Wounded Warrior Reform: Conference Call
The White House held a conference call to talk about the new Wounded Warrior Reform. The VA disability system, they say, is not consumer friendly, which is a large understatement. It no longer reflects the constituency it serves, and hasn't really been updated since World War II. Karl Zinsmeister, Assistant to the President for Domestic Policy, spent some time explaining the reform effort to a group of bloggers.
We need a new system to meet the new requirements, and they want to do a "complete restructuring" of the VA disability system. They want a new focus on rehab, and they want to make sure that disabled vets can get back into the mainstream of American life.
Questions:
* How will this curtail bureaucratic nightmare currently in operation? The current system requires vets to navigate both Defense and VA systems in parallel, and it's exhausting. The first step will be to eliminate the DoD from the loop. In the future, the DoD will only judge whether the vet can continue in the service. If not, the vet will transfer immediately to the VA, where they only have to deal with one bureaucracy.
* - The VA isn't exactly a friendly bureaucracy either -- Karl says that's true. They're going to make the process much more straightforward, more efficient. They have to rewrite the injury schedule, a 600-page document that has been band-aided for 50 years. They're going to redesign it from scratch, which will produce a cleaner, rational system.
They will also work on a transition benefit to keep people covered during the transition to the VA. They also want to focus on rehab resources. Right now, completion of rehab is only at 30%, so they're going to give incentive payments for rehab completion. Second will be the financial compensation for the injuries themselves. Third, they're also going to produce a compensation schedule that accounts for quality-of-life issues. Right now, that's completely subjective and inconsistent, and forces the vets to work harder for their compensation.
* Why now? -- The President feels very strongly that veteran care should be a high priority for the executive branch, and himself personally. He was "scandalized" over the Walter Reed issue, and instead of giving a smaller response, Bush wanted a complete system overhaul to fix all of the problems facing vets.
Interesting. I'm certain that the Walter Reed story formed the main impetus for this project, but the Sunday article in the Washington Post regarding the difficulties facing one veteran with brain damage and/or psychological issues from his service also had to have impacted the White House. Let's hope that this will produce some real reform for our wounded veterans, so that they do not have to come begging bureaucrats to get the compensation and assistance they need to recover from the injuries done to them in the service. As Zinsmeister said, this should be the last group of Americans who have to enter an adversarial role with their government.
The President's speech on this reform project can be found here.
Posted by Ed Morrissey on October 16, 2007 4:39 PM | Comments (18) | TrackBacks (0)
Comments (18)
Posted by BB | October 16, 2007 5:04 PM
This is beyond overdue. Fingers are crossed.
Posted by njcommuter | October 16, 2007 5:09 PM
If Congress has anything to say about this, it will extend into the next administration, to become a political futbol or die a very lonely death. Let's keep an eye on it and see who "supports the troops."
Posted by docjim505 | October 16, 2007 5:36 PM
Good luck on this one. It's disgraceful that the VA doesn't operate more efficiently, and that "reform" is needed. I guess it's the cloud in the silver lining of not having had to fight a major war in thirty years.
Posted by coldwarrior415 | October 16, 2007 6:21 PM
First of all, the deplorable conditions at an out building at Walter Reed that was the focus of many "investigative" pieces last year were do in total to the cutback on funding for maintenance of that facility, originally scheduled to be closed this year under BRAC.
Stop gap measures were taken, but when funds are cut since the building was coming down anyway, this is what happens. Even the main building at Walter Reed was serverely deficient on many wards. Saw no mention of this aspect in the MSM. Only as lot of Bush doesn't care about the vets.
Seems the desire of Congress to get all they could out of the "peace dividend" from the end of the Cold War available funding was spent on other things, first, leaving the veteran and the active duty troop as usual far behind the curve.
As for the promised reforms with VA, it's about time. I hope there is an abundance of follow-through on this one.
I'm a vet, and as have a number of my fellow vets, I have avoided using VA facilities for the sole reason that most around here are throwbacks to 1946.
We, as a Nation, have to embrace that we owe our wounded vets a debt we can never fully repay. And if it takes money to upgrade VA facilities across the country, then let's do it. Perhaps use the funds that were intended for the expanded S-CHIP as start-up money? There is enough pork in current and proposed earmarks in current legislation to more than amply fund what is required.
Upgrading records management to 21st Century standards and simplifying the process of obtaining benefits is also high on the list of things that need to be revamped. As for the Admin side of the house, I really do not like talking on the phone to a bored GS-5 about things about of which she has no inkling and then being told that "that's the way it is..." Maybe hiring only vets to do this would enable a more front end user friendly service? Marrying up VA facilities with major medical universities is also someething that should be considered.
Again, we owe them.
Posted by Christoph | October 16, 2007 6:27 PM
coldwarrior415, emotionally, I support your decision, yet when you write, "There is enough pork in current and proposed earmarks in current legislation to more than amply fund what is required," I don't think you actually know what you're talking about.
A majority of people will jump down my throat on this, I know, but you are grossly oversimplifying.
Should it be done? Yes. Are there still going to be real budgetary constraints in this healthcare program as in all? Yep. Should this be a priority? Totally. Must you do better? Yes. Real, structural reform? Yes. More money? Agreed.
But the part in quotes was way oversimplified..
Posted by Christoph | October 16, 2007 6:30 PM
Most of your comment though, especially this observation: "I'm a vet, and as have a number of my fellow vets, I have avoided using VA facilities for the sole reason that most around here are throwbacks to 1946," is hard to dispute.
Posted by Papa Ray | October 16, 2007 6:58 PM
As someone who has dealt with the VA for many years in two different locations, I can only say that throwing money at it will not work. They have tried that a few times.
The problems are not unlike a huge corporation has. Too many chiefs and not enough indians and indians who are not paid enough to stick around long enough to learn what they are supposed to do.
And the regs, the paperwork and the wait...wait...wait...until you might actually have to go to your local hospital ER. Where when you find out your a vet, really don't want to go though the hassle of dealing with the "government". But most of them do, only to call or write you over the next several months wanting you to make the government pay them.
The VA does pay them but later rather than sooner, sometimes as much as a year later.
That is of course after you fill out paperwork, call them, and calll them and fill out paperwork and then more paper work.
It is a nightmare of paperwork and phone tag.
If you are really ill or disabled, this is a real problem. That is unless you have someone to do the calling and the paperwork for you.
Many don't.
Caring for millions of patients well is a job that I'm not sure anyone can do. But everyone is right, we have to do better.
Papa Ray
West Texas
USA
Posted by coldwarrior415 | October 16, 2007 7:00 PM
I see your point.
What I was trying to get at is that each day in Congress they are already spending money that hasn't been printed yet on projects of dubious importance and I am sure that a move to revamp the VA/Department of Veteran's Affairs to the extent required is going to have a lot of members of Congress crying that we don't have the funds to do so. Yet, there seems to be ample funding for pork and earmarks and all sorts of things that are not even remotely as valid as what the VA and our current veterans need.
Posted by mrlynn | October 16, 2007 7:10 PM
Perhaps this is a naive question, but—
Is there any reason why we couldn't just close down the VA system and give every veteran a voucher good for a choice of the best medical-insurance/health-care plans out there?
American has the best hospitals, private medical groups, and private physicians in the world. Why create a second tier of medical care just for veterans? Just make sure they can afford the best we can offer.
/Mr Lynn
Posted by Steffan | October 16, 2007 7:30 PM
Believe it or not, they are doing one thing right.
SSA has an expedited disability claim process for Wounded Warriors:
http://www.ssa.gov/woundedwarriors/
Check it out. There are a lot of useful links on that site.
Posted by John Stephens | October 16, 2007 8:53 PM
"Is there any reason why we couldn't just close down the VA system and give every veteran a voucher good for a choice of the best medical-insurance/health-care plans out there?"
Vouchers for veterans? You mean like the CHAMPVA system for the families of dead and severely disabled veterans? Try finding a doctor or HMO that'll take a CHAMPVA patient. Go ahead, I'll wait.
But I won't be holding my breath. CHAMPVA screws with health providers even worse than the rest of the VA medical system. However, unlike ERs, doctors don't HAVE to take CHAMPVA patients, and nearly all don't.
So thanks but no thanks. What we've got is bad enough, without giving VA bureaucrats a way to make it even worse.
Posted by coldoc | October 17, 2007 1:50 AM
VA Health Care = Hillary Care
An example of a government-run health care program with over 78 years of "history". Do you want it??
VA Health Care is just one part of the VA mission. Like anything else, if they "reorganize" the Health Care, they will rob some other program to pay for the new costs... unless Congress is wise enough to add the additional funding needed. Want to bet on that happening?
Posted by coldoc | October 17, 2007 1:57 AM
It occurs to me that once Hillary Care is implemented, the need for VA health Care, Medicare, SCHIP, TRICARE, and all the other Government health care programs goes away, and all of them can be eliminated! Private Insureance Companies will not be needed except to provide the administration of the program.
Posted by mrlynn | October 17, 2007 7:56 AM
I asked: "Is there any reason why we couldn't just close down the VA system and give every veteran a voucher good for a choice of the best medical-insurance/health-care plans out there?"
John Stevens responds: "Vouchers for veterans? You mean like the CHAMPVA system for the families of dead and severely disabled veterans? Try finding a doctor or HMO that'll take a CHAMPVA patient. Go ahead, I'll wait."
No, you misunderstood my suggestion. We would offer a veteran a selection of the best health-insurance/medical care plans in his area, and give him a voucher to pay for the one he choses. The veteran would have a top-of-the-line health plan and unlimited catastrophic insurance through one of the established carriers, e.g. Blue Cross, Aetna, United, etc. We would not use Champus or any government entity. The government would just pay the premiums (and maybe reimburse for incidental expenses, like copays).
Better yet: We should set up and fund Health Savings Accounts for veterans, along with the required catastrophic insurance coverage through established carriers. Then the veteran would have a tax-free savings vehicle to which he could add as well as the VA.
/Mr Lynn
Posted by Joe Mama | October 17, 2007 8:55 AM
It's sickening how we treat the one's who sacrifice to give us freedom.
Posted by Chris | October 17, 2007 1:24 PM
What is the purpose of the VA?
I can see the VA serving at least 4 functions that often compete for resources.
The first and most important is the immediate care of our wounded veterans. It is my understanding that when a serviceman is significantly injured they are first treated at active military facilities but are transfered to VA hospitals upon discharge. To me this is the highest priority of the VA. It is probably also the smallest constituency
The second function and next most important is the long term care of veterans with service related illnesses. Some are obvious like amputations other are less clear like exposure to defoliants. This is a clear function but of lower priority than number one.
The third function is health care for Veterans that is not service related. I don't claim to know all of the rules around what is covered and what is not but I do not think that all health care need be covered. This needs to be looked at carefully.
The fourth function, is a place for Veterans to hang out. From my sister's experience at a VA hospital as one of her Residency posting she discovered that there were a number of veterans who were at the hospital for time periods far in excess of the medical necessity of the procedure . We don't have many old soldiers/sailors homes in this country. I am not sure why but I expect that with that this would relieve some of the pressure from function 4 and reduction of pressure on the systems would reduce the forms and bureaucracy.
Well defined functions tend to be more efficient than ill defined functions.
Posted by Michael | October 17, 2007 1:59 PM
The VA is an anachronism.It exists primarily for the career employees and the funding and training od medical personel who have little interest in its stated mission.The caseload it reports is fundementally inflated and,in most cases,barely of medical neccessity.I spent 15 years employed in the system and found the number of unique veterans using the system to be quite low.It's the same chronic,non-combat related patients who are essentially trying to qualify for a disability that any clear thinking veteran would deny them.(I spent 4 years in the Marines with 2 tours in Nam so I had knowledge of units,locations and actions...and I can tell you the number of fraudulent claims seemed staggering to me.)The VA is vested in keeping illness,especially chronic conditions,active and on the rolls for "vist count purposes"which equal funding as we all know.
My sense is 50% of the facilities could be closed ,pronto.But this will never happen nor will any meaningful change of service provision as thias serves a pork-barrel function for elected officials.
I've grown weary of meeting fellow vets from my era who chide me for not "playing the game with the VA"and getting some disability rating which I'm not entitled to.
The VA and its disability game is sadly a cottage industry in todays America.The truth is that so many veterans who truly rate this help are crowded out by the fakers and their handlers.
Semper Fi
Posted by mrlynn | October 17, 2007 9:55 PM
Says Michael, The VA is an anachronism.It exists primarily for the career employees and the funding and training od medical personel who have little interest in its stated mission.The caseload it reports is fundementally inflated and,in most cases,barely of medical neccessity. . .
All the more reason to close the VA down and move veterans into the regular health-care/health-insurance system, using vouchers to subsidize them.
I'd like to see one of the Republican candidates with the gumption to propose this.
/Mr Lynn