Police and get the veteran charged and fined?  If you request to speak to the administrators and they refuse, you can also be charged with presenting disruptive behavior, hindering hospital operations, disturbing patients, being arrested, and fined?  The bureaucrats have designed a self-fulfilling system in the VA that protects wrong-doing and punishes anyone who dares question the status quo, and this is trained into the employees.  Worse, this is about the only training they receive that is competently delivered!

A CHIP was completed at VISN 8, the Sunshine Healthcare Network in St. Petersburg, Florida.  Congratulations are for passing the CHIP with only two recommendations for improvement.  Honestly issued praise.  My concern is the low bar for success that was surpassed, but this is not the fault of VISN 8’s leadership, but the VA leadership in Washington, DC.VA 3

Long have these articles mentioned and decried the designed incompetence found in every single process, procedure, and action taken by the VA.  It is not surprising then that design incompetence is still seen and cost resources.  Nothing new, but you, the taxpayer, need to be aware of this, for the excuses have run so thin you can read contractual mouse print through the excuses!

The history:

“In October 2017, VA entered into an interagency agreement with the Defense Logistics Agency (DLA) to use its Electronic Catalog (ECAT) to order VA medical supplies and equipment not available through existing contracts.  VA created the ECAT Ordering Guide to describe VA policies and procedures for placing orders and outline the ordering officials’ responsibilities.  As of April 1, 2021, VA had spent approximately $592 million on purchases through ECAT.”

The findings:

“The VA-OIG found that the Procurement and Logistics Office (P&LO) did not govern the ECAT program adequately.

    • The ECAT Ordering Guide excludes the requirement for VA ordering officials to consider the Federal Supply Schedule (FSS) contracts for sales orders; purchasing through FSS could have saved VA up to $4.4 million.
    • The guide also incorrectly describes how to apply the Rule of Two, potentially excluding veteran-owned businesses from contracting opportunities.
    • Ordering officials did not follow documentation requirements in the ECAT Ordering Guide, and P&LO did not conduct required annual reviews of the interagency agreement.”

Do you see the designed incompetence?  The VA gets green-lighted to consolidate ordering to save time and money, then develops the processes and procedures to open the door for fraud, theft, and abuse, providing excuses for the VA-OIG to accept when responsibility and auditing occurs.  Hence, roadblocks are launched instead of saving money and reducing the government’s costs.  Instead of bringing order out of chaos, more logs of chaos are added to the fire.VA 3

Worst of all, the VA-OIG has to invest money to tell the VA common-sense solutions, couched as recommendations, to fix the problems the VA purposefully designed into the process.  That is your tax dollars at work, your neighbors losing opportunities, and your employers getting the shaft intentionally by the VA.  Again, only for emphasis, I ask, “When will the bureaucrats be held accountable for their malfeasance and culpability in abusing people, committing fraud and theft, and refusing to do their jobs properly?”

When discussing malfeasance and designed incompetence, the following inspection at the Carl T. Hayden VAMC in Phoenix, Arizona, is applicable as an example.  The VA-OIG conducted an inspection to assess allegations concerning sterile processing services.  The list of findings reveals a lot of bureaucratic shenanigans, and with my knowledge of the leadership, I deduce the shenanigans were driven by leadership at the hospital.

  • The VA-OIG found Sterile Processing Services (SPS) staff failed to don personal protective equipment in decontamination areas.
  • The VA-OIG did not substantiate that SPS staff falsified Resi-Tests by documenting the same lot number for endoscopes.
  • The VA-OIG identified missing documentation of Resi-Test results from October through December 2020 but found that the policy was followed. Leading to a question about the effectiveness of the policies and the designed incompetence in those policies and procedures, which the VA-OIG never addressed as this would have been outside the investigatory scope; more designed incompetence?
  • The VA-OIG found no infection concerns associated with inadequate reprocessing of equipment.
  • The VA-OIG did not substantiate that SPS staff failed to follow validation testing requirements for biological indicators and Bowie-Dick tests for sterilizers.
  • The VA-OIG found that SPS staff followed reprocessing steps according to standard operating procedures and instructions for use.
  • The VA-OIG did not substantiate that SPS staff did not have adequate reprocessing supplies.
  • The VA-OIG found that floor-grade instruments received in decontamination areas were discarded and not reprocessed.
  • The VA-OIG found that SPS staff reviewed instructions for loaner trays upon receipt at the facility.
  • The VA-OIG did not substantiate that SPS staff failed to receive documentation for instruments sterilized at another VA facility.
  • The VA-OIG concluded that SPS leaders were knowledgeable of the practice standards.VA 3

Again, a mixed bag of findings.  After a tumultuous year of sterile scandals, it is refreshing (almost) to observe a sterile facility operating at standard.  Draw your own conclusions about the role of the leadership in this inspection.  To me, the most critical part of sterilization of reusable equipment is the proper use of personal protective equipment, but the VA-OIG did not appear to see this as crucial as I do.  From the inspections I have experienced, failing to use personal protective equipment properly is an automatic failing grade, but the VA-OIG only made a single recommendation for improvement.

quote-mans-inhumanity-2While the above are not all the reports from the VA-OIG launching 2022, they present the bulk of the criticisms and reflect the need for greater scrutiny and improved leadership at the VA.  More to the point, these represent the danger the American public is in from a runaway government that keeps biggering (with a nod to The Lorax and Dr. Seuss)!  The VA is abusing your veteran neighbors, and you are paying for it.  Doesn’t this stir in you feelings motivating to action?  If not, please ask yourself why.  Do veterans deserve to be abused relentlessly?  Do you like being complicit in a crime perpetrated by bureaucrats, cheered on by elected officials, and paid for by your tax dollars and the future of your children through forced taxation and out-of-control debt?  The choice is yours, I know my choice, and I WILL continue to resist the government atrocities every step of the way!

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

The Year-End Maelstrom! – More VA Shenanigans! (Where is the accountability?)

2021 has finally ended, but before it ended, the Department of Veterans Affairs (VA) – Office of Inspector General (VA-OIG) increased the pace, and the following is but a taste of the year-end insanity foisted into my inbox.  With more than 45 emails to sift thru, some of the topics had to be culled, and I regret that I had to cull the emails.  Each and every VA-OIG report deserves to be scrutinized, evaluated, and the actors punished, many times with criminal court.  I don’t know what’s worse, summating these stories or getting hit with a truck; seeing as I have been hit by a truck, I think the truck is easier.

We begin the recount of VA-OIG stories with another veteran, deceased because the VA Medical Center refused to do their job and provide continuity of care after a 33-day hospital stay.  Leaving me wondering if this was intentional malpractice due to the cost of the veteran to the VA.  Listen to the findings of the VA-OIG, then make your own decision.

The Malcom Randall VAMC’s interdisciplinary team (IDT) failed to develop a discharge plan that adequately ensured patient safety and continuity of care.  The Malcom Randall VAMC did not have a discharge planning policy that outlined IDT membership, communication expectations, or roles in discharge planning.  The OIG found that the occupational therapy provider did not verbally communicate a new recommendation for a home safety assessment or take action to stop the discharge until the safety concerns were addressed.  Additionally, an attending physician failed to review written recommendations for home healthcare services from consultative and ancillary providers before composing the discharge plan for the patient.  The social worker, who had significant responsibility for ensuring the adequacy and safety of the patient’s discharge plan, also failed to incorporate recommendations by the occupational therapy provider and failed to discuss and offer home health services to manage the patient’s venous leg ulcer and monitor infection of the right leg.  The OIG also found that social workers did not consistently complete thorough and detailed psychosocial assessments that would be pertinent to discharge planning.

Remember when the media became hysterical when then VP Candidate Gov. Sarah Palin suggested ObamaCare would institute “Death Panels?”  Bureaucrats decided that the government had invested sufficient money into a patient and was going to stop providing medical care.  When this media hissy-fit was going on, I claimed that the VA had been exercising this right to discontinue care for a long time.  Several people took umbrage at this commentary; yet, what do we find from the VA-OIG, a dead veteran, five recommendations by the VA-OIG to do the job these “providers” were already hired to perform, and I am left thinking, “Death Panel in action.”

What else should I conclude with no accountability, responsibility, and consequences?

On the topic of holding a job with responsibility and not being held accountable, we find another hit to the VA and their lack of IT/IS security.  Desiring brevity but passing along factual information, the following summary has been condensed:

The Federal Risk and Authorization Management Program (FedRAMP) standardizes security and risk assessments for cloud technologies for federal agencies, including VA.  In April 2019, the VA Office of Inspector General (VA-OIG) received allegations that VA’s Office of Information and Technology’s (OIT’s) Project Special Forces (PSF) was not following FedRAMP policies or VA policy for deploying software-as-a-service (SaaS) applications.

      • The VA-OIG found that OIT granted security authorizations for applications FedRAMP did not authorize.
          • Eight of the nine applications cited by the complainant were used on the VA network—some without FedRAMP or VA authorization.
          • Another three applications were approved to operate on VA’s network without FedRAMP authorization.
      • The OIG did not substantiate that PSF-developed applications were improperly managed outside the VA Enterprise Cloud group.
      • PSF did not follow VA security requirements in developing interfaces that allow third parties to “plug into” the VA to send and retrieve data.
          • OIT personnel stated, “no formal OIT authorization process until April 2019.” After that date, the review team did not find instances of VA-authorized applications without FedRAMP authorization.
      • OIT staff “apparently” misunderstood the FedRAMP authorization requirements for SaaS applications containing data classified as less sensitive.

Please note if you think the VA IT/IS performance has improved since April 2019.  You are sadly mistaken, as in 2021, there have been three major VA-OIG reports declaring how IT/IS systems at the VA remain insecure, failing legislative mandates for basic security, and are hopelessly too expensive and useless.  I have two VA-Apps on my phone, both of which work “sometimes,” and never sufficiently support the end user.  Worse, these apps do not interface with the old software the VA is helplessly tied to while the new software continues to prove its uselessness and security problems in real-world beta testing.

Tell me, would you trust the government, any of the alphabet agencies, with your child to babysit?  If not, why do we trust the government to secure our identity?  If so, please elaborate, for I would love to know of a government/NGO operating with trust and efficiency.

Continuing under the heading of failure to perform the job hired for, we find the VA-OIG issuing a total of 20 recommendations to Vet Centers.  The Vet Centers included record keeping of suicidal veterans seeking mental health support as a point of reference.  Not for the first time, but I keep hoping it’s the last.  The VA continues to fail veterans, abuse veterans actively, and take advantage of veterans, and I remain unconvinced this torture of their customers is not intentional.  Maybe not all employees, for I have met some great employees, but the leadership appears hellbent on killing as many veterans as possible.

Why isn’t this big news, huge headlines, and a major story to the corporate media?  Where is the coverage?  You cannot convince me that 1)You are not aware of this story and 2) That you are unfamiliar with its implications.

VA statement on GPO printing and mailing delay

WASHINGTONDue to supply chain and staffing shortages, the vendor contracted by the Government Publishing Office to provide printing services for the Department of Veterans Affairs is experiencing delays in printing and mailing notification letters to Veterans and claimants.  The disruption may impact the ability of some claimants to meet required deadlines via written correspondence with the VA.

In response to the mailing delays and to protect the best interest of claimants, the Veterans Benefits Administration is extending its response period by 90-calendar days for claimants with letters dated between July 13, 2021, and Dec. 31, 2021.

For those not aware, everything in the bureaucracy abbreviated as the VA is time-sensitive.  Miss a deadline, and you have no opportunity to recoup lost time without investing significant amounts of resources.  Since I continue to be in an embroiled battle with the VA over not receiving a proper decision in 2004, time delays represent problems untold due to budget cuts and bureaucracy, and the VBA and VHA bureaucracies will do everything they can not to help you.  Then we add the time delays, and the consequences can be disastrous.  Think veterans dying with an active application for benefits, and you come close to how big this story is, and not covering it with wall-to-wall coverage is the epitome of lackluster asininity!

It took dead veterans on waiting lists to get bad press through the Media fawning over President Obama; what will it take to penetrate the media quilt for Biden?  Continuing under the heading of failing to do the job you were hired to perform, we find another VA-OIG comprehensive healthcare inspection (CHIp).  Guess what; this one is beyond utterly dismal and flagrantly reprehensible!

The administration and delivery of care to female veterans continues at its expected and atrocious, slovenly pace, being outstripped by one-winged butterflies.  How can the VA Leadership continue to keep their jobs when they allow such incorrigible behavior from lower staff members?  Would the elected Representatives and Senators address this question?  You were hired to scrutinize the government; that is the only other job you have after writing fair and equitable legislation to all citizens.  Why should you be re-elected when this behavior abounds, and you refuse to scrutinize the executive branch officers?

Consider the following,  “The VA-OIG audit team estimated that improper payments for acupuncture and chiropractic care amounted to about $136.7 million during fiscal years 2018 and 2019.”  Continuing, “The audit team also found that VHA did not always follow guidance when reauthorizing acupuncture and chiropractic care.  Not documenting assessments of prior treatments before authorizing additional care may interfere with veterans’ treatment.”  Failure to ensure your underlings have established proper processes and procedures that are effective and followed is a prerequisite to holding a leadership position.  Where is the leadership at the VA?  Where is elected representative scrutiny?  What are the consequences for doing a poor job of cleaning the house and protecting the taxpayer?

How big is this problem?  Try upwards of $341 Million, on top of the $136 Million already discussed, and before the full force and cost are known on delays in properly notifying veterans in a timely and efficient manner.

The VA-OIG audit team found that some providers are billing VA at a significantly higher rate for high-level evaluation and management services than their peers in the same specialty.  The team determined that in fiscal year (FY) 2020, more than 37,900 non-VA providers billed and were paid for significantly more high-level evaluation and management codes than were all providers in that specialty on average.  These non-VA providers received about $39.1 million (13 percent) of the approximately $303.6 million paid for all non-VA evaluation and management services.

Additionally, some providers billed separately for evaluation and management services when the global surgery package was in effect.  This package is supposed to cover all surgery-related services for a set period.  The review team identified more than 45,600 providers were compensated about $37.8 million in FY 2020 for these evaluation and management services.

Improper payments were not easy to detect because VHA staff did not retrospectively audit medical documentation as required.  Additionally, the OIG found no evidence that VHA or contractors trained non-VA providers on documenting evaluation and management services, similar to how VA providers are qualified.  The OIG determined VHA risked overpaying for evaluation and management services by about $19.9 million in FY 2020.”

While discussing audits, failed processes, and the lack of consequences for senior leadership, we must break and wish a “Happy Birthday” to the audit hits turning 10, 12, 15, 21, and older.  It never ceases to amaze me how these financial failures can continue to age, and nobody is held accountable!  May you age out and finally be corrected!  Would the elected leaders of America like to know why the VA is consistently failing financial audits?

VA continued to be challenged in consistently enforcing established policies and procedures throughout its geographically dispersed portfolio of outdated applications and systems.”

Now, explain why we should re-elect any elected official to office?

Elected officials, your job is to scrutinize and write legislation; that is what we, the electorate hired you to do.  Do you realize the far-reaching consequences of your failure to perform your job?  Let me introduce you to an example:

Anthony Medrano, a veteran of the US Marine Corps and former employee of VA, admitted that between approximately November 2015 and May 2020, he submitted claims to VA in which he purported to be disabled to obtain caregiver benefits for his wife, when he was actually able-bodied and even participated in fitness challenges and coached youth sports.  Medrano was sentenced in federal court to eight months in custody for defrauding VA out of more than $183,000.  He executed this scheme while employed by VBA as a veterans service representative, a position in which he explained benefit programs and entitlement criteria to veterans applying for VA benefits.”

Or the following:

Barry Wayne Hoover of Tampa, Florida, a veteran of the United States Navy, exaggerated the extent of his visual impairment to receive VA disability benefits to which he was not entitled.  Specifically, Hoover manipulated the results of subjective tests of his peripheral vision to reflect that he had only a five-degree visual field and was legally blind.  VA found that Hoover was 100 percent disabled based on those manipulated tests.  Hoover was found guilty of theft of government funds and making a false statement to a federal agency.  He faces a maximum penalty of 10 years in federal prison.  His sentencing hearing is scheduled for March 2022.”

How about this:

Professional Family Care Services, Inc. (PFCS), a home health services company based in Fayetteville, North Carolina, has agreed to pay more than $45,000 to settle civil False Claims Act allegations related to fraudulent billings for work by a recently convicted felon under their employ.  During 2015 and 2016, PFCS billed VA for home health services provided to W.R., an Army veteran, even though, at that time, W. R. was residing with the company’s employee, Certified Nurse Aide Tracey McNeill.  PFCS based its billing for those services on falsified timesheets provided by McNeill, who failed to provide both the time and quality of care required under the VA program.  After several months living with McNeill, purportedly receiving home health services provided by McNeill through PFCS, W. R. had to be admitted to the hospital.  He was extremely malnourished and ultimately died within a few days of admission.  Earlier in 2021, McNeill was convicted of wire fraud for her misconduct related to W. R., sentenced to 12 months and one day in federal prison, and ordered to pay over $90,000 in restitution.”

Morality is exemplified by leadership and then exercised under scrutiny.  Because you, the elected officials, refuse to be morally upright and scrutinize the government, the executive branch officers and employees have become careless, irresponsible, and taken the American Taxpayer for a ride!

Each time the VA-OIG reports an investigation beginning with the death of a veteran, the root cause is always a failure of people to do the job they were hired or contracted to perform, and the casualty is a dead or severely injured veteran.  The culling of the email included a urologist who performed procedures, puncturing internal organs, and not notifying the patient.  Several other CHIp summaries reflected the egregious and despicable leadership hidden at VHAs and VAMCs across the country.  Other Vet Centers possess failing bureaucrats just trying to hide until they reach retirement and escape.

America, you deserve better from the alphabet agencies representing the executive branch!  Fellow veterans, please do not give up hope; we can still help protect this country from those enemies domestically located who make your lives a living hell.  Please pass the word, these VA-OIG investigations deserve to be read, and questions asked!  Elections are coming; join the fight as a citizen and run for office.

© Copyright 2021 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the images.  Quoted materials remain the property of the original author.

Year End (2021) – An After Action Report

Bobblehead DollBetween Christmas and New Year 2019, I accepted an offer to write more frequently for a group that, at the time, was calling itself “No More BS.”  What an amazing opportunity the challenge to write more regularly became, and how much I have come to enjoy writing.  Like all things in life, the challenge came with a cost; I had exhausted myself mentally, I was spent by October.  Physically my body could not answer the call of my mind, and my mind was screaming at me to stop.  Let’s talk about drivers and BS, for the importance to American society success is found in ending the BS.

Little Joey Biden and his Afghanistan Debacle are still unfolding, and I fully admit this turn of events from August 2021 has left me numb.  When America left Hanoi (April 1975) and Vietnam fell, many Americans, especially veterans, felt defeated in ways hard to describe.  Who knew that in such a short space of time (less than 50 years), America would repeat Hanoi (August 2021) by a couple of magnitudes?  Some very cynical veterans I know suspected the politicization of Afghanistan would lead to a repeat of history; but, I can honestly say I never expected Biden to act in such a disastrous and self-defeating manner.

Leaving Americans, allies, and stakeholders on the ground, holding the bag of responsibility, remains the quintessential yellow-spine craven move of the new century.  One of the greatest insults from my time in the US Military was the corporatization of the military officer corps.  Disconnecting responsibility and accountability, honoring weak-kneed drivel to the detriment of the professional NCOs and the soldiers, sailors, airmen, and marines has been utterly unacceptable.  Why; because every corporatized military in history has failed!  Now, America has Afghanistan and Vietnam, and the government leaders refuse to acknowledge they are the problem, and the sitting president rewards pubescent behavior.  Sickening!Angry Grizzly Bear

The military, to be effective, must be out of sync with the society they protect.  A sacrifice principle is required from those who love country more than themselves and voluntarily wear their country’s uniform.  Yet, the politics and political leaders refuse to allow the military to act at home and abroad, so we repeat history.  May I ask, how many more Vietnam’s and Afghanistan’s does America need to relive before accepting that personal sacrifice is quintessential to a strong military?  Mr. President, Little Joey, when does the BS end, and the motivation to lead return from bureaucratic hands to professional officers and NCOs?  For I warn you, what you have right now is a mob, and you desperately need a military!

But, Afghanistan, in all its depravity, is not the only outrage from this year where BS needs to end.  Consider something with me, the power of jury trials.  High-profile trials have been occurring and continue through this holiday season and end-of-year celebrations.  How incredibly grateful I am for the rule of Constitutional Law that provides for a jury by peers.  More often than not, juries get the law right and hand down fair verdicts.  Yet, the Corporate Media refuses to accept that jury trials are the best method for handling problems in a constitutional society.  I have seen the media meltdowns repeatedly when juries hand down verdicts the media have tried and failed to influence.

Now ask yourself, dear reader, why does the media try cases before all the facts have been presented?  Power, the answer remains ever simple, the media have become what they consider as THE single greatest power in American society.  The self-delusion is a steaming hot pile of BS dished up for public consumption 24/7/365, and the media refuses to eat the BS they are serving.  Considering themselves better than common citizens, above the law, the media companies have decided they can arbitrate, decide, and deserve to be listened to and obeyed.  Well, jury trials work, and it is time more journalists are introduced to the concept through defending themselves in a court of law.

QuestionWorse than the corporatization of the US Military has been the continual erosion of the rule of law.  The Uniform Code of Military Justice is regularly abused for the benefit of the powerful and the destruction of the weak.  When the law is cheapened, joked about, and castigated, the trust in civil society is broken, and the military is but a smaller example of what is occurring in American society as a whole.  When warriors are not judged by their deeds, but upon their political connections, the society hiring warriors, training warriors, and sending them into harm’s way will quickly find the warriors are gone.  Their replacements are not worth the honor and trust.  Leading to society being taken over and destroyed.

Feel free to disagree, but Rome remains the quintessential example in history of what happens when a republic fails to accept social consequences, infects its society from within, and then picks fights with neighbors.  Rome had the greatest military in recorded history, and it fell ingloriously all because the military, a microcosm of the society as a whole, decided politics was more important than the rule of law.  Popularity became more important than law and obedience to the rule of law.  Who taught Rome to fall; who brought the Roman Legions to their knees?  Look no further than their politically elected leaders who spent their time and the people’s money in riotous living, perversions, and trying to evade responsibility for their actions.  Tell me, are we not seeing the same exact abuses in current society that is witnessed on the pages of history with Rome falling?

What is the only difference between Rome’s fall and any other government with elected political leaders?  Advanced weaponry to include nuclear weapons.  What is the only safeguard in republican and democratic societies strong enough to save those societies from repeating Rome’s example; learning history and obeying the rule of law.  Of the two, learning history is more important, which is why learning history was the second casualty in the fight to overthrow the rule of law.  The first casualty was teaching students how to read.

The abuse of children remains an utter abomination, and rightly so.  But until the political leaders can be made to accept they are facilitating abusers of children masquerading as K-12 School Districts and teachers, the abuse of children, the wasting of precious resources, and the sacrifice of innocence will continue and worsen.  In Virginia’s gubernatorial election this past November, the central theme was public education.  Virginia, as your newly elected officials come into power, are you willing to watch those elected and demand they obey the electorate’s will and change education in your commonwealth?Lemmings 1

Over the holiday, I watched heart-wrenching videos of parents who almost lost their child to suicide because the teachers groomed the child into transgenderism, all without the parent’s knowledge.  Worse, the parents were abused by the government when the teachers involved called “Child Protection Services (CPS).”  Tell me, when bureaucrats join together for the abuse of those they are duly sworn and duty-bound to protect, who is at fault; the elected leaders!  What did the elected leaders do when the parents complained; they joined forces to continue abusing the child and the parents.  The exact opposite of what they were hired to do, scrutinize the government employees and protect the electorate from abusive government operations, practices, and people.

Unfortunately, some of you think this is only happening in California, Virginia, New York, or some distant city/county/state.  No, the truth of the matter is this is occurring in your child’s school district right now.  Your children, grandchildren, cousins, and neighbors are all being abused and harmed, and the rot is at your doors.  Don’t take my word for it; investigate for yourself.  Go to local school board meetings and ask to see the curriculum your child is being exposed to, and you will find the truth, and the truth will first abhor, then anger, and then motivate you.

I hope the motivation will be sufficient to inspire action to become more informed, pay closer attention to local political races, and stop allowing incumbents a free pass to officiate in the destruction of America.  One of the frequent conversations in my home is, “What are my plans after I complete the Ph.D. degree I am chasing?”  The temptation is real to run for political office, either mayor or school board, sheriff, or judge; I want to get into this fight to defend the America I love.  Most people think the battle for America’s soul is being fought in the US Senate or House of Representatives when the reality is the fight for America’s soul is being fought and lost in local elections, and it is time to find strong candidates who are willing to run for office and fight this fight locally.

Jesus, Minion Memes Aren't Funny : terriblefacebookmemesThe biggest lesson I have learned in writing this year, a degree doesn’t represent smarts or capability; those come by working in the trenches for something more important than self.  The US Navy taught me endurance in the face of insurmountable odds and enemy shenanigans, and the US Army taught me to think and have grit and determination.  I know I am not perfect; I am not the “picture perfect politician.”  I prefer blue jeans and button-downs to suits and ties, but I know people, and I prefer real people to the fake effrontery currently holding the reigns of political power.

Writing this past year, I have faced my demons, and while I still fight those demons, I know the need to engage is real, helping others promotes healing, and teaching provides the opportunity to learn more perfectly.  I know the power of citizens motivated to protect hearth and home, and I celebrate freedom.  I would see my neighbors armed with knowledge, possessing the motivation to speak out and act according to beliefs and win the American heritage left us.  I believe in America, and I know that when Americans are left alone, they use the power of freedom to change the world; all we need is to shrink the government, and America will begin to blossom again.LinkedIn Image

Shrinking the government begins locally.  The local government protects against county and state government abuses.  The state government protects against federal violations.  The federal government protects borders and provides for the common trade of goods across state lines.  Limiting government is not a bad idea at all; in fact, it is the only good idea that can help save America.  Join me!

© Copyright 2021 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the images.  Quoted materials remain the property of the original author.

“That’s Crazy!!!” – More Chronicles from the VA – Chapter 2

I-CareAs bad as the last several months have been, I hate adding more bad news; but the Department of Veterans Affairs (VA) – Office of Inspector General (VA-OIG) keeps reporting, and I keep summating.  Due to the absolute overabundance of incredible bureaucratic insanity, today’s article format will necessarily shift to report more and comment less.  Don’t worry, I will still comment on the more egregious examples, for some of these VA-OIG reports are scarier than Joe Biden dressed as a mall Santa at a Fourth of July celebration feeling up little children!

  • 2020 Pre-award reviews of contracts totaled $81 million; guess what:
      • 24 of the 31 contracts awarded contained conflicts of interest.
      • 25 of the 31 contracts had problems with overcharges for hourly rates of services rendered.
      • 6 of the 31 price gouged Medicare.
      • 25 of the 31 contracts, if they had adequately followed the contract process, would have saved taxpayers $16 Million. – Would it shock anyone to hear this is just the “tip of the VA-OIG” report iceberg?

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  • Financial Efficiency Review of the Southeast Louisiana VAHCS in New Orleans; guess what:
      • The VAHCS in New Orleans scored 75% out of 90%. The VA does not try to get a 100% because they regularly fail financial audits as a fact.
      • Actual costs are difficult to relate in dollars and cents because the leaders intentionally hid costs from the VA-OIG, then blamed the new medical center director.
      • Avoidance costs, Purchase card abuse, prime vendor program abuse, and more were employed to avoid proper fiscal practices.
      • Audit, FAILED! No accountability, no person held responsible, and the taxpayer is left holding the bill!

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  • Followup to VAHCS Ozarks Pathology Failures From Dr. Levy Scandal; guess what:
        • Levy Scandal for those who do not remember. – Intentional misdiagnosing, VA coverup, refusal to discuss with patients affected. The report is ghastly!
        • 5% of the patients have now been contacted, and the VA-OIG considers this a “success.” I sure hope you are not part of the 24.5% patient population.
        • Here’s the rub in the 76.5% notification, “an absence of a clearly defined process for clinical providers to alert the Clinical Review Team if later changes in a patient’s health required reconsideration of institutional disclosure.” Does the VA-OIG still want to cheer about that notification rate?
        • Less than 5% of the severely sick patients have been notified of the scandal and the problems created by Dr. Levy. Is this how the VA admits culpability, waiting for the patient to pass?
        • Now, here’s the real kick to the balls; “The VA-OIG determined facility processes related to disclosure of the pathology errors and amending patients electronic health records generally met Veterans Health Administration policy requirements, but opportunities for improvement existed.” – Are you KIDDING ME?

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  • Speaking of fiscal inefficiency and audit failures. The VA continues to overspend and under-deliver on prosthetic devices, especially for shoe inserts.
        • In the fiscal year 2019, such items—artificial limbs, shoes, shoe inserts, and compression garments—accounted for about $318.8 million, or about 9 percent of prosthetic spending.
        • Oversight of prosthetic spending was ineffective, resulting in medical facilities sometimes reimbursing vendors at unreasonable rates.
        • Medical facilities spent about $10 million more than reasonable rates in the six months from October 2019 through March 2020.
        • Rates and data in databases remain unreliable, no oversight, and those in charge of oversight are missing in action. Yet, the VA continues to spend pell-mell.  Does this sound like fiscal responsibility to you?

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  • VA-OIG double-speak lives, and is blatantly observable in the following report, the “Contracting Officer Warranting Program.”
        • For those unfamiliar, a simple explanation: “A warrant gives federal contracting officers the authority to obligate taxpayer dollars. VA’s contracting officers help serve our nation’s veterans by procuring the goods and services required for their care and support.”
        • Never forget – There have been long-standing concerns (Never Resolved) with VA’s contracting officer warrant program. Since 2015, the VA Office of Inspector General (VA-OIG) has issued multiple reports [describing how] warranted contracting officers exceeded their authority and made decisions that put veterans and VA facilities, resources, and information systems at risk.
        • Never forget – The VA-OIG has documented multiple times, and the VA has never resolved, that the VA’s acquisition management has been included on the Government Accountability Office’s (GAO’s) high-risk list for fiscal impropriety and poor contractual adherence.

BUT…

        • The VA-OIG found that while VA’s contracting officer warrant program complied with Federal Acquisition Regulation requirements, opportunities exist to strengthen the program and that the VA lacked assurance that all contracting officer warrants were justified and necessary. – Essentially, this is bureaucrat double-speak for, continue to lie, cheat, steal. We like our job and want to continue, and since Congress doesn’t care, neither do we!

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  • The VHA continues to suffer from employee shortages. I have written about this shortage until I am blue in the face and my fingers ache.  I am fed up telling the VHA how to fix this problem.  If they want answers, call me!

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  • Nurse Bethann Kierczak of Southgate, Michigan, was charged with theft of government property and theft or embezzlement related to a healthcare benefit program. She allegedly stole authentic COVID-19 vaccination record cards from a VA hospital—along with vaccine lot numbers necessary to make the cards appear legitimate—and then resold those cards and information to individuals within the metro Detroit community. – Frankly, with the way the Federal Government is acting, this theft is almost understandable and acceptable.
          • No! I am not condoning an illegal action!  I am simply stating that Pelosi and her ilk do 10-times worse hourly by Congressional standards and get away with those crimes!

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  • Donald Peter Auzine of Baton Rouge, Louisiana, pleaded guilty to conspiracy to commit health care fraud. Bonnie Jean Lawless Diaz of Slidell, Louisiana, pleaded guilty to misprision (or knowing concealment) of the commission of a felony. From March 2014 through October 2016, Auzine, the marketing manager at Prime Pharmacy Solutions, defrauded TRICARE and other benefit programs. Diaz concealed the fraud by knowingly submitting compounded medications for which there was no medical necessity. Both will be sentenced on January 4, 2022.

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  • Amanda Dawn Rains of Fayetteville, Arkansas, pleaded guilty to conspiracy to commit mail, wire, and healthcare fraud, obtaining federal employees’ compensation fraudulently, and paying kickbacks. Rains, a former executive with a Rogers medical supply and billing company, participated in 2013 to 2017, defrauding the US government and private insurance companies.

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  • Robert Seifert of Utica, New York, was sentenced to two years in prison for making telephonic threats to Albany Stratton VA Medical Center employees. He admitted that on January 14, 2021, he made successive calls to three separate employees and left each of them threatening voicemails in which he used demeaning and offensive language. Seifert’s threats caused the employees to fear for their safety and property. He will also serve one year of post-imprisonment supervised release.

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  • Patsy Truglia of Parkland, Florida, pleaded guilty to two counts of conspiracy to commit healthcare fraud and one count of making a false statement in a matter involving a healthcare benefit program. From January 2018 through April 2019, Truglia and other conspirators generated medically unnecessary physicians’ orders via their telemarketing operation for orthotic devices like knee, back, and wrist braces. Truglia, co-defendant Ruth Bianca Fernandez, and other conspirators caused approximately $25 million in fraudulent durable medical equipment claims to be submitted to Medicare, resulting in approximately $12 million in payments.

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  • Larry Ray Bon, 62, was sentenced to over 16 years in prison for shooting a firearm inside the West Palm Beach VA Medical Center in Florida. Bon brought the firearm to the emergency room, and after becoming frustrated with medical staff, he retrieved it from his wheelchair and fired several shots. In March 2020, he pleaded guilty to three counts of assaulting, resisting, or impeding federal employees and one count of possession of a firearm in a federal facility with the intent to commit a crime. At that time, Bon was committed to the custody of the US Attorney General for 25 years of mental health care and treatment at a suitable medical facility. However, Bon was determined to no longer need psychiatric hospitalization and was recently sentenced accordingly.

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Finally, if you want a really good reading, you can visit the VA-OIG page and see the lowlights of the VA-OIG’s reports for yourself by visiting the page here.  Excluded from this list are the usual reports of malfeasance and misfeasance captured in the comprehensive healthcare inspection (CHIp) reports, where we find the exact carbon-copied hits from report to report.  We find moral distress, problems in staffing, continued refusals by leadership to train staff, and the ever-present refusal to attend disruptive committee meetings.  Also omitted from this summation were the inspection of veteran centers and the myriad of failures, bureaucratic ineptitudes, and abysmal behaviors.  Frankly, I could not stand being depressed more by writing and analyzing another moment’s detestable and criminal behavior.Angry Grizzly Bear

What curdles the food in my stomach, this is just the VA.  What about all the other official and unofficial government agencies in the alphabet of the executive, legislative and judicial branches of what we collectively call “the government.”  To all the freedom-loving people in America, please awake and arise; we need you!

© 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.

 

Authoritarian Audacity – Consider This…

Bobblehead DollEliadis, Hill, and Howlett (2005) edited a book, “Designing Government,” used in many different academic institutions to teach courses on government in the United States.  The book and the authors are well known in academic circles, so when I discuss the findings in the book, I am not pulling information from an unknown, hardly read, obscure source.  I wanted this made clear from the beginning, for recently, several media sources have tried to declare that the cost of government is inconsequential and does not hinder a country’s economic forecasts significantly.  As I continuously state, draw your own conclusions.

From pages 60 and 61 for “Designing Government,” we find the following statistics; the authors put them in chart and graph form, I have placed them in bullet form; this is the only change to the statistics made.  Reported for Canada’s government in Canadian Dollars (1995).

      • 1973/74 – Economy-Wide cost of compliance costs $58 Billion
      • 1987 – Economy-Wide cost of compliance costs $78.7 Billion
      • 1993/94 – Economy-Wide cost of compliance costs $85.7 Billion
      • 1995/96 – Economy-Wide cost of compliance costs $83.4 Billion
      • From 1988 40% to a forecast of 47.2% in 1998, Regulatory costs of compliance increased.

According to the Canadian Federal Budget for Fiscal Year 1973-1974 as presented by Minister of Finance John Turner in the House of Commons on 19 February, 1973 Total Revenue was $22.997 Billion, Total Expenditures $25.208 Billion. With a deficit of $2.211 Billion.  If the cost of compliance for federal regulation was $58 Billion, the entire Canadian Budget could have been funded twice without deficit spending, with funds left over.  Tell me, what exactly is the number of “significant” for the cost of government??u=http2.bp.blogspot.com-BKwWSo412lIUngTRkmSYwIAAAAAAAARd8GqxDhvovmRgs1600salestaxcartoon.jpg&f=1&nofb=1

Now, wait a minute, you say, this is just a single year.  I could be gerrymandering and cherry-picking my data to make a point.  I haven’t listed a point yet.  But you’re correct.  Let’s run another year just to see what else is out there.

According to the Canadian Federal Budget for Fiscal Year 1987-1988 as presented by Minister of Finance Michael Wilson in the House of Commons on 18 February, 1987 Total Revenue was $97.215 Billion, Total Expenditures $126.232 Billion. With a deficit of $29.017 Billion, the cost of regulation in that year alone was $78.7 Billion.  Firstly, that is a lot of deficit spending in a little over a decade.  Secondly, that is a lot of growth in government regulation costs in the same period.  Thirdly, one is left to ask using historical records why both the cost of government and the deficit spending went up so significantly during the same period.Working Dollar

According to the academics, the answer is a little dry, “extreme forms of rhetorical hyperbole.”  A simpler version of the answer is this, the politicians in power are staying in control by scaring the hell out of the electorate using extreme cases, fear-mongering, and the media to hype fear!  But, don’t believe me, do not take my word for this at all.  Watch the news, go backward using YouTube, watch the news, and look for the latest “Boogeyman.”  In the 1980s, the boogeyman was the USSR.  In the 1990s, the boogeyman changed, morphed, and all but disappeared, becoming local crime issues.  2000 began, and we had corporations become the boogeyman.  Then 9/11 hit, and terrorism became the watchword.  Then we had the southern border and wars, and then we had big tech, big pharma; fast forward to 2020, and we have COVID, the unvaccinated, and the list goes on.  Rhetorical hyperbole in the extreme, drumming fear as the only constant 24/7/365 as the only reporting done by the “media.”

All the while, what is happening in government?  What is the current cost of government regulation?  Canada conveniently, like many other governments post-2000, hides their costs of regulation in hundred of pages of marketing materials and calls this  a “plan,” a “budget,” and a “roadmap.”  Finding simple facts like how much federal regulation costs my family and me into an arduous task.  However, if you can decipher all the lines and arrive at an answer, feel free to leave it in the comments below.Apathy

The point is, the information is not accessible, transparent, or quickly locatable, even though you pay for the government to report this information to you.  A perfect example of authoritarian audacity, and it is rampant in every single government across the globe.  Hey United Kingdom, they say the Internal Revenue Service in the United States is bad at reporting financial data to taxpayers; you have the US beat!  However, France and Italy have you beat!  But China and Cuba have you guys beat except for Venezuela and Brazil.  Canada and Australia are dark horses somewhere in this race; Japan, Vietnam, Thailand, and many more are on the list somewhere.  The only easy place to find data is Switzerland and Iceland, and even there you still have to swim upstream against marketing and government bureaucratese!

Knowledge Check!Taxpayers, the point is simple, you are paying to be hoodwinked.  You are paying to be lied to, manipulated, robbed, cheated, and left holding a bag full of blank checks and IOUs by the government officers elected, born into office, and who stole their way into power in your countries.  The bills do not go away when governments fall; ask Russia how they are doing with the USSR’s bills and problems.  Ask Venezuela how they are coping with the loss of their country and the accounts from their failed government.

Deficit spending countries, Canada, US, UK, Ireland, Spain, Greece, etc., you might want to pay a little attention here, cause when your economy finally fails, the bills come due, and who pays then?  Not the politicians who wrote the blank checks.  Not the special interests who benefited from the governments they sucked the money from.  Certainly not the Hollywood stars and media elites who consider themselves above everyone else.  The citizens pay, and they pay in blood, they pay in sweat equity, and they pay in treasury long after the principal and interest have compounded, and the debt creators have turned into worm fodder.Lemmings 1

Regulatory costs are always significant and exorbitant in time and treasure long after the wage earner is paid for being the putz that hinders and represents the government your taxpaying dollars support.  Regulatory costs are never free!  Regulatory costs are always triple, if not more, in dollars and cents than what a legislator thinks they will be.  For example, when Obamacare was priced as costing $10 Trillion, the smart taxpayer tripled the cost before considering anything else about the legislation.  The same is true for every other piece of legislation from the school board and the mayor’s office through the governor’s office to the federal level.  Every price tag should be tripled before consideration simply because the various accounting offices always downplay the numbers as a human failing.

But you have got to be joking.  Government cannot possibly cost that much money.  Let’s test that theory, using the United States, 1996 dollars, and Social Regulation for FY 1997 as reported by the OMB under Executive Order 12291 and 12866 from the following link.

?u=http3.bp.blogspot.com-CIl2VSm-mmgTZ0wMvH5UGIAAAAAAAAB20QA9_IiyVhYss1600showme_board3.jpg&f=1&nofb=1Total social regulation costs for 1997 were $198 billion.  Please note that this total does not include costs of regulations that totaled less than $100 million or regulations from independent agencies. There is a possibility that some agencies might have underestimated the costs of their rules.  Thus, the $198 Billion is a guess, and the end total is probably much higher.  Moreover, the estimate of $198 Billion is based upon educated guesswork performed and accepted by academics, legislation, and other banking regulations.  Not included in the costs of regulation are the simple transfer costs of money inside the banking system itself, as these are not considered as costs of regulation.

Did you catch that; certain costs are not considered because Congress allows them to be not considered.  Thus, Congress can lie about regulation costs, fees, taxes, and other monetary adjustments.  The only person who ever is accountable is the taxpayer left holding the statement for deficit spending.  Then the agencies have the audacity to need specially trained personnel to fill out paperwork to meet obscure fraud and deception laws and charge these costs back to the taxpayer as costs other than costs for regulation.  Best of all, tax paperwork is not considered a cost to regulation; paying taxes is not a regulatory cost.  Why not; taxes cost businesses to operate and cannot be changed into different categories?

Tax BurdenThe point is elementary; those who think they have power, bureaucrats in government employ, consider themselves authoritarians.  These authoritarians have presumed to possess the audacity to control how they spend your money because their bosses have allowed them leniency through laziness and disinterest.  Through a lack of scrutiny, the bureaucrat has become fat on power and must be placed upon a diet if a government “of the people, by the people, and for the people” is to survive.  Are you more aware of the problem?  What will you do today and tomorrow to help fix the problem?

© 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.