A single man, while having the ability to change and effect many areas, maybe even breath life into a dying body, has little or no chance to affect the overall eventuality of said course the would be corpse is heading on its own; if it sees no wrong in its course, if it has no intention of changing, if it has no idea what the root cause of which the deathly infirmity sprang, it can not fathom the depth of cancer within, the mind of the afflicted whispering in dark places, and not even an inkling to the life styles that brought him to this dark deaths’ doorstep in the first place. This is the conundrum, the leader yelling to a deaf man who thinks he can hear, as he runs headlong off the cliff.
What did it matter General Shinseki’s gave an illustrious and distinguished carrier of years with self-sacrifice and service to the protection of the rest of us Americans? Giving himself almost immediately in his long carrier in honor and dedication, to the point of multiple bronze stars, purple hearts, valor and honor, body parts, a life, dreams, all handed with dutiful ease for a single purpose as to only grant for the rest of us a possibility of life with a bit more comfort, security, and knowledge that our children can sleep at night without the fears that plague so many others throughout this world.
Some might say, what would I know, the writer of this article, never serving in the armed forces, didn’t work at the VA, how could I possibly even begin to think could comment on something I know nothing about?
Well, let me try!
For almost twenty-five years I practiced physical therapy in my own private practice, and for the greater part of that time frame, my office was literally only a couple of hundred feet from the Phoenix VA, the same VA that has become so newsworthy of late. Many a time would a veteran come wandering into my office hoping to be seen for his physical therapy needs, wondering if our office could possibly give him care, a handful of help, a thirsty man’s relief, a morsel he so desperately desired
It was at these moments we would become frequented with one of the heartaches that had become a regular daily routine in and around the bureaucracy that surrounded a veterans desire to merely receive some kind of reasonable medical treatment in a socially acceptable time frame. Medical Care which was only promised him in writing before his armed service was solicited years before.
Oh sure they could receive a pain med’s or some kind of muscle relaxer, but how can any rational thinking care provider possibly think that relaxing the muscles or dumbing down this person, could possibly help relieve the irritation, limitation on his life, or restrictions of this soldiers’ bodies, its freedom, his injured torn tissue or compressed disc has caused. Not to mention the possible addiction that could occur if pain meds are used for that long.
But that’s not where it ended!
These men out of desperation would more often than not venture into the private practices of Family Practitioners, often paying out of pocket because the wait to be seen by VA was too great. So prescription in hand they walk into my office, with the hope of some kind of relief in their eyes, not unlike my own child pleading for relief after scraping bloody his knee. But the nightmare of malcontent has only begun, for now, the bureaucracy again is called into motion.
Over the course of the last few years, insurance companies have used the ploy of verifying coverage, stating to an unsuspecting public that they are making sure that a person will have payments for a medical visit.In a short time to follow, an even later need to actually receive authorization before services could be rendered was initiated, basically giving permission to grant care, as a way to manage care (Joke!), the truth; cut costs by limiting services.
As it now stands the Doctor no longer tells you whether or not you will receive a needed medical procedure, but that right rests upon the non-medically trained person sitting behind the computer screen, staring into that heartless box of circuits, and decides based on a tabulation of data or cost-effectiveness stockholder desired profit margins and penny balancing ratios, whether or not you will have your care authorized. Nowhere worse is this seen than in the attempts to receive authorization around Veterans.
Prescription in hand! Care needed verifying and prescribed by a Doctor! The physical need witness and verified by a licensed Therapist who can give the patient what treatment he needs! But here lies the problem; getting care authorized at an out of VA location, even if the said clinic is contracted with veterans insurance plan, takes a special authorization, and again this can take weeks, even months. First the number you must call to request authorization always comes into an answering machine, of which return calls never seemed to come. Delays again!
One of the more astute, and by most peoples standards, almost to the point of crazily fanatic vet., who wouldn’t take no for an answer, said one day; “the only way to get it done is call over and over and over again, for a week or two straight and then they will call you back”. So this became the standard at my office for trying to receive even a call back from the “Auth Department” at VA.
But if we thought about treating without the authorization and we did, we were promptly told that any treatments being done outside of the authorization of the “All Important Claims Representative” would be denied and not be paid. Further, she was quick to remind us that; “unauthorized care could not be billed to the patient, because of contractual agreements the insurance company placed in our practicing agreement, treating unauthorized care could violate our contract and risk cancelation”, basically denying us the ability to treat other vets in the future.
We would have to treat basically for free, and risk financial repercussions, I could easily have filled a clinic the size of Walmart with such patients! But these poor soldiers, also because of injury and trauma were outcast economically as well, were often unable to pay anything out of pocket because of their own work and physical limitations.
I often would ask, considering the degree of difficulty even a few visits could require, why would the Vet still choose to be seen in the private sector? The answer was always the same, when it care to veterans care at the VA; long waits, overcrowded care facilities, understaffed, the lack of any empathy especially from the admission or administration, often even contempt they were given for bothering the staff member in the first place, the overall and standard feeling the Vet’s received was one of; “quit bothering us, and lets push them through as fast as possible to get them out of our hair!”
Now granted my experience was limited only to people who already had run into delays or negative behaviors, I have heard from many Vet’s who only had pleasant and positive experiences in their VA experience.
I had once commented to a Vet who told me of such a wait or foul treatment, about how my dog seemed to receive better care at the veterinarian’s every time I took him than he seemed to receive at the VA!
I explained my dog gets in on the same day, the people at the front desk smile and treat the dog nice, they have assistants that care and help with the visit, the Doctor actually sees the dog, and spends time with the dog more than just a minute or two, seeming to actually care, the dog gets touched not just talked at, a care plan is determined and finally a care is initiated immediately. I was not surprised that this story was received with just a simple nod of the head, a smirk, basically a simple affirmation by the Vet.
One might say; well doesn’t the veterinarian get paid cash by the dog owner so the dog should get better care, but the fact that these men and women risked their lives for the service and protection of our country seems to me as at least payment for common curiousness, and treatment better then a dog.
By today’s standards and even the most minimal care situations, patients still should expect to be seen in a reasonable time frame, at least within a day or two from the onset of an injury, to at least assure a treatment can be established before the injury worsens or other complications would arise. And if that time frame cannot be given because of full appointments or scheduling conflicts, I would feel it is reasonable to expect that said patient should be able to go elsewhere to receive care.
Complaints of waiting, and malcontent, bureaucratic red tape to the point where the Vet just wants to give up, or the injury gets so far along he just learns to live with it was common. A typical attitude reported by the Vet’s regarding hospital administrative staff is that the Vets are sometimes regarded as below them, bothersome, and not worth their time even to hear.
It doesn’t surprise me that as many complains or like comments I had heard throughout the years, would it finally come to the light of the public eye that “wait list or black listing” occurred against Vet’s who for no other reason than they might have made some lazy self-righteous nail filing office staff member mad, resulting in them being put on the bottom of a list, their file being put on the bottom of the pile, their request stuck in the no-work drawer or worse yet filed in the “Circular Receptacle”, that seemed to be the case I witnessed for years.
Oh and just try to get some kind of outsourcing contract for Vet’s in the private sector, the same restrictions, red tape, waiting time frames, denials and blacklist occurred. Insurance companies feed the public the lies that they contract to assure quality care, but anyone in the industry would tell you they contract to limit the availability of service, restriction of pay-ability by themselves and basic control over their constituents.
The VA falling short on so many levels that it would be considered by any reasonable thinking individual to be an atrocity to the taxpayer, who do care for the least for these people, the men, and women who have given and risked so much for us and our children, is not just a single problem that can be solved by any one man, even a General a War Hero. For it is a systemic problem that permeates within the entire attitude of the health care society at large.
The VA is no different, it has been strapped with this obligation to care for the remnant of war and military spending, the political machine creates when it sends our sons into battle. Not everyone who participates in various levels of care for Veterans seems to care at all about them as people, and merely see them as burdens.
And what of our Government bureaucracy it can stand back and watch, knowing this has gone on for years, as its underlying agenda’s or reasons play out, while at the same time spend billions to fund these wars, all for the call of liberty?
No many at the VA don’t care about these people any more than the bureaucracies that sent them and profits from their deaths do!
So here comes the promises of reform! Send in a hero General Eric Shinseki, of which no one will ever doubt he could lead these obviously failing troops, who is used to having his orders followed without question. But somewhere along the line do we have to assume the body of the problem admits to itself there is a problem, then we have to hope it communicates to the leader there is even a problem and doesn’t just lie, and act as if it doesn’t exist, sweep it yet again under the rug, and hope it will fade from sight.
No, the problem is not a following of orders type issue, but a question of the heart of the Body of the VA. If the heart was changed, the parts of the body would recognize those parts of which didn’t fall in line with the new found love, honor and integrity, they would report these dishonorable actions or individuals that lie in dark corners, and the leadership would extract them as it would any cancer if healing of hearts could not be accomplished.
The General while no doubt a great Commander and fine man, was doomed the minute he walked onto the playing field, for he was fighting a battle he was not trained for, any more than just being a heart patient somehow qualifies you to operate on one. For any chance of success he would have to have gotten in touch with the very heart of the VA if he had any hope in understanding the scope of the problem before him, and unfortunately, that heart right now has no intention of changing it is the bureaucracy we live in.
By Peter Colla PT
“Dear Jesus, I pray for those soldiers who might have lost their lives while waiting for care, and I pray further for the General, that he does not lose heart and realizes in his sacrifice, yet again the battle may now finally be exposed for a healing win.”