Democracy vs. Republic – American Governance

Please note: A republican method of governance does not mean everyone belongs to and votes the “Republican Party” ticket.  Nor, does the democratic governance method mean everyone adhering belongs to the “Democratic Party” ticket.  The political party is not the style of governance, and this is the first distinction that must be realized.  No political party deserves your support, unless they espouse, and live, what you want them to espouse and live.  America has had good and poor elected officials from both major political parties.  America has even changed major political parties; and this is a good thing!

The Duty of AmericansToo often people are confusing democracy, democratic governance, and the American Republic.  Talking heads in the media get this wrong all the time.  Hollywood has never gotten the distinction correct, ever.  But, this ignorance might be by design as Hollywood has always been a breeding ground for disinformation, propaganda, and elitist posturing.  Regardless of the political party, or lack of political party, every American citizen should be able to recognize Democracy from Republican styles of governance.  The following uses real events to help distinguish the line.

A democracy, at its most basic level, can be described and defined by the control of an organization by the majority of its members.  A simple majority is all it takes to gain the high ground and punish the loser.  A simple majority is if 100 people gather in a room, they need 51 to agree to support a single idea.  Democracies are full of simple majorities who then try to proclaim a moral high ground, and then attempt to extrapolate the single simple majority into a system of keeping the simple majority.

A republic begins with the philosophy and doctrine that embraces equality between its members as the ideal in governance.  Recognizing that today’s majority is tomorrow’s minority, rules provide equality between people, and all titles are transitory.  A republic is messy; equality in treatment under the law allows for every person to have the same opportunity because their inalienable rights have provided them with eternal potential to become anything they desire.  This is especially true when a person desires through their actions, attitudes, and behaviors, which is not desired by the rest of the society, provided the individual does not break the law.  However, laws are not changed to outlaw behaviors, curb ideas, or infringe upon inalienable rights as laid out and codified in the Bill of Rights.

Lady JusticeFor example, The Department of Veterans Affairs (VA) – Office of Inspector General (VA-OIG), recently sent a report regarding an investigation of Peter Shelby, the previous VA Assistant Secretary for Human Resources and Administration (HR&A), who steered a $5 million contract for the benefit of individuals with whom he had a personal relationship.  This is a prime example of democracy in action.  The person in charge had to pay for the simple majority that kept him in power.  Consider the following direct consequences of Mr. Shelby’s actions.

“The contract … included talent assessment services for evaluating whether to hire or promote candidates. When the contract concluded in August 2019, it became evident that VA had purchased services far in excess of what it could use. VA used only 232 of the 17,000 one-year training licenses it purchased for $3.8 million and VA received no value whatsoever for the talent assessment services because required privacy and security certifications were not obtained.”

Mr. Shelby was allowed to resign when he discovered he was about to be fired from Government service.  Thus, he keeps all his retirement, all his Federal benefits, and the money gained from his ill-gotten ventures.  In many countries around the world, these actions are considered, “Realpolitik.”  Realpolitik is politics or diplomacy based primarily on considerations of given circumstances and factors, rather than explicit ideological notions or moral and ethical premises.  In America, Mr. Shelby’s actions are illegal and should have been punished accordingly.

Government Largess 3The American Public has witnessed the same political gamesmanship (realpolitik) in the US House of Representatives, the Senate, and the Presidency, for a long time.  All because, the line between a Republic and a Democracy has been intentionally blurred by those in power, to stay in power.  Never does realpolitik benefit the rule of law, or provide equality as a basic and fundamental position of governance.  Bringing into the conversation the critical quality of genetic behavior and the exponential growth of behavior from one generation to the next.  If Mr. Shelby’s actions can be traced upwards through the behavior of elected officials; how many more unethical behaviors are hiding inside the government workforce waiting for their opportunity to practice realpolitik at the expense of the veterans, taxpayers, and citizenry of America?

Genetic behavioral growth is witnessed when a congressional member is allowed to bend an ethical rule in the name of politics so the simple majority can be sustained.  The next generations are the governors and state legislatures who then replicate and advance that unethical behavior to one that is blatantly illegal, but not “really bad.”  Extramarital affairs, drug use or abuse, alcohol abuse, spouse abuse, homosexuality, etc., are all not “really bad,” laws that are regularly shattered and overlooked to maintain the simple majority.  This then leads employees of governments to act in a looser and more illegal or unethical manner, stealing the public money, misusing government tools and supplies, or in the case of Peter Shelby, forming a relationship and then steering a $5 Million-dollar contract to the entity that most benefits him.

Behavior-ChangeIn a republic, those in power recognize the genetic nature of their behavior, understand that any lapses in good judgment are dangerous, and work to live in a manner that first allows for equality among all.  Even if they must tell another person no.  Consider how much corruption is in Washington, D.C., and every state capital in America, all because the simple majority has lured good people into acting against their principles, against the Republican form of American governance, and against the law established and maintained by the people, for the people, and of the people.  The simple majority will always, to maintain power, refuse to say no, set boundaries, and live by rules and laws.  The republican form of government lives by nothing else but the rules and the laws because equality only occurs under the rule of law.

Notice something important, the first rule of realpolitik is to disconnect the equality of everyone for the power of ruling.  Just as in the book “1984” we see some are more equal than others; which is an extension of democracy.  Then, realpolitik disconnects explicit notions of morality and ethics from actions and behaviors.  Thus, equality is the first casualty in the hostile takeover of democracy.

Consider labor unions for a moment.  Disney produced the movie, “Invincible,” or the story of Vince Papale and the NFL Eagles.  In the movie, there is a union striking, and one sign is made clear, “Striking is DEMOCRACY IN ACTION” [emphasis in original].  The truth in this lie is that strikes are selfish, and represents democracy perfectly.  But, the strike is not democracy in action, the labor union is democracy in action as a legal “pyramid scheme.”  The strike of a labor union, along with all the other work slowdowns, bureaucracies, and other silly games played to thwart republic governance are but tools of democratic leaders to exercise their power.

Religious ThoughtThe labor union spouts a lot of good democratic styled speeches; but acts like thugs, for the benefit of the elected few, at the cost of the dues-paying members.  Proving that democracy is the last thing a labor union wants as the labor union remains a Marxist method of governance.  Take any labor union, anywhere in the world, and you will find the elected officials living large on the backs, sweat, and labor of the dues-paying members.  The fewest of the few long-term dues-paying members will be provided benefits and a lifestyle to be desired, but never obtained, even though the dues have been paid, the labor performed, and the sacrifices made.  The Wall Street Journal has covered the loss of benefits paid for through dues payments, and while the Wall Street Journal does it’s best to keep the union out of the picture, it is not the company’s filing lawsuits, but the unions.

Always, the same principle determines the separation between democracy and republican governance, equality under the law.  The solution is not found in more government programs to “level the playing field,” which is a democratic principle that has never worked!  The solution is found in less government.  Equality under the law is not found in government force; but, in less government potential to exercise that force.  In the 1980s President Reagan was heralded for his nationalizing of the air traffic controllers; thus, ending a strike of the national air traffic controllers.  But, the air traffic controllers still have the same inequalities, same problems, and the same issues as experienced under the air traffic control unions.  Nothing changed fundamentally, and this overreach of government, “for public safety,” has kept the air traffic controller in bondage.  Sure, the cage is nicer, but the cage is still a cage; only now, there is no possible way of escaping the cage.  The same is true of railroad workers, teachers, and so many other employees kept under a labor union’s thumb, or government mandate.

In a democracy, it is perfectly acceptable to maintain the simple majority through nefarious means and ends.  Whereas in a republic, the equality that keeps everyone equally refuses the nefarious types every society produces from having a purchase hold to establish themselves.  Consider the violence that has rocked America since May 2020.  Consider also, all the violence that has shocked and dismayed America since the Watts Riots in 1965.  The Watts Riots are a perfect template reflecting the problems of democracy.

The media, and many people in government including most of the judicial branch, allowed personal anger over issues to become a violent outpouring, where the victim was the community and not the actual target of the violence.  People acted in a selfish manner, with a total lack of self-control, and the community of Watts burned to the ground.  The land is barren, dreams destroyed and lives ruined.  Since the Watts Riots, the community has reached out for more democratic solutions, as if this was not the reason the Watts Riots happened in the first place.  Fast forward from 1965, and every riot since has been glorified for their anger levels, because this helps feed the democratic solutions, keeping people unequal, refusing people their eternal potential, and denying inalienable rights to maintain power and authority.

America, we need to stop the lies that democracy is the “American Way.”  Superman was correct, “Truth and Justice” are the American Way, which is the Republican manner of governance.  America was established upon the fundamental principle that ALL are first equal under the law.  Sure, we have not always lived up to the ideal; but, we are human.  Our humanness is allowing us to falter, not fail.  We fail the great American Republic every time we allow a democratic solution that forces people onto unequal terms.  We stumble, we fall, when we forget that equality is precious and considering all to have the same equality means allowing people to suffer consequences of attitudes and behaviors.

President AdamsWhen one person can be supported in their immorality because of their money (Jackson, Kennedy, Epstein, Clinton, Weinstein, etc.) when others are punished for the same crimes (pedophiles, murderers, thieves, rapists, etc.) we have a democracy.  When all, regardless of money, titles, political power, etc. are held to the same laws and legal standards the great American Republic survives and gains strength.  To rebuild the American Republic, we must first cleanse the inward vessel, removing from public office all those who refuse the blessings and work of a republic for the ease and captivity of a democracy.

© 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:

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Tragedies, Travesties, and Uncomfortable Truths – Shifting the Paradigm at the Department of Veterans Affairs

For the uninitiated, the Department of Veterans Affairs (VA) has three chief administrations the Veterans Health Administration (VHA), the Veterans Benefits Administration (VBA), and the National Cemetery (NC).  The majority of the problems a veteran is going to experience originates in decisions from the VBA, which then influence care with the VHA.

I believe in giving credit where, and when credit is due; thus, please join me in congratulating the VBA for meeting a significant milestone.  From the VBA press release we find the following:

“On August 11th, VA updated portions of the rating schedule that evaluate infectious diseases, immune disorders and nutritional deficiencies. By updating the rating schedule, Veterans now receive decisions based on the most current medical knowledge of their condition.”

The reason this is good news stems from so many veterans leaving the military with problems caused in the service where the VBA has dictated there is no injury due to the rating scales, forcing the VHA into a treatment problem where the patient is concerned.  More on the rating scales issue momentarily.

I-CarePlease join me in mourning another death at the hands of the VHA, which is labeled by the Department of Veterans Affairs Office of Inspector General (VA-OIG) as “largely preventable.”  A patient in the West Palm Beach VA Medical Center was in a mental health unit and committed suicide.  Largely preventable is a vast understatement when hospital leaders only begin caring about the veteran committing suicide after the suicide, where training and policy adherence was not mandated prior to the suicide, and the lack of cameras and staff monitoring allowed for a patient, already having trouble and this trouble is known to the hospital providing treatment, to take their own life.  No staff monitoring every 15-minutes was occurring; why?  Why were the cameras non-functioning?  How long had these problems been known and nothing was being done to correct these discrepancies.

Let me emphasize a truth about suicide.  A person expressing desire to suicide is not weak or lazy, and they will not “find a way.”  Having had depression sufficient to consider suicide in the past, I can tell you from personal experience that friends help, talking openly and honestly helps, and the emotional burdens placed upon a family when a suicide is successful are tremendous, as well as the guilt the surviving family must overcome.  This veteran did not have to die, their death was “largely preventable,” and for their death to occur on VA property, in a mental health ward, remains a tragedy.  That the VHA dropped the ball and allowed, through leadership failures, non-working technical means, and training deficiencies, this veteran to die is disgraceful!

The VBA is committing travesties of justice every day.  Consider the following, in the past 15+ years since I left the US Navy, I have had discussions with veteran service officers (VSO’s) across the continental United States on my own claim, and while supporting other veterans with their claims.  A recent example serves to illustrate the problem.  A Spine Anatomyveteran has bulging disks in the cervical spine.  The MRI shows disk degeneration, stenosis, and other problems in the cervical spine.  The veteran has an “S-Curve” in the thoracic spine caused by carrying bottled gas containers from the pier into the ship.  There is stenosis and disk degeneration in the thoracic spine.  The lumbar spine has bulging disks, degeneration, and stenosis.  Three separate areas of the spine, three distinct injured areas, yet, the VBA calls the spine issues, “Lumbar strain.”

Any person who has taken human biology in K-12 education can tell that spine issues in cervical and thoracic are not “lumbar strain” and would not need “new and material evidence” to understand that the first decision was flawed.  Yet, for the veteran to obtain a rating for their spinal issues, they must find an orthopedic spinal specialist, not affiliated with the VHA, and get a letter of diagnosis detailing why these separate areas of the spine are not “lumbar strain.”  The current corporate medicine world, finding an orthopedic specialist will require a non-VHA doctor as a primary care provider (PCP) to refer the veteran to a specialist.  Without a significant cash investment, time investment, and replication of VHA completed tests, x-rays, and MRI’s, the veteran will not be able to obtain a letter detailing the issues sufficient to sway the VBA in correcting their initial judgment.

The veteran will be stuck between three bureaucracies, the VBA who is denying the claim for spinal injury, the VHA who cannot diagnose and document a problem sufficient to meet the VBA standards, and the corporate medicine outside the VHA.  Yet, anyone with a passing understanding of human anatomy and biology can logically make the leap that the spinal issues cannot all be lumped under “lumbar strain.”

I continue to ask, “What is a veteran to do?”  Many times, the veterans in this position are either unemployed or employed below their skill level because they are in pain, they have medical issues requiring treatment, and they cannot obtain the treatment needed because the VBA has not allowed a military service claim to be placed upon the medical records for the VHA to treat.  To chain medical professionals to a rigid and dead bureaucracy, by refusing their ability to diagnose a problem for another VA administration is, without a doubt, a terrible decision, and dangerous practice.  To refuse to investigate a medical problem, restricted breathing with chest pain because the pain is not related to heart and lungs remains a travesty and an abuse of the patient.

To the elected Federal officials, why are you not demanding improvement to the VHA and the VBA?  Why do veterans have to die in the care of the VHA before any improvement is made to the bureaucracy you created?  Where does a veteran go to obtain relief from the bureaucratic nightmare where the VBA and the VHA are refusing to help the veteran?  The tragedy in this entire article is that the VA cannot enforce policy adherence, controlling the risks to avoid incidents like those detailed, and demand better performance from the people and the systems that are supposed to help the veterans.  The travesty in this article is the policymakers between Secretary Wilkie and the front-line employees; who is helping the veteran navigate these rocky shoals and dangerous waters of government policy?

I have met some great VSO’s, employees of the VBA and VHA, and interviewed with phenomenal people working in the National Cemetery; yet, they all have the same problem, the millstone around their necks is the regulations, policies, procedures, and red-tape of the VA that has been designed to refuse help as the first response to every question posed.  Thus, as I have asked Senator Udall (D-NM) and Representative Haaland (D-NM), as well as countless other Federally elected officials between 1997 and the present, what is a veteran to do to obtain the help they need from the VA?  Who would the veterans approach for guidance and support?  When the VBA is demanding “new and material evidence” before acting to support a veteran, how does a veteran obtain this evidence?

I know of hundreds of veterans who were affected by an independent duty corpsman in the US Navy who threw records over the side of the ship to avoid being held accountable for bad decisions and patient abuse.  Because these records are not in the medical files, injuries sustained in the service are not documented, and the VBA will use this as an excuse to deny claims.  What is a veteran to do?  Where does the veteran go?  How does a veteran correct something that occurred beyond their control to obtain treatment for decades-old injuries?  You the elected officials allowed the bureaucracy to be built, you are responsible for correcting these issues experienced, what are you doing to affect change and support Secretary Wilkie in fixing the VA, and by extension the VBA, the VHA, and the NC?

The American people are watching how you treat veterans, and we are not pleased!

 

© 2019 M. Dave Salisbury

All Rights Reserved

The images used herein were obtained in the public domain; this author holds no copyright to the photos displayed.

 

Uncomfortable Truths – Procedural Breakdown and Leadership Failures

I-CareOn the 5th of August 2019, a VA-OIG report was delivered, but I was unable to comment due to the tragic incident documented in that VA-OIG report.  A veteran died, and while this of itself is troubling, the tragedy was how that veteran died.  Thus, the delay in writing about this veteran’s death and the VA-OIG report.

For the record, I worked at the Albuquerque VA Medical Center from 2018-2019.  From my first day to my last, I asked for, begged, pleaded, and reported that a lack of written procedures opens the VA to avoidable risks.  I was instructed several times by employees who had a minimum of five years in the administration of the hospital, who led the hospital mainly after hours, that writing anything down means responsibility.  But, responsibility is avoided at all costs by the leadership who are keen to keep from losing their power and job if something went wrong.  I countered that written procedures, where training on those procedures is documented, means that responsibility and accountability do not, automatically, result in lost employment, all to no avail.  Thus, the VA Medical Center in Albuquerque operates by gentlemen’s agreements, verbal directives, gossip, and personal opinion.

How is this accountable leadership?  What will it take to change this culture of irresponsibility?

The VA-OIG report documents that a nurse inappropriately labeled the patient as dead and did not commence resuscitation efforts.  Documentation was not completed, appropriate processes and procedures were not followed, and proper training was not conducted.  The crash cart, for a Code Blue emergency, was unlocked and deficient.  The leadership teams and committees did not correctly follow procedures and review the incident.  Reprehensible, detestable, and criminal are just some of the adjectives I have been using on this incident; but, the VA-OIG made nine recommendations.  Why does this not comfort me, comfort the family who lost a loved one, or suggests to America the problem will not be repeated?

I know the written procedure problem exists in the Phoenix Arizona VA Medical Center, the Cheyenne Wyoming VA Medical Center, and the Albuquerque New Mexico VA Medical Centers as I have been a patient of all three.  From the VA-OIG report, I must presume this problem is VA-Medical Center-wide, and I have to ask, why?  The military believes in writing everything down, redundancies, and accountability for records and documentation are taught from day one.  How is the VA able to operate without documentation, written processes, and documented procedures?

A running theme in the VA-OIG reports delivered since I began tracking VA-OIG reports in 2015, continues to be that documents are not properly completed, not maintained correctly, not audited timely and appropriately, or missing entirely.  Missing written procedures detailing how to perform tasks, and leadership were not forthcoming with the written procedures and policies needed to complete the tasks appropriately assigned.  A hospital in the private sector with these problems would be inundated with malpractice lawsuits, Federal inquiries, and threatened with closure; yet, the VA can operate without document controls, written processes and procedures, and escape any consequences, why?

The VA-OIG report detailing the death of a veteran in a behavioral health unit is not the first, nor will it be the last; but it should be!  This veteran’s death should be a clarion call for every hospital director in the Department of Veterans Affairs, Veterans Health Administration, to demand an immediate correction, that leads to written procedures, clearly defined directions, and training in following those procedures — then monitoring those procedures for updates and shelf-life.  This veteran’s death doesn’t even raise the eyebrows or curiosity of the lowest congressional staffer, and that is shameful!

Senators and Congressional Representatives, what are you doing to support Secretary Wilkie and his team in demanding answers and implementing corrective action?  Hospital directors, what are you doing to fix this abhorrent behavior in your hospitals?  Hospital directors, what are your directors, supervisors, and leaders doing to improve performance and follow Secretary Wilkie’s leadership to enhance the VA?  There is no excuse for another dead veteran at the hands of the providers and nursing staff in the VA Health Administration.

America, please join me in mourning another veteran’s passing.

This veteran did not have to die!

 

© 2019 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.

 

Uncomfortable Truths – An Open Letter to the Department of Veterans Affairs and the Congressional and Senatorial Representatives of the United States of America

I-Care

I write by way of greeting; I write by way of exhortation to action, as the current status quo is reprehensible and unacceptable.  Uncomfortable truths are those realities where bureaucracy has superseded logic and leadership, creating situations where the harm of the patient/customer is the first and only business.  There are good people at the Department of Veterans Affairs; but, these people are being crushed by the bureaucracy, the stifling mental inertia, and the lack of actionable leaders to propel change at the Veterans Benefits Administration (VBA), the Veterans Health Administration (VHA), and the National Cemetery.

An example of uncomfortable truths: I witnessed a veteran enter the emergency room of the VA Medical Center, and be actively, but passively, abused.  Because he was a regular, and sometimes came in and was obstinate, and because he was homeless, he had a history with this emergency room and staff.  The staff actively overlooked him, they talked bad about him, they cussed him out behind his back, and his service was suboptimal at best when he was finally treated.  As this veteran was not the only one being treated in this manner, this was brought to the attention of hospital leadership; the person reporting the abuse was terminated without cause.  This is a leadership issue, a process problem, and an excuse not to change.

Another example of uncomfortable truths: the VBA needs/wants “New and Material Evidence” to process/review/correct a claim.  The Primary Care Provider and all specialty clinics at the VA cannot provide “New and Material Evidence,” as they are not diagnosticians.  Thus, the veteran is left stuck between two bureaucracies that refuse to help, because the rules do not allow the providers to help; this a leadership problem and a process issue.  How can the veteran afford outside insurance to obtain the “New and material evidence?”

Earlier this month, the OIG sent out a report over death at the VA due to leadership inefficiencies and can be found here, VA-OIG report.  Over the last week, three more incident reports have been discharged from the VA-OIG.  Report 1: Has a veteran dying of suicide, because the decision-making process, a process designed specifically to improve communication to aid high-risk patients were not implemented, tracked, and reported properly.  The decision-making process is expected to employ a full patient-care team (PACT) in evaluating and making decisions that affect the patient’s care.  The process was not followed, and the veteran who is already at high-risk for suicide and known to the PACT was deactivated, leading to a veteran’s death.  The VA-OIG made a recommendation to improve the process, the same process that was disabled, leading to a dead veteran.  How does this make sense?

The uncomfortable truth is multi-faceted in this case.  Leadership does not do record audits to ensure the deactivation of high-risk patients does not become “lost” in the bureaucracy.  Leadership is not flagged when the PACT disagrees with the treatment of a patient.  Finally, the VA-OIG has no teeth to reprimand, insist, and improve compliance; they can only make recommendations after the fact.  Congressional representatives and Senators, you allowed the VA to have its own dedicated inspector general, why?  What will you do to enhance the leadership at the VA?  Do not tell me again; we will hold “Committee Meetings.”  These committee meetings have been, and continue to be a feckless waste of taxpayer time, money, and never addresses the core issues apparent.

Report 2: Covers a veteran needing an appendectomy and had to wait for three hours for the surgeon to become available to perform the surgery.  The VA-OIG confirmed the delay in care, but essentially settled for, “Well, the patient lived, so no problem here.”  If that statement seems overly simplified of the process, tell me why the patient had to wait.  Why pay records and timekeeping records were messed up for a single month (May 2018), and how pay and timekeeping records got messed up in the first place.  The VA uses a national system for reporting time worked, but not all employees use the same payment system.  If true, why aren’t all employees, to include residents, surgeons, and staff using the same pay system?  The wait is blamed on poor communication, communication in scheduling surgery, communication between resident and surgeons, and communication because the “appropriate documentation” was insufficiently maintained.

I know from sad experience that there are nurses and doctors who write things down in notebooks, on scrap paper, and on paper charts, when the computer on wheels (COWS) is readily available.  The excuse is always, “I am too busy to use that thing.”  I know the VA has spent an excessive amount of money to get digital records, installing digital records, getting digital records to work when needed, and delivering the digital record available to mobile stations to document what is happening with the patient.  I have some grave concerns for checkbox medicine; but, blaming a surgical delay on improperly maintained documentation remains a wholly inexcusable and unacceptable statement in an official investigation.  Why was this lame excuse allowed to stand?

Report 2, exemplifies a multi-faceted problem presenting a need for a multi-faceted approach to correction.  Leadership at the hospital must be actively engaged, ensuring processes and procedures are optimized to deliver the “I-CARE” customer promise.  Communication chains are a leadership tool, and when broken, correction demands accountability and responsibility to resolve correctly.  Reporting is a leadership function to ensure liability and corrective action as a normal operating procedure.  Did anyone ask why the documentation was not maintained?  Was this lack of documentation maintenance a design flaw to hide what happened during this incident as an extension of designed incompetence?

Report 2, demands answers on two distinct issues double-dipping, and the continued practice of collective design incompetence. Double-dipping by providers working for the VA at the same time they are working at other medical institutions, is this occurring?  Why?  I understand there is a provider shortage at the VA.  I know doctors need to make money, and doctors make money by seeing patients, surgeons make money performing surgery.  The VA-OIG report appears to gloss over the practice of double-dipping e.g., on-call from one hospital while working at another, or working at another hospital while the VA expects you to be at their hospital.  Senators and Congressional representatives, are you investigating the potential for double-dipping?  Will it take a dead veteran before you even care about double-dipping occurring?  I make no accusations; I am asking honest questions on this issue in an attempt to learn more.  Will you do the same?

One of the most egregious problems at the VA is designed incompetence to allow a malefactor the ability to hide behind bureaucracy to avoid accountability and responsibility.  Designed incompetence remains a significant problem and I do not see any of the mid-level managers, leaders, supervisors, trainers, etc. acting to eliminate designed incompetence to the improvement of the Department of Veterans Affairs.  During President Obama’s Administration, I watched a Congressional Committee meeting where whistle-blowers were invited and testified about the designed incompetence that allows for an individual to pass the buck, duck responsibility, and protect their jobs and power at the VA.  I keep discussing design incompetence, because the mid-level managers, directors, and supervisors at the VA refuse to address and correct this issue.  Senators and Congressional Representatives, why do you allow this practice to continue?  Did you know that this is the primary method for discriminating and harming whistle-blowers?  Of course, you did.  I have seen several committee meetings where this exact issue was discussed, and the bloviation from the committee does nothing.  You are the leaders in our Republican Society, when are you going to act, in concert with Secretary Wilkie (who’s doing an exceptional job), correcting and insist these practices cease?

Report 3: Involves 60,000+ veterans, is this number sufficient to warrant permanent action on the proper billing of insurance companies and veterans, or does this number need to exceed some other level before it warrants your attention.  If a different level is required, what is that magical number?  I guarantee that veterans from all states and territories are involved here, as their representatives, what will you do?

Directly from the VA Website, we find two different uses for funds collected:

  • “VA is required by Public Law 87–693; 42 USC. 2651, commonly known as the Federal Medical Care Recovery Act, to bill the health insurance carrier that provides health care coverage for Veterans to include policies held by their spouse. The money collected goes back to VA medical centers to support health care costs provided to all Veterans.
  • Funds that VA receives from third party health insurance carriers go directly back to VA Medical Center’s operational budget.”

You, the elected officials of the Republic of the United States of America, enacted these laws and improper billing of veterans and insurance companies, causes financial harm and distress; this is your problem!  Do you understand that even if money is returned to a veteran, the financial injury has been done?  Those veterans who have paid a bill, or the insurance company that paid a statement, they didn’t need to pay is an interest-free loan to the government, and this is wrong!

There are literally tons of money at stake here; I know my local VA Hospital said, “The funds collected when we bill insurance companies come directly to this hospital for construction projects, renovations, new equipment, and so forth.”  Report 3 is but one of how many VA-OIG reports where improper billing is occurring. Incorrect billing drives the cost of healthcare up.  Hence, Obamacare costs more because the VA is not accurately billing.  Medicare costs more because of improper billing.  You the elected officials are directly responsible for ensuring proper billing occurs as an aid in reducing the costs of healthcare.

Where are you? Will you act?

 

© 2019 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.