“That’s Crazy!!!” – More Chronicles from the VA Chapter 6

I-CareI promised a follow-up article after Chapter 5; it took me the better part of 48 hours to cool down sufficiently to write coherently to effect an update.  On 18 March 2002, I wrote about an appointment with my Primary Care Provider (PCP) being tardy, unprepared, and bureaucratese in supposedly holding a phone appointment with me.  01 April 2022, not an “April Fools Joke,” at 0731 hours, lasting 9 minutes, my PCP called me to get my approval to have me changed from her PACT team to another provider’s team.  Apparently, in the highly red taped world of PCPs at the El Paso VAHCS, there must be an hour-long handoff call when a provider initiates a change of PACT team.  I have my doubts and smell designed incompetence!

Let me pause here for a moment.  I generally need two hours to write an article after conducting research.  18 March 2002, it took a bit longer to draft that one due to the need to blow off steam with some choice words and choke down the urge to beat a few brick walls with my fists.  I am generally a very controlled person, and the fact that this PCP was so stunningly incompetent, rude, and HIPAA clueless, I admit I lost my cherub-like demeanor!  That the patient advocate was able to get my secure message, upload the comments into the electronic medical record, and contact the provider before the provider had even logged the patient notes, speaks volumes about the ineptitude of the PCP.  Worse, in the call on 01 April, the PCP was still on speakerphone, still disregarding HIPAA security, and quoted lines out of context from my message to the patient advocate.  Speaking volumes about the processes and procedures of the patient advocate’s office to investigate patient claims without breaching confidentiality.  Another topic for another day entirely!PACT_model

28 March 2022, I received the following from the patient advocates office, quoted completely:

We have received your secure message addressing your concerns.  I will be sending a Patient Advocate Tracking notification with your concerns to our Primacy Care Service for review.  They will be contacting you via telephone to discuss your concerns.”

I never heard anything from this mysterious “Primary Care Service” group/team.  01 April 2022 was the first response, and that was from the PCP.  Sourcing the Department of Veterans Affairs (VA) and the Office of Inspector General (VA-OIG), the PCP is the second most important member of the Patient-Aligned Care Teams (PACT) at the VA; the patient is the essential member and an actively engaged and knowledgeable patient is preferred.  I promise the VA-OIG has not even scratched the surface of the problems with recalcitrant, snowflake, and bureaucratic PCPs endangering patient health with the VA.  Not my first run-in with an inept PCP; I sincerely hope it is my last!PACT 3

In returning to the 01 April call, we find another interesting piece of data.  The PCP affirmed that abdominal pain could radiate from, say a hernia, to other parts of the abdomen, but this is for a specialist to diagnose, not a Family Practitioner.  Get that; the PCP is directly reversing all the published documentation by the VA and the VA-OIG by declaring that a specialist is the only person who can adequately decipher and detail why pain is occurring—putting all the PCPs in the VA Health Administration under the bus as merely button pushers and drug dealers.  Then the PCP has the temerity, nay the chutzpah, to suggest a trust deficiency existing between myself and the PCP.  Is it any wonder that people are detested, forlorn, melancholy, madder than a wet chicken with a raging case of hemorrhoids with the care they receive from VA healthcare providers?

Again, I repeat, only for emphasis, when any updates arrive on this issue, I will publish them in their entirety to allow the VA the opportunity to rebut, refute, or explain.  Like the ongoing saga with VISN 22, the Phoenix VAMC, and being arrested and injured three times by the VA Police, I am not holding my breath and awaiting a logical response.  If this were the only problem in the two weeks since the PCP shenanigans, the VA would be in pretty good shape.  Alas, we know, dear readers, that the VA is in dire condition, and the elected leaders need to be scrutinizing the VA a LOT more closely than they are.VA 3

We begin the latest chapter of VA-OIG reports with yet another physician bilking the government:

Robert Clay Smith, a Louisiana physician, pleaded guilty to conspiracy to commit healthcare fraud, wire fraud, and illegal remunerations (taking kickbacks).  According to court documents, the scheme, which ran from 2013 until 2017, involved individuals associated with a medical supply and billing company recruiting Smith to dispense pain creams and patches to his workers’ compensation patients by offering him a split of the profits.  The company acted as the billing agent for Smith, handling all the paperwork and submitting the allegedly fraudulent claims to the US Department of Labor, Office of Workers’ Compensation Programs, and private insurers.  In exchange, the company paid Smith 50 to 55 percent of the profits collected from successfully billing insurers, at markups of 15 to 20 times what the medications cost.”

Plus the following:

Robert Schneiderman of Langhorne, Pennsylvania, admitted to participating in a massive compounded-medication kickback scheme that he and others ran out of a pharmacy in Clifton, New Jersey.  Schneiderman pleaded guilty in federal court to one count of conspiracy to commit healthcare fraud and one count of conspiracy to violate the Anti-Kickback Statute.  From 2014 through 2016, Schneiderman and his coconspirators used Main Avenue Pharmacy, a mail-order pharmacy with a storefront in New Jersey, to run a fraud and kickback scheme involving compounded drugs like scar creams, pain creams, migraine mediation, and vitamins.  Schneiderman was the president of Main Avenue Pharmacy and was a founder and CEO of its corporate parent.  Main Avenue Pharmacy received over $34 million in reimbursements from healthcare benefit programs on compounded medications alone.  Approximately $8 million of that total was paid by federal payers.  Schneiderman himself earned over $400,000 through the course of the scheme.  This case was investigated by the VA OIG, FBI, Department of Defense OIG, Defense Criminal Investigative Service, and Department of Health and Human Services OIG.”

Don’t forget this one:

Dr. Harry Doyle, a psychiatrist from Philadelphia, Pennsylvania, and his wife, Sonya Doyle, have agreed to pay $3 million to resolve alleged violations of the False Claims Act.  The alleged violations include submitting false billing to the US Department of Labor Office of Workers’ Compensation Programs (OWCP) for psychiatric services that were not provided and upcoding and double-billing patient claims.  The Doyles have also agreed to be voluntarily excluded from federal healthcare programs for 25 years as part of the settlement.  This is the largest recovery against a single psychiatrist in the history of the OWCP.  A multiagency investigation of Dr. Doyle’s practice revealed that from January 2013 through April 2021, the Doyles allegedly billed for services not rendered, some of which occurred when they were not physically present in the United States.  This case was investigated by the VA OIG, the Department of Labor OIG, and the United States Postal Service OIG.”

More is coming on this one:

Ten Texas doctors and a healthcare executive have agreed to pay more than $1.68 million to resolve False Claims Act allegations involving illegal remuneration in violation of the Anti-Kickback Statute and Stark Law.  According to a multiagency investigation, from 2015 to 2018, the doctors allegedly received thousands of dollars in illegal remuneration from eight management service organizations (MSOs) in exchange for ordering laboratory tests from Rockdale Hospital doing business as Little River Healthcare, True Health Diagnostics LLC, and Boston Heart Diagnostics Corporation.  Little River funded the illegal remuneration to the doctors in the form of volume-based commissions paid to independent contractor recruiters, who used the MSOs to pay numerous doctors for their referrals.  The MSO payments to the doctors were disguised as investment returns but were based on and offered in exchange for the doctors’ referrals.  As part of their settlements, the defendants have agreed to cooperate with the Department of Justice’s investigations of other parties involved in the alleged law violations.  To date, 17 doctors and two healthcare executives involved in this scheme have agreed on settlements totaling more than $2.7 million.  The civil settlements resulted from a coordinated effort between the VA OIG, Department of Health and Human Services OIG, Defense Criminal Investigative Service, and the US Attorney’s Office for the Eastern District of Texas [emphasis mine].”

Elected officials, the next time you are asked about the incredible amounts of fraud in government-provided healthcare and insurance, do not buy the media talking points that the fraud is minimal, contained, or anything but designed incompetence on the part of the bureaucrats to act as a jobs program for investigators!  The same investigators who are refused sufficient tools to investigate shenanigans by employees in the Federal Government adequately.?u=http2.bp.blogspot.com-fGEUjJsJ2h4VcJgswaisnIAAAAAAAABcsoFqEewPF_E4s1600quote-if-the-freedom-of-speech-is-taken-away-then-dumb-and-silent-we-may-be-led-like-sheep-to-the-george-washington-193690.jpg&f=1&nofb=1

Frankly, all of these cases need the government workers to be held accountable, and the myriad of red tape loopholes CLOSED!  I remember an election; I forget who and the exact when, but a significant election plank in the platform was healthcare reform, promising to clean up the swamp and bring accountability to Washington and the government.  The public is still waiting, and I know enough of you have run on this topic from both parties to repaper the walls (inside and outside) of the White House.

Yet, even if only outside providers and executives were scheming, the VA might not be in too bad a condition.  Except for the employees of the VA, VHA, and VBA, which continue to be caught up in ethics violations at a minimum:

The VA-OIG conducted an administrative investigation that included a congressional request to look into allegations that Charmain Bogue, former executive director of the Veterans Benefits Administration’s Education Service, committed ethical violations arising from her spouse’s consulting work for Veterans Education Success (VES).  VES is a nonprofit advocacy group that regularly had business before the Education Service.  The allegations also pointed to possible incomplete financial disclosures by Ms. Bogue concerning her spouse’s consulting business.  In their work, investigators uncovered evidence of other potential conflicts of interest and related misconduct by Ms. Bogue [emphasis mine].”

VA-OIG finding:

    1. Bogue participated in Education Service matters involving VES without considering whether it raised an apparent conflict of interest and acted contrary to the ethics guidance she received from her supervisors.
    2. Bogue sought résumé feedback from the president of VES to aid in her search for career advancement without considering whether this raised apparent conflict of interest concerns in subsequent VES matters. VES also endorsed Ms. Bogue for presidential nominee positions.
    3. Bogue provided insufficient detail about her spouse’s business in 2019 and 2020 public financial disclosures; VA ethics attorneys had found them compliant. She remedied the subsequently identified deficiency in her 2021 disclosure.
    4. The OIG found that Ms. Bogue refused to cooperate fully in the OIG’s investigation by refusing to complete her follow-up interview. Her husband and VES president also refused to participate in OIG interviews, and the OIG lacks testimonial subpoena authority over individuals who are not VA employees.   Bogue resigned from VA in January 2022.VA 3

UPDATE: 14 April 2022Sen. Grassley was hoodwinked by the VA on this issue and The Daily Signal (linked) has more of this report.  I covered this before, I repeat only for emphasis, when you are discharged from the VA, you lose your ability to be a “whistle-blower.”  As a point of fact, this is how the VA is able to hide a lot of their shenanigans, get rid of the person rocking the boat, invent the paperwork, cover the whole incident over as a “bad-apple” and keep you collective heads down and mouths shut until the VA-OIG investigation concludes.  The VA’s ability to abuse whistle-blowers is further compounded by Federal Attorneys who cherry-pick the cases they know they can win.  Which further protects the VA’s shenanigans and disheartens and mystifies those who have been wrongly terminated.  The Daily Signal reflects this pattern of corruption perfectly citing the records obtained by Empower Oversight.

Some commentators have claimed that blaming elected officials for not scrutinizing or not providing tools to investigate entirely is unduly unfair to the congressional representatives.  Really?!?!?!  The VA-OIG conducts an investigation, the people being investigated refuse to comply, and the VA-OIG is toothless to enforce a full and complete investigation to initiate Attorney General and FBI investigations and actions to recompense the defrauded taxpayer.  Ms. Bogue and the VES have invalidated any trust the taxpayer should have in their respective activities, but this, like so many other investigations into VA employees, will die of apathy before anyone is held accountable.  Even though a congressional representative demanded an investigation, nobody is being held liable.  Nobody is forced to compensate the defrauded taxpayer, yet the taxpayer is still expected to elect the same old representatives to their jobs.  Blaming the congressional representatives (legislative branch) for not scrutinizing the executive branch, one of only two jobs these people have, is somehow unfair?  NO!Exclamation Mark

Remarkably, between the 18 March disaster with the PCP and 01 April’s compounding idiocy, the VA-OIG published an ironically titled investigation report.

Improved Governance Would Help Patient Advocates Better Manage Veterans’ Healthcare Complaints.”

Imagine that, more designed incompetence negatively impacting the veterans seeking care at a VA medical facility, stating the obvious by the investigators.  Who on earth would be responsible for seeing that regulatory agencies had the tools needed to scrutinize and demand corrective action?  Calling all elected officials, did you notice that one of the prima facia tools a veteran has to report problems, conveniently called “patient advocates,” does not have the sufficient authority, adequate oversight, and tools to execute their jobs?  The VA-OIG reports the following:

The Patient Advocacy Program helps advance the Veterans Health Administration’s (VHA) efforts to improve customer service, support veterans’ access to quality care, and provide a mechanism to resolve healthcare issues.  Patient advocates document veterans’ concerns, communicate the resolution, provide follow-up and feedback, and identify trends for potential opportunities to improve medical facilities.  In FY 2020, VHA tracked about 162,000 serious complaints in its patient advocate tracking systems.”

Angry Wet ChickenOn a side topic, VA-OIG, how do you define a “significant complaint” and separate it from other types of complaints?  Honest question, the information was, to quote my PCP, “remarkably” missing from your investigation report!  Would the VA-OIG like to know why so many veterans’ complaints have risen to a “serious” level?  You reported the exact problem:

A complaint is considered resolved when the complainant communicates the outcome, and the record is closed in the tracking system.”

Maybe, the VA-OIG merely overlooked the logic problem, but complaints increase when the solution pushed down the throats of the veterans does not fix the actual situation.  Honest question, no sarcasm involved.  Is a “serious” complaint one where significant harm or death to the patient has occurred?  Is a serious complaint one that breaks federal laws, EMTALA, comes readily to mind??u=https3.bp.blogspot.com-fYRTNk48SCwT8ua0IRDWPIAAAAAAAAFZUpexSmJsN2Kos1600overcoming-adversity-help-yourself-believe-cubby-motivational-1289878102.jpg&f=1&nofb=1

Having had “solutions” forced down my throat, speaking only for myself, I am thoroughly sick of having the patient advocates bureaucratize my complaint, then fail to act, and then compound the problem by quoting policy to me as a reason to close the complaint, when the VHA never have written policies and procedures!  Maybe, you might want to look into the root causes of some of those “closed” complaints and ask root causation questions!

What did the VA-OIG find when they investigated the patient advocates?

    • VHA lacked adequate governance of the Patient Advocacy Program.
    • VHA did not effectively issue and implement adequate policy, monitor complaint practices, and provide guidance to medical facility directors responsible for local program management.
    • Patient advocates did not always enter complaints into the system.
    • Even though complaint records generally appeared to be closed on time, patient advocates did not always document the communication of the outcomes to the complainants.
    • The VA-OIG substantiated an inadequate program policy to identify clear expectations and responsibilities.
    • The VA-OIG found that they (patient advocates) did not always adhere to the documentation requirements to show full complaint resolution.
    • At the local and VISN levels, responsible personnel did not consistently analyze patient advocate tracking system complaints about trends.

Feel free to read the complete abomination of designed incompetence for yourself.  Essentially the VA-OIG concluded that the VHA has been burning taxpayer money in a patient advocacy program, and the designed incompetence is so apparent it can be tracked from L2, where the James Webb telescope is located!  Worse, you won’t need the James Webb telescope to see the designed incompetence!James Webb Space Telescope

Unfortunately, I could have guessed the first three findings without looking.  Every VA program is designed so ineptly, reprehensibly led, criminally incompetent, and with such dastardly deceptive doings that fiction writers’ storylines have to be written better to sell books.  You cannot make this stupidity up and make a profit.  Hollywood would run screaming into the night if they made a true story about the ineptitude found at the VA!

Knowledge Check!Elected officials, where are you?  The VA-OIG presents copies of their findings to you, and I have yet to witness a single one of you holding the VA Leadership criminally responsible for the failures at the VA.  Even when the VA is killing hundreds of veterans, the US Congress refuses even to act upset, let alone scrutinize for a change!  Remember how many veterans were intentionally killed in Phoenix waiting for treatment?  How many VA employees lost their jobs and pensions or were forced in front of a judge for murder?  It is a fair question, where are the elected officials in the legislative branch working to end the criminal “fraud, waste, abuse,” and designed incompetence in the executive branch?

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

NO MORE BS: Climate Change is GOVERNMENT CONTROL!

Angry Grizzly BearTo some of you, I am preaching to the choir; but sometimes the choir sings better when they have more knowledge.  Please help sing louder.  To others, what I am about to say is so far out of your current understanding that your brains might hurt; I am sorry.  You will never understand snowflakes and trolls, but I am willing to take that chance!

According to the Wall Street Journal, the fraudulent president, President Biden, is taking the same plan President Obama used to restrict America to a Climate Change job-killing pogrom!

Mr. Biden is essentially doing an end-run around the Constitution, which requires approval by two-thirds of the Senate for the President to enter a treaty. The emissions reductions that foreign leaders pledged on Thursday aren’t legally binding, but Mr. Biden intends to use regulation to bind Americans.”

This single statement should scare every American, whether you believe in Climate Change Hype or not.  President Obama and now President Biden refuse to act within the law where climate change is concerned.  This means there are nefarious problems, greedy hands, and legal issues the sitting president is trying to keep hidden from American citizens.  Unfortunately, this is just the beginning of the Climate Change Pogrom Plans that have been made public.Problems

What is a Pogrom?

A pogrom is a violent massacre or destruction by a government entity against its own citizens.  Nazi Germany changed the law, then massacred legally their Jewish, Catholics, Handicaps, mentally handicapped, and other aspects of undesirable citizens.  Stalin and Mao have used pogroms to murder, execute, and destroy their own people, neighbors, and many others.

Why is Climate Change a Pogrom?

From the Wall Street Journal, “Businesses will be conscripted as foot soldiers in the progressive war on fossil fuels.  America’s founders believed that the Constitution’s separation of powers would safeguard individual liberty, but this assumes Congress guards its power” [emphasis mine].  The separation of powers was supposed to stop this madness.  As President Obama demonstrated, there are loads of chicaneries the legislative branch can get away with, and Congress and the Judicial Branch refuse to exert their powers.

Millstone of Designed IncompetenceNow, let’s talk about the 10-year plan, a $2.3 Trillion plan that is a “more-than-infrastructure proposal” but is nothing but the Green New Deal in disguise.  So far, the best record for the details that have been released comes from DailyMail.com.  We need to be clear, not all the details have been released, but those released details should scare every person in America into action against this power seizure!

  1. Biden vowed that America would be “on a path of a zero-emissions economy by no later than 2050.”
      • Where is the US Congress in agreeing to this plan?
      • Where is the complete plan laid out for the American People to review and approve?
      • America is a Republic (if we can keep it), and I do not see anything that reveals this information, neither does DailyMail.com.
  2. From experts, to reach a zero-emissions economy, the following will have to occur within the next 10-years:
      • All meat consumption, especially red meat, will have to drop to less than 4 pounds a month per American, or roughly 90% of today’s consumption rates for red meat and a 50% cut in all animal consumption. Essentially, America would be on a 0.18 ounce of meat per day for protein.
      • Every single American will have to buy an electric car, currently a $55K investment.
      • Electric heat, solar panels, windmills, and more would have to be drastically increased, increasing the cost of electricity to roughly $5700 a month for heating and cooling your home.
      • The costs of the plan, to start, begin at $2.3 Trillion. If ObamaCare is any indicator at how fast cost estimates by the government are surpassed, a closer cost estimate is around $500 Trillion!  Don’t forget the farrago that was the ObamaCare Website!  Including:
          • $85 Billion for infrastructure modernizing public transit.
          • $174 Billion replacing lead pipes and modernizing drinking water and sewer systems.
          • $100 Billion to protect nature-based infrastructure.
          • $40 Billion for housing infrastructure.
              • What does this mean?
          • $100 Billion for upgrades to the electrical grid.
          • $100 Billion for new public schools.
              • Why?
              • Isn’t this a state issue?
              • Aren’t I, and every other American, already paying for school modernization?
          • $10 Billion for upgrading federal buildings.
              • Why isn’t this already occurring?
          • $35 Billion for investing in climate science.
          • $10 Billion for an enforcement arm, called the Civilian Climate Corps.
  1. How many dairy farms, ranches, and other animal husbandry jobs will be lost to reduce protein intake to 0.18 ounces daily?
  2. How many restaurant jobs will be wiped out due to the costs that will disproportionately fall upon the reduced middle-class and lower class of people?
  3. How many American jobs in Natural Gas and Oil fields will be lost to other countries that do not have to follow the same plan to reduce emissions?
  4. How much of the economy will be sacrificed for science projects and liberal pipe dreams?
      • Public transit systems are a colossal waste of tax dollars just for inner-city transit; how about intra-city transit?
      • AMTRAK hasn’t been able to turn a profit on carrying people between cities ever; how does modernizing public transit improves the loss of taxpayer dollars down this well of liberal insanity?

Andragogy - LEARNRemember, our pattern for this insanity is from President Obama, who had a comfortable first two years due to a friendly House and Senate. They could not do these enviro-legislation issues due to US Constitutional problems, so President Obama used executive orders.  Again and again, climate science has proven to be a money-sucking black hole for taxpayers while the limited few buy new jets, new luxury yachts and force restrictions upon everyone else.

ApathyHow many people will die from the cold or the heat due to the cost of electricity, electricity failure, and not having a backup or tertiary source for heat or cooling?  Every year America sees people die from the cold and excessive heat.  Want a pattern for how higher electricity costs and liberal-brain dead solutions work; let’s look at California.  Last year, loss of power killed people on medical equipment, where electrical lines were not properly maintained, sparked fires, and rolling brownouts are common.  Now that you see the middle and lower class sacrifices, ask yourself, did Speaker Pelosi (D) or any of here Hollywood and political buddies suffer any inconveniences from brownouts and loss of electrical power?

LookHey Speaker Pelosi, how big are your freezers and refrigerators again?  How many do you have in your walled mansion?  How much electricity do you consume?  Climate scare is a method for an unconstitutional power grab, plain and simple, and every single American needs to be actively engaged in fighting these restrictions!  The fight for liberty is cloaked in “Climate Science,” and every nation on earth has been infected with this power-grabbing sickness where politicians win and the citizens lose!

© 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.

Department of Veterans Affairs Chronicles of Shame

I-CareAs a veteran who struggles with post-traumatic stress disorder (PTSD), stemming from military sexual trauma (MST), where a first-class petty officer jumped on my back and tried to rape me.  When I see the Department of Veterans Affairs – Office of Inspector General (VA-OIG) reports on PTSD from MST, I pay close attention.  Since the Department of Veterans Affairs (VA) continues to deny my MST claim because MST does not happen to men, I get agitated when I see these VA-OIG reports repeating year-over-year with the same excuses and designed incompetence.  Designed incompetence is all about creating ready-made excuses for failing to perform correctly the role one has been hired or promoted to perform.  Consider the following:

“In 2018, the VA Office of Inspector General (OIG) reported that nearly half of disability benefit claims that were denied service connection for post-traumatic stress disorder (PTSD) and were related to military sexual trauma were not processed properly.”

That is the first sentence of the VA-OIG report released on 08 December 2020 declaring that the improvements suggested by the VA-OIG in 2018 had not occurred.  The following statistics come directly from the report issued.

      • 18,300 claims or approximately 16% were processed incorrectly in Fiscal Year 2019
      • 118,000 claims were submitted

Why were the claims processed incorrectly; because of designed incompetence by the Department of Veterans Affairs – Veterans Benefits Administration (VBA).  From the report, we find the following five root causes, or excuses: emphasis mine.

    1. Most errors occurred because claims processors did not verify or ask veterans to provide the disorder’s cause, known as an in-service stressor.
    2. In other cases, claims processors did not request a medical examination, medical opinion, or clarification of inconsistencies in the examination as required.
    3. Claims processors made these errors because they did not fully understand PTSD stressor types and the stressor verification process.
    4. VBA’s Compensation Service did not mandate any national training for claims processors on these subjects except during the first year in the position.
    5. In addition, VBA’s procedures manual was not effectively organized to allow staff to locate this information and lacked specific guidance for some aspects of PTSD claim processing.

VA SealWhy are the causes of the problems considered designed incompetence, because they never change!  At the VBA, the processors all need constant training to remain current in their positions; but never receive the training.  The VBA never holds value-added training sufficient to train the employees on their jobs, but this remains the number one excuse to justify poor performance in VA-OIG inspections.  Failure to perform the job is also not a new excuse, where the VA-OIG reports are concerned.  Not understanding how to ask for help is also not new, and frankly astounds and mystifies observers that those hired remain employed when their performance clearly remains insufficient to the job expectations.  While it is unique to the VA to see a procedure manual, it is only natural and expected that the manual is poorly organized, poorly executed, hard to follow, difficult to find, and generally useless.  The VA is famous for this designed incompetence trick.

You say, “Big Deal;” everyone knows the VA is messed up, full of failures, and is generally known for poor performance.  Why this is a “Big Deal” stems primarily from the costs associated with poor performance.  An annual salary is paid for the processors, the adjudicator, and the entire chain of command, totaling in the hundreds of millions of dollars.  The veteran has to pay for lawyers and other services to appeal the original decisions, which take time.  The veteran has to pay for a third-party Nexus Letter to accompany the claim to declare the original claim was faulty.  All of this requires substantial time investments and other resources, all because the original work has to be duplicated.  How many times the claim is duplicated depends upon the processors’ abilities to do the job they were hired to perform.

Your car breaks down; the tow truck driver only secures your vehicle 84% before driving to the auto repair facility, is this satisfactory performance?  Your surgeon has an 84% success rate where his patients will live after surgery for tonsil removal, is this satisfactory performance?  You are in hospital; your nurse only gets your pain medication to you 84% of the time or is only 84% accurate in providing the right patient the proper medication; is this satisfactory performance?  Of course not, but for government employees, this level of performance is “award-winning.”

Military CrestsCongress mandates VBA claim error rates; there is supposed to be a quality assurance check to reduce the error rates.  Yet, with all the checks, the balances, and the quality assurance programs, the VBA continues to surpass the error rates and physically harms veterans due to their inefficiencies.  Yes; a failure rate of 16% is a “Big Deal!”

Want to know how bad the VA is managing your taxpayer monies; read the audit released 14 December 2020.  In that audit, you will find comments like the following:

      • The material weakness involving information technology security controls has been reported for more than 10 years.
      • VA did not substantially comply with federal financial management systems requirements and the United States Standard General Ledger at the transaction level, as required by the Federal Financial Management Improvement Act.
      • [The] VA’s complex, disjointed, and legacy financial management system architecture no longer supports stringent and demanding financial management and reporting requirements.
      • VA continued to be challenged [with] consistently enforcing established policies and procedures throughout its geographically dispersed portfolio of outdated applications and systems.

In light of the recent computer hacking issues the Federal Government is experiencing, knowing that the VA has dumped hundreds of millions of taxpayer dollars to patch and repair, and sometimes replace (sort of), legacy (old, expired, useless, insecure, unreliable, etc.) technology over the last 20-years, how is the VA able to keep getting away with these designed incompetence excuses?  Congress, when will you hold the administrator’s feet to the fire for making progress on these glaring issues?  Congress receives these VA-OIG reports and audits before they are made public, yet the elected representatives cannot take a moment to check this poor behavior.  Why not?

Police and Government Lines of CongruenceFor the first time in more than a decade of chronicling the VA-OIG reports, I am mentioning a monthly highlight (lowlight) condensed report.  This report is unique due to the insanity of criminal investigations mentioned, the results of audits, and the healthcare inspections.  When you have 18 defendants in a bribery scheme, where 15 plead guilty, who defrauded untold Millions of dollars in Florida, the problem is not so much with the employees, but the organization that allowed this to occur since 2009!  A noteworthy criminal investigation indeed.

The highlights (lowlights) of November 2020 also include a VA physician from West Virginia being indicted for abusive sexual contact and simple assault and a surgical supervisor in Northern Ohio who defrauded the VAMC of approximately $3.2 Million in two separate schemes.  Regarding financial audits and the importance of improving that ancient technology, a VA Fiduciary has been indicted for misappropriating government funds from Pennsylvania to the tune of more than $155,000.  Best of all, a husband and wife team from California, technical school owners, bilked the GI-Bill of more than $29 Million since 2015.

The criminal issues the VA is facing regularly are not a one-off issue, but an organizational design problem as the frauds, thefts, and malfeasance reported is ever only the very top 1% of the problem that is ongoing and systemic in the Department of Veterans Affairs!  The November 2020 report discussed an incredible number of canceled patient appointments because veterans and COVID mask mandates do not play well together.  Yet, the VA Federal Police cannot stop persecuting veterans for their physical inabilities to wear a mask.

Thus, where are the elected officials from the legislative bodies who possess oversight and funding responsibilities?  Where is the executive branch of government in correcting and demanding specific action from the legislative branch?  Where are the administrators at the Federal, VISN, and Local levels in performing their jobs?  The designed incompetence must cease forthwith to allow for practical changes to be made and the organizational design to be corrected.  For the VA-OIG to be forced to accept the same tired, lame, and detestable excuses, year-over-year is the epitome of abuse to the taxpayer and veteran alike!

The Duty of AmericansWorst of all, this condensed version did not even scratch the surface of the issues reported in just three VA-OIG reports.  Shame!  Shame! Shame!  Shame on the elected officials, Republican, Independent, and Democrat, who have allowed this problem to grow and done nothing!  Shame on the myriad of presidents who have done nothing but throw good money after bad, without demanding progress and holding real people responsible for real results!  Shame on every single VA employee who shirks their job for easiness to the pain and suffering of a veteran, dependent, or spouse!

© 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 images.
All rights reserved. For copies, reprints, or sharing, please contact through LinkedIn:
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The US Bill of Rights – Knowing the Paradigm

GI JoeDuring much of the 1980s G. I. Joe cartoons had a commercial that ended, “Knowing is half the battle.”  In the spirit of “knowing,” the following is a discussion on the US Bill of Rights.  The US Bill of Rights is the first 10 amendments to the US Constitution.  Many people think that the US Constitution begins with these 10 amendments, and there remains significant ignorance over what is said, and what is meant, in the US Bill of Rights.  Finally, the US Bill of Rights, or the first 10 amendments, was passed by the US Congress and ratified by the states too, “… Prevent misconstruction or abuse of its (US Government) powers, that further declaratory and restrictive clauses should be added, and as extending the ground of public confidence in the Government, will best ensure the beneficent ends of its institution.”

Never forget, the preamble to the US Constitution describe why governments are formed stating, “… In order to form a more perfect Union (government), establish justice, insure domestic tranquility, provide for the common defense, promote the general welfare, and secure the Blessings of Liberty to ourselves and our Posterity.”

Amendment 1 states: “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press, or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.”  There is much to discuss regarding what is being witnessed in America right now where the First Amendment is concerned.  Peaceable assembly does not include throwing rocks, blocking traffic, interrupting the free flow of commerce into or out of a building, starting fires, shouting, screaming, or anything else like unto the behavior witnessed in America by radicalized youth and adults.  How does one tell the difference between peaceably assembly and protests; the answer is simple and comes down to one word, respect.

Aretha Franklin (1967) taught America about R-E-S-P-E-C-T and just following the basics she sang about, will differentiate between mobs and peaceably assembling.  But, do not forget, there is a purpose to peaceably assembling, to “petition the government for a redress of grievances.”  Petitioning does not include screaming, using a megaphone, “sit-ins,” and other actions that disrupt the working of the government.  The actions of those in Portland, Seattle, New York, and several other cities where fires burn, private and public property is destroyed, commerce interrupted, business halted, and fear is spread, is the work of anarchists, terrorists, and villains, not people peacefully assembling to petition for redress.  Politicians take note, if you cannot tell the difference between a peaceful assembly and a riot, I am sure there are several police officers who can make the difference perfectly clear.

Respect is a two-directional path leading to communication, improvement, and the betterment of society.  If the respect flows out but is not returned, then the problem is with the receiver being selfish and communication will never occur.  If the sender is not sending out respect, the problem is a selfish sender, and contempt is all that will be returned.  Why is respect important; because in today’s political environment there is no respect.  Contempt for the voter, contempt for the other political side, contempt for law and order, contempt is running rampant and the fruits of contempt are a bitter fruit indeed.

Politicians, ask yourself, what do you do to reflect respect to the people you represent?  What do you do to reflect respect for the office you hold and the heritage left you as you fill the duties of that office?  What does your staff do to reflect respect back to those who hired you, through an election process, and pays for your staff through forced taxation?  If you only represent the big business and big donors who helped elect you, you are not respecting anything or anyone, especially yourself.  The first amendment to the US Constitution reveals much about a person, almost as good as holding up a mirror of the soul.

Amendment 2 states: “A well-regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed.”  Much continues to be said and written about this amendment.  Many have tried to wrestle meaning from this amendment that runs contrary to the specially selected wording in the amendment, covering their actions by calling their shenanigans “the intent of the authors.”  Each citizen of America was considered a member of the militia, and as such the security of the American Republic, rested first in the hands of freedom-loving, gun-toting, people.  Stop selling snake oil, start accepting the fact that those who try to “judge intent” of the US Constitution are the problems in America.

kpiAmendment 3 states: “No Soldier shall, in time of peace be quartered in any house, without the consent of the Owner, nor in time of war, but in a manner to be prescribed by law.”  The language of this amendment, particularly, never ceases to amaze me.  In order to protect the liberty of individuals, soldiers cannot be housed in a citizen’s home; thus, protecting the ability and freedoms of thought and property from unlawful government intrusion.

Since fourth grade, it has amazed me to no end that the second amendment needed to be understood through the intent of the authors, but the first and third amendments needed no “intent” clarification.  This is not irony; this is blatant bias and opinion masquerading as benevolence.  I reject utterly and completely any and every argument based upon the “intentions” of the authors in understanding the US Constitution.

Amendment 4 states: “The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no Warrants shall issue, but upon probable cause, supported by Oath or affirmation, and particularly describing the place to be searched, and the persons or things to be seized.”  Speaking of “intentionality arguments,” the fourth amendment continues to be replete with interpretations by judges, lawyers, interfered with by bad case law, and weak-kneed Supreme Court (SCOTUS) decisions.  Like the third amendment, the fourth is all about keeping the government out of a person’s home, properties, papers, and so forth.  If there is anything more egregious in modern America, the abuse of the US Constitution must rank first, and foremost, in the minds of every American.  Several current issues are before the court and the lawyers will make more money, and the judges will make more money, but the citizens of America will be abused.

Lady JusticeConsider how the Patriot Act, a horribly misnamed piece of legislation, allows for warrantless searches in the name of protecting America.  Like the Affordable Care Act produced the reverse and increased the cost of health care while reducing the quality of health care, the Patriot Act has stripped patriots of safety in their property, papers, and so forth.  2018 had two cases argued before SCOTUS regarding warrantless searches and seizures; warrantless search and seizure is unconstitutional, yet they occur.  The two cases of warrantless searches were both decided by SCOTUS in the petitioner’s favor (Collins v. Virginia & Byrd v. Government).  SCOTUS has ruled on cellphone data, and many regarded that law as dangerous due to the argument that survives that since the government owns the technology the cell phone providers use, then the individual users have no right to privacy or constitutional protections by using cellular phones, cellular data, and where that user goes is able to be scrutinized without warrants.

Now, enter the lawyers, attorneys, and armchair lawyers who will argue and complain about my ignorance of the law, throwing up arguments, and muddying the issues.  Yet, the ACLU is making the arguments that the Patriot Act has reduced the American Citizen’s rights to the fourth amendment.  FISA Courts have been discussed due to the role they played in obtaining warrants to illegally spy on political opponents.  FISA Courts should scare the hell out of every American!  Yet, the Patriot Act passed with no debate, no discussion, and many legislators never read the bill before or after voting.

Amendment 5 states: “No person shall be held to answer for a capital, or otherwise infamous crime, unless on a presentment or indictment of a Grand Jury, except in cases arising in the land or naval forces, or in the Militia, when in actual service in time of War or public danger; nor shall any person be subject for the same offence to be twice put in jeopardy of life or limb; nor shall be compelled in any criminal case to be a witness against himself, nor be deprived of life, liberty, or property, without due process of law; nor shall private property be taken for public use, without just compensation.”  FISA courts empowered the FBI to be the politician’s best friend and the freedom-loving person’s worst enemy.  The taking of private land for public use continues to be abused beyond measure.  Eminent domain abuses abound, and one axiom of law I have come to appreciate is as follows, “Bad cases make bad case law!”  Where the concept of “eminent domain” is concerned this axiom remains telling, and the abuses of government unabated.  Between the principle of eminent domain and the Patriot Act, the fourth and fifth amendments have been stripped, the power shifted to the bureaucrats and politicians, and the abused American Citizen left without recourse.

LinkedIn ImageAmendment 6 states: “In all criminal prosecutions, the accused shall enjoy the right to a speedy and public trial, by an impartial jury of the State and district wherein the crime shall have been committed, which district shall have been previously ascertained by law, and to be informed of the nature and cause of the accusation; to be confronted with the witnesses against him; to have compulsory process for obtaining witnesses in his favor, and to have the Assistance of Counsel for his defence.”  When it comes to legalese muddying the intelligence of an issue, I have not found anything more convoluted than the definition of a “speedy trial.”  Worse, with the FISA Courts not having to inform the accused, a person could be accused of a crime and never know they have been accused.

Amendment 7 states: “In Suits at common law, where the value in controversy shall exceed twenty dollars, the right of trial by jury shall be preserved, and no fact tried by a jury, shall be otherwise re-examined in any Court of the United States, than according to the rules of the common law.”  The seventh amendment remains important specifically for the re-trial in a different court of an issue settled by a jury trial.  Enter the convolution of “small claims court” as a method of settling matters between people or businesses (under $10,000).  To be frank, you can have a jury trial in small claims court, and some issues are worth having a jury hear evidence.

Amendment 8 states: “Excessive bail shall not be required, nor excessive fines imposed, nor cruel and unusual punishments inflicted.”  What does excessive mean according to a dictionary; “more than is necessary, normal, or desirable; immoderate.”  Bail is all about incentivizing a person to appear in court.  Excessive bail used to be set in England as a means of keeping a prisoner in jail, to work.  Thus, the founding fathers desired bail to be reformed to prevent people from wasting away in jail from poor living conditions, harsh work conditions, and languishing in prison for a considerable time without trial.  Modern America has seen the abuse of language, the plasticization of terminology, and the convolution of excessive, into decreasing bail to nothing.  New York and California both have laws representative of these practices, to the detriment of law enforcement, the revolving doors of prisons, and the decrease in safety for the citizens affected.

ScalesAmendment 9 states: “The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.”  Rights of the people, the US Constitution, and the individual constitutions of each state and commonwealth in the American Union, cannot infringe upon other rights of the people as they individually dictate.  How did we American Citizens lose sight of this amendment and what it means?  How did we lose the US Constitution?  Under Amendment nine FISA Courts should never have been established.  The right to die without health care intervention is encapsulated in the ninth amendment, but somehow this has been lost.  I remember distinctly losing the classroom debate that assisted suicide is a right under the ninth amendment; I also remember the day when states started passing laws to counter assisted suicide.  Consider the case of Boston Children’s Hospital v. Justina Pelletier, and you will find the ninth amendment abused and tattered by the hospital bureaucracy, as well as horrible malpractice.

Amendment 10 states: “The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.”  Yet, America is replete with Federal and State laws which represent government overreach.  Yet, America is inundated with bureaucracies who design new rules without the consent of the legislative branch that empower the executive branch to trample individual rights, state’s rights, and liberties.  America, you have been abused by a runaway government, powered with politicians and bureaucrats who strive to “keep the gravy train running,” at your expense.

According to the US Constitution can a person choose to live in poverty; yes!  According to the US Constitution does the government have the power to pass out government benefits, which are nothing but taxpayer funds; no!  Yet, the US Government and the various states and commonwealth continue to choose who to pass out government funds to and interfere in people’s lives and choices.  How many times in American History has the actions of government improved a situation; zero!  War on poverty; lost!  War on drugs; failed.

Whale in OceanThe politicians, from both major parties, are guilty of government overreach and unconstitutional power grabs at the city, county, state, and federal government levels.  America must stand, to survive America must return to the roots established by the US Constitution.  Yes; this means getting the government out of Social Security, Welfare, and butting its nose into the rights and liberties of the individual citizen.  Consider the following, a whale and the ocean.  Does the government represent the whale or the ocean?  For if the government is the ocean, then the wale is reliant upon the government.  But, if the whale is the government, then we the citizens of America are the ocean and the government is dependent upon us.  The US Constitution claims the government is the whale and we the citizens are the ocean, and the government depends entirely upon the consent of the governed.

Well, I am revoking my consent!  The government has abused me enough.  I am done with government and bureaucratic overreach.  I reject the thought posited by Charles Reich that I am the property of the government.  Until the government is placed upon a strict constitutional diet, I revoke my consent to be governed.  We, the American Citizens, can retake control from the bloated feck beasts in government and correct the course of this Republic through the powers provided to us in the US Constitution.

The Duty of AmericansI speak by way of invitation; join me, revoke your consent to be governed by these totalitarians!

© 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 text quoted from another source set in italics and is not the property of the author.  Minor punctuation and spelling changes made.

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