Congress May Fix VA Hospitals By Merging Them With Military

DeepseekerADS

Gold Member
Mar 3, 2013
14,880
21,725
SW, VA - Bull Mountain
Detector(s) used
CTX, Excal II, EQ800, Fisher 1260X, Tesoro Royal Sabre, Tejon, Garrett ADSIII, Carrot, Stealth 920iX, Keene A52
Primary Interest:
Other
Congress May Fix VA Hospitals By Merging Them With Military | The Daily Caller

02/15/2016
Source: The Daily Caller
by: Luke Rosiak

Congress is exploring a dramatic transformation of Department of Veterans Affairs (VA) hospitals that would merge them with Department of Defense (DOD) facilities and treat active duty soldiers and veterans side by side.

Many veterans and lawmakers believe the VA healthcare system is in dire need of complete overhaul, and the idea of privatizing it has been increasingly popular. But lawmakers have also quietly been pondering a fix that would take it in the opposite direction — militarization.

A massive pilot project called Lovell Federal Health Care Center in North Chicago just completed a five-year trial, with seemingly positive results. The joint DOD-VA hospital now sees most patients within one day and nearly all within one month of their desired appointments, and ranks in the top five of VA hospitals in overall wait times.

This stellar performance comes as veterans have died waiting for care at traditional VA hospitals. Lovell also excels in patient satisfaction ratings and was named a top performer by a nationwide hospital accreditation group.

Lovell is now the only place in the country where a Korean War vet and a sailor’s pregnant wife may pass each other in the hallway. If any VA staff member needed a reminder that the elderly they are treating are there because of heroic service, the sight of a uniformed Navy recruit also on his way to a physical exam might drive home the point.

The joint hospital’s capacity for treating women vets has improved because DOD hospitals have long cared for the wives of soldiers; active-duty soldiers benefit from VA’s experience in mental health.

The DOD and VA have been authorized to share resources since the 1980s and there are nine smaller jointly operated facilities around the country, but none has ever been as large as Lovell. When a Navy hospital and VA medical center were both dilapidated, then-Illinois Rep. Mark Kirk urged the building of a combined facility. The DOD and VA agreed to the merger in 2002 and it opened in 2010 after a $130 million construction effort.

Congress conceived of it as a pilot program that would report back after five years, with success meaning merging DOD and VA hospitals in other cities would be considered.

It is unclear to what extent the current Congress will embrace the larger vision set into motion years ago. Sen. Johnny Isakson, chairman of the Senate Committee on Veterans’ Affairs, refused to say whether he even knows about the massive experiment, much less what his opinion on replicating it nationwide it might be.

But one aspect of the merger — having military engineers take over for VA’s beleaguered construction office when it comes to building hospitals — already spread nationwide this month, with Congress giving all VA construction projects to the Army Corps of Engineers. The VA’s biggest recent project, a Colorado hospital, went $1 billion over budget and department officials could not explain why. Even so, the VA’s construction administrator got $30,000 in bonuses.

So far, the merger’s financial savings appear underwhelming, and Congress did not seem to press the VA and DoD to realize efficiencies, a major benefit of most mergers. Lovell simply requested a budget equal to those of the two predecessor hospitals combined, and congressional appropriators agreed.

“Cost savings, mainly one-time construction savings, were one of the original considerations in deciding to integrate the two facilities, but FHCC officials told us that they are unable to determine whether these savings were actually realized,” a Government Accountability Office report found.

Some savings have been apparent. The hospital voluntarily returned $12 million, with annual appropriations now reduced by that amount. More significantly, it has not needed to tap into extra emergency funding for things like an expensive Hepatitis C medicine, as other VA hospitals have.

And improvements to the level of service are apparent, with the hospital rising in VA’s ranking system.

Veterans navigating traditional VA hospitals have long yearned for care that was closer in quality to what they received as enlisted men.

“We take pretty good care of our active duty,” Steve Holt, Lovell’s director, told the Daily Caller News Foundation. The Navy simply wouldn’t tolerate a healthcare system that became a bottleneck for recruit readiness, he said, and that fact has benefited vets from all military branches.

In 2014, Lovell provided medical care to 25,000 vets, 4,000 active duty personnel, 10,000 family members, and 50,000 Navy recruits.

The merger has also impacted the culture of the workforce vets are treated by, with 1,000 active-duty military working alongside 2,000 VA civil servants. Military members are known for strong work ethic and unforgiving standards, which vets say they haven’t always seen with VA staff.

Holt is a veteran and a doctor, which also sets the facility apart; only two out of 60 directors in the VA’s traditional healthcare system fit that description.

“One in three of my staff wear a uniform, and there’s a realization of how they relate when they see those sailors that makes them more loyal, more appreciative and more willing to speak up and say ‘you know if you did it this way, you’d do it better,'” he said.

The military culture has permeated the civilian staff in part because sailors who work at the hospital or are there for treatment go on to work there in a civilian capacity after they leave the military. Better yet, military medics work there after they retire from the armed forces, alleviating a shortage of doctors that is one reason the VA fails to treat patients in a timely manner.

The cross-exposure “is an important source of recruitment,” Holt said.

An operating agreement attempts to navigate the merger of two massive bureaucracies. Lovell’s agreement says it is supposed to split top jobs between VA and military personnel, and have a VA person in the top job. Holt became a VA executive after retiring from an Air Force hospital in 2005, and Lovell’s second-in-command is a Navy captain.

Military influence is especially heavy now at Lovell because the VA has failed to assign executives to the hospital, leaving many positions filled in an “acting” capacity by military, a review of personnel listings shows.

In combining the two organizations, administrators had to merge two different sets of policies, and said that they selected the most stringent from each.

Next month, reports assessing Lovell’s five years are due from the DOD, the VA, the Government Accountability Office and an auditor. Administrators will deem it a success.

“They want to continue us, they thought that would be more efficient and effective,” Holt said. “Personally I’d like to see the model done elsewhere.”

They have the backing of Kirk, who is now chairman of the Senate’s VA appropriations subcommittee. “I would like to see the Lovell model become one that we can reproduce across the country in order to combine resources and improve veteran care,” Kirk said.
 

Unclebuck257

Sr. Member
Aug 31, 2013
479
397
North Central Texas
Detector(s) used
AT Gold, Garrett Carrot PP
Primary Interest:
All Treasure Hunting
Deep,

Interesting concept and I appreciate you posting this in detail. I had no idea that this type of a project was going on and I can readily see the benefits as indicated in this article. Although I can see the benefits, as I've stated in this program, I can also see greater benefits for some using the VA Healthcare System if it were to go private and expand that way. The above system doesn't help those vets who would still have to travel long distances, although when they finally got to the location this article seems to indicate a much better quality of treatment. Additionally, the article seems to admit that some vets are still having to possibly wait 30 days for an appointment to see a specialist. That's better than "over 30 days", but still lacks the urgency some vets need with their appointments.
 

foiler

Sr. Member
Mar 17, 2013
395
389
Kansas
Detector(s) used
Fisher, Wilson-Neuman, Whites, Minelab, Tesoro and others I've long since forgotten
Primary Interest:
Metal Detecting
While it's a step in the right direction I don't believe it's a cure for the problem. In the beginning there where no doctors at the VA, but like all government agencies they began their empire building, creating the inefficient beast they've become. The VA needs to go back to it's original mission. That was identifying service connected injuries and disabilities. The VA should be in the 'administration' business as their name indicates and not the medical business. Identify a vet's medical problems and provide them with a medical card that allows for medical treatment for those problems by any doctor of their choosing. Forcing a veteran to go to a military base or VA facility is inconvenient to a large portion of vets that don't live near one. If military bases start treating all vets where are they doctors going to come from, Bangkok? They don't have enough now as it is.
 

Last edited:
OP
OP
DeepseekerADS

DeepseekerADS

Gold Member
Mar 3, 2013
14,880
21,725
SW, VA - Bull Mountain
Detector(s) used
CTX, Excal II, EQ800, Fisher 1260X, Tesoro Royal Sabre, Tejon, Garrett ADSIII, Carrot, Stealth 920iX, Keene A52
Primary Interest:
Other
The only insurance I have (except the mandatory medicare) is the VA in Salem, Virginia - a pretty old facility but with continuous modernization. I have no complaints, but will admit 30 day minimum for appointments. I've had two eye surgeries, a hemi-colonectomy, and two basil cell carsenomas removed plus all the miscellaneous etc appointments and tests. It's a 90 minute drive each way.

Since I've been going there for the last 5 years it has gotten so crowded I have to park about a mile away. Hordes of Iraq & Afghan vets coming in, along with all the forgotten ones who probably didn't even know they were eligible. I know I didn't know I was eligible until my barber told me in 2009.

As for this change, I have to believe it might be a good change - get it out of the government bureaucracy - so many of these hospitals are monstrous based on the news articles we keep seeing. They sent out that Veterans Choice Card, but nothing ever became of that - I guess I should throw away that "Temporary Program" card.

A great recent experience I had was about three weeks ago I fell and broke a rib. It was raining and in the afternoon, I e-mailed my primary care and forewarned him that I would be going to the emergency room the following morning. Received an almost immediate phone call wanting me to go there right then. Because of the hour and the pouring rain, the long drive over the mountains, and the pain I was in, I made the trip the next morning. They got right on me.
 

Unclebuck257

Sr. Member
Aug 31, 2013
479
397
North Central Texas
Detector(s) used
AT Gold, Garrett Carrot PP
Primary Interest:
All Treasure Hunting
Deep,

Read your experience regarding three weeks ago about your being treated for a broken rib. I guess my question to you now is..Did the VA pay for your treatment at a local civilian hospital ER? I realize that they should have but I have learned from personal experience that even though your local primary care facility tells you to go to a local emergency room for treatment, that doesn't necessarily mean the VA will pay for it, ESPECIALLY when the vet has Medicare coverage. It happened to me and the VA REFUSED to pay for the care I received at a local hospital because " I had other insurance" referring to my medicare coverage. That "Having other insurance" was not just an excuse in my case but was one of the 5 or 6 pre-printed reasons the VA had already printed on the turn down form the VA can use to turn down a claim made by a vet. At that rate, ANY VET over 65 is toast because of medicare coverage! Be careful my friend. As in your case, my primary care told me to go to a local ER too, but they DO NOT make any decisions regarding whether or not the VA will pay for that treatment. What that means is that YOU will wind up paying for anything medicare does not pay for with the doctor or the hospital.
 

OP
OP
DeepseekerADS

DeepseekerADS

Gold Member
Mar 3, 2013
14,880
21,725
SW, VA - Bull Mountain
Detector(s) used
CTX, Excal II, EQ800, Fisher 1260X, Tesoro Royal Sabre, Tejon, Garrett ADSIII, Carrot, Stealth 920iX, Keene A52
Primary Interest:
Other
Uncle Buck, that's darned good information to know.

I didn't go to a local ER, I figured they'd throw me on Medicare and I'd be stuck with a big bill. I planned to head to the VA ER.

When I went to the VA, I checked straight in with my primary care at about 0730. I'd barely even sat down when a nurse came out to get me. I was rather surprised they grabbed me so early. Nurse took me in, questioned me, and then took my blood pressure = unbelievable 218/158. Danged! I attribute it to the stress of the pain and my normal of running high - I could barely walk, couldn't take a deep breath. Doctor took me straight in, examined me. My lungs had been filling up with fluids and when I coughed because of this I darned near passed out.

It was my bottom left rib, apparently had bruised my lung, kidneys, and gut. I don't even know what I fell on, took me an awful long time to get back up, just laid there. Ranks among the greatest pain I'd ever felt.

I asked about a rib protector and he said he didn't want to do that, and that they normally didn't do that. He was really, really concerned about my BP - as was I after seeing the results. The highest my BP had ever been was 180/130 - been on BP meds for years. He made me take a BP pill in front of him - "Here take this now".

He loaded me up with meds, a new BP script, one for the fluids, one for the internal swelling, and then one really strong pain killer. I had to seriously convince him I'd stay with that BP med. And I have - that high number really got my attention. People die with much less than that, I'd been sporadic over the years.

And, then he sent me home. I didn't step into the ER, just his office.

Thing is, I'd broken the rib on Sunday, dealt with it until Wednesday afternoon before calling - I just couldn't take the pain any more. And I certainly was noticing the fluid build up.

Still real sore as you can imagine, but no real pain, and I stopped taking the pain pills a week ago. Have a reserve now in case I have anymore misadventures - which is bound to happen. I've always been kind of a klutz.....

Sometimes we do tend to be bull headed....
 

Unclebuck257

Sr. Member
Aug 31, 2013
479
397
North Central Texas
Detector(s) used
AT Gold, Garrett Carrot PP
Primary Interest:
All Treasure Hunting
Deep,

I live out in the country about 75 miles NW from the nearest actual VA hospital. If I could have, I would have gone to the VA Hospital but with the pain I was in, I couldn't even drive and barely made it to the civilian hospital about 15 miles from my home. Just wanted you to be aware of that preprinted form they send out for denial, especially with that "other insurance" block they can check as a reason. As I said, anyone with Medicare is then toast because all of us over 65 have it, I believe, but most of us over 65 vets, because of the VA, don't carry any additional Medicare coverage that would normally cover overages beyond what regular Medicare would pay. That leaves some of us vets exposed to possibly some rather high bills Medicare didn't cover! Glad to hear that you're doing better too.
 

OP
OP
DeepseekerADS

DeepseekerADS

Gold Member
Mar 3, 2013
14,880
21,725
SW, VA - Bull Mountain
Detector(s) used
CTX, Excal II, EQ800, Fisher 1260X, Tesoro Royal Sabre, Tejon, Garrett ADSIII, Carrot, Stealth 920iX, Keene A52
Primary Interest:
Other
You're right Buck! When I applied only for Medicare, I started getting calls trying to get me to sign up for the add-ons = they add up to some real money on an income of SSN. But then that drive over the mountains before daylight in pain certainly wasn't fun!
 

kcm

Gold Member
Feb 29, 2016
5,790
7,085
NW Minnesota
Detector(s) used
Tesoro Silver uMax
Primary Interest:
Other
Wow, what an eye-opening thread!!

Where we live is 48 miles from the local clinic/hospital, and a 3-hour drive to the nearest VA hospital....unless that's in Fargo, which would be another hour away. So, have been on the state medical rosters. Went to Arkansas after my dad passed away and ended up in an auto accident. There we were stranded 1,100 miles from home, without transportation, only MN-state medical insurance, and the VA had stopped taking new applicants several months before.

Add to that how the civilian medical works up here (in MN) - the doctors push to see you as often as they can get you in. Appointments have gone from 1/2 hour to 15 minutes to now 5 minutes or less if they can get away with it! It's the new wave of trying to meet rising medical costs while still lining so many pockets - railroad as many people through as possible. Doctors are limited in nearly every aspect of what they can do, what medications they can prescribe, etc. It's no wonder that the VA is having such problems. And even here locally, our doctor may want to see us in another 60 days. Well, that's all but impossible, as there is often no room on the books for well over 4 months away!

I agree that the VA should go back to administration - that was a very good suggestion IMO. However, ANY military base "should" be allowed to take in veterans if necessary - or at the very least veterans with medical problems due to active service. Maybe that already is - I do not know. The nearest military base is over 200 miles away, and I have not had a need to take up those resources.

....My point to all of this? ...Just rambling, I guess.

Oh, as for dental, I "do" have state dental coverage. ...Just no dentists willing to accept it! The nearest is about 6 hours away, assuming they still accept it (that was 12+ years ago!!)

I had much better medical AND dental care back when I had to pay out of my own pocket! But then, I had better health as well.
 

Top Member Reactions

Users who are viewing this thread

Top