Tuesday, June 27, 2017

Reaction to Trump’s budget for VA. 

Opinion: I guess the problem is not necessarily the amount in the budget, but rather who benefits the most from the changes being planned.  The VA’s “Choice” program, for example, would be allowed $3.5 billion extra as I understand it. Whether that is good or bad might depend on the details that were not revealed.
Many people may not know what that program is.


Choice
“Choice” at least as I understand it is another way of saying “privatization" of the VA. In other words, fixing things so that private healthcare companies can skim $$ off the top of the  VA budget, rather than expanding the number of Veterans Centers. 

So I have mixed feelings. On the one hand, I will be glad if our services are expanded or even if they are not cut.  On the other hand, I an expanded “Choice” might be used to deal a blow to the VA system itself, in favor of privatization.  When you have a limited budget and you expand in one area, that translates to shrinking on another area. Expanding Choice might be viewed as an attack on government social services, turning them over to private industry.

What I like about Choice: I like being able to select my own doctor in my own town if I live more than 45 miles from the VA center.

What I don’t like about Choice: On the other hand, I have yet to successfully access that service. I had trouble when I tried to communicate with them by phone, as I was basically deaf at the time. Using  phones is frustrating even now  that I have a Cochlear implant.

Unless they have changed, the Choice program has all of the same problems that other cost-cutting programs have when it comes to communications. I had difficulty managing the phone system. I was not able to to a chatline with them or find messaging services, in short I could not find a representative to get my questions answered. I was frustrated. A deaf person needs to be able to find direct chat lines, or secure messaging services to the provider.

I also questioned whether Choice is the best way to expand services to Veterans. The feeling I had was, “This is fine, to be able to get someone locally in some cases, but what if that same money were spent expanding the local VA medical centers?” 

The Choice program (as I understand it) aims to enable Vets to get services in their own communities instead of traveling to distant VA centers, and to give them a broader choice of providers.  But funding of Choice is a double-bitted ax that lops off funds that could be available for other VA programs, in effect giving our VA money to private companies whose focus may be profit.

If we chose to, we could create more VA centers rather than skimming the cream off the top to give to private health care companies.  So I am afraid the new plan may be all about politics and economic models, not about health care for veterans. This is definitely something to keep a close eye on. Here is a link to an article on the topic of the VA Budget.


IT programs
I wonder why they cutting the IT program: Is this a way of robbing Peter to pay Paul?

For veterans living at distances from VA centers, as I do, the technology program has been a great asset. I think in some ways it could be streamlined, however there are aspects of it that I love. Especially, the VA in my area is very diligent to respond quickly to any requests for information or services. I can  check all of my appointments online if I forget the times, dates or whatever. I can also change appointments easily online. And much more. So naturally, as a disabled veteran I have concerns about cutting technology.

My Seattle experience: I am, or was, deaf, most likely due in position in the eight-inch gun turrets. Because of this the VA was able to provide a Cochlear implant in my right ear. Almost overnight I went from being deaf for all practical purposes, to understanding most conversations I encounter in daily life. Pardon the cliche, but the VA provided for me a modern miracle of hearing, but to experience this miracle required frequent travels between Tri Cities, Washington, and Seattle, some 200 miles distant. In spite of the long distances I found almost instant communications via the VA’s Secure Messaging services. I found it so easy to arrange appointments, or to ask questions  or provide feedback.

How many of you with private doctors can simply message a question to your physician and get a quick reply from the doctor himself? Time after time?  I have done this on several occasions with the VA’s IT programs. 


One of the disconcerting things about health care in general is that it is a pain to give or receive information from healthcare companies. With my VA account it is easy. They have been very quick to reply via their private messaging services, with virtually no gatekeepers bogging you down. So I like aspects of the IT that I hope will not be discontinued. Their data bases are also searchable. Without the IT messaging services, I don’t see how I could have managed the Cochlear implant surgery and numerous followups. When snow storms hit, I found it easy to reschedule, all of this because of the VA’s IT programs.

For this reason, I hope any changes to the VA IT programs will be made carefully and thoughtfully, not cutting programs just to be cutting them. Like any program, IT can probably be improved, but let’s make sure this improvements actually improve services for Veterans. Thanks.

In Summary: Although I am glad that VA will continue to be well funded, I have concerns that the changes are being made not to benefit Veterans, but  to line the pockets of private enterprises. Along with such programs as privatized prisons, and (attempted) privatization of Social Security, I think so-called Choice may involve a misguided effort to force a somewhat failed economic model on all aspects of government spending. 

#vabudget #politics #economics #opinion, 

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