the continuance of reform for va healthcare

The Continuance of Reform for VA Healthcare

To President Barack ObamaBy Brian Mazurowski

Introduction

• Dear Mr. President,I would like to address you in regards to

furthering VA healthcare reform. I am convinced that funding the agency should be increased. This matter is not only a necessity, but also an imperative one. In addition, an amendment for limitations on military service related conditions is appropriate as well. At the end of this brief, not only will you be more informed on the situation, but contain the knowledge to make the right decision.

Commendation

• Formally, I would like to appreciate your decision to appoint Robert A. McDonald as VA Secretary, whom intends to run the VA more like a business. Based on the current organizational culture of the Veterans Administration, as made recently transparent in the CQ Researcher, the VA needs a strong authority. This correlates with Max Weber’s bureaucratic model, which entails that the rational-legal authority asserts obedience.

Commendation

• Further, Weber’s rational-legal approaches the basic structure for accountability through such obedient boundaries, because it describes the flow of power and responsibility from top officials to those at the bottom of the organization. This bureaucratic structure leads to efficiency, and therefore it is imperative that the VA has a strong leader such as Mr. McDonald.

The Call for Increased Funding

• There is a need for the VA because there is 6.6 million patients that seek the VA medical services each year.

• The VA has 278,000 employees 150 medical centers, 819 outpatient clinics, 300 counseling centers, 135 nursing homes and 104 residential rehabilitation centers, which all cost money to maintain.

• Due to the contemporary issues, McDonald has created a Customer-Service Department that reports to him. The communication between patients and McDonald have proven to be imperative. This department will also cost money to maintain.

The Call for Increased Funding• Must recruit thousands of health care professionals at a time when the

private health care system also faces severe shortages and is able to pay higher compensation. Therefore the VA needs for more personnel and higher salaries for doctors and other medical professionals.

• McDonald, who said he needs to hire 28,000 new health care providers, and to add between $20,000 and $35,000 to the starting salaries of physicians and dentists and has declared employee recruitment “job one right now.”

• McDonald must “earn back the trust of the veterans,” Carolyn Clancy, interim undersecretary for health .

The Call for Increased Funding• In order to earn back the veteran’s trust we need a

sufficient $61.1 billion medical care appropriation, compared to your administration’s request for $59 billion.

• We need your administration’s $1.2 billion VA construction budget increased to $3.9 billion to build medical facilities.

• With the increase of the veterans medical care budget we could treat patients more often.

• Analysts are predicting more than 95 million individual appointments this year alone. Next year it could increase to 100 million

• Construction and maintenance backlogs of projects that have already been approved, are waiting to be developed.

• “60-year old facilities do not get better with age.” – VFW National Commander William Thien


• Staff shortages are “the root cause of the scandals – inadequate numbers of support personnel and nurses and physicians and physicians assistants,” – a government employees union representative. Adding more if necessary will be difficult because of low VA pay rates.

• Private-sector doctors earn 20 percent to over two times more than VA physicians make.

• McDonald, who said he is “worried about our ability to recruit and retain talent,” said he will evaluate pay scales across the department.


• Mr. President the VA cannot return to the problem festered times. Therefore it cannot return into the inability to make timely appointments for many of the 6.6 million patients. This resulted from inadequate staffing, a more complex caseload, population shifts that create soaring demand at some VA facilities, poor internal communications.

The Call for Increased Funding• Viable solutions that have happened and that the VA looks to perform in the

near-future…• Shrink the headquarters bureaucracy, modernize management practices,

establish a department-wide electronic record keeping system and emphasis on primary and outpatient care , which is cheaper and more efficient than hospitalization.

• Seeing patients within 14 days of their requesting an appointment.• Cut spending annually maintenance on vacant property.• Fully implement the planned system capabilities.• Strict debit card authorizations with document trials.• Firm cuts on awarding bonuses.• New legislation enables McDonald him to fire workers more quickly than before.

Should Not be limited to military related

• Veterans who served a minimum of two years in peacetime should not be entitled to a lifetime of health care at taxpayers expense if not directly related to service-related health problems.

• VA does not, and virtually will never have sufficient resources to serve all veterans.


• The establishment of a priority list has alleviated certain problems. Veterans with the most severe service-related disabilities are at the top, while more-affluent veterans without disabilities are at the bottom.


• Private Care is not the answer because it promotes inaccuracies. Lack of communication between private health care and VA. Having a patient receive both VA and private care lead to “duplicative, uncoordinated and inefficient” treatment” according to a RAND study.

• Private Care can also be more expensive.


• VA can negotiate lower prescription drug prices and avoids unnecessary treatment.

• Nearly 56 percent of VA patients today are being treated for illnesses unrelated to their service.


• There have been solutions to fight long-term costs but contemporarily they serve to be costly …

• Recent bi partisan legislation provides funding for more in-house staff, tackling the wait-time issue head on.

• Clinics are kept open longer


• The viable solutions have resulted in …

• The VA has completed 1.2 million more appointments in July through October than in the same period in 2013

• Made 98 percent of appointments within 30 days of either the date the patient requested or the date a VA provider said was “clinically appropriate.”


• Two week goal was unrealistic. VA pays for private care to keep a veteran from waiting longer• The VA also needs to promote whistleblowing, to catch a delinquency as prompt as possible.


• “The VA should focus its resources on specialized services, including treatment for combat trauma and rehabilitation that is unique to war veterans” – American Enterprise Institute Representative

Conclusion

• Mr. President, now that you have been fully informed on the situation, I am confident in your absolute support in this matter. Thank you for your time and patience. God Speed.

• With Warm Regards,Brian Mazurowski

Bibliography

• Price, Tom. “Reforming Veterans’ Health Care.” CQ Researcher Nov. 21 2014: 985-1008. Print.

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