Tag: Elected Representatives

When is Enough… ENOUGH? – More Chronicles from the VA

QuestionHonest question.  I surpassed my ultimate threshold in waiting for the VA to improve in 2010 and stopped accepting the excuses, the platitudes, and the whiny discourse from the VA.  Elected officials charged with scrutinizing the US Government, when has patience been surpassed, and you will cease allowing this nefarious Kabuki?  The veterans are waiting, the taxpayers are fed up, and you need to make a decision and act.

Consider the following investigation by the Department of Veterans Affairs (VA) – Office of Inspector General (VA-OIG).  The scenario:

“The VA Office of Inspector General (VA-OIG) conducted an audit to determine how effectively the Veterans Health Administration (VHA) billed private insurers. [Billing private insurance is a piece of legislation that the VA has haphazardly followed.  The VA remains the first party payer and is authorized under 38 USC 1729 to bill and collect reasonable charges for nonservice-connected care where such veterans have other private health insurance.]  Prior OIG investigations have shown that VHA has missed opportunities to recover funds that could be used to help finance care for other veterans.  VHA’s Office of Community Care (OCC) manages community care programs and bills private insurers when needed.  OCC must submit reimbursement claims before insurers’ deadlines are reached, or they may be denied.”

The legislature passed laws demanding action, and the result was:

      • OCC did not establish an effective process to ensure staff billed veterans’ private health insurers as required
      • OCC did not collect an estimated $217.5 million that should have been recovered, a figure that could grow to $805.2 million by September 30, 2022
      • OCC’s billing and revenue collection process also was not synchronized with insurers’ filing deadlines, and claims information was not always available for billing
      • Pending workload volume and staff shortages hindered effective billing
      • OCC was broadly aware of challenges to its process to bill and collect revenue from private insurers; its responses were insufficient to correct these issues.

Hundreds of millions of dollars are sitting on the table, and the VHA – OCC still cannot properly follow the law.  Worse, they are slower than molasses running uphill in Michigan in January to pay community providers, inventing hoops and red tape nonstop for providers, which increases the cost of healthcare.  This is not the first VA-OIG investigation on this issue in 2022, let alone since 2000; with the same findings, the same recommendations are issued, and nothing improves.  Thus, I have two questions:

  1. When is enough ENOUGH?
  2. How does this reflect the VA Administration’s commitment to the vision of the VA?VA 3

Consider the following; the VA-OIG regularly conducts comprehensive healthcare inspections of VHA facilities.  The findings of these investigations are supposed to spur institutional improvement.  Regularly the VA-OIG places the following comments into the reports of these investigations, hoping nobody will ever read the report and find these facts.

“The VA-OIG found deficiencies in identifying sentinel events and conducting institutional disclosures.  Additionally, there were repeat findings from the June 2017 comprehensive healthcare inspection related to inter-facility transfers.”

Imagine a private company being inspected by the government for a moment where previous investigation findings were not improved; what would happen?  An army of lawyers would descend on the customers looking for those harmed/injured, legions of lawyers would pour through employee records looking for injuries and other potential claims, the government would seize assets and halt production, all this and more.  The media would be covering 24/7 news cycles on the slightest allegations of wrongdoing.  Elected officials would be hurrying to write legislation and find a media talking head to bloviate to.

What do we hear where the VA is concerned; not even crickets!  The VA has played complicit roles in veteran deaths, and still not a peep, word, or even crickets.  Remember, these findings occur frequently enough that not finding these remarks is a cause for celebration and is exceedingly rare.  Thus, I have two questions:

  1. When is enough ENOUGH?
  2. How does this reflect the VA Administration’s commitment to the vision of the VA?VA 3

Other oft findings from comprehensive healthcare inspections include the following:

      • Medical center leaders were generally knowledgeable about selected data used in Strategic Analytics for Improvement and Learning models (SAIL Metrics). – What does “generally knowledgeable” indicate? Why have we accepted general knowledge from those who should have specialized, detailed, and comprehensive knowledge and use this knowledge in daily practice?
      • Outpatient satisfaction survey results were generally higher than VHA averages but revealed opportunities to improve specialty care experiences for female veterans. – Please note beating the VHA average is good but nothing to brag about. Beating the VHA averages is akin to claiming to be the biggest pig in a pig wallow.  Sure, you’re big, but you are still covered in mud!
      • Employee satisfaction survey scores for the medical center were lower than VHA averages. – Not a surprising finding in any way, shape, or form. Employee morale is scathingly low, and it shows in every customer interaction!  More comparing pigs by size in a pig wallow, and it’s not like the VA would punish whistleblowers, fire productive people, castigate, denigrate, deride, and treat employees like chattel… Oh, wait, yes, it is!

Interestingly, I receive 3-10 of these monthly investigation reports from the VA-OIG, and too often, they read like someone is cutting/pasting the findings from one report to the next.  Thus the conclusions of these findings occur frequently enough that not finding these remarks is a cause for celebration and is exceedingly rare.  Therefore, I have two questions:

  1. When is enough ENOUGH?
  2. How does this reflect the VA Administration’s commitment to the vision of the VA?VA 3

Let us consider another VA-OIG investigation, which, unfortunately, recurs too frequently where inappropriate conduct is a norm, not an exception.  VA facility leaders’ response to inappropriate relationships.  Regular readers will know how common it is to find inappropriate relationships and sexual misconduct by VA Employees to other employees, underlings, and veterans.  The scenario:

“The VA Office of Inspector General (VA-OIG) conducted a healthcare inspection to evaluate leaders’ response to the knowledge of inappropriate provider-patient relationships.  The VA-OIG determined that while facility leaders initially addressed three inappropriate relationships between mental health providers (Providers A, B, and C) and mental health patients (Patients A, B, and C), multiple factors affected the effectiveness of those actions.”

Finding the following:

      • The OIG found that effective facility leader actions to investigate and address the inappropriate relationships of Provider A and Provider B occurred only after an Office of Accountability and Whistleblower Protection complaint.
      • Facility leaders ineffectively addressed Provider C’s inappropriate relationship before Patient C died by overdose.
      • Facility leaders failed to report Providers B and C to their state licensing boards promptly.
      • Failed to report Provider A to the appropriate professional certification board.
      • Facility leaders did not take actions to address the circumstances that contributed to the death of Patient C, who was involved in an inappropriate romantic relationship with Provider C.

Regrettably, the VA-OIG could not determine if an adverse patient event occurred when finding that the inappropriate relationship played a role in a veteran’s suicide by overdose.  I understand investigative scope creep, but this is ridiculous.  You have a dead veteran in an inappropriate relationship with a provider, and you cannot investigate if this was an adverse event.  What type of bureaucratic inertia sponsored this madness?

Some items in this investigative report stand out, beginning with the fact that the facility leaders who refused to take action remain employed by the VA!  Knowing about problems and not taking prompt and decisive action is negligence in performing one’s duties.  Possessing authority and refusing to implement policies and procedures, ensuring compliance by professionals, defies description and should result in VISN leaders losing their jobs!  Unfortunately, these inappropriate relationships are not rare; even if the VA-OIG has not gotten around to investigating the problems, ask the VA employees, and you will find the proof of concept and incredibly high frequencies.  Hence, I have two questions:

  1. When is enough ENOUGH?
  2. How does this reflect the VA Administration’s commitment to the vision of the VA?VA 3

In the annals of government fraud, waste, and abuse, the following VA-OIG investigation must rank in the top 20 somewhere.

“The VA Office of Inspector General (OIG) initiated this review to evaluate whether purchases of iPads and iPhones for veterans met mission needs while minimizing waste during fiscal year (FY) 2020 and through the first two quarters of FY 2021.  In July 2020, Connect Care officials purchased 10,000 iPhones with unlimited prepaid data plans for the homeless veterans enrolled in the HUD-VASH program.  However, 8,544 of the 10,000 iPhones remained in storage as of July 2021, as demand for the iPhones was much lower than anticipated.  The OIG found that this resulted in an estimated $1.8 million wasted data plan costs.  The OIG also identified opportunities for improvement regarding data plans for nearly 81,000 iPads purchased.  Because Connected Care did not have strong enough oversight procedures for reducing or eliminating data plan waste, it incurred approximately $571,000 in additional wasted data plan costs.”

When I was offered telehealth, I was responsible for providing the equipment and maintaining an Internet connection.  This was made clear by the VHA Administrators before they signed off on allowing me telehealth and reiterated by my providers when they renewed permission.  How can the VHA and VA leadership and contracting officials imagine this is acceptable?  How many of these devices are still in the hands of veterans?  How many have broken, been pawned, or otherwise not survived?

Again, not casting aspersions, merely asking questions, namely the following:

  1. When is enough ENOUGH?
  2. How does this reflect the VA Administration’s commitment to the vision of the VA?VA 3

I could weep from the frustration felt in reporting another veteran’s death by suicide, receiving care from mental health providers with the VA, and being investigated by the VA-OIG, where the providers are complicit.  The scenario:

“The VA Office of Inspector General (VA-OIG) conducted a healthcare inspection to evaluate VA-OIG-identified concerns related to the assessment and documentation practices of a behavioral health certified registered nurse practitioner (BHNP) and leaders’ completion of BHNPs’ ongoing professional practice evaluations (OPPEs).”

The findings:

      • The BHNP did not perform thorough suicide risk assessments for a patient who died by suicide.
      • Identified multiple deficiencies in a BHNP’s assessment and documentation practices, including the absence of comprehensive suicide risk assessments, failure to complete abnormal involuntary movement and metabolic assessments for patients prescribed particular antipsychotic medication, missing informed consent or a risk-benefit discussion when prescribing off-label medications, failure to resolve rule-out diagnoses, and substantial copy and paste use.
      • Finding adverse clinical outcomes for one of eight patients for whom the BHNP did not document a comprehensive suicide risk assessment, as required by The Joint Commission.
      • Finding the Nurse Manager evaluated BHNPs as satisfactory in the OPPE elements of copy and paste use for the fiscal year 2018 through the first half of the fiscal year 2021 and safety plan completion for high-risk suicide patients for February 2020 through the first half of the fiscal year 2021, without these elements being evaluated.

Is it clear why I am asking about where the limitations of patience are?  The supervisor was directly responsible for leading the BHNPs and failed, and while it is not mentioned, we can presume this person remains employed.  Failed to train staff, failed to supervise staff, refused to do your job.  Yet, you remain employed (probably) and (potentially) were promoted, as this is the regular pattern for VA employees caught but who are politically acceptable or connected.  The supervisor is directly connected to a dead veteran, a family is weeping this holiday season, friends are missing, and all I can do is keep asking the politicians:

  1. When is enough ENOUGH?
  2. How does this reflect the VA Administration’s commitment to the vision of the VA?VA 3

Do you also feel the weight of responsibility; your tax dollars fund this abuse.  Representatives of your government are complicit in adverse patient events, including death, and they refuse to engage, holding government employees accountable and fixing the mess.  Veterans signed a check, telling the government we will perform duties and obligations.  Why aren’t the veterans honored for their sacrifice and respected by elected officials and government employees, especially at the VA?

America WeepsThe VA’s mission statement is “to fulfill President Lincoln’s promise “To care for him who shall have borne the battle, and for his widow, and his orphan” by serving and honoring the men and women who are America’s veterans.”  The statement is meant to echo the reverence given to the men and women who serve in the American military with honor.  Reflecting that this body (the Department of Veterans Affairs) is tasked with serving them respectfully, similar to how they served their nation.  One final question is, “Does killing, abusing, and harming veterans equate to honoring the VA mission statement?”

© 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.

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Legitimacy and Consent – Principles Governing Power

In the book 1634: The Baltic War (Ring of Fire Series Book 3), a point was raised:

“A ruler needs legitimacy before all else, and legitimacy, in the end, must have its base in the consent of the governed.”

Bobblehead DollIn reviewing the US Constitution and Bill of Rights, a person will find the term consent a mainstay of constitutional law, foundational to establishing and solidifying the legitimacy of the citizen in this Constitutional Republic.  Let’s be specific here and take a moment to understand the principles of consent.  Consent occurs when one person voluntarily agrees to a proposal or desires of another.  It is a term of common speech, possessing specific definitions used in law, medicine, research, and sexual relationships, to name but a few.

Consent does not dictate or imply legitimacy; legitimacy is independent of consent, but actions of those in charge must be legitimate, or the governed’s consent makes the government’s actions illegitimate.  Hence, the need to understand legitimate activities and how these actions are either legitimate or illegitimate.  Legitimacy depends on the root word legitimate; if something is legitimate, it complies with the law, follows established or accepted rules or standards, and must be valid and logically sound.

Using a piece of recent legislation, we can more fully understand the point about something being legitimate and appropriate to the consent of the governed.  40-years ago, the US Congress (The Senate and the House of Representatives) stopped passing budgets to authorize and oversee federal government spending, and the holders of America’s checkbook began using continuing resolutions (CR) instead of appropriating funds as part of a national review of expenditures to a published budget.?u=http2.bp.blogspot.com-fGEUjJsJ2h4VcJgswaisnIAAAAAAAABcsoFqEewPF_E4s1600quote-if-the-freedom-of-speech-is-taken-away-then-dumb-and-silent-we-may-be-led-like-sheep-to-the-george-washington-193690.jpg&f=1&nofb=1

Consider with me, no CR appropriates money, merely extends a previous CR approved by Congress.  40 years of making the same mistake doesn’t legitimize the actions of Congress not to pass a budget.  The original CR was illegitimate and was against the consent of the governed, so every single CR replacing a balanced budget since has been against the consent of the governed as the actions were illegitimate, even if those making the decisions claimed they were needed or legal.  Thus, the CR fails the sniff test for government spending.  A historically wrong decision does not legitimize the current actions of the elected.

The law clearly states the US House of Representatives must pass an annual budget.  Part of that budget process must include evaluating the spending previously and determining if those writing the checks performed their jobs appropriately.  This is why independent audits of government agencies, including each of the members of Congress, are desperately needed to maintain the economic health of the United States.  For the Department of Veterans Affairs, the Department of Defense, and every other agency to continually fail audits is 100% illegitimate and against the consent of the governed.

Does this make sense?  Your personal and family financial fiduciary health requires an end-of-month audit of spending, a balancing of the checkbook, and an evaluation of expenditures to meet budgetary restrictions and fiscal goals and objectives.  At the end of the year, you evaluate all the past year’s spending in preparation for the annual tax deadline.  Yet, the example of the executive, legislative, and judicial, both at the state and federal levels, is not reflected in the daily struggles of the governed.  Making the government’s actions illegitimate and against the consent of the governed.  These two principles, legitimacy and consent, reflect a significant portion of the basis of the anger many in America feel but cannot express.Plato 2

Why do we struggle to express this anger?  We have not understood the principles of consent and legitimacy.  In a constitutional republic, if what those elected are doing hurts one portion of the populace, it hurts the entire population.  We do not have a democracy where a mere 51% of the people benefiting can justify destroying the other 49% of the population.  Why does the US Constitution require what the media calls a “supermajority” erroneously?”  Because in a constitutional republic, the rule of law protects all citizens equally, thus providing legitimacy to follow the law, an impetus to adhere to the law when no legal authorities are directly observing you, and allows for the consent of the governed to be honored and upheld even if a small minority disagrees with a decision by the elected authorities.

Hence the difference between a democracy and a constitutional republic.  We are encouraged under the rule of law to disagree, petition the government peacefully, and insist the elected representatives follow and live by the same laws they enact.  Nothing in the US Constitution allows for an elected representative to play the stock market for personal gain, to abdicate their duties by voting via proxy, disregarding their legally authorized obligations, or many of the methods for abusing the citizenry that have become “accepted” because a vocal minority pushes an agenda.

Speaker Pelosi cannot claim that something is acceptable merely because she was the house speaker.  The president cannot break the law simply because they are the commander in chief of the armed forces.  Elected representatives cannot, and should not, be making money trading stocks with insider information.  The list of what has become acceptable behaviors of elected officials is long and egregious.  Always the same two principles balance as a means to judge those behaviors and actions.  Is what they are doing legitimate and consensual to the expressed opinions of the governed?  If the answer to one is negative, the elected representatives have no power to govern.Apathy

Consider the crime of rape.  If consent is withdrawn, the intercourse is non-consensual and illegitimate, and a legal charge of rape can be investigated for criminal activity.  The same is true for speeding; the laws clearly state speed limits are acceptable, breaching the limit in a motorized vehicle is unsafe, and simply because the occupants of the car consent don’t make speeding legitimate.  Both consent and legitimacy must be approved to make an action acceptable.

If the driver operating a vehicle demands that speeding is legitimate, will a judge or police officer agree?  Does a passenger screaming about the need to go faster legitimize the illegal actions of breaking speed limits?  If a passenger suddenly replaces the driver, even though they own the vehicle, is responsibility for actions moved to the new driver or remain with the owner or original driver?  These are easily understood questions when consent and legitimacy principles are fully understood in context.

Consider the ramifications of neglecting legitimacy and consent.  Does a make-out session between two consenting adults mean the sex was consensual?  No, because if one party does not want sex, merely wants to make out, provided both parties have reached the legally determined age of consent, the make-out session is consensual, but not the sex.  This is not splitting the proverbial legal hairs.  If making out and sexual intercourse are two separate actions, which they are, then the legal need for consent legitimizes sexual intercourse.

Now using this analogy, let’s evaluate the legislation for not passing a budget.  Not passing a budget is one action, but not passing a timely budget does not justify a continuing resolution to authorize government spending.  Not passing a budget, not conducting audits, and not demanding fiscal responsibility are all separate actions but never legitimize the continuing resolution.  The root cause does not justify the stop-gap spending.  Just like consensual necking does not legitimize sexual intercourse or speeding on a highway.

The courts have been very clear actions supporting lawbreaking do not imply permission or consent.  Consider the laws of drunk driving, the rights of the injured victim, or the families of those killed.  Society has allowed, through legislation, the ability to drink alcoholic beverages provided the consumer is over a specific age.  Does the legal permission to drink automatically legitimize the consumer to operate any motorized vehicle after drinking; of course not, and laws have shaped and changed drunk driving behaviors since 1910.  The consumer is granted consent based on age and legal limitations to drinking alcoholic beverages but is not legitimized to drive, ride a horse, operate a bicycle, boat, etc., while intoxicated.  Those injured or killed did not grant consent for the consumer to ruin their lives.  Hence the consent of the governed and legitimacy of drunk driving laws are established, and the consumer’s responsibility to drink responsibly is solidified in society.The Duty of Americans

Returning to the continuing resolutions, the fiscal insanity of the government and the bureaucrats’ fiduciary irregularity contradict the governed’s consent.  Taxes are paid, but the taxpayers still hold responsibility and accountability for the money they earn to pay those taxes.  Through electing representatives to oversee how tax monies are spent, the responsibility to provide an accounting for those funds is exchanged by the citizenry electing to the elected.  The citizen cannot be held directly responsible for the actions of the elected representative.  Still, through fair, transparent, and legal elections, accountability for the actions of the elected is expressed.

By failing to provide clear and logical, transparent, fiscal accounting to the electorate, the elected representative is discounting the consent of the governed and delegitimizing the concerns and investment of the voters who paid the taxes.  Precisely like the consumer who drinks alcoholic beverages and then insists they can drive home safely.  Understanding the principles of legitimacy and consent is a prerequisite to clearly identifying the problems in government and then correcting course to right the ship of the state.Patriotism

Does anyone want to return to the legal days when a rape victim is blamed for exciting the mind of the rapist who took sexual advantage and committed an act of violence?  Does anyone want to return to 1900, when drunk driving was socially acceptable if you were rich enough?  Does anyone want to cancel the speed limits and try to declare the lack of speed limitations makes roads safer?  Of course not, so why do we, the electorate continue to allow for fiscal insanity with our tax dollars?  Why should we ever accept another continuing resolution?  Why should we even pay taxes when those spending the money have so egregiously spent our money until how many umpteenth-great-grandchildren are in debt to their eyeballs?

Please allow me to specify I am not advocating a person stop paying taxes and risk judiciary action!  I am advocating understanding consent and legitimacy as keys to government power and how the power being exercised currently needs to be evaluated.  You are free to reach opinions different than mine.  I implore you to understand how legitimacy and consent of the governed lend the right to rule, in our constitutional republic, to the elected representatives.

Legitimacy and consent must be the number one motivating factor for every decision of those elected.  Until we, the electorate, demand they change course, we will be forced to wash, rinse, and repeat until America is left an empty shell, her people driven into captivity by her enemies, and the American Dream is shattered for personal political power by those who we elected.

Detective 4Returning to where we began, “A ruler needs legitimacy before all else, and legitimacy, in the end, must have its base in the consent of the governed.”  Whether a ruler is a hereditary monarch, an elected representative, or a despotic tyrant, legitimacy and consent remain principles upon which power is derived.  Absent either legitimacy or consent, the ruler has no power to govern; lacking power, that rule is either quickly deposed or will shortly be destroyed by those being abused in the name of governance.  History is replete with examples of citizens who have rejected their consent after actions were taken that delegitimized the ruler’s power.

No, this is NOT a call for violence, merely a plea for understanding consent and legitimacy, evaluating what you see in each branch of government, and then making a personal decision to continue to grant consent or withhold consent from those who claim to “represent” you in the halls of government.  How you choose is your choice, and you are free to make that choice.  I know my choice and have already withdrawn my consent to be governed by the current elected representatives.

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

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.

What We Are Witnessing – What We Can Do!

Angry Grizzly BearThe US Senate passed the non-infrastructure bill, loaded with everything but infrastructure initiatives and a bloated price tag that is not paid for, which will increase inflation and the National Deficit.  The US Senate is on its way to passing a $3.5 Trillion spending spree, again no accountability, no restraints, not paid for, balloons the government, and robs freedoms and liberties from every American.  Did you know all legislation that spends money is supposed to originate in the US House of Representatives?

Long ago, a couple of legislators crammed down some rules that allowed for spending bills to originate in the US Senate, as long as the US House of Representatives got the legislation, eventually, and voted for that legislation.  Generally under immense pressure from the upper house and the special interest groups lobbying for the lower house to “just go along.”  All of which is legal but unconstitutional, but allowed as legislative chicanery called “doing business in Washington.”

Tired of Politikal-Gimmickry yet?  I am!

My wife brought up an interesting question regarding the now resigned Governor of New York, Andrew Cuomo, “Will he be prosecuted?”  I do not know, and from the headlines, I cannot tell.  Worse, it is not apparent if a deal was struck to compensate the victims from the New York taxpayers and avoid accountability if Gov. Cuomo left before electioneering could begin to hinder Democratic efforts to keep the office in New York.  Tell me, how can private industry have significant penalties for even a suspicion of sexual impropriety, but government elected officials can weasel out of accountability time after time if you are in the appropriate political party?Angry Wet Chicken

Speaking of Ex-Governor Andrew Cuomo, his anti-apology/resignation speech was the worst kind of political skullduggery since Anthony Weiner was disgraced for sexual impropriety.  If Chicago is the land of pay-for-play politics, then New York must be for sexual impropriety politicians, beginning with William Jefferson and Hillary Clinton!

Tired of Politikal-Gimmickry yet?  I am!

Can someone tell me how and why YouTube, Facebook, LinkedIn, Twitter, and other Social Media companies, private companies, can block content and customers?  First, the companies take money to be news outlets and media giants, obtaining tax breaks and special benefits for being tech giants and other prime companies for the government.  Then, they squawk they have the right to silence content, isolate content providers, shame politicians, and spout political beliefs like private companies while receiving public funds.  The IRS came down hard on churches in the 2020 election cycle for having 501 C status and being mouthpieces for political speech; how is this not the same principle with social media companies?  Why aren’t social media companies forced to either maintain neutrality or stop receiving preferential treatment from the government?

Tired of Legal and Politikal-Gimmickry yet?  I am!

Exclamation MarkLet’s talk about scientific facts for a moment, and if you like, feel free to look up the corresponding research.  I am not a medical professional, epidemiologist, virologist, or chemist; however, I can read a research paper, and this is what I have found.  One of the reasons it is so difficult to vaccinate against viral infections is the ever-changing viral infection itself.  Essentially, the virus mutates a lot, and these generational mutations tend to keep a vaccine from working effectively against a virus for very long.  The only sure-fire way to protect a population against a viral infection is to allow the people to experience the viral infection and build herd immunity.

The Delta-Variant of the Sars-COV-2 (COVID-19) viral infection is essentially a fizzle.  Vaccinated people are catching this mutation, spreading it, and then complaining, “But I got vaccinated.”  However, the fizzle is that the virus has mutated into a half-life in a previous mutation, and the Delta-Variant is a half-life again of the previous half-life.  This is why the Delta-Variant will make you sick but not keep you sick, and the antibodies your body builds against Sars-COV-2 are actually beneficial in the long run.  Having said all this, do you think the media will report this information; do not bet the farm, Lucy!  Will, the government, relinquish control; hold your horses, Mack!  Totalitarianism has broken out, and reigning in these out-of-control bureaucrats and power-hungry politicians will take a lot more than the half-life deaths of Sars-COV-2.Anton Ego

I am a person of action; I do not take kindly to being told to sit down and wait or shut up and stand still!  Never have been; in fact, learning patience has been one of my biggest challenges and hardest lessons, and I still fail gloriously DAILY!  Worse, I see the danger and the emergency, and I desperately feel the need to take action immediately!  It makes me good in the trenches but not very good in the stadium.  Here are my thoughts on taking action now; agree or disagree, take action NOW!  We can talk about the problems later!

      1. Start right now, calling the US House of Representatives and DEMANDING in the strongest language possible that your elected representatives refuse the boondoggles being passed in the US Senate right now!
      2. New Yorkers, you are some of the toughest people in the world; show it! Put your backs up, put your mouths in gear, and DEMAND that Governor Cuomo be held accountable, in a court of law, for the crimes for which he is accused.  Guilty or not, these accusations need to be settled in a courtroom.  Not a pressbox, not a media-feeding frenzy, but by a jury trial!  Force the truth!
      3. America, lead the world in throwing off the totalitarianism that is killing representative government across the globe! From the mayors to the governors to the US President, it is time to end the farrago called COVID and throw the bums OUT!  Yes, this includes the MEDIA!  The politicians’ lapdog needs to be held accountable for spreading half-truths, lies, and falsehoods for personal power, and rightly so.  When discussing the media’s role in spreading and fanning the flames of COVID, we include social media and hold these tech companies responsible for their roles.  Nobody is “Too Big To Fail!”
      4. If the elected officials, including judges, refuse to listen to you, begin the recall procedures! Refuse your consent to be governed!  You own the power of and the keys to the government, and it is past time for the government to begin fearing us, the electorate!The Duty of Americans

As the politicians take the rest of August off, lets us remind them who is in charge.  Turn off your TV.  Turn off your Cable.  Turn off your social media.  Call, text, email, and visit their town halls, demand an audience with the elected officials.  Get heard!

© 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.

Division vs. Unity, Labels, and Big Tech

Angry Wet ChickenLast week, while scrubbing my SPAM folder on Gmail, I discovered that Google had arbitrarily been sending several emails containing news of a more conservative slant straight to SPAM.  Why would Google arbitrarily act in a manner to thwart the delivery of email?  A topic for discussion later in this article.

America faces a huge test right now; division is costing us opportunity, liberty, freedom, and potential.  Worse, it will eventually destroy the United States of America, a free Republic (if we can keep it).  What is this nefarious foe; a lack of unity.  The political parties have become so divisive that families are being torn asunder over something as petty as which political party to embrace.  Religion, lifestyle choices, employment opportunities, and so much more are being used to erode America at the family foundation.quote-mans-inhumanity

Socialsolutions.com reports some disturbing statistics from 2018.  However, the COVID-Farrago has seen these numbers only increase, and the numbers for 2020 are still not compiled and updated.  ACLEDdata.com provides some of the statistics from 2020, and the political violence inflicted on families is stunning!  Where does the blame lay for all this violence, property damage, public property destruction, and the host of terrorism committed in George Floyd’s name; the US President, Vice President, Speakers of the House and Senate, the governors, the mayors, and state legislators.

Bait & SwitchI am not excusing individual accountability for specific acts, but every silent politician in America has condoned the divisive behavior.  The corporate media have fed the violence and division, and the press has even been videoed participating in the violence.  My wife stated something, “The problems have become too great for any single individual to make a difference.”  I vociferously disagreed then and state unequivocally now that good is still in the majority of America and Americans and that one individual who declares enough is enough can make a world of difference!

Charmaine Yoest, Jack Spencer, John G. Malcolm, and James Carafano, writing for The Daily Signal, published an article on 11 June 2021 worthy of reading.  The twelve points they outlined are listed below, and additional commentary is mine.

      1. Protect Our Vote – I cannot stress this enough. The November 2020 elections, like all elections since we allowed computers into the mix, were fraught with illegal and illicit behaviors and reflects malfeasance towards the voter. However, that problem is specifically targeted at the local political leaders and judges who refused to allow time for transparent investigations.  President Biden and his administration are definitely not helping the situation.  Getting the Federal Government out of elections is the pre-eminent step we need to return State Rights to State Governments.President Adams
      2. Secure Our Border – America was built on defensible borders, and neglecting those borders is the height of Treason! Webster defines Treason as “The betrayal of allegiance toward one’s own country, especially by committing hostile acts against it or aiding its enemies in committing such acts.”  Hostile acts can be refusing to act when problems arise if the failure to act benefits you personally.  The continued flaunting of National Security on America’s borders (North and South) is treasonous, and those committing these actions of inaction need to be held accountable before the bar of law!photo_slideshow_max
      3. Stop Adding Debt – Of all the points raised in this Daily Signal article, this point is second most important, only behind defensible borders! Inflation must be fought with smarter monetary policies.  Want a good reference for smarter economic policies; Mark Skidmore is a leading economist in the field of government economics and is almost entirely unknown unless you have a hobby in following government monetary policies.  Dr. Skidmore has worked with a highly intelligent team of economists to try and find more than $94 Trillion in lost money in the Federal Government.  Before America spends another dime, a full and transparent audit must be completed, all the books opened, and criminal charges brought!Plato 2
      4. Stand Up To China – One of the things I particularly loved about President Trump, and honestly, there weren’t very many, was his hard stance against China! I applaud President Trump’s efforts at leading America while surrounded by enemies foreign and predominantly domestic!  But to take a hardline stance against China is still desperately needed; yet, what do we see in the capitols of America, kowtowing to China by America’s elected leaders.  ENOUGH!  Stop committing Treason with a dedicated foreign enemy!Apathy
      5. Do NOT Raise Taxes – [Emphasis Mine] You cannot spend yourself out of debt, and you cannot tax your populace for personal benefits to remain elected by buying votes through forced taxation and government largess! America has never had an income problem; we have always had a spending problem!  Debt is captivity, captivity to our enemies is Treason, and those committing Treason need to be held accountable before the law.  From the bureaucrat to the politician, every single one needs to be held responsible for what they have and have not done in properly honoring the funds delivered to the Government through forced taxation!Life Valued
      6. Stop the woke! – From Critical Race Theory to wave upon wave of identity politics, America is being divided so as to be more easily conquered. If you cannot see how dangerous these lines of division are, we need to talk about waking up mentally and recognizing the 800# Gorilla in the room!  You do not need to have special identity laws for every single invented identity, and going down that slippery slope produces nothing but harm, chaos, and destruction.  Ask Caesar from Ancient Rome how identity politics worked in Ancient Rome.  History relates what happens at the end of the identity politics games, and the results are never beneficial!Courage
      7. Cut Red Tape – Another one of those things I applaud President Trump for doing was cutting the Federal Government Red Tape to free the American worker, businesses, and manufacturing. Want a startling statistic; besides inflation, the only other driver of higher costs is government red tape.  I learned this as a kid when I saw the taxes included in a gallon of gas.  I asked if the same was true of all prices and my parents had no idea.  Thus began my hobby of understanding and tracking economics!  But, do not take my word for it; look up the cost of bread from 1940 to today, and look at how much government red tape has influenced just a loaf of bread.  We, the proper owners of the Government in America, must regain the reigns from the asylum patients and cut government red tape!The Duty of Americans
      8. Help Us Sleep Safe at Night – Talk about a conjoined issue with defensible borders! Tell me, why are portions of America’s National Parks just as deadly as Northern Mexico?  I have read first-hand accounts of scouts stumbling upon drug manufacturing facilities, landmines and guerilla war tactics employed to dissuade investigation, and the armed terrorists living in America’s National Parks to produce drugs for the American markets.  Before Big-Tech thought this would blacken certain political parties’ chances at re-election or election, many of those stories were scrubbed from the Internet.  Tell me, do you sleep safer at night right now than you did three years ago?  My home security costs have skyrocketed, 24/7 surveillance makes me feel like a prisoner in my own home.  Yet, the elected officials have blocked all attempts at using the military to root out the terrorists and gangs from America’s National parks and defend the US Borders.Plato 3
      9. Stop Big-Tech! – Have you noticed the censorship occurring across the Internet? How one day you can find stories on a specific topic and the next you cannot locate those same sources?  Perfect example, in February 2020, I could find Dr. Fauci’s research on Coronaviruses and many other research topics.  Now, I can find nothing of those early research projects that proved Dr. Fauci is either lying in his research then or lying to the public now.  I have emails being sent arbitrarily to SPAM if it is content Google opposes politically.  I have witnessed LinkedIn, Twitter, Facebook, and other social media restrict access, shut down accounts, and destroy people’s livelihoods, all because of content the Big-Tech does not find politically palatable.  I am done being censored, censured, and prohibited, all because some tech company does not like the truth!PACT_model
      10. Deliver School Choice – Long have I written that K-12 education is sexually grooming and abusing America’s children instead of teaching them how to read, write, and think logically through arithmetics. K-12 education in America, since the 1860s, has been purposefully designed not to teach students how to read because a literate society knows freedoms and liberties, and an illiterate society can be controlled.  Hence, I disagree with these authors; even school choice cannot save America’s youth from abuse at the hands of teachers and bureaucrats embedded in the education system.  The individual states need to be freed from the Federal Department of Education.  Then, the states need to revamp what education means and begin to throw out the bureaucrats and increase the abilities of teachers to lead and instruct in their classrooms!Patriotism
      11. Empower Patients, NOT Government – [Emphasis Mine] Being a disabled veteran, having my medical care through the VA, I could not agree more that the Government needs to be ripped out of healthcare and the doctor-patient relationship. However, we also need the litigious nature of society to be corrected.  The cost of malpractice insurance is so exceedingly prohibitive that doctors cannot practice independently, and the corporatization of medicine has been growing twice the government intrusion rate!  Thus, the red tape needs to be removed, government intrusion needs to be clipped, and people looking at the judicial branch as a gold mine need to be shunted and stopped!Social Justice Warrior 2
      12. Make Our Streets Safe! – Again, we find an issue with root causes behind defensible borders, military action to fight the drug trade, and the overhaul of the criminal justice system. When the criminal has more rights and protections than the victims, justice is not served!  When sentences do not include community service to repair damage to a society, justice for the community is not served.  When jail has more privileges than not being incarcerated, the criminal justice system is everything but bringing justice to criminals!  We have enough trash, graffiti, weeds, and other community service work needing to be performed for three armies of criminals.  Get them on this service instead of sitting all day.  Worse, all those “peaceful protestors,” a.k.a domestic terrorists, need to be out repairing the damage to the communities they wrought!

Knowledge Check!Unity is a precious resource America has always enjoyed in abundance, and the political enemies of America despise America for the unity that has always been here.  We might fight like brothers amongst ourselves, we might have ancient grudges and family disputes that spill over state lines, but we are inherently a unified people.  Stop allowing the media to preach division, hate, and identity politics.  Stop allowing those elected as representatives to divide you and your family.  America, we have a choice before us, unite and live, or divide and fall.  All of the changes discussed stem from a simple point, will we choose to unite and live or allow division to separate us to be conquered as unpitied sacrifices in a contemptible struggle?

Image - Eagle & FlagJoin me!  Join with your neighbors and family members!  Let us for a community of responsible and intelligent citizens, who are informed, and active in halting the government abuses at every turn!  As a united front, we can win!  Believe that, and we are halfway to restoring America to the ”Shining city on a hill!”

© 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.

How Do I Know? – An Update on the VA Mandatory Mask Policies and VA Leadership Failures

Question24 May 2021 – 1200-1500 I visited the Las Cruces Community Based Outpatient Clinic (CBOC) in Las Cruces, New Mexico.  Upon entry, I was asked to wear a mask.  I described I could not wear a mask, and the employee said I might be required to wear one but left the decision to those working more closely with me.  I waited in line and was called to the Team 2 window, where a gentleman was more than happy to assist me in getting the paperwork started to change VA hospitals after relocating.  About 45-minutes into my time in this CBOC, the gentleman asked me to wear a mask.  I told him I could not and had brought my VA Doctor’s note as proof.  The gentleman read the letter, confirmed I was good to receive care without the mask, and provided exceptional customer support.

After the past year at the Phoenix VAMC, where my every movement on the property was shadowed by VA Police officers looking for a reason to injure, arrest, cite, and force me from the property, the employees here in Las Cruces was a breath of fresh air.  However, the experiences in Las Cruces provide further evidence of the following facts:

      1. The Hospital Director has statutory authority for adapting and creating policies and procedures that benefit the safety of the employees and the patients. A point I stressed to the leaders of VISN 22 and the Phoenix VAMC to no avail.
      2. The Federal Mask Mandates can be situationally applied for the circumstances of the individual. Yet, another point I have repeatedly stressed since July 2020, and the first time I was injured, arrested, cited, and forced from Federal Property. At the same time, I was being denied emergency care under EMTALA and having my HIPAA information repeatedly violated by the VA Police Officers.
      3. The bombastic and unprofessional behavior of the Federal Police employed at the Carl T. Hayden VAMC is a problem of the leadership, and the failures of leadership to instill professionalism, proper attitudes and behaviors, training, and tactics in approaching and handling situations in the Phoenix VAHCS. At the behavior of the Federal Police Officers in the Phoenix VAHCS, Che Guevara, Mao, Stalin, and Fidel Castro would be proud!VA 3

How can a person be sure the problems caused are a direct result of leadership failures?

ApathyBy tracing behaviors, attitudes, and influence to their source, the police chief acts as he considers appropriate, but the underofficers generationally multiply and mirror his behaviors.  The same is true for the chief who takes his example from the assistant director, director, and hospital leadership.  Chains of command always have this consequence; the example of those above are mirrored, replicated, and multiplied to impress the higher officers to gain attention and promotion opportunities.  Want to take a measure of a leader; look to the most junior person in the chain of command and watch them for behaviors, attitudes, and actions that originate in the leadership.

GavelCase in point, long have I detailed and described the failures of leadership at the VA.  The latest is a wire fraud scheme in Jackson, Mississippi.  From the Department of Veterans Affairs – Office of Inspector General (VA-OIG), we find the following:

“Anthony Kelley, the owner of Trendsetters Barber College in Jackson, Mississippi, pleaded guilty to two counts of wire fraud in a scheme to steal federal funds. From October 2016 through March 2019, the college offered a master barber course that was not accredited by the state’s board of barber examiners. Kelley fraudulently represented that this course was approved and, as a result, was allowed to collect GI Bill money from veterans enrolled in the program.”VA 3

As the lowest person in the chain of command, Mr. Kelly was allowed to attempt to commit fraud by the VA.  Never in these reports is the VA employee, their supervisor, and their manager, who were complicit in allowing fraud to occur, mentioned and held accountable.  Somehow, we, the taxpayer, must presume that those committing frauds could hoodwink the Department of Veterans Affairs without any inside help.  Help coming directly or indirectly from government employees charged with investigating, ensuring, and following proper protocols and procedures to protect against theft and fraud.

Angry Grizzly BearLet the US Attorney and VA-OIG special investigators crow about catching the person perpetrating fraud.  Before they break open the champagne, they need to be looking into the leadership that either overtly or covertly allowed this fraud to occur.  The elected officials need to be demanding why fraud opportunities are so rampant at the Department of Veterans Affairs that criminal proceedings are being reported almost every week and asking about the culture of corruption and leadership failures allowing these behaviors to thrive.

Is it a “Culture of Corruption?”

Absolutely; the VA is sick with a culture of corruption!  It is my sad duty to report on another employee who was able to steal from the VA, stealing hydrocodone and oxycodone prescriptions from the VAMC mailroom and mailboxes at some 40 locations in Kerrville, Ingram, and Center Point.

“Scott M. Brown, a pharmacy technician at the Kerrville VA Medical Center in Texas, was charged with one count of theft of US mail for stealing hydrocodone and oxycodone prescriptions from the medical center’s mailroom as well as from residential mailboxes between March and April 2021.”VA 3

Currently, Mr. Brown is being held in custody and remains innocent until proven guilty in a court of law by a jury of his peers.  However, the fact that Mr. Brown has been charged and is in custody speaks volumes to the lax leadership that allowed these prescription thefts to occur.  Where is the VA-OIG in asking how the robbery was possible?  Where are the special investigators demanding answers from the leadership on policies and procedures that an employee could easily violate to obtain these drugs?  Who else was involved, or had to know, what was happening and said nothing?Plato 3

The Department of Veterans Affairs has been overtaken by those without skill, knowledge, and ability to understand cause and effect and properly interrupt the cycles of corruption.  Worse, these same people will bleat about how they need more money for technology solutions when their personal example, leadership failures, and human-to-human relationships are the actual problems.  The leaders will bleat like sheep in a corral about engagement, customer service, and industry buzzwords because they have no substance and even less desire to see things change.Plato 2

Recently I detailed the failures at the Department of Veterans Affairs on information technology.  The fallout from the deplorable designed incompetence in the IT/IS infrastructure at the VHA continues to represent just how incompetent the current leaders genuinely are.

“To promote compatibility with the Department of Defense’s electronic health record system, VA is replacing its aging record system. This requires VA medical facilities to upgrade their physical infrastructure, including electrical and cabling. The OIG determined from its audit that the Veterans Health Administration’s (VHA) cost estimates for these upgrades were not reliable. VHA’s estimates did not fully meet VA standards for being comprehensive, well-documented, accurate, and credible. The audit team projected that VHA’s June and November 2019 cost estimates were potentially underestimated by as much as $1 billion and $2.6 billion, respectively. This was due in part to facility needs not being well-defined early on. The estimates also omitted escalation and cabling upgrade costs and were based on low estimates at the initial operating sites. Because cost estimates support funding requests, there is a risk that funds intended for other medical facility improvements would need to be diverted to cover program shortfalls. The Office of Electronic Health Record Modernization (OEHRM) also did not meet its obligation to report all program costs to Congress in accordance with statutory requirements. Specifically, OEHRM did not include cost estimates for upgrading physical infrastructure in the program’s life cycle cost estimates in congressionally mandated reports. Although VHA provided OEHRM with an approximately $2.7 billion estimate for physical infrastructure upgrade costs in June 2019, OEHRM did not, in turn, include them in life cycle cost estimate reports to Congress as of January 2021. OEHRM stated it did not disclose these estimates because the upgrades were outside OEHRM’s funding responsibility and that they represented costs assumed by VHA facilities for maintenance—including long-standing needs” [emphasis mine].VA 3

Angry Wet Chicken 2Did you catch that; the office specifically tasked with handling estimates intentionally low-balled estimates, did not include all necessary contractual requirements, and then lied to Congress to cover their hides, and fell back upon designed incompetence to skirt blame, responsibility, and accountability when the VA-OIG came investigating.  Lying to Congress is a CRIME!  Yet, these federal employees can break the law with impunity, and all the VA-OIG can do is make recommendations for improvement!  If you want to read the full report of shame, you can find it here.

Leadership is change; management is stagnation and corruption.  When will the VA start hiring leaders to enforce, demand, and execute change to benefit the taxpayer and the veteran community?  Where are the elected officials willing to work with newly hired VA leadership in establishing legal frameworks for evicting employees who refuse to change from the federal workforce?  When can the veteran community and the taxpayer expect to see real and tangible change at the VA?

Knowledge Check!I am not asking these questions and not expecting an answer!  I am asking these questions looking for and expecting real results to begin immediately, if not sooner!  This is a national embarrassment with a global impact, and it is time for the United States to lead in correcting their detestable government workforce!

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

NO MORE BS: Come, Let Us Reason Together – Chapter 4

Bird of PreyPSA:  I am not a cynic; I understand the concepts being discussed, and it might appear that I am cynical about insurance companies by the tone of the writing.  Please note, I am generally in favor of the insurance industry.  However, when government mandates insurance coverage to spread the risks out for the benefit of the insurance industry, insurance has become a tax.  When a business offers insurance, but the co-pays and the costs are too high, insurance is no longer a benefit, and I want the option to opt-out of the employer “benefit.”

Insurance as a concept has been around for a long time, historically speaking.  Maritime insurance was a concept from the 1340s, and Benjamin Franklin dreamed up property insurance in 1752, becoming America’s first insurer.  Insurance separated investment as a method of managing risk, making investing more palatable and shoving the consequences of natural disasters, pirates, and other methods of losing onto another responsible party.  Some of the biggest names in insurance can trace their roots to the Great Fire in London in the 1660s.  We mention all of this, as a foundation for understanding the role and the meaning of insurance.

Interest vs. Investing

Ziggy - The GovernmentInterest, in this usage is referring to the advantage to a group or single person, as well as improving one’s welfare.  Maritime shipping would take on several loads, and people who owned those loads had a vested interest (having a personal stake in something) in seeing that ship arrive on time at its intended destination.  For example, sugar has been a huge commodity in history, and a sugar mill would ship the sugar to destinations for sale.  People interested in improving their welfare could invest in the sugar mill, or with a higher risk, expecting a higher return, invest in the shipping company, or the ship.  Thus, investing became one where opportunities to increase interest became popular.

The modern stock market traces its roots to the 1600s and the Amsterdam Stock Exchange, where for the first time, people interested in investing could be joined to companies needing investors, and money could exchange hands for certificates (stocks or bonds) showing interest.  A point of reference, the Dutch East India Trading Company was an original benefactor of the Amsterdam Stock Exchange, and sugar, molasses, and spices were the commodities being shipped.  Not saying all the Dutch East India Trading was in non-human commodities, but sugar was a huge driving factor for separating risk through insurance that drove the stock exchange creation.

photo_slideshow_maxOne final point, government’s have interests, generally traced to those paying the highest taxes, or with the most political connections.  Government’s do not have allies, as much as they have groups of governments that share a common interest.  For example, countries belonging to NATO.  NATO is the North Atlantic Treaty Organization and was designed for those countries with interests in seeing trade safely through the North Atlantic.  Not all the countries in NATO are friendly with all the other countries, but the common interest in seeing trade and markets operate smoothly has generated NATO and kept it alive since 1949.  Government never has friends; they only have relationships based upon mutual interests.  These are cogent points that must be remembered!  Incredible as it seems, interests change, and when interests change, relationships between countries and governments force ideological changes, and today’s relationship might not be the same tomorrow, which is one of the reasons why the United Nations is such a pile of hypocrisy and uselessness!

Insurance and Investing

Insurance as described by Webster’s dictionary is a practice or arrangement by which a company or government agency provides a guarantee of compensation for specified loss, damage, illness, or death in return for payment of a premium.  The payments of premiums provide the insurance company with vast sums of cash.  Some of which are placed into long-term investments, medium -term investments, stocks, bonds, T-bills, and other methods of protecting the money paid in premiums.  The higher the risk, the higher the cost of the premium.  The one rule in insurance that has never changed from the 1300s is, if the insurance company can collect a premium, and not pay on a claim, the interest the premiums collect remains and the shareholders see larger returns on their investments.

Calvin & Hobbes - EnmityHence, lawyers and bankers have a vested interest in seeing insurance companies not have to pay claims, but still collect premiums.  Thus, contract law was established, and the insurance companies took full advantage of language to protect their premiums from paying a claim.  Another growth industry directly tied to the insurance industry, was special courts for hearing claims and awarding damages (Tort Law).  Cornell Law university provides some clarity on tort law, “A tort is an act or omission that gives rise to injury or harm to another and amounts to a civil wrong for which courts impose liability.  In the context of torts, “injury” describes the invasion of any legal right, whereas “harm” describes a loss or detriment in fact that an individual suffers.”  Placing insurance companies squarely into the middle of tort law, and thus opening up new avenues for protecting against paying a claim from the premiums paid and invested.

Types of Insurance

ApathyImportant to understanding, Carl Marx and communism uses the ideas of mutual insurance companies to create a society where all share the risks, all benefit in the gains, at least in theory.  However, like insurance companies, someone in communism must enjoy all the benefits for taking the risk of establishing the community, and the reality of China, Cuba, and USSR become evident.  Where the leaders take everything for themselves, and the regular people live in squalor and depredation.

Janet Hunt wrote an great article on types of insurance companies and her article can be found here.  Currently there are nine different types of insurance companies available and are detailed below:

    • Mutual Companies – owned by policy holders who are also considered shareholders, sharing the risks, and benefiting from the lack of paid claims.  The mutual society of this type of insurance company shares dividends and when losses occur, generally the shareholders (policyholders) might not see an increase in premiums.
    • Stock Companies and Mono-Line Carriers – Stock companies are corporations and the distribution of dividends become payments to shareholders.  These insurance companies are very averse to paying claims.  Mono-line carriers only carry a single type of insurance.  For example, a company might only carry car insurance, specializing in just car insurance provides savings in overhead, and they might have agreements with other carriers to provide linked coverage for other insurance products.
    • Lloyds of London – When you want to insure the weird, Lloyds of London is the carrier of choice.  I cannot tell you how hard I have laughed at people willing to insure body parts, unusual, or high-risk items.  Share my laugh, look up what policies Lloyds has written insurance policies for and you too can have a good chuckle.  Lloyd’s does carry insurance for mundane and normal, but those policies do not make me laugh.  I feel sorry for the citizens of the United Kingdom, since Lloyd’s of London is backed by parliament, the taxpayers are on the hook for Lloyd’s losses eventually.
    • Alien Carriers – These are insurance carriers that are owned and operated in one country, doing business in another country, selling premiums, and paying claims.  Important to note about alien carriers, the lawyers charged with engineering methods to control risks to paying claims can create a nightmare using the laws of both countries.  Alien carriers can also be operating in one US State but be owned and governed in another US State.
    • Domestic Insurance – These are companies who are owned and operate in a single US State, or other geographical area.  For example, a domestic insurance company in Texas, might or might not have the ability to operate outside Texas, where it would be considered an alien provider.
    • Direct Sellers – Do not use insurance agents, selling directly to the public or insurance consumer.  To be considered a direct seller, the majority of the business occurs online or over the phone.  Direct sellers are pretty straight forward, and some of the biggest names in insurance providers are direct sellers.
    • Captives – A captive insurance company is a unique insurance provider, generally specializing in one type of insurance product for a specific industry or groups of individuals.  For example, if a business owns a fleet of vehicles, they will have insurance through a captive insurance company who specializes in handling the risks of fleet vehicles.  Another type of captive insurance company occurs when a parent corporation needs insurance but builds a branch of their company to handle the insurance instead of going through an insurance company.  In this model, the parent company keeps the premiums in-house and has a vested interest in protecting their investments.
    • Standard Lines – This is your normal insurance company with insurance agents, local offices, is regulated by the state board of insurance, pay fees into the general state guarantee fund, and are subject to the laws and ordinances of the state in which they operate.
    • Excess Lines – Think of these companies as insurance for high-risk individuals and companies, who cannot get insurance through a standard line company.

I know, that is a whole lot more than you think you want to know about insurance companies.  However, my only logic for making these distinctions in this article is to aid in understanding the classifications of insurance company, and some of the peculiarities in insurance products.  I feel the more you know, the better questions you can ask, leading to improvements in your bottom-line.

Emtional Investment CycleWith all the ties to investing, savings products, and the flow of money into and out of an insurance company, the discussion of insurance companies remains critical.  Especially when the government can create an insurance company, then mandate that company be used to provide coverage, creating a tax and fee that the taxpayer might not realize.  For example, around the time that states began demanding drivers have car insurance, GEICO began selling policies to non-government employees.  GEICO is an acronym for Government Employees Insurance Company, and by selling policies to non-government employees, the government is able to reduce the risk of insuring their employees.  Thus, an argument can be made that the government only created GEICO to reduce the risks of insuring government employees, as well as benefiting from a flush of cash from premiums paid.

Ziggy on GovernmentBoth Lloyds of London and GEICO leave me worrying for taxpayers.  However, since the US Government is the only provider for some types of insurance, specifically flood insurance, which is mandatory for homeowners living in a flood plain, one must ask more questions about where the money goes and why?  What steps have been taken to protect the public from large scale incidents where the insurance company will have to make massive payments?  What does the government invest in to protect the premiums paid against the time of claims?

When a person begins discussing savings instruments, investments, and the links between insurance companies and government, a lot of potential questions arise, and the answers become more sparse inversely to the specificity of the questions asked.  For example, if a savings account interest is so low, due to inflationary spending by the government, what interest does the government, as a holder of savings accounts, receive for their investment?  Where does the government invest their premiums from insurance payments?  How is the government protecting their customers from inflation as a result of poor fiscal policy?Plato 2

Never forget, an insurance company must pay dividends to their shareholders who have invested interests (money).  GEICO is a Berkshire Hathaway company, and stopped being publicly held in 1996.  The questions for why the Government Employee Insurance Company is wholly owned and operated by Berkshire Hathaway opens a lot of questions.  This would be akin to Lloyds of London being sold to a private company, where parliament stopped caring or backing Lloyds.  Why becomes a major question requiring detailed answers.  Look at the political situation in America at the time of the sell, and more questions rise, and less answers are provided.

Knowledge Check!America, when it comes to cash flow, money, and government fiscal policy, we need answers.  We need the elected representatives to understand basic economics, and we need to hold a tighter rein on those elected representatives.  The current fiscal health of America is poor, solely because of the elected representatives and their bureaucratic minions.  We must have a solution that protects America, and this solution needs every citizen involved and engaged.

© 2021 M. Dave Salisbury
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