(1) Had a great meeting with the VA Secretary yesterday. The good news? Shulkin is a good man that cares about helping our nation’s vets. He agrees that the VA needs significant reform.
(2) Lots of good things happening. Shulkin has made the VA far more transparent. Examples: the VA is publishing wait times publicly for the first time. He’s shrinking the VAs footprint by doing away w/under utilized facilities.
(3) Shulkin also recognizes the need for significant cultural change as well. He specifically referenced a generalized cultural malaise some VA employees have when dealing with veterans. In some cases, even a lack of respect towards veterans.
(4) Secretary Shulkin also wants veterans to have more choices regarding their healthcare. And he wants those choice to be made with, and aided by doctors and clinicians. Not bureaucrats. Which is also good.
(5) Although I have to say, that despite all of this sounding great and reading even better on paper. It comes down to one critical thing for me.
Who is the approval authority for whether or not a veteran gets real choice? You guessed it. The VA.
Who is the approval authority for whether or not a veteran gets real choice? You guessed it. The VA.
(6) I talk to veterans every day. I always ask them if they’ve received their choice card. Most have. Then I ask if they’ve been able to use it to choose a healthcare provider when they couldn’t get an appt at the VA.
I’d say 99% of the time, the answer is no.
I’d say 99% of the time, the answer is no.
(7) Why? Because those requests are shunted back into the bureaucracy where they’re lost track of, denied, or simply take too long to approve.
(8) I asked the VA Secretary about how they evaluate facilities for closure. Bottom line, they measure each facility’s effectiveness against other healthcare providers in that same community. And the ones below community minimum standards for care can be flagged to close.
(9) My issue with this? Again, each individual VA facility is in charge of reporting their stats. After the secret wait list scandal and many others, how can they be trusted to report those stats accurately?
(10) institutional bureaucracies almost always protect themselves first. There isn’t a single VA facility out there that will report negative stats which could lead to their own closure.
(11) and if bad facilities aren’t being held accountable or identified properly, then vets in those communities will suffer.
And with the VA the approval authority for “choice” a veteran doesn’t really have the flexibility to escape these sometimes toxic environments.
And with the VA the approval authority for “choice” a veteran doesn’t really have the flexibility to escape these sometimes toxic environments.
(12) I know this situation is immensely complicated. And I’m not placing blame on anyone at the VA, Secretary Shulkin included. The Secretary gets it.
(13) but what I am saying is this. The VA requires bold changes. Nearly everyone recognizes it. The HVAC bill that’s floating around doesn’t even come close to fixing the issues. In fact, I’d say at least from a “Veterans Choice” standpoint, takes us back a few years.
(14) @realDonaldTrump campaigned on Full choice for veterans, & holding bad employees & inefficient facilities accountable. Right now, that’s not happening. Congress needs to get their ass in gear.
Veterans lives in many cases literally depend on it.
Veterans lives in many cases literally depend on it.
