Seriously – Let’s Have the Conversation!

Hillary Clinton is infamous for an explosive remark made in a Congressional Bird of Preyhearing, “At this point, what difference does it make.”  While I genuinely detest quoting this particular person, she has a point where the 2020 Elections are concerned, not a good point, but a point.  At this point, what difference does it make in discussing the 15 Million votes from 2020 that were improperly counted, improperly handled, erroneously scrapped, and treated scandalously?  Will these votes change the fate of Afghanistan; no.  Will these votes remove the fraudulent president; no.  Will these votes correct an abuse of the voter in 2020 and place the real winner of the election into the presidency; no.

What difference “… at this point does it make?”  It changes how we move forward in voting.  It places the onerous upon current sitting politicians to safeguard voting systems, processes, and procedures to ensure this madness never occurs again!  Riddle me this, was COVID hyped and mass-fear spread to allow for voting to be abused to push a useless and senile president into office?  I digress.

Exclamation MarkHence, I would like to open the conversation into improving voting in America.  It is long past time for common sense voting safeguards to be installed and mandated at the local levels of government.  Here are my suggestions, let us use logic and discern the best path forward for America.

      1. Refuse the Federal Government legislation being pushed in the US House right now, the “For the People” Acts to demand a “Federal Government Mandate” for voting. Let’s be frank; the Federal Government could not handle collecting Social Security taxes from payroll and keeping that funded.  Do you really think they could handle something simpler, like voting?
      2. Eliminate the computers! I am done being some byte that a programmer can manipulate.  End the charade, open the transparency, and stop using vote computers.  A paper ballot is perfect!
      3. The paper ballot should carry a digital signature containing my picture in digital form and my digital signature, as verified by my government-issued ID. Don’t drive; that’s okay; you still need a government-issued ID to purchase alcohol, tobacco, firearms, take a plane trip, and a hundred and one other things.  The DMV can issue you an ID.  One ballot, one ID, one signature, one person, not hard to count, not hard to track, and no problems with security.  The technology has been around for 20 years to take and print a digital fingerprint; it is past time to combine a bio-metric tag, a digital tag, and a wet-signature with a ballot to end the nightmare of who completed the ballot.
      4. More transparency, more accountability, and more importantly, less mail-in balloting will mean sending teams to registered voters in hospice, long-term care settings, and hospitals and securing completed ballots using evidentiary procedures that can stand up in a court of law. Plus, it will mean penalties for breaking the law.  What happened in Maricopa County was a farce!  What happened in Atlanta and Philadelphia was a farrago. Too often, the primaries are just as fraud-riddled as the general elections speak volumes for the problems in local governments where laws are in place.  Still, the election officials always escape with their pensions intact into retirement.The Duty of Americans

Wisconsin, Michigan, Maine, New Mexico, Utah, Washington (especially Seattle Metro Area), Wyoming, Ohio, I wouldn’t think you have escaped scrutiny because the media left you alone in the 2020 election cycle.  I have personally witnessed the problems in your states, and I know how bad your elections are!  Worse, in New Mexico, primarily in Bernalillo County, I know the bad apples and remember them from being interviewed for a job.

Angry Grizzly BearOn the topic of local governments and Election Officials, apolitical should be the word of the day.  When a person walks into the election offices, they should not be bombarded with political messages.  Case in point, Bernalillo County, walk into the majority of the County offices, not just the election official’s offices, and look at the political affiliations on display.  Take a walk through the parking lot, look at bumper stickers, enter the offices, and find the same political messages on display in the people working inside.  You work for the government; apolitical is the least a person can expect from government employees; this is often referred to as professionalism!

Does being apolitical at work mean you lose your first amendment rights; yes!  Private-sector employees lose their rights; why should government employees keep their Constitutional Rights when private-sector employees lose their rights?  How fast will employment law change when government employees are treated like private-sector employees?  Yes, let’s have these conversations.  Let’s discuss these topics openly, in the public forums, on social media, in the town squares, and come to workable solutions.

© 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.

Blood is Blood – The Logic is Flawed!

Exclamation MarkLast night, during one of my frequent periods of wakefulness, a headline blew my mind, “There is no difference between blood and blood – Horowitz removes restrictions on gay men donating blood,” as reported by the Jerusalem Post.  Using this logic, then going maskless is not a problem, and being vaccinated or not vaccinated is not a problem either, for blood is blood.  Worse, consider the ramifications; the safety and integrity of the blood supply have been a critical problem from the first day humans realized we could take blood from one person and put it into another person successfully.  Mistakes in the integrity and safety of the blood and blood product supply cost people their lives!

I am not here to discuss the political aspects of this move.  The Health Minister of Israel (Horowitz) will be measured and weighed by his electorate for good or ill.  How and when the Health Minister will be measured and weighed will be up to the people in Israel, and I hope they will choose wisely.  I have no further comments on the political side and wish Israel the best of luck on this issue.

However, on the practical aspects of blood and blood product, safety and security, I have a LOT of concerns and have some authority, knowledge, and ability; thus, I will speak to this issue.  As I begin, I will state, again for the record, I do not care about your bedroom choices (hetero-, homo-, etc.), keep them to yourself and your legal age of consent consenting partner, and I could care less.  However, medical professionals should know some risks as they handle body fluids, especially when donating those fluids for others to use in an emergency.

Pin on Signs and SymbolsDuring the 1980s, both the American Red Cross and the Canada Red Cross Society suffered blood tainted scandals due to insufficient testing of, knowledge of, understanding of, and the dimensions inherent to donating blood and blood products where sexually transmitted diseases were concerned, especially AIDS/HIV.  AIDS/HIV was not the only sexually transmitted disease that crossed through blood transfusions, Herpes, Gonorrhea, and many more all had their times in the spotlights as diseases making their ways into donated blood and thence into patients without risky lifestyles, who contracted these diseases after receiving transfusions of blood or blood by-products.  The first cases were noticed in the US Military, where patients started having problems with these sexually transmitted diseases after being wounded and receiving life-saving blood or blood by-products and then catching an infectious disease.  Even Malaria has records of being passed through blood and blood by-products, so just presuming that sexually transmitted diseases are the only diseases to worry about is not acceptable.

Claiming “blood is blood” is the height of exaggerated ineptitude for a political cause.  Yes, red stuff oozing from a mammalian host can generally be typified as blood, but not all blood is the same, nor is all blood equal.  This is why monkey blood is not harvested for use in humans, why Ape blood is not transferred into elephants, and human blood has a letter classification system.  Whale blood cannot be used in dolphins, nor is it compatible with human use; thus, claiming “blood is blood” remains a thoroughly ignorant comment of the highest magnitude!

The 17th AnnualGive the Gift of Life Holiday Blood Drive | B104 WBWN-FMTake a minute, those of us who lived through the 1980s health scares and blood scandals.  By the way, that is plural for a reason; blood scandals keep happening because blood security and integrity and politics do not mix, and every time some politician thinks they can mix safely, we have another blood integrity scandal, and people die!  Do you want to take the risk of being in an auto accident, being rushed to a hospital, receiving blood or blood by-products, and coming home with a transfusion disease?  What about dialysis patients who regularly receive blood or blood by-products; do you want to add another worry to your list of health concerns when receiving care?

Sign Donation Blood Heart Donor Icon Stock Illustration - Illustration of icon, design: 79488667Now, suppose the findings on a medical record were being made public, and the patient’s rights trampled, where disclosure of lifestyle risks kept that person from donating blood and were being published. In that case, I might believe there was a “rights” concern to be vocal about.  However, this is not the case, and refusing a population with known high risks for passing multiple communicable diseases through all types of body fluids, from donating said fluids to the general population, is just sane and common sense medicine.  It is not discriminatory to exclude those who choose a higher-risk lifestyle to participate in specific activities where the health and welfare of the general population are concerned.Blood Donation Sign Wall Poster Background Material, Love, Blood, Donation Background Image for ...

Case in point.  If I travel to Thailand, whether I engage in the sex trade or not, I am refused from donating blood for a specific period after I return home, and I will have to pass a blood test before my blood is accepted at the blood bank.  Plus, because I prefer to give plasma, I will have to prove I am clean twice before I can give plasma again.  This is not discriminatory; this is a safety precaution to protect the rest of the blood and blood by-product supply from contamination.  Now, if I engaged in the sex trade in Thailand, I would be banned indefinitely from donating blood, regardless of condom usage, and the remarks would be permanent across the entire records of the Red Cross.  All because the threat is too great to risk allowing this heterosexual male access to donate blood and run the risk of contaminating it with a disease from Thailand.  I know people in South Korea, who caught unique diseases during the Korean War, who cannot return to the United States, ever.  The United States made this decision not to run the risk of contaminating America with what they caught.  Not discrimination, simple public health policy.

Knowledge Check!Now, we return to the crux of the argument.  If “Blood is blood,” then being vaccinated does not matter because blood is blood and public health and safety are not issues where communicable or infectious diseases are concerned.  If this is correct, why do we still have COVID restrictions?  If blood is not blood, why bow to political pressure on something that is definitely not a political but a medical safety issue?  Politicians and those who cling to the government for an answer to every single problem cannot have this issue both ways.  Either blood integrity and safety is a medical issue where common sense practices trump individual rights for the common good and safety of donating life-giving fluids, or life requires taking risks, and we can shut down the regulatory boards and panels, reducing the costs of medicine.  I am all for reducing the size and cost of government; while I might not argue fully for making all those cuts in medicine regulation, a choice needs to be made and then supported.  Choose wisely!

© 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.

Teaching the President Responsibility – I Never Thought I Would See the Day!

Angry Wet ChickenPresident Biden, you, and your administration disgust me!  I did not vote for you, but I was willing to support you as president back in January and show you respect.  Even though I continue to have reservations regarding the veracity of the 2020 Elections, the transparency of the election counts, and the skullduggery witnessed, I was willing to give you a chance.  Your actions in Afghanistan have sundered my cherub-like demeanor and turned the extended olive branch into a torch for your pyre!

Let me be perfectly clear, the blood of every soldier, sailor, airman, Marine, who has served, is serving, or will serve in Afghanistan is on your hands for your ineffective and wholly useless policy in that country!  Worse, the tears and blood of children being abused, murdered, raped, and assaulted are also on your hands.  You allowed a mostly peaceful situation to become an open and festering warzone, again, and it is all your fault!  You cannot blame Congress, you cannot hide behind the media, you cannot shirk accountability behind generals and pentagon officials, you are the Commander in Chief, and it is your sole responsibility to lead the armed forces of these United States.

Sure, we in the service swear an oath to the U.S. Constitution and the officers appointed over us, but the first officer we pledge obedience to is the U.S. President.  You, sir, need to learn responsibility for the men and women you lead.  I plan to teach you and every American who is privileged to read this article the power of the office and the responsibility of the office you hold.  How will I instruct you; through the U.S. Presidents who came before you!Angry Grizzly Bear

The power of Commander in Chief is derived from the U.S. Constitution:

Article II Section 2 of the U.S. Constitution, the Commander in Chief clause, states that “[t]he President shall be Commander in Chief of the Army and Navy of the United States, and of the Militia of the several States when called into the actual Service of the United States.”

Mr. President, you need to take two lessons from President General George Washington.

      1. But lest some unlucky event should happen unfavorable to my reputation, I beg every gentleman may remember it in the room that I this day declare with the utmost sincerity, I do not think myself equal to the command I am honored with.”
      2. In politics as in philosophy, my tenets are few and simple. The leading one of which, and indeed that which embraces most others, is, to be honest, and just ourselves and to exact it from others, meddling as little as possible in their affairs where our own are not involved. If this maxim were generally adopted, wars would cease, and our swords would soon be converted into reap hooks, and our harvests be more peaceful, abundant, and happy.”

Do you understand these two fundamental principles of being the Commander in Chief?  Humility is not a weakness but an inner strength to know and do what is right in exercising your command.  You were given the greatest honor possible, to lead men, and women, into battle, and you have pissed that honor away for trinkets not worth a mess of pottage!Plato 2

The second principle of being the Commander in Chief is demanding honesty, first from yourself, then from others.  Is the job too big for you? It’s no shame to admit you are in over your head.  It is no shame to realize you need help.  It is a crime to act like you have the brains and talent, lying to yourself, while the world burns like Rome and Nero fiddles!  Your counselors, administration, and vice president are all crooks, scoundrels, and fools, but you have the responsibility!  This is why honesty is so desperately needed and fundamentally critical.

President Jefferson provides the following principle for the Commander in Chief, and while President General George Washington embodied this principle, President Jefferson said it best:

If we are to guard against ignorance and remain free, it is the responsibility of every American to be informed.”

Knowledge Check!Are you informed about the consequences of your decisions?  If so, why are you continuing to adhere to wrongheaded decisions that are destroying America, ruining Afghanistan, and allowing China to threaten her neighbors, bully her neighbors, and be the aggressor party in a prelude to war?  Do you not understand that your responsibility for the consequences of your decisions is eternal, and you owe the God of this land, even Jesus Christ, accounting for how you have led during your time in office?  The blood of innocent people is on your hands because you and your advisors have refused to listen, refused to act, and chosen the worst possible action when working to the detriment of everyone on this planet.  You are actively failing as a president; does this not matter to you?

Inherent in the law is the following axiom:

Ignorance of the law is not an excuse for breaking the law.”

You need to understand this principle, for failure to be learned is not an excuse, ignorance of the law is not an excuse, and ignorance of the consequences is not an excuse.  You cannot blame your staff when standing before a judge and jury, nor can you evade responsibility and accountability. Honestly, the responsibility ultimately stops at your desk, the music ends, and you are left holding the bag full of whatever crap landed on your desk.The Duty of Americans

President Jefferson also provides the following axiom for a Commander in Chief, one which you have avoided your entire life, and it is time you were made to should this burden as an adult!

A nation, as a society, forms a moral person, and every member of it is personally responsible for his society.”

What does this mean; allow me to explain using your example.  Your first, Second, and Third attempts at running for president were fraught with verbal gaffes where outright lies, bald-faced untruths, and plagiarized speech were put forth for the public as your ideas and ideals.  Thus making you a liar, a thief, and the worst sort of scoundrel possible, yet, through gerrymandering and a lot of money and your Jello-like spine, you have managed to stay in office long past your maximum level of incompetence.  What sort of moral society have you been promoting and living in?  Do you realize you are responsible for that moral decay you have been broadcasting from your senate office?  Do you know that your morals are now being stamped upon the military, and the military is going to find that your morals do not fit the honor, courage, and commitment needed to fulfill the mission?  The Uniform Code of Military Justice, which you now fall under as Commander in Chief, would find you guilty and in need of severe punishment.  How can a soldier, airmen, Marine, sailor, etc., go before the mast for UCMJ punishment with you as Commander in Chief and be found guilty of morals you exemplify daily?  By the way, this is the same problem your buddy Obama suffered from for eight damnable years when he occupied your chair!Patriotism

Speaking of eternal consequences, and being the Commander in Chief, President Lincoln has some choice words for you to learn.

      1. In times like the present, men should utter nothing for which they would not willingly be responsible through time and eternity.”
      2. You cannot escape the responsibility of tomorrow by evading it today.”
      3. With this honor devolves upon you also a corresponding responsibility. As the country herein trusts you, so under GOD, it will sustain you, [or utterly reject you].”

Knowledge Check!As you have been weighed, measured, and found wanting, I will take a moment and explain to you what these three quotes mean for the Commander in Chief of the U.S. Armed Forces.  Firstly, watch your language.  You have not done very well with this in the past.  Your lies, half-truths, falsehoods, and plagiarized speech is beyond contempt, but the useless speeches you keep giving threatening to put legal and law-abiding citizens in prison for the sole crime of making a living is beyond detestable and shows a definitive lack of character.

Secondly, your words last for eternity.  I remember watching you as a child and thinking, “Putz!” Then cheering when the news broke that you had chucked your campaign for president.  How wonderful the Internet is for bringing back your words for your shame and discomfort, and how I enjoy watching your comments fall from your lips and condemn you for the liar and cheat you are.

Thirdly, those crimes are coming back in spades by trying to evade responsibility yesterday for being a liar and cheat, a thief, and a robber.  But, you have been placed into a position of honor for which you are not comfortable, for which you have not the strength, stamina, and mental fortitude to perform the necessary duties the role commands.  Who is making the decisions in the White House?  Why?

Dont Tread On MeFinally, we come to the absolute crux of the matter.  As Commander in Chief, the honor of commanding men and women in the military comes with a corresponding responsibility. The country loves her military and trusts you to treat them appropriately.  You did not do so in January and got a minor backlash.  You are not doing so in Afghanistan and will catch a much higher backlash as the media watches a repeat of Saigon in Kabul as the Embassy is evacuated.  Your buddy Obama has a dead Ambassador he has never answered for, which (historically) has always been a declaration of war.  What do you have?  An entire country laid to waste, the waste of millions of dollars in materials, millions of lives destroyed, and the wasted efforts of millions of people and multiple presidents.  You have betrayed the American people’s trust, and you will be held accountable, just like your good friend Mayor Lightfoot (with stickyfingers) is being held accountable in Chicago, only many, many magnitudes worse!

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

Compliance Problems and Dead Veterans – More Shameful VA Misconduct Chronicles

Angry Grizzly BearThe Department of Veterans Affairs (VA) – Office of Inspector General (VA-OIG) is filling my inbox by mid-week again, and the volume never ceases to amaze and mystify.  Over the last 10+ years of reporting on the VA-OIG reports, I have learned that when the volume is exceedingly high by mid-week, there are reports the VA-OIG is hoping to get overlooked in the crush.  Luckily for them, I am here to ensure nothing gets overlooked; you’re welcome!

We begin with more fiscal insanity and the failure to comply with regular auditing and business financial practices that would see a private company’s owners in prison.  Let’s be clear; Congress passed specific legislation to single out government agencies to demand they comply.  One of these unique pieces of legislation is called the Payment Integrity Information Act (PIIA), which audits the VA regularly fails.

Please note, last year, the VA failed two programs on the PIIA; for the fiscal year 2020, the VA failed two of the programs, consistent failure is a leadership problem.  Yet, the VA-OIG claimed the following:

To VA’s credit, it noted a decrease in improper payment estimates two years in a row and a decrease in its improper payment rates for nine programs and activities.”VA 3

Consistent with the previous fiscal year’s PIIA reports, yes; still a leadership problem, yes.  But I am not so generous as the VA-OIG, for I know many a non-profit and for-profit organization that has been fined heavily, bankrupted, and put into conservatorship over the same actions.  Nothing ever happens to the leaders at the VA failing to do their jobs!  12 programs and activities totaling $11.37 Billion, and never are the leaders held accountable for failure; let that sink in for a minute or two.  Read the report, you tell me, should real people be held responsible for failing to follow the law?

Gravy Train 3The VA-OIG conducted a comprehensive healthcare inspection (CHIp) of the Roseburg VAHCS in Oregon; for the regular readers, I bet you can guess what was found.  Yup, the employees feel morally distressed in how they are being pressured to treat the veterans.  Are you surprised; I am not, but there still might be some people, somewhere in America, surprised that the VA abuses the veterans they are honor-bound to serve.  The most tenured leaders have been in place since 2016.  I wonder if the moral distress and the leadership hiring are correlational data points, for I know that from 2012 to 2017, there was a lot of shuffling of VA leaders at the local VAMC/VAHCS level due to dead veterans in Phoenix from death list scandals.

The VA-OIG claimed the following:

The VA-OIG identified concerns with root cause analysis action implementation and outcomes measurement. Leaders were knowledgeable about employee satisfaction and patient experiences. However, they had opportunities to improve their knowledge of VHA data or system-level factors contributing to specific poorly performing Strategic Analytics for Improvement and Learning measures.”VA 3

Tell me something, how can you have a job for more than four years, be rated as knowledgeable about the measurement analytical methods, but not be knowledgeable about root cause analysis, action implementation, and systems-level factors contributing to poor performance?  To gain your position, you had to grow professionally through the bureaucracy and the various sub-levels of VA leadership to lead a VA Hospital.  Yet, somehow, after all this time and experience, you have inadequate knowledge about the essential functions of your job.  Quoting Colonel Potter here: “HORSE HOCKEY!”  Does this sound remarkably akin to designed incompetence to anyone else?cropped-bird-of-prey.jpg

Meaning, I do not believe your lies!

Traveling to Fayetteville, Arkansas, and the case of Dr. Robert Dale Bernauer Sr. (74), who has pled guilty to workers comp fraud and four other charges of fraud, where the total amount of fraud existed from 2011 to 2017 and more than $1 Million.  Co-Conspirators and the insurance company are not named but should be.  Worse, this scheme involved workman’s compensation insurance for Federal and State employees, Federal agencies, State agencies, and private employers.  While the lawyers and attorneys all crow about catching a doctor who committed fraud, and I am glad he was caught, where are all the state and federal employees who had to know this was going on and did not do their jobs?

Through the insurance company, the doctor was charging 1500-2000% higher for medication marked up. Indeed, this should have raised some eyebrows and questions somewhere in the six years this fraud lasted.  Who is asking why this did not raise red flags at the state and federal levels?VA Seal

Weep America, another veteran, has died by suicide, and the VA is culpable due to bureaucrat inertia and outright failure to follow the guidelines and rules as established.

The VA-OIG found that staff did not adequately evaluate the patient’s condition when reviewing the patient’s high-risk status.  Facility staff did not assign a Mental Health Treatment Coordinator (MHTC) prior to discharge or establish a facility MHTC policy, as required.  The Recovery Engagement and Coordination for Health – Veterans Enhanced Treatment (REACH VET) provider did not outreach the patient as required.  Facility staff did not comply with Veterans Health Administration suicide risk assessment procedures and did not notify facility leaders or suicide prevention staff of the patient’s death by suicide” [emphasis mine].VA 3

Why was the staff allowed to fail so severely here; they were not appropriately trained.  Staff failures and training failures are symptoms of leadership failures, and a veteran is dead!  Which staff has been fired for their failures?  Which leaders have been fired without retirement or potential for rehiring for a deceased veteran as the final act in a chain of events that began with failing to perform their job?  How many times will this story have to repeat before Congress acts to reflect the interest and the responsibility invested in their office by the electorate?  How many times is this story repeating without the benefit of the VA-OIG doing a full-blown investigation?Angry Wet Chicken

Unfortunately, the following report involves the abuse of an intimate partner and bureaucratic inertia.  While the complete record is not revealed (thankfully), what is revealed is detestable to the Nth degree and includes 214 days of spousal abuse, bureaucratic inertia, and mental health failures to protect the spouse and help the veteran, ending with the veteran’s suicide.  The saddest part of this story, it took almost three years for this suicide to be investigated by the VA-OIG (2019).

“The VA-OIG found that despite the patient’s and spouse’s intimate partner violence (IPV) reports, inpatient mental health unit staff did not consult with the IPVAP point of contact or ensure the spouse felt safe with the patient returning home upon discharge. The inpatient psychiatry resident did not timely complete a progress note addendum, which resulted in other clinicians not having access to critical IPV-related information for 34 days. Facility staff failed to consider a consultation with the Office of Chief Counsel, although the Veterans Health Administration (VHA) advises employees to “work with your Office of Chief Counsel” regarding state reporting requirements for victims of IPV. Outpatient mental health staff did not consult with the IPVAP point of contact or document discussion of IPV resources or treatment options, as the OIG would have expected. The Facility Director did not ensure the development of an IPVAP protocol, as required. Although a licensed independent provider was appointed as the IPVAP coordinator, facility staff and leaders did not identify the assigned IPVAP coordinator as a resource at the time of the patient’s care in 2019. The VA-OIG also found that VHA guidance about IPV training responsibilities was unclear.”VA 3

Let’s talk about some realities of mental health.

      • 50% of the patients seeking mental health see no improvement.
      • 10% of the patients seeking mental health support will be injured by the mental health provider.
      • 33% of the mental health patients choosing a pharmacological solution experience harm or no relief.

If you add these numbers up, that’s 93% of the population seeking mental health support not being helped or being harmed by mental health providers.  This does not mean that mental health providers need to give up, but they need to work harder to find solutions and meet their patient’s needs.  It means timely provider notes are mandatory!  It requires providers to have a plethora of options for treatments, obtain patient buy-in, and follow up with the patient.  It involves treatment facilities to write procedures and operating policies that allow for rapport between a patient and a provider that is not disturbed as long as that relationship is healthy and progress occurs.

Knowledge Check!America, it is time, and past time, for the Department of Veterans Affairs to be overhauled from stem to stern.  To be held up to scrutiny, transparent audits and the leaders held accountable and responsible for the failures and abuse of veterans, their spouses, and dependents.  These last two stories, especially, have left me spiritually sick and mentally angry!  There is no excuse for the inertia evidenced, no excuse for the designed incompetence, and no excuse for the abuse to continue!  Where is Congress?  Where is the US President?  Where are the House and Senate speakers (Major and Minor) raising a rhubarb and demanding hearings, opening Department of Justice inquiries into misconduct and malfeasance when these egregious VA-OIG reports are brought before them?  Where is the media in demanding the politicians pay attention?

Satire? Obama ISIS Speech Depresses Nation | Hooper's War - Peter Van BurenWeep America!  Those who have defended you and me are being fed into the machine of bureaucratic inertia and spat out as broken or dead constructs — bereft of hope, lost in red tape, and denied solutions and care.  Pets and farm animals are treated better than veterans, and I cannot help but wonder if this was designed purposefully to satisfy the whims and fancies of the politicians currently in office.  Treat an animal like a veteran is treated, and you will be publicly shamed on national TV faster than a snake can shed its skin.  You will receive more media attention, more lawyers and politicians will hound you, and consequences galore will fall all over you.  Shameful!  Utterly shameful!

References

American Psychological Association. (2012, August). Recognition of psychotherapy effectiveness. Retrieved from http://www.apa.org/about/policy/resolution-psychotherapy.aspx

Corbett, L. (2013, December 17). Psychotherapy based on depth psychology is a superior approach [Video file]. Retrieved from https://youtu.be/e4JQamcq24c

Lilienfeld, S. (2007). Psychological Treatments That Cause Harm. Perspectives on Psychological Science, 2(1), 53-70. Retrieved from http://www.jstor.org/stable/40212335

Smith, B. L. (2012). Inappropriate prescribing. Monitor on Psychology, 43(6), 36. Retrieved from http://www.apa.org/monitor/2012/06/prescribing.aspx

© 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.

COVID-19: The Origin Story

Knowledge Check!Please note, from the beginning of November 2019, it was clear that there was a viral disease that had upset the Government of the People’s Republic of China (China). As a result, people were getting sick, the news was being censored, journalists published, and the viral infection had started in Wuhan Province, China. So, shortly after Christmas (2019), Big-Tech began censoring the stories that had originated in November 2019 and restricting access to the truth.  Those of us who were closely following these events started to suspect things that raised concerns.  The combined actions of the media, social media, the Chinese Government, and the lackadaisical world governments raised eyebrows.  By February 2020, COVID-19 was on us, and the travel restrictions were already 90-days too late!

From February 2020 to the present, the only truth about the origins of COVID-19, beyond simply that it started in Wuhan Province, China, is pure suspicion and absolute conjecture!  However, every citizen on this planet needs to be concerned!  The Daily Signal ran an interesting article on COVID-19 that should wake every American up to the dangers President Obama’s (D) Chief of Staff Rahm Emanuel and Secretary of State Hillary Clinton (D) promised when stating, “Never let a crisis go to waste.”

Plato 2American policy on using biological, chemical, or nuclear weapons, in war or peace, the user was subject to a nuclear strike in retaliation.  President Obama (D) and his “Red Lines” in Turkey that weren’t worth spit on hot pavement changed this policy.  One of the more problematic theories put forward has been that China used COVID-19 to “Dry Run,” a bio-war weapon, and gather real-world data on how the world would respond.  I have covered the links to this in previous articles and am not repeating myself for emphasis!  This scenario is frightening in the extreme, especially since China has nuclear retaliatory strike capabilities.  Worse, China has climbed in bed with Russia and Iraq, both of whom are skilled at invading the US/Mexico border with impunity.

Should China admit the United State’s involvement in the gain of function research at the Wuhan Virological Laboratory on coronaviruses, what does this do to credibility and US Relations?  The United States halted the gain of function research on coronaviruses and other viruses.  EcoHealth Alliance, an organization taking American tax dollars, sent their research to China to keep the research going.  We have several American college laboratories with their hands in the gain of function virology research.  How much, who, when, and why all remain pure guesswork now, as much of those articles have also become “mislaid” on the Internet!  Facebook, Twitter, LinkedIn, and Google specifically have worked overtime scrubbing these source articles as “misleading” on COVID-19 as the official reason for censoring knowledge.  The truth will shortly come out as to how much money China invested in getting Big-Tech and Social Media into bed together and working for the PRC’s Marxist Government!Apathy

Until February 2021, I had access to several peer-reviewed sources that walked the reader through how research done in the United States was sent to Canada, Australia, Japan, and eventually to Wuhan Province, China.  Unfortunately, Big-Tech and Social Media continue to censor and scrub, and these resources have evaporated.  If you have links to these resources, please share them in the comments section.  The lock on information is as bad as the disinformation and propaganda machines of Nazi Germany where COVID is concerned, and that also should be investigated thoroughly!

Two questions hinge upon the origin of COVID:

  1. What should be the penalty?
  2. How should the penalty be delivered?

Keep a couple of thoughts in mind; China is not their Government; what responsibly do taxpayers have in representative governments who helped gain function research?  Are the people of China to pay with their lives for the actions of their detestable Government?  In a representative government, the people are where the “buck stops” when accountability and responsibility are needed.  Is the reason for taking action and getting involved in your Government clear?

Bird of PreyAmerica, I cannot stress this enough, I am not excusing the Wuhan Laboratory for their practices.  The news has reported bad freezer gaskets, trash just dumped, and thousands of other errors in operational laboratory practices that should never occur in a certified laboratory researching viral gain of function research.  I am not excusing the American Government nor EcoHealth Alliance for their roles in this COVID-Farrago.  However, the fix to recovering from and avoiding future bio-weapons being released is to be found in the capitals of the US and all her states.  The Government in America is the problem, and the solution begins with the ballot box!

© 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: Bureaucratic Fiat, a Veteran Suicide – Scrutinizing the Government

ApathyThe Department of Veterans Affairs (VA) is in trouble due primarily to the employees’ lack of written directions, procedures, and processes to complete work.  Of the poor Veterans Health Administration (VHA), there is none worse than the Carl T. Hayden VA Hospital system in Phoenix, AZ.  I support this conclusion with both personal observations and through comparative analysis.  Much research has gone into this conclusion, and while there are other VHA’s that compete for the bottom, the clear winner remains the Phoenix VA Medical Center (VAMC).

What is bureaucratic fiat?

Bureaucratic fiat is government employees who make decisions in their positions who rigidly adhere to any rule not to perform their job, inconvenience the customer, or thwart responsibility, accountability, and maintain their positions.  Bureaucratic fiat survives sections from the Office of Inspector General (VA-OIG) through designed incompetence, lack of training, confusing processes, unwritten rules and guidelines, and simple negligence.

LinkedIn VA ImageVeteran Suicide!

Outside of first responders and active military, the suicide rates of veterans are too high and rising.  The suicide rate is disgusting to behold and tragic beyond words.  Of all the topics I discuss, veteran suicide remains my pet topic.  When veterans or military members (Reserve, National Guard, or Active) commit suicide, this rips a hole in communities, families, and the guilt the family and friends carry is so intense, they struggle not to commit suicide themselves.

Scrutinizing the Government!

DetectiveThe VA-OIG reported on a veteran who committed suicide, with ties to the Carl T. Hayden VA Medical Center in Phoenix.  The veteran reported to the hospital, asking for help.  The VA-OIG found that processes were intentionally not followed.  Help was not forthcoming, and the veteran committed suicide before the VA got their thumbs out and offered this veteran help.  The VA-OIG found the following:

      • “While the patient awaited the testing, facility staff failed to offer mental health treatment.
      • The social worker did not complete a suicide risk assessment and relied on another social worker’s suicide risk assessment completed eight months prior.
      • A family member called and left a voicemail message for the social worker. However, the social worker’s documentation did not include essential information, specifically that the patient died by suicide.
      • Upon learning of the patient’s death by suicide, a Suicide Prevention Coordinator failed to complete timely documentation of outreach to the patient’s family… the mental health delegate did not approve the community care psychology consult within three business days, as required by VHA.
      • The third-party administrator scheduled the patient for therapy rather than psychodiagnostics testing.
      • The facility scheduling staff did not complete required outreach efforts when the patient missed a primary care appointment one day before the patient’s death by suicide.
      • The Suicide Prevention Coordinator did not complete the patient’s behavioral health autopsy within 30 days, as required.”

One incident, one VAMC, one veteran, and nothing from the VA will protect veterans and improve the adherence to the policies and procedures moving forward; why even investigate by the VA-OIG?.  I weep with this family who lost their loved one to suicide.  I scream in frustration that the VA can continue to kill veterans struggling with suicide with impunity.

Detective 3Do not be deceived; this is not the only incident in Phoenix or all of the VA Healthcare System.  A veteran reaches out for help with suicide ideation, receives bureaucratic nonsense instead of support, and is treated to the red tape that becomes the noose in the suicide of that veteran.  One event a year is a tragedy of epic proportions.  The list never seems to end, nor do the bureaucrats ever get held accountable for their inactivity, contributing to veteran suicide.

12 November 2020, The Military Times reported that from 22005 through 2018, veterans committing suicide had risen dramatically, to a high in 2014 of 6,587.  Is the epicness of this tragedy more apparent?  Presuming that each of these veterans had two parents who came together and invested time to create the child that became the veteran,  13,174 parents now weep to lose their son or daughter who committed suicide.  According to the US Census, families in America had 1.9 children per couple (2014), rounding up to 26,348 is the potential parents and grandparents affected by suicide, and 52,696 is the pool when siblings are added.  If each of these suicides had a significant other, with two parents and two siblings, the potential affected by suicide is now approximately 105,392.  Add employers, friends from employment, communities, and educational or academic acquaintances, and the number of people affected by suicide can quickly reach a million people.  I used 2014 as the year to base the numbers upon as this was the highest number currently available, but 2020 saw a dramatic increase in suicide among all age groups and those with the Census delays; I doubt America will learn the full impact from COVID government madness any time soon.

LookNow, consider the following, each of those veterans who committed suicide in 2014 (6,587) had a suicide prevention team in place at the VA who failed to act.  6,587 people who deserved better treatment at the hands of the government employees, who have pledged 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.  Failed the veteran and played a role in the suicide of the veteran.  Rarely do the veterans who commit suicide, in VA parking spots, on Federal property receive the attention they deserve.  I am intimately aware of one such issue with the VA Medical Center in Albuquerque.  The veteran could not get help, became frustrated, walked to his car, and killed himself.

2019, The Washington Times, who proudly continues to declare that “Democracy Dies in Darkness,” ran a story about veterans who take their lives on VA Campuses, is a “form of protest” against the VA Healthcare system.  No, this is not generally the case; the veteran is not protesting; they are fed up with the fight to be respected, noticed, and receive assistance from people who have pledged to fulfill the Department of Veterans Affairs Mission Statement.  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.”

DutyI demand to know where are the legislative branches of government in scrutinizing the operations at the VA?  Why are suicide rates allowed to climb without significant input from the legislative branch?  Why are veterans, directly after an encounter with the VA bureaucracy, committing suicide without in-depth investigations where heads roll for failing to perform the most basic customer service in fulfilling the VA’s Mission Statement?

While an employee of the VA, to get to the directors of the hospital’s offices, I had to walk past this mission statement that hung on brass letters, and all my attempts to aid in change fell on brass ears and plastic lips!  Every time the VA-OIG reports another death by suicide, death by negligence, with ties directly to VA employees not performing their jobs, I want to scream in frustration!  Veteran suicide rates are egregiously high, and for veterans to commit suicide within 96 hours of a visit to the VA is 100% unacceptable!  Why 96 hours; because to date, this is the longest time between actions by the VAMC and the death by suicide the VA-OIG has reported where VA employees should have been held accountable for their refusals to act in a manner to prevent a veteran from committing suicide.

Millstone of Designed IncompetenceAfter over a decade of reading and reporting VA-OIG reports and investigations, the deaths by suicide and negligence are the ones that raise my ire the most!  I would see the VA improve, but until the VA admits, or is forced by elected representatives to admit, they have a problem, nothing will change.  But the horror in that sentence is that veterans will continue to commit suicide and die through VA Employee negligence, and their deaths are as unremarked as if these heroes were common criminals who died in a prison brawl.  This remains an abysmal testimony to the incompetence and uncaring bureaucrat found in the VA’s vaunted halls!

© 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: Diversity, Equality, Inclusion, and Assimilation

Public Service Announcement:  The following article is probably longer than desired.  However, I am trying to cover a lot of basics where tyrants have invaded and are attempting to gain control.

LookLet me be perfectly clear; I do not care what you look like, your handicaps, abilities, or disabilities, or frankly, anything other than how you do your job and live your life to not interfere with other people’s freedom.  Hence, when the discussion inevitably turns to diversity, equality, and inclusion (DEI) in the workplace, I fully believe that you are the number one driver of equality and inclusion in the workplace and society.  You choose to become offended if you feel not included at work.  You decide to feel marginalized, and in choosing to feel marginalized, your choices and consequences are solely yours.  Except, you demand your consequences be the problem of the business and community.  That behavior is childish, selfish, and reveals your ignorance!

Does discrimination occur, absolutely; but discrimination does not disappear magically when a diversity, equality, and inclusion workplace initiative is launched!  Discrimination does not disappear because someone passed a law.  Your attitude, actions, and decisions are all choices you make that come with natural consequences for you.  You drive your ability to be included the majority of the time.  Individual choice and consequence are the reality never spoken of during DEI initiatives.  Failure to include personal choice, assimilation, and consequence remains a glaring hole in DEI training topics.

quote-mans-inhumanityAssimilation

Assimilation is the act of assimilating, and assimilating is all about taking in and understanding something fully.  The Borg from Star Trek gave assimilation a bad name.  Worse, some people erroneously proclaim that when you assimilate, you give up pieces of yourself.  Assimilation is all about taking the best of you, adding to the best of us, and making the whole stronger than the individual parts.  Yet, every DEI training I have been forced to attend has been pessimistic about assimilation and assimilating into a stronger whole.  Assimilating is also about absorbing and integrating into a wider society or culture.

For example, a balanced diet includes non-favorite foods, but those foods are good for you.  Your body assimilates the good and the bad foods consumed, eat enough poor nutritional foods, and the body suffers physical and mental health problems.  Eat too many good foods, and your body will assimilate foods differently and possibly begin to reject certain foods.  Hence, balance is needed to properly diet and strengthen the body.  Extremes in food, like attitudes, are bad for the body as a whole.  The same choice and consequence cycles that drive the assimilation of foods into the body are the same choices and consequences when applied to workplace assimilation into existing cultures.  Extremes are hazardous to health!

Editorial - Educational TruthDiversity

Diversity is all about variety and including variety in a social environment.  Diversity has been stretched to become a practice of including people of various backgrounds, ethnicities, and other societies into a greater community.  The problem with the plastic second definition of diversity is the assumption that a variety of different people are automatically not wanted or desired in the social environment currently.  History has never been kind to different people in a society.  This is true of ethnicities, cultures, disabilities, and abilities, and nothing will change discrimination in any organization made up of human individuals.

A friend invited me to a bar; I was not accepted into that bar’s culture as I am a veteran and do not share other lifestyle choices of the bar’s dominant culture.  Discrimination happens; if you choose to become offended by the selection of diversity in a community, that is your problem.  I did not become offended at the other patrons in a bar and demand that they accept me, it did not matter to me one way or the other if I was accepted or not, and this should be the same stance everyone should be taking!

Life ValuedEquality

Of all the terms we are discussing, equality is by far the most plasticized, twisted, deformed, and dangerously laden with unnecessary baggage!  Equality is all about a state of being equal.  Equality comes from the “Rule of Law” and the application of “The Rule of Law” for all in society.  Except, equality is not what is desired in the term equality when speaking of DEI, but “Social Equality.”

Social equality is a state of affairs in which all people within a specific society or isolated group have the same status in certain respects, including civil rights, freedom of speech, property rights, and equal access to certain social goods and services.  Essentially, social equality is all about twisting “The Rule of Law” into exceptions for specific socially acceptable groups; instead of equality, social equality is all about bringing all onto unequal grounds before the law.  There is no equality in social equality, ever!

Andragogy - The PuzzleInclusion and Discrimination

Inclusion is all about the practice of being included.  That’s it, the whole enchilada; inclusion is all about being included.  However, what does it mean to be included; here is where ideas like fit, temperament, desire, and choice and consequences enter a social group, community, or organization.  Where DEI is concerned, inclusion is all about shifting the margins, dropping the individual decisions, and forcing all to be lumped together regardless of personal desire.  Worse, inclusion is forced with the power of law without regard; hence all are injured in an attempt to be “socially inclusive.”

Discrimination is the unfair or prejudicial treatment of people and groups based on characteristics such as race, gender, age, or sexual orientation.  Except, discrimination happens all the time, and efforts to be more “inclusive” have done nothing to reduce discrimination.  I was hired for an inside sales position with a 90-day trial period.  My wife dropped off some equipment I had left at home one day.  The bosses learned my wife is older than I am; from that day to the end of my trial, when I was released without cause, the attitude towards me was significantly and tangibly different.  Skin color, ethnicity, gender choice, sexual bedroom choices, and every other possible thing can be the source of discrimination, and nothing will change this facet of human behavior.

Admitting that discrimination is happening is not being defeatist, nor am I suggesting that discrimination laws should be scrapped.  I am relating a truth about human behavior and why the law cannot dictate moral behaviors!  Demanding inclusion does nothing to reach the core roots of the problems with discrimination in society.  Which is another truth for certain that must be recognized and discussed.

Andragogy - LEARNExclusion

Exclusion is the opposite of inclusion but also represents a risk.  The risk of exclusion is found in the legal arguments from discrimination, not the risk of being omitted.  More, exclusion has stricter requirements than elements of inclusion ever will.  For example, insurance policies have specific criteria that exclude coverage as a means for controlling risk.  The same thinking on insurance policies is the same as what occurs in social environments when a person is actively excluded.

For example, in the US Army, my platoon sergeant and my squad leader had a group of people they were comfortable with both on and off duty.  I was not welcome because I hit more of the exclusion criteria than the inclusion criteria.  I did not enjoy sports, wasn’t a drinker, a womanizer, and several other items.  Off duty, this wasn’t that big of a deal.  On duty, this exclusion caused me tremendous problems as I learned to be a soldier.  Still, the choices for inclusion or exclusion came down to preference and accountability.  As the First Sergeant and the Commanding Officer allowed these discriminatory practices to exist, I had no right to complain, and my mistakes were my own.  It was a difficult period in my life, but I survived and was stronger for the challenge.

Literary FiendIndividual Identity

Who are you?  What makes you an individual identity in a socially expanding group?  The United Nations has declared your culture, gender, sexual preferences, and race are all personal choices as part of a unique identity created, changed, and designed for and by the person making the choices.  What the UN fails to mention are the consequences.

In the US Navy, I served with a woman who was as white as the freshly driven snow, but she identified as black.  According to the United Nations, this is acceptable.  This sailor spoke, acted, and identified culturally as black even though she was white, blonde hair, blue-eyed, and the antithesis of cultural black identifying characteristics.  I am not one to judge and, frankly, could have cared less how she identified herself.  But the command through a total fit when she showed up to morning quarters with dredlocks.

Remember, your identity is your choice.  I care less about your identity than I do about a fly.  How you work, what you do, and your respect for others’ rights matters to me.  But, do not make your choices to be an individual affect my life.  Do not thrust your identity into my world and demand respect; I do not care about your identity!

CourageGroup Identity

Group identity is the melding and assimilation of identities and behaviors needed to work together effectively.  That’s it; the whole casserole!  Take any sports team, any sport, and you will find the same in winners and losers, those who choose to assimilate the group identity gain success.  Those who refuse to assimilate will lose every time.  Pick a sports movie; here are a couple of suggestions where you will see for yourself the truth of the power in assimilation:

        • We Are Marshall
        • Friday Night Lights
        • Glory Road
        • Hoosiers
        • Invincible
        • Miracle
        • Radio

Group identity requires sacrificing individual identity for a cause bigger than oneself.  Yet, for DEI training, when is this ever discussed?  Winning business organizations cannot be successful without individuals sacrificing their individual identity for group success.  How have we forgotten this rule of nature?

Lever UpSubordinate Culture

Subordinate cultures, micro-networks, ol’ boys network, whatever you call it, subordinate cultures are designed around those who refuse to assimilate and make their choices the problems of managers and leaders.  Consider those who hyphenate their cultures, Indian-American, Russio-Chinese, Irish-Israeli, etc.  You will find someone who refuses to assimilate and cannot understand the need to be whole culturally and who could be more without the hyphen.

In the US Navy, I met more than ten first-generation Americans from Jamaica, Africa, Cuba, Brazil, Puerto-Rico, and other places.  Not a single one of them would consider hyphenating their status as American.  Yet, too often, people who have been in America for multiple generations feel a need to hyphenate to identify themselves.  Why establish a subordinate culture?  A subordinate culture is assumed to be lower in status than a dominant culture.  The subordinate culture is treated of lesser importance, deemed under the control of something else, and all because of the hyphenation.  Is being subordinate desired; if so, why?

President AdamsDominant Culture

The dominant culture is the most powerful or influential culture in an organization.  Essentially, more people assimilated and sacrificed for the success that the organization is enjoying than refused.  Yet, in DEI training, dominant culture carries negative baggage and is not allowed as it could be misunderstood.  Seriously, the concept peddled in this training blew my mind.  What happens if the LGBTQ+ community became the dominant culture in a country; would it be accused of the same claptrap the LGBTQ+ community currently claims they suffer?

Why did Rome fail; they lost the “Rule of Law,” and the subordinate cultures took power and could not unify the majority of people when invaders came.  One of the greatest Republics in the history of man is responsible for improving millions of people’s lives.  Failed and fell an unpitied sacrifice in a contemptible struggle over the same issues every single business and democratic country in the world is facing right now.

Grit is a MarathonIndividual Choice

I was part of a first-day introduction activity for new hires (2016), and one of the new hires made an individual choice to identify themselves in the following manner, “I am John Smith, I am non-binary queer with a passion for anal sex.”  What does this have to do with the position they were hired to fill?  Which audience member in a professional setting needed or wanted this information?  The declaration automatically put the entire audience on the defensive; the Human Resources representative was placed into a difficult position and called a 10-minute break to regain composure and finish the introductions.

How you choose is your business!  I will respect your ability to choose as you desire; keep your choices to yourself, as I will keep my preferences to myself.  Believe it or not, we can work together really well without disclosing our personal choices and lifestyles outside of employment.  But, when you make your preferences my problem, I will deal with them the same as I deal with that pesky fly, ignore!

Content of their CharacterConsequences

Self-awareness, curiosity, and empathy are what I was told today that will make DEI work, and through learning and unlearning, DEI can make an organization stronger.  I agree the learning is vital, curiosity is always a valuable tool, self-awareness is important, but empathy is dangerous, divisive, and deadly!  Failure to recognize the need for assimilation and sacrifice places the burden onto people who have enough on their plate with their responsibilities in their work.

quote-mans-inhumanity-2Imperative to the improvement and liberation of thought and the power of people is the eradication of litigated moral behavior.  We, the individuals who make up our communities and businesses, must recognize the 800# gorilla in the room, mandating inclusion, refusing assimilation, denying the need to sacrifice individual identity for group success; these must be enshrined into our cultures, again!  Let us embrace these truths and design our “Liberty FIRST Cultures” around a single “Rule of Law,” where people are respected and freedom blossoms!

© 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: Responsibility

LookDale Renlund made a powerful point:

“… Blaming others, even if justified, allows us to excuse our behavior.  By so doing, we shift responsibility for our actions to others.  When the responsibility is shifted, we diminish both the need and our ability to act.  We turn ourselves into hapless victims rather than agents capable of independent action.”

Consider this statement with me as we observe and review recent events in America and the world.

  1. The Department of Veterans Affairs – Office of Inspector General (VA-OIG) reviewed the administration of spina bifida benefits for children born to Vietnam veterans, found internal communication and data sharing were the root cause of administering the benefits program incorrectly. The Department of Veterans Affairs – Veterans Health Administration (VHA) and the Veterans Benefits Administration (VBA) blamed each other for administration failure.  Applying Renlund’s point, we find that blaming each other equally provided the excuse for neither bureaucratic administration to accept responsibility.  Blocking movement towards action in correcting the problem, and ultimately the victims will continue to be children born of Vietnam veterans who deserve better and cannot cut the red tape to reach help desperately needed.  Worse, the blaming has turned the VBA and VHA from independent administrations into victims who deserve pity, instead of a boot kicking for their customers’ abuse!
  2. The VA-OIG, in another inspection, found COVID to be the root cause for shortages and outages of personal protective equipment (PPE). Except none of the 42 facilities surveyed ran out of anything.  Stocks dipped low, but outages of supply never occurred.  The blame for the low stock was also found on data and lack of reporting data correctly.  While people were praised for acting to “shift supplies, create new processes, and order supplies promptly,” the people could not be blamed for the low stock levels and were made into victims of COVID and data mismanagement.

Detective 4Please allow me a brief public service announcement: in business, one finds Juran’s Rule.  Juran’s Rule states that when there is a problem, 80-90% of the time, the processes are blamed, not the people.  The processes, or the written (supposedly) directions to perform a task, are so convoluted in government that Juran’s Rule could slide into 98% of the problem and still not run out of process convolution before people can be blamed.  Yet, the leadership of the VBA, VHA, and every other government agency refuse to look at the processes and eliminate, change, correct or even take action to review the processes.

Thus, Renlund’s point steals potential from people, as people become hapless victims to processes and procedures, instead of the commander of their duties and roles as hired.  The shift of responsibility from people to processes is the danger found in Juran’s Rule, not the truth in Juran’s Rule.  Thus, action to correct is diminished because responsibility has been shifted from leaders to the processes they are already responsible for monitoring.  Hence, when I see the VA-OIG allowing data or business processes to be blamed for the failure of people to act, according to the roles they have been hired to fill, I doubt the ability to fix the right problem.

  1. Using Renlund’s point, here is a typical VA-OIG inspection summary. See if you can spot the responsibility shifting, the inaction, and the problems.
      • The Department of Veterans Affairs – Office of Inspector General (VA-OIG) examined whether the VHA had effective procedures for (1) purchasing, (2) inventorying, and (3) tracking biologic implants such as skin substitutes and corneal or dental implants. The VA-OIG found deficiencies in all three areas at four medical facilities it visited. The audit team determined that purchasing agents did not always record implant purchases correctly or use the appropriate funds. The purchasing agents did not register 2,931 of 10,305 purchased biologic implants in the proper system [emphasis mine]. Instead, agents documented the implants in various local spreadsheets, databases, and third-party systems. Purchasing agents improperly used logistics funds instead of prosthetic funds, making it difficult for VHA to account for biologic implant spending fully and effectively budget or use funds for other purposes. Due to inadequate guidance, the OIG found that the facilities visited had an inaccurate inventory of biologic implants, did not use a standardized system, and did not consistently review stock on hand. The staff could not locate 714 biologic implants in inventory at the four facilities visited, valued at almost $1.1 million [emphasis mine]. The audit team also found 288 additional unrecorded items, valued at nearly $433,000, in storage locations [emphasis mine]. Poor inventory management can jeopardize prompt care, as medical providers may need to delay or cancel procedures if implants are unavailable. The facilities visited failed to track at least 45 percent of implants reported as used from October 2017 through March 2019 [emphasis mine]. VHA did not designate responsibility for overseeing tracking, develop a national policy on how facilities should track biologic implants, or have a standard tracking system that meets accreditation requirements. Effective tracking is needed for facilities to notify veterans if the manufacturers recall their implants.
      • Are the problems of shifting responsibility and the magnitude of the problem more understandable? Feel free to use the comments to discuss this example.LinkedIn VA Image
  2. In the final example, we find another common problem at the VHA, the refusal to alert patients promptly about test results, with the same worn out and tired excuses, time, and refusal to employ and document according to standards. People did not do their jobs, and it took “several concerned members of Congress” to initiate a VA-OIG investigation to certify there was a problem. Still, the solution by the VA-OIG remains tepid at best!  Leading to questions for Congress to allow these problems to thrive and advance the issues that VHA hospital leadership intentionally designs incompetence into their processes and procedures, then dares the patients seeking care to find a solution to force the administration to do their jobs.  Irony strikes again in the VA-OIG reports; the same issue was investigated and reported with the same “recommendations” almost every month throughout the last two-years.  Why aren’t the VHA local leaders being held accountable by their VISN leadership teams for failure to act to fix their problems proactively?

DetectiveToo often, the pattern at the VA, is exemplified in every other government agency for the keen observer to witness; act in a manner unacceptable, hide behind broken processes intentionally designed to hide purposefully designed incompetence, and escape responsibility but retain their jobs into retirement.  Essentially, the leaders of government agencies have employed the pattern discussed by Renlund for personal gain at the expense of the frustrated taxpayer.

When responsibility has been dodged, the answer is not to allow retirement, but to demand correction, holding people accountable, and set performance standards that include penalties for failure.  Training will have to occur, but cannot happen until written directives, policies, and procedures appear, that form the standard for employees’ behavior not responsible for the designed incompetence created by leadership.

In a “Liberty First Culture,” the adults looking to demand change take the pattern offered by Renlund and recognize the behavioral issues that will need correcting.

“… Blaming others, even if justified, allows us to excuse our behavior.  By so doing, we shift responsibility for our actions to others.  When the responsibility is shifted, we diminish both the need and our ability to act.  We turn ourselves into hapless victims rather than agents capable of independent action.”

Gadsden FlagAmericans [A(h)-ME-I-CAN] are not hapless victims; we stare responsibility in the eye, accepting the responsibility, and choose to act in a manner that shows we have learned the lessons and are prepared to improve.  The time to correct the government that represents us is Right Now!  We must act, recognize the designers of incompetence for the traitors they are, and remove them from employment in government, promptly!

© 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: Lest We Forget

With multiple religions having records, beliefs, and access to Isaiah’s writings, I begin with a compelling point from the Old Testament.

Surely your turning of things upside down shall be esteemed as the potter’s clay: for shall, the work say of him that made it, he made me not?  Or shall the thing framed say of him that framed it, he had no understanding? (Isaiah 29:16)”

Having watched the events of this new year unfold, this verse of scripture has taken on a new life.  Consider how the naysayers have turned the speech from President Trump to a spontaneous show of support, into a call to storm the capitol.  Turning things upside down for a political point is a revered tool of the political left, and the world has watched, many in glee, to see this trouble and torment occur.  Frankly, my honest man betrayed sensibilities feel like a Sherman Tank hit them!

Life ValuedThe verse above from Isaiah also speaks to another point needing discussion; the work we do has consequences we cannot escape!  Accountability and responsibility follow the choices we make, like shadows; accountability and responsibility are ours to accept or reject, but they never go away!  For example, Speaker Pelosi spent the better part of 6-months refusing to help Americans during this governmentally fed emotional hysteria called “COVID,” but as soon as Biden/Harris won, fraudulently, the presidency, it was time to hurry up and act!  Now, Speaker Pelosi has exercised her “Trump Derangement Syndrome (TDS)” and ramrodded another erroneous impeachment through the US House of Representatives.  Aided and abetted by, if the count is correct, ¾’s of the GOP, acting as craven yellow-belly spineless entities.

What will the future say of harassing an innocent person, all because it was “politickly expedient?”  Nothing Good!  The accountability for this disaster entirely rests upon the shoulders of those participating in the public lynching of a sitting president, and that is beyond detestable behavior!

Theres moreCompanies can give and take at their discretion to the political parties of their choice; that matters not.  But, if you claim to represent the American People, duly elected, and you weaponize government to browbeat, hammer, control the electorate, you will be held accountable!  Hence, I call for the voters to begin holding the newly formed 117th Congress to task for their misbehavior.

Speaker Pelosi, why did you invite COVID positive people with acute flu-like symptoms to vote in the House?  How much money did you spend on useless plexiglass partitions?  The erection of those partitions occurred in the dark of night, with no oversight, no discussion, no knowledge of the American people.  What funds did you take the people’s money from to pay for the wages and materials?  What was the contract process for the work to be accomplished?  How did these sick representatives arrive in Washington and leave Washington?  If COVID is as bad as you have been harping on from Jan 2020 to today, why were these House members exempt from the COVID-related security checks and other nonsense heaped upon Americans?

The Duty of AmericansIf your two supporters for your speakership were allowed to travel freely, then COVID is not as dire and dangerous as you have been preaching.  What about those members who were exposed and have now tested positive because your decisions put them in the House of Representatives while contagious?  May their families sue you personally for lost wages, harm, and being infected with COVID?

Speaker Pelosi, how did the metal detectors get added over a weekend?  Why has the security to the “People’s House” been increased, and where did the funds originate?  Why were the previous security measures acceptable for other capitol groups, but somehow after what appears to be a staged riot, the security measures are no longer adequate?  Do you know why the riot and the response to the extreme citizen behavior appear staged; the security people had lots of warnings from the FBI for months that a demonstration of support for President Trump was being arranged on social media.  Why were the capital guards not doubled?  Why were the security entrances not better manned?

BLMTake another large group who came to the capital, BLM.  The guards for the House were doubled, on alert, and ready if anything happened.  As House Speaker, Speaker Pelosi has the power to direct DC Police and other law enforcement agencies. Still, for a Trump Support event, magically, all the security protocols were purposefully not instituted, but after damage and a riot that left five people dead, it is suddenly time to tighten security checks and policies.  Something is wrong and smells to high heaven!

While we are on the subject of the riot and the potential for that riot to have been staged and managed, where is individual accountability?  President Trump never encouraged violence or violent demonstrations.  I have watched the speech he gave; President Trump said exactly the opposite and urged for law and order.  In President Trump, America has witnessed a politician who is 100% supportive of the “Rule of Law.”  Totally the opposite of you, Speaker Pelosi, previous presidents (Clinton and Obama come readily to mind), and so many other elected officials in and out of Washington, it makes me sick.

Wasting TimeYet, you have wasted valuable time in the 117th Congress to blackball, criticize, shame, and express disdain while weaponizing the Federal Government against President Trump, his family, his associates, his administration representatives, and a host of other private citizens.  Why?  I cannot believe this is all TDS, especially since before Donald Trump became President Trump, you and the rest of the liberal-leftists loved Donald Trump.  Explain why you and your politically connected cronies have belittled, attacked, and heaped shame on a person you used to admire for his work, dedication, and kindness?  All of you sure took his money fast enough as political donations; Et Tu, Brute?

America is in a crisis, largely made by politicians of both parties, fed by an emotional media, and protected by a weaponized government.  How many times has Pelosi promised to “Drain the Swamp” the metaphorical reference to the appalling actions and behaviors, largely from her party, and yet, has never lifted a finger in action?  Another verse of scripture fits here with a little adaptation.

“My soul is sore vexed: but thou, O Lord, how long” (Psalm 6: 3)?

LinkedIn ImageHow long Speaker Pelosi?  How long liberal leftists?  How long will America have to be sorely vexed before charges are brought for your treason and vilification of America?  How long will America be patronized by one-side of your mouths and vilified from the other side?  How long will honest men and women be called terrorists for serving in America’s military arms while you enjoy the liberty of their service?  My soul is sore vexed; I know millions of other people share in that sentiment.  Thus, how long will you proclaim to be the head of the People’s House of elected representatives and continue to ignore, shame, and abhor the people of these the United States of America, a free people, under law, a Republic like none other in history?

© 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.
All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:
https://www.linkedin.com/in/davesalisbury/

Updated Inspector General Reports – Department of Veterans Affairs: These Actions Must Cease!

I-CareLong have I written about the Department of Veterans Affairs (VA) and the Office of Inspector General (VA-OIG) reports which cross my inbox.  Long have I been utterly disgusted with the waste, fraudulent behavior, and the utter disregard for the patient witnessed in the VA Medical Centers across America.  As a veteran and taxpayer, it is past time to begin to see action to rectify these types of issues.

The VA-OIG conducted an inspection to evaluate concerns related to a Virtual Pharmacy Services (VPS) pharmacist’s discontinuation of antidepressant medication for a patient of the Minneapolis VA Health Care System, which resulted in the patient not having prescribed antidepressant medication for approximately six weeks before dying by suicide.  The VA-OIG found that the pharmacist never notified the psychologist, never checked the patient’s record, simply discontinued the medication.  While the VA-OIG found process and procedure issue, the fact that a medication could be arbitrarily discontinued without a “Red Flag” being raised with the provider and the patient is deeply troubling.  Worse, the quality control processes in the pharmacy did not trigger a problem when a medication was discontinued without a provider order; why?

There is a dead veteran, and a pharmacist who claimed they did not know they could access a patient file; and the excuses do not hold water!  This incident is a tragedy of epic proportion and I must ask, how many more veterans will die because medications are arbitrarily turned off?

ProblemsThe next VA-OIG inspection is a bit of a pretzel, there is another dead veteran by suicide, and processes and procedures were recommended by the VA-OIG to correct some small issues in bariatric surgery patients.  Reading this report, it appears that this veterans’ suicide was not directly connected to preoperative counseling for bariatric surgery which was essentially the scope of the VA-OIG investigation.  If there is a connection between the bariatric surgery and the suicide, it was beyond the VA-OIG investigatory scope.  Hence, the VA might not be at fault for the suicide, but the VA-OIG recommendations indicate more can and should be done in the future to decrease the risks postoperatively.

Let me be clear, room for improvement to decrease risk does not assign or negate blame in this situation.  The death of a veteran through suicide remains a tragedy and the VA can and should be doing more to help reduce veterans committing suicide.  With the convoluted processes and the contradictory bureaucracies inside the VA, much more can be done as an organization to streamline and bring efficiency, transparency, and responsibility to the employees making patient decisions.

Chinese CrisisAnother VA-OIG report does clearly reflect the responsibility and lack of care a patient received at the VA.  The Tennessee Valley Healthcare System in Nashville is responsible for test results still not being properly communicated to the veteran in a timely manner, which delays treatment and care.  Fall 2018, a patient went undiagnosed and untreated for pancreatic cancer due to failures in communicating test results, collaborating with the primary care providers, and for the electronic health records not containing a system of alerting providers that an adverse test result occurred.  Hence, this patient’s problems have three root causes:

  1. Failure to notify the patient.
  2. Failure to collaborate between different hospital units for patient care and safety.
  3. Failure of the electronic health records programming to include alerts.

From personal experience, I must wonder if any patient notification would have made a difference.  The patient notifications are simply the results, not definitions, no descriptions, just ranges, and results.  Hence, the patient notification process must include clarity of the results so non-medical people can understand what was found and the implications.

While I applaud the VA-OIG for insisting that an internal review is conducted and problems rectified, I have significant doubts that change will occur.  It appears that unless the VA-OIG is following up on their recommendations; which is outside the VA-OIG’s authority, the change will not occur.  A truly unfortunate series of events occurred in this patient’s life and the bureaucracy of the VA will prevent anyone from being held accountable for the failures, nor will change occur to protect another veteran.

The W.G. (Bill) Hefner VA Medical Center in Salisbury, North Carolina, was recently inspected for concerns regarding anesthesia provider’s practice.  While no issues were found under the VA-OIG scope regarding the provider’s practices, other issues were discovered.  The problems found were all administrative in nature and included the usual training, timely record keeping, following the policies established by VHA, etc.  Juran’s Rule states that “When there is a problem, 90% of the time the problem lies with policies and procedures, not people.”  How, and when, a person does their job is more often the root of the problem and is evidenced again with this VA-OIG investigation report.  The fact that this problem continues at all VA Medical Centers (VAMC) across America is indicative of a systematic issue in poor organizational design, then in the individual employee.  The VA must address these organizational issues that breed complacency in employee adherence!

LinkedIn VA ImageWith confirmed cases of nepotism still occurring in the VA, this time in Miami.  With continued issues regarding ethics violations and the proper use of time and materials for teleworking employees.  With the continued employee obstruction witnessed in so many cases of records not being readily available to VA-OIG inspectors.  The VA desperately needs to have a deep cleaning and reorganization.  Why has the VA not adopted ISO-9001 for Hospitals?  Why hasn’t the VA adopted ISO-9001 for the VBA or National Cemetery as a coherent process for organizational change and improvement?

Consider that there remains a dearth of written processes, procedures, and policies in the VA.  So much so that more than one VA Hospital operates on “Gentlemen’s Agreements” between departments, instead of official policy statements and procedural plans.  This lack of written policies and procedures is the excuse and the general recommendation of so many VA-OIG inspection reports that I am shocked Congress has not begun asking about this single issue.  The first rule I learned as an EMT was, “If it is not written down, it never happened.”  I was told this is the first rule of medicine; yet, somehow the VA can escape without writing down how to perform work.  Doesn’t that seem strange to anyone else?

Where the lack of written procedures is most noticeable, is at the Veterans Benefits Administration (VBA), where the quality control people missed 35% of the errors routinely, never checked each other’s work, never learned lessons to improve performance, and were not properly supervised.  Yet, training, communication, and written procedures are routinely used as excuses, and corrective action is outside the VA-OIG investigatory scope.  So, while the problems are being identified, the leaders are refusing to do their jobs!  From the VA-OIG report comes the following details:

“The VA-OIG estimated that during the review period, regional office managers inappropriately overturned errors in 430 of 870 quality reviews (about 50 percent) where claims processors requested a reconsideration from a quality review specialist- identified errors. The VBA has not established adequate oversight or accountability to ensure the timeliness of error corrections. The OIG estimated that during the review period 2,000 of 4,400 identified errors (45 percent) were not corrected in a timely manner and 810 of 4,400 identified errors (18 percent) were not corrected at all.” [Emphasis Mine]

Again, I ask, where are the written procedures that form the standards of work which are used to hold employees accountable?  With an 18% error rate never being addressed by quality control, this means that veterans are being underpaid or overpaid for their benefits, and the VBA does not care that these issues are killing veterans.

Survived the VAPersonally, I experienced a VA overpayment that took more than 3-years to payoff.  Three years where my benefits were docked for an administrative mistake that was not found until the next decision was made on my claim several years after the original mistake was made.  What is worse, the mistake I paid for, was not a mistake at all, and the funds were later returned as another quality person found the error and corrected the documents accordingly, but the discovery took another VBA claim decision to catch, from beginning to end this issue of overpayment took three different decisions by the VBA and more than 8 calendar years from beginning to end.

Every single taxpayer in America has a personal stake in seeing the VBA do their jobs timely, efficiently, and correctly.  Every single veteran in America has a vested interest in seeing the VBA perform their roles with fewer rates of error than those reported by the VA-OIG.  Every elected official in America benefits in some way from the decisions of the VBA and should be able to demand higher quality decisions, better performance, and more transparency from the VBA.  Consider, if the problems of performance are this bad for a spot check analysis by the VA-OIG, how bad are the real numbers?

The VBA was also investigated for improper payments to schools through the Vocational Rehabilitation and Employment Program (VR&E) to the tune of $554,998.  Most of the errors were in transcribing numbers and the electronic program did not raise any alerts or attempt to rectify the problems, and no quality control system is in place to protect against human error.  The VA-OIG investigatory scope included 1.8 million payment transactions from 01 Jan 2014 to 30 Dec 2019.  While this is a much better error rate; the fact that the technology and the work processes were not catching these errors timelier, which means more billing issues, more wasted resources, and more problems for the VA, the VBA, the VR&E program, the taxpayer, the colleges and universities, and the impact goes on and on.

The VBA was also recently inspected for failing to accurately decide service-connected heart diseases.  The root cause was the questionnaire developed to ascertain what and when regarding the heart diseases experienced.  Six months, 01 Nov 2018 through 30 Apr 2019, were selected and 12% of the claims were improperly decided which totals $5.6 Million in improper payments where a veteran either received too much or too little for their claim.  Necessitating repayments or backdated payments once new and material evidence was procured to force the VBA to make a new determination.  Inaccurate decisions on claims involve a lengthy appeals process, expenses for testing, and the veteran is always responsible for the mistakes made on their claim.  Thus, the exasperation of these mistakes on the families, friends, and communities of the veteran involved in a VBA mistake.

When the VA-OIG finds errors made by the VBA the veterans affected are not notified that the VBA made an error in their determinations.  The VBA does not form a task force to evaluate these errors and correct them internally unless money is owed and then the collections department is left to muddle through the decision, not the VBA.  Thus, when veterans ask for transparency in the VBA processes, we are asking for the VBA to own their mistakes, fix the problems they are creating, and correct the errors in a timely fashion.  It should not require new and material evidence to trigger the VBA to make a new determination when the VBA made the original mistake in determining eligibility in the first place!

All because the quality controllers do not have written procedures to measure standards of performance against.  All these errors are due to improper organizational design and old computer systems, which are ready-made excuses for not performing work in a timely and efficient manner.  All because the leadership fails to delegate, monitor, observe, and function.  Why are the leaders missing, because they are all in meetings, all day, every day, and not at their desks!

Military CrestsJust like the labor union provided bumper sticker proclaims, “SAVE the VA!” [Emphasis in original], it is time to “SAVE the VA!”

© Copyright 2020 – M. Dave Salisbury

The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the pictures.

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

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