VA’s secretary, Dr. David Shulkin, spoke to the press corps in the White House briefing room this morning – diagnosing VA and providing his prescription for its ills.

“As a physician I tend to look at things in terms of the way I was trained – assess, diagnose, and then aggressively treat the patient,” he said before outlining the current state of VA, clearly identifying risks the department faces in caring for Veterans.

Watch the briefing online, courtesy of PBS Newshour.

Shulkin identified key areas that require attention.  These included:

Access to care

VA now has same-day services for primary care and mental health at all 168 medical centers with 22 percent of patients seen on the same day. Yet Veterans are waiting more than 60 days for new appointments at about 30 locations nationwide. Sixteen percent of primary care clinics are over 100% capacity – meaning Veterans are not being seen soon enough. “We need more clinical and support staff as well as more space in order to solve this problem,” Shulkin said

Paying providers

Community Care, especially VA’s Choice Program, has increased access to care for millions of Veterans with 500,000 community providers in the Community Care Network. However, providers are still frustrated by delayed payments to the point that some of them are leaving the network. VA is encouraging the private sector to use electronic submissions to allow faster adjudication and payment.

Community care

VA is currently required to administer eight separate Community Care programs, which is inefficient and causes confusion for Veterans, providers and VA employees alike. Shulkin said, VA has to “reject a minimum of 1 out of 5 community care claims. This is much higher than the private sector and we need Congress to help us fix this. We continue to work with our partners – including the White House, Congress, VSOs, and community providers – to develop and pass legislation that will ensure VA Community Care is easy to understand, simple to administer, and meets the needs of Veterans and their families. We have to pass legislation this year or these issues will persist.”

Quality of care

VA now shares star ratings and comparisons between VA medical centers and local community hospitals to provide Veterans with information to make informed decisions about their care. Upon setting of the website, VA has identified 14 medical centers with 1-star ratings, meaning they are below the community standard of care. VA is actively deploying teams and implementing performance plans at each of these centers to improve care.

“Veterans shouldn’t have to accept low quality care. They deserve our very best,” Shulkin said. “When they aren’t getting our best, they should be able to access the best their community has to offer. That is exactly what we are working to achieve with our new Choice plan. “

Disability claims and appeals

VA currently has more than 90,000 disability claims that are taking more than 125 days to process.   The secretary wants to cut that time in half over the next two years.

“The time to get an appeal decision is far too long- taking almost three years for a veteran to get a decision,” Shulkin said. “It takes Congress to fix this, and I am grateful that the House passed legislation last week. We need our friends in the Senate to act as soon as possible.”

Information technology

More than 20 VA facilities have out of date systems and processes for inventory– making it difficult to ensure doctors and nurses have the supplies and equipment they need to care for Veterans. Currently, 75 percent of VA’s IT budget is spent on sustaining infrastructure, including legacy systems that are at risk of failing – potentially crippling mission–critical operations.

“Our scheduling systems and our financial systems are outdated – contributing to excessive wait times for Veterans. Both systems are in the process of being replaced but it will take a few years to complete this,” Shulkin stated.  “We have to modernize our IT systems by using commercial, cloud-based solutions.”

Capital assets

VA facility condition assessments have identified critical infrastructure deficiencies of more than $18 billion that require remediation, including structural seismic, electrical distribution and mechanical systems such as heating and ventilation.  On average VA buildings are nearly 60 years old, with only about half built since 1920.

“VA will be working with Congress to implement our plan for modernizing our capital asset infrastructure through a national realignment strategy – allowing us to improve our buildings and facilities to meet local Veteran demand, and provide better healthcare services – all while being a good steward of taxpayer dollars,”  Shulkin said.

Accountability

Under current law, VA must wait at least one month to hold an employee accountable for misconduct or poor performance. VA currently has around 1,500 disciplinary actions pending.

“Our employee accountability processes are clearly broken,” Shulkin said, citing a having to wait more than a month to fire a psychiatrist who was caught on camera watching pornography on his iPad while seeing a Veteran patient. “We need new accountability legislation, and we need it now.”

Staffing

Currently it takes VA an average of 110 days to onboard a nurse and an average of 177 days for a nurse practitioner. In his remarks, Shulkin called for position management capability to provide the agency structure to create jobs based on specific duties and responsibilities that are required to meet the needs of Veterans. Low salaries for health care providers and prosthetics representatives are also making it difficult to recruit and retain critical positions. As an example, the 2016 median salary for biomedical engineers was $85,620, while the national VA average for a VA biomedical engineer was $65,677 – nearly 25 percent below the private sector.

“If VA cannot compete with private sector salaries, we will be unable to retain qualified providers and support staff,” Shulkin said. “To help with staffing shortages, VA will be pursuing legislation to expand graduate medical education training opportunities.”

Bureaucracy

Shulkin described VA’s central office as too big and too bureaucratic. “We need faster, clearer decision making authority that gives Veterans more control of their care and services,” he said. “I have directed that VA Central Office remain under a hiring freeze as we consolidate program offices, implement shared services, and reduce our overhead by at least 10 percent.”

Additionally, the secretary is taking action to reduce burdensome regulations that simply do not make sense to make it easier for Veterans to engage with VA.

Fraud, waste and abuse

Detection and prevention of fraud, waste and abuse ensures VA’s resources are spent on what they were meant for – care and services for Veterans and their families. VA has been able to prevent $27 million in fraudulent payments and identified potential duplicate payments of $24 million last year.

Veteran suicides

The most recent study shows that 20 Veterans a day are dying by suicide. This is a national public health crisis that requires a whole of government approach and key partnerships with communities and private sector organizations.

Shortly after taking the helm of VA, Dr. Shulkin authorized emergency mental health services for those that were other than honorably discharged – a population of service members who are at the highest risk of suicide.

For more on the areas highlighted by the secretary, see the ‘State of VA” fact sheet by clicking here.

Dr. Shulkin’s overarching plan for VA seems to be fairly simple: Recognize (and admit) the risk to Veterans, develop the best possible solution and eliminate the bureaucracy standing in the way to make it happen. In many cases, the rules will need to be rewritten and in some case the law will have to change.

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69 Comments

  1. Veteran June 12, 2017 at 10:35

    If you were a Veteran with a Level of Care your focus would be on Veterans not the organization.

    You are taking our steak and selling it downtown and giving us Chicken.

    Why don’t you give the VA Top Security Clearance for the purpose of medical treatments, and what about missing medical records? Most want treatment to be confidential and handled IN House. You open a bag of worms to class action suits……

    Why must Veterans give up money to pay for this? May God help us.

  2. Reginald Thomas June 9, 2017 at 17:28

    The veteran’s primary medical provider should not be an employee of the VA. By instituting private primary doctors linked into the VAMC the “fox will not be in charge of the hen house” and the medical care of the veteran would take the front seat. This will make the primary medical doctor liable to the veteran as well as the VA and it will make more doctors available to provide care; provided, the approval system for care is handled in a timely manner by the VA. I have the choice program and have found the VA actions to approve treatment to be like watching a ping pong ball game. I’ve had a specialist comment, after I went several months in severe pain, “A dog would have gotten quicker care!”
    I applaud Dr. Skulkin agenda that seem to be on the right track. But I strongly feel that primary doctors working for the VA is ethically wrong.

  3. Timothy Fitzgerald June 9, 2017 at 11:47

    Why is it there is now place to tell the VA about my problems with the VA. For instance My having waited to get glasses from February 8th 2017 until now June 9th 2017 and still no glasses, because of the incompetence & uncaring VA. If I were a US Senator I would have had them in a couple of days.
    I have been a disabled Vet since the Vietnam war (100%) service connected. I have a whole list of VA stories. The VA has a way of wording their questionnaires in such a way that they always end up looking that we are all very satisfied.
    WE ARE NOT

  4. Edwin Glasser June 5, 2017 at 10:56

    I have been trying to get a copy of my medical records which the VA has. They received my third request in Oct 2016. I know they received it because the third time I sent it, I sent it registered mail. I have a copy of the signature of the person that signed for it. Here it is June 2017 and I’m still waiting. All told it’s been over a year and a half I have been trying to get them.

    • David Bearden June 6, 2017 at 12:54

      Be patient, I got mine in a little under 3 years. (lol) But they were incomplete.

  5. Summer Snow June 5, 2017 at 10:31

    When I download my blue button medical info I see SEVERAL instances of outright lies. The only reason I can think for the lies is the VA nurses and doctors are “cooking the books” so they can continue to get “performance bonuses”. But in some instances that doesn’t even make sense unless there’s something I don’t know about.

    For example…..

    They say I reported I have a living will on file with them. I do not, and did not report that. Outright lie, plain and simple.

    They say I answer negative to both questions on the PHQ-2 depression screening every visit. I answer positive to both questions every visit. Another outright lie.

    They say I have nicotine dependency. I haven’t had a cigarette since September of 2010. How do I have nicotine dependency? Another outright lie.

    They say I refuse the Pneumococcal PPSV23 vaccine every visit. It has NEVER been offered. I just found out recently it’s an ESSENTIAL vaccine for people with my lung condition. Yet another outright lie!!

    They say I refused information on being fat. No such info was ever offered. Probably rightly so because I’m 6ft tall and weigh 183lbs. Had they offered “fat” info I probably would have laughed at them, but still to say I refused the info is another outright lie, since it was never offered.

    And the list goes on, and on, and on, and on. Probably around half (maybe more) of what they have in my “blue button” medical file is just plain and simple outright lies cooked up by who the hell knows, for who the hell knows what reason!!

    If you have a va.gov account, go download your file and I guarantee you’ll find it’s a laughing joke. Only they don’t realize it’s not a joke. They’re playing with peoples lives. And that should be criminal.

  6. Stephen Rafe June 4, 2017 at 15:08

    I have been trying since last August to get surgery on two fingers and my wrist. Community Care and Health Care Network keep making one bureaucratic error after another. Also, I have been getting the bureaucratic dance from VA for over three years on my claim for COPD/asthma despite even DAV’s efforts on my behalf. Finally, I can’t get a straight answer on whether my service-connected disability payment should increase due to worsening of the problem.

  7. Linda June 4, 2017 at 14:32

    Jeffrey, you are right. We need to all get on the band wagon and write, call and email all of the congressmen and senators to complain about cutting IU for Veterans. We need to call the local paper s and let them know what is going on, so all the vets will know about this, so it can’t be shoved under the rug. I knew when Trump placed a NON-VET as head of the VA, we were in trouble. Get out the word. Put it on Facebook, Twitter and any other means of communication you can think of.

  8. Al Meadows June 4, 2017 at 11:52

    There is an awful lot of fake appointments being made, that is contributing to the backlog and over 30 days to get a real appointment for some veterans that need the treatment. I have had to wait long enough that I just went to my family doctor and paid out of my pocket, only a couple times. I heard from some workers at the VA that they were doing fake appointments to make everyone providing treatment look busier then they really are. If you have a director setting making false appointments or blocking out times there could be appointments the computer wont make 2 at the same designated time.

  9. Daniel Santos June 3, 2017 at 17:33

    I’m a 100% veteran. The service and help from the Phoenix VA is extremely laughable. I have had multiple providers and everyone wants to change my meds. First provider stopped my pain meds, and held my meds until I saw a video, the second laughed every time my wife or I raised am health problem. The third is a nurse practitioner whom I’ve never met. All three wanted to change my meds. There was nothing wrong, I was just asking for refill.
    All three should be fired for not providing proper medical care. I my heart of hearts nothing will be done just like when I contacted Senator Flake, a very large and deep hole.

  10. John L Todd June 3, 2017 at 13:26

    I would like to know who came up with the “Combine Rating Scale”? This has to be the most unfair pay scale I have ever seen. I cut and pasted the following right from the VA’s website.
    Examples of Combining Two Disabilities
    If a Veteran has a 50 percent disability and a 30 percent disability, the combined value will be found to be 65 percent, but the 65 percent must be converted to 70 percent to represent the final degree of disability.
    Similarly, with a disability of 40 percent, and another disability of 20 percent, the combined value is found to be 52 percent, but the 52 percent must be converted to the nearest degree divisible by 10, which is 50 percent.
    Example of Combining Three Disabilities
    If there are three disabilities ratable at 60 percent, 40 percent, and 20 percent, respectively, the combined value for the first two will be found opposite 60 and under 40 and is 76 percent. This 76 will be found in the left column, then the 20 rating in the top row. The intersection of these two ratings is 81. Thus, the final rating will be rounded to 80.

    If you have number of ratings, they should be add and paid with normal addition math. My example 30 + 30 + 10 + 10 = 80.
    I will contact my Federal Sen. and Rep. on Monday! I have only heard over the last year how everyone wants to help veterans. It’s seems to me that our government gives money to everyone but a veteran pay scale that makes no sense is just wrong and needs to be fixed. I wonder how many vets can be helped with this one easy fix?

  11. william f farley June 3, 2017 at 13:14

    On the morning of my third day in Vietnam I went into shell shock – I was comatose/out for a week, afterwards having major blackouts but still functioning during my blackouts – scary. I would find myself in places that I had no idea where I was. The VA offered me 70% permanent & total with 30% unemployability so I took it. And it’s long after a year now to appeal it. I receive $300. a month now from social security, which means if this passes the VA is going to take $1600.00 out of my monthly check because I’m receiving $300.

    I’m 68 and to worn out/beat up to work. If this happens I will be homeless. I will not be able to afford renting a place and can assume my marriage will end.

  12. John Oller June 3, 2017 at 10:59

    I am a 69 year old Vietnam veteran given the IU status due to my service connected disability. If I have been unemployable, how can I have possibly contributed to SS? If this passes, it would mean I would be looking for a job at 69+ trying to buy food and pay my mortgage. Veterans voted for President Trump for positive change – not to change the rules midway through the war to win one battle. How can we organize a petition to send to the press and government officials to let people know what is being proposed and to protest this? We need to shed light on this so everyone sees it and can voice their opinion.

  13. earl w morton June 2, 2017 at 23:36

    choice saved my life the cancer was removed in 3 weeks not 3 to 6 months at va also not a penny out of pocket.

  14. Dean Smith June 2, 2017 at 22:54

    I served my time in war .., I have all the documents to prove what I did and the scars to prove it . I proved it and was given my award . Now at 70 years old you want to take
    It away !! You say the Vietnam Veterans got a bad deal
    I’ve lived my last 50 yrs hearing people apologise for
    What I went through . Most of them will never know .
    We had a recent 50 year reunion honoring those that
    Served in Vietnam . Did it make me feel better ? No !
    It made me feel worse . It brought back memories long forgo
    Forgotten and bob hope events that did not include me
    Because I was in the jungles fighting for my life and the
    Lives of my fellow Marines ! Then on Memorial Day of all
    Days you announce that you are going to strip off
    The unemployabilty to those vets who reach retirement
    Age . At a time that our conditions are worse and
    Our finances already thin with no chance of getting a
    Job or being able to hold down a job. It’s no
    Wonder people are confused bothered and bewildered
    With the VA . Every month we receive our check we
    Wonder if this will be the last . I’m sure if Donald trump
    Was completely aware of some of these proposals
    He would not be in favor of financially distroying
    Us . Rethink your position Director and please let us know .

  15. andrew maffei June 2, 2017 at 20:23

    Yeah, the day I go to the VA AND they Actually do something for me I think I’ll have a heart attack…I am so sick and tired of being told “Well were sorry, but there’s nothing we can do for you” I wont hold my breath waiting for them to fix anything…
    Every time I have approached the VA I’m meet with the attitude that it’s their money, and I’m trying to take it from them. I have gotten to the point I don’t even bother with the VA anymore. Nice way to treat a retired veteran!

    AM, USAF (Ret)

  16. Linda S. Smith June 2, 2017 at 19:12

    C’mon senate pass the new appeals rules. 845 days to wait for a dro review at NY City regional office is a nightmare especially when my claim has been at NY City regional for 11 years.

  17. Ronnie Wilkins June 2, 2017 at 15:53

    I too receive “IU” payment. My rating is 90%. I sent a letter to Sulkin, although i doubt he’ll ever see it. I also sent a similar letter to my congressman providing a breakdown of how the loss of the “IU” would affect my life. If my wife lost CHAMPVA coverage, comparable coverage would cost her $1035 a month. Overall, i would lose $2450 a month. Now, like i said, i receive 90% rating, i can’t imagine how catastrophic it would be for those vets thst are 60, 70 and 80%. I find it appalling that the presiident, who never served, would appoint someone, who never served, to head the VA. That’s like hiring a auto mechanic to work on nuclear weapons!
    Ok, I’m off the soapbox.. Your turn.

  18. David Sexton June 2, 2017 at 15:43

    Back in 2009 I went to the VA for Blood pressure medication and they would not give it to me and ended up having
    a stroke. Spent 7 months in a coma. Just 1 year ago went to the VA for meds for my AFIB and they would not give
    it to me because I had a stroke in 2009. I ended up having another stroke. I find these VA nurses to be totally inexperienced
    and do not need to be servicing War Veterans. The VA needs to use the doctors and nurses from Medicaid. I will not go
    to the VA any more and use Medicaid for my doctors.

  19. David Bearden June 2, 2017 at 15:40

    I am happy to hear that many people are getting good care from their VA facilities, but please understand that not all are. I do really appreciate what care I get but there are many easily rectified problems at our facility that would greatly increase the quality of care for our veterans.

  20. David Bearden June 2, 2017 at 15:36

    I don’t think much will happen. I used choice and now have hospital bills in collections and bad credit marks. The VA, Healthnet or the hospital can’t or won’t help’ It’s my problem they say. VA doesn’t have pulmonologists so I have to use the choice program and my Dr. doesn’t think he should have to go out of his way to help vets. I’ve been trying to get an operation for months. It took me 4 months to get oxygen and my VA primary care nurse doctor said oh well. Been tryin to get pulmonary rehab since Feb, 2016. I can’t even get a portable oxygen concentrator to fly on a plane. Medicare has them VA doesn’t have them. Our Va is a social club. Some are good people and some excellent Doctors but it’s overrun with incompetency.

  21. Robert H. Cole June 2, 2017 at 15:17

    It is not widely understood that many disabled veterans are retirees who usually enjoy excellent health insurance provided by DOD, known as ‘Tricare For Life”. That program provides primary coverage to the retiree until Medicare provides primary coverage under social security. At that time, Tricare for Life becomes the secondary health insurance provider. Consequently, the proposed VA Choice Program does not apply to military retirees.
    Like all other veterans, disability ratings for military retirees, including IU (Individual Unemployability) are determined by the VA which is also responsible for disability compensation. The elimination of compensation based on IU in order to fund Choice or any other VA program is patently unfair to all disabled veterans, and is especially unfair to military retirees who have no basis for receiving VA health benefits.

  22. George Shields June 2, 2017 at 14:59

    “Secretary Shulkin on the ‘State of VA’: Making VA into an organization Veterans deserve” Well now I know what my Government and Veterans Affairs thinks of me and the rest of the men and women that have served and fought the wars of our country. If this proposal concerning IU goes through they are basically saying this is what you deserve “Nothing” all you old wore out Vietnam vets hurry up and die. I volunteered to serve my country in 1969, I spent 18 months in Vietnam and served for 71/2 yrs.
    I think it is every Veterans Duty to spread this every way they can whether it effects them personally or not. Something like this may happen to you and you will need all the support you can get. I’ll be there for you, so be there for the ones that need you now. The news has not covered this same with Yahoo and MSN.

  23. George Robert June 2, 2017 at 14:56

    What is wrong with everyone? Dr Shulkin a couple years ago there was an independent report released by the MyVA initiative that clearly showed that our healthcare costs would increase if we decided to use the disconnected decentralized civilian healthcare system as an option. Why on earth would we do such a thing? I would think your time would better serve our veterans and the VA by preventing the ill-informed politicians and big money people from getting a piece of the VA’s budget. Simply take the money and fix our house.

  24. Douglas Meyers June 2, 2017 at 14:48

    I need help with getting my VA medical providing prescriptions as I sent in a 10 EZ form in the early 1990’s and never heard from the VA. Then in the late 1990’s I filled out another one sent it in and they said I wasn’t eligible, I don’t get it. I served from 1966 to 1969 in the US Army Airborne.

    What is a Veteran
    Under Federal Law, Title 38 of the Code of Federal Regulations , a veteran is any person who served honorably on active duty in the armed forces of the United States, discharged under honorable conditions.

    Also qualifying events are any person who served in the active military, Army, Naval, Marine Corps, Air Force, or Coast Guard Service of the United States and was discharged with a honorable from the service due to a service-connected disability or filed a claim and was service-connected for a disability sustained while in the service.
    In which having a service connected disability that veteran would have a VA Medical Card, others wouldn’t have such a card not receiving veterans medical benefits, but still being a veteran of the United States Military.

    Veterans Eligibility
    For the purposes of VA health benefits and services, a person who served in the active military service and who was discharged or released under conditions other than dishonorable is a Veteran.
    Basic Eligibility
    If you served in the active military service and were separated under any condition other than dishonorable, you may qualify for VA health care benefits. Current and former members of the Reserves or National Guard who were called to active duty by a federal order and completed the full period for which they were called or ordered to active duty may be eligible for VA health benefits as well.

  25. Mary Carol Raines June 2, 2017 at 14:45

    IU was promised as total and permanent!!! I guess the BA doesn’t care. My husband has suffered many years due to Agent Orange. Once again no one cares about Vietnam veterans. If we had known that IU could be taken away we would have applied for increase above the 70%. My husband may die before this is decided. What happens to me if he is deceased. Will they still strip me of ChampVA? Very upsetting.

  26. George Preston Nowlin, Jr. June 2, 2017 at 14:11

    I get great care at our VA clinic in Harrisonburg, VA. All the folks there have a friendly approach to taking care of us. Check in really easy with the computer check in program. Almost all of my time in the waiting room is within ten minutes of my appointment time. We have had some changes in physician’s staff but all still seems to be on target in trying to help us veterans!

    • Bikenstein June 6, 2017 at 13:28

      I’m happy for you. Consider yourself more fortunate than others. I wish Tuskegee, AL clinic was the same. We do have some great physicians and staff but not nearly enough to characterize our facility by them.

  27. Nick O June 2, 2017 at 13:24

    Taking away benefits from the most disabled is NOT what a “Grateful Nation” should be doing!

  28. Jeffrey D. McMahon June 2, 2017 at 12:47

    In my long life as a Human Being, as well as that of a Vet., I have noticed tha when politicians say things like:
    “Making VA into an organization Veterans deserve”, what they really mean is making changes.

    Mostly those ‘changes’ are taking something away from Veterans to balance the budget. A tsk, by the way, no politician as been able to do since there was a budget.

    Veterans deserve everything from the goverment. Politicians do not fight and die in wars. They just sit back and make decisions the just keep it rolling (Viet Nam, Korea, etc).

    I know that war is good form business. It is not any good at all for theose that are sent to die for it. Nor, the mothers, fathers wives and children that weep at their funerals.

    If you really need to ‘make changes’ Then make the right ones., THE CHANGES NECESSARY TO SERVE THE VETERANS’ NEEDS.

    And pray to who or whatever you know as God for guidence. Don’t rely on that carot top idiot for anything.Unless he wants to sand against the wall and e a dart board.

    • DL June 2, 2017 at 15:17

      Take your medical weed and have a drinky.
      Real people can’t understand your crap.

  29. Keith L Stone June 2, 2017 at 12:29

    Time to drain the swamp at the VA. I am sure there a some good people in some places within the VA but the diagnosis is terminal. Time to disband and allow only private care. Local service and the VA would simply process the payments. I know this sounds more simple than it really is however it is time for radical change. The VA is bloated and ineffective.

  30. John Walters June 2, 2017 at 12:09

    There are many conflicting stories on DAV.org comments about VA Budget that cancels disabled veteran stipend payments at age 62+. Please post a clear description of President Trump and Secretary Shulkins Budget changes on this item, and please explain initials for programs such as “IU.” Thank you.
    P.S. VA doctors & surgeons have saved my life several times. God bless you all.

  31. Daniel K Carper June 2, 2017 at 11:51

    For all of us Veterans who have IU Disability, we are being stripped from the benefits that we have earned and that was approved by the VA. THIS ACTION IS UNACCEPTABLE!!! Choice is not worth the paper it is written on for most of us. Some how, we need to stop this proposal from going through. He emphasized on everything but the IU. If this goes through, we will lose everything we have. As far as COLA, we haven’t been given anything that helps us in the economy we’re living in. Please contact everyone you can to stop this guy from taking everything away from us. I don’t know about most of you, but I spent 21 years supporting this country and their freedom and I’ll be damned if I’m going to sit back an let someone like him disgrace us!

  32. Portia Butler June 2, 2017 at 11:45

    I worked in the VA system during the 80’s as a new graduate and the same issues that are being discussed now were the same then, with the exception of salary. You were paid more than the private sector. In my opinion Congress diverted all the funds, putting us in the situation we’ve today. The VA system is were a team of nurses of which I was a member, evaluated the use of DRG’s and the framework remains today for determining length of hospital stay. In addition, the Columbia, S.C. hospital was one of the best. As stated previously, the demise of the system is due to state and federal governments.

  33. Jeff Adler June 2, 2017 at 11:38

    He is turning it into a bigger disaster than Hiroshima. Enough said.

  34. Jan June 2, 2017 at 11:19

    I forgot to mention that before the CHOICE program, I was referred for care with no effort on my part. Canandaigua and Buffalo VA were able to attend to my needs with ease. Now with the new CHOICE program, my life and the life of my doctors has become more difficult and stressful. I enjoyed the care that the VA provided, but now hands are tied with the new system and care was almost denied for my asthma shots.
    It wasn’t broken at the Canandaigua and Buffalo VA facilities – why did they try to fix it??? It wasn’t broken!!!!!!!!!!!

  35. Jan June 2, 2017 at 11:11

    The NEW system is difficult to navigate… After navigating all the phone calls and misdirection, I finally got approved for treatment at an approved VA care facility. I just received a letter stating it is not covered. Choice approved it and they set up the appointment!!!!!!!!!!!!!!!!!!!!
    How is it not an approved appointment??????????????????????????????

  36. john bolles June 2, 2017 at 11:05

    There is no coordination between the VA, Health-net, providers and the veterans in the choice program. It’s like being in a revolving door with no exit. I’ve been at it for 3 months to get eye surgery and have been told I have to start over. The provider is fed up with having to send in all the documentation multiple times. My VA primary just called after3 months to tell me I need eye surgery. An 8th grade class could come up with better policies and procedures. WOW the new and improved VA!!

    • Bikenstein June 6, 2017 at 13:20

      STAY AWAY from Health-net. It causes way too much stress. See a patient advocate to help get any action at all. I have been trying to get pulmonary rehab since Dec 2015. Hernia operation since Jan this year. I’m very close to (maybe 3 weeks away from) my first rehab appointment. My hernia is getting bigger every month. And watch out you don’t get billed for services using veteran’s choice and your credit eventually ruined over their lack of “coordination’.

  37. Ronald Rytter June 2, 2017 at 10:54

    What percentage of declined claims are being approved when they are reviewed under a NOD review? I suspect the percentage is quite high which indicates an improper evaluation initially.

    Would reduce the the claims being under review which would free up those needed for NOD review which would provide more qualified persons to work on the more difficult cases providing a positive outcome and less stress on the claimant.

  38. William Karp June 2, 2017 at 10:50

    The VA is a great organization doing it’s best for the veterans, I am a combat disabled veteran and I have used the VA for 30+ years with few complaints, might be that some vets expect too much and some are never satisfied,
    sounds political to me!

    • Robert D Roenfeldt June 2, 2017 at 12:17

      Your level of care has a great deal to do with your location! I have been very pleased with our outpatient clinic, but have had problems at major VA hosital (How would you like to wake up while undergoing eye surgery?). Know vets in other states ( Ibelong to a veterans motorcycle club, so contacts world wide). Hear about all levels of care.

  39. Daniel K Carper June 2, 2017 at 10:50

    He forgot to mention doing away with Individual Unemployability!!!! He’s making sure that this is kept as a low profile under his major proposals like most of them do to cover up proposals that will affect a large number of Veterans. His proposals were listed at Military.com. We need to contact everyone we can to to stop this proposal to be denied. This is serious and he’s trying to get congress to approve it without most of us not knowing it hidden in his overall proposals.

    • William Howlett June 3, 2017 at 19:17

      Thank you Daniel K. Carper. Doing away with Individual Unemployablity and therefor removing 225,000 from the VA Benefits is UNBELIEVABLE!!! Get the word out there that our benefits are going away if nothing is done. At 72 years old I’m ready to go to war again, to fight for our benefits.

  40. joel alvarez June 2, 2017 at 10:50

    If not only That To Add my Son as Dependent Its Still in procces since oct 2015 and They alway told me Ur notification letter will go out any moment they been told me That Monthly since last Yrs

  41. GARY DALE GWALTNEY June 2, 2017 at 10:46

    IF YOU TAKE MY UI FROM ME IT WILL WIPE US OUT. OUR HOME MY WIFE’S CHAM V A HEALTH INS. WE WILL BE LIVING IN OUR CAR. MY HEALTH INS WILL BE LOST,CANT AFFORD THE PREMIUM.IN OTHER WORD’S WE WILL HOMELESS NO HEALTH INS OR MEDS WE BUY A LOT ON MED’S. THE BOTTOM IS WE WILL DIE.

  42. Richard D Mencl June 2, 2017 at 10:45

    I have found the VA treatment at the CBOC in Charlottesville, VA to be very good; appointments are timely, staff are considerate, and the doctors are knowledgeable. They have treated me for about 10 years. When the CBOC has to refer me to the VAMC in Richmond, there is sometimes problems getting timely appointments, but I believe the care they give is on par with what my wife gets from her outside doctors. I have noted that much of the VAMC care comes from PAs and NPs. I have no problem with that as long as these personnel are being overseen by VA doctors. The phone system at VAMC has been a real problem. Getting through to the right office and getting someone to answer the phone takes way too long. I have been using the Myhealthevet email system to avoid waiting on the phone. Overall, I am very thankful for the VA!

  43. LANCE JAMES BOYD June 2, 2017 at 10:40

    AT THIS TIME I’M VA RATED AS 70% SERVICE RELATED DISABILITY, I HAVE BEEN WAITING FOR OVER 3 YEARS FOR A DECISION ON MY UPGRADE TO 100% DISABILITY SO I CAN HAVE MY TEETH FIXED. I HAVE FOLLOWED AND RESPONDED TO EVERY REQUEST FROM THE VA AND HAD TO GO TO A ATTORNEY FIRM IN HOPES THEY CAN GET SOMETHING DONE. BUT STILL I CAN’T GET TO A PHONE INTERVIEW AND AT 71 I MAY DIE BEFORE THIS GETS SETTLED. CAN YOU OR ANYONE HELP?

    SINCERELY,
    LANCE BOYD
    PORTLAND, OREGON

    • Robert D Roenfeldt June 2, 2017 at 12:09

      Contact your senator or congressman. Most of them have a person on their staff to help with veteran/VS issues. Mine was a great help!

  44. Richard G McHenry June 2, 2017 at 10:34

    For some reason, Shulkin is able, in my opinion, to better focus on and communicate what he wants to change. My experience with VA Health has been very good. I am a Vietnam vet, only coming into VA Health in 2011. I chose to get care at a small VA hospital versus a much larger one that was closer to me…happy to drive the extra miles and glad I can.
    The choice Program, for me, was a weird experience. I was fortunate that when I had to use it, the health issue was not a serious one. My VA hospital staff were furious over the treatment I received from Healthnet, the coordinator of the program. So, they do care.

  45. Glenn Lego June 2, 2017 at 10:29

    Is part of the fixing of the VA taking away needed benefits from disabled Vets? Also I turned 65 five years ago and no one will give me a shingles vaccine which I should have had . What’s up with that?

  46. Kathryn June 2, 2017 at 10:25

    One of Dr. Shulkin’s remedies would be to cut off the head of this problem by taking from the elderly disabled vets by hitting us in our pockets. Something that has sustained us in life. This plan to take our money will put us out of our homes and we will join the ranks of praying for social security at best. Something for future soldiers to think about. This gets worse with every new director

  47. js June 2, 2017 at 10:22
  48. Charlie Fox June 2, 2017 at 10:21

    Secretary Shulkin , cutting benefits to elderly disabled veterans to further the cause of Veterans Choice program is unconscionable. Veterans Choice is a laugh at best, ask me, I have been there and used it. Why are you even thinking about putting older veterans into poverty by cutting their Individual Unemployability. They have lost years of prime earnings, they have lost years of paying into Social Security by being disabled, and now you want to do this ?? I am appalled to say the least

    • William Howlett June 3, 2017 at 19:30

      Thank you Charlie Fox! 225,000 veterans are targeted to be dropped from receiving VA Benefits because of doing away with Individual unemployability. Get the word out there to stop this madness!

  49. George Fagerstrom June 2, 2017 at 10:13

    This is just talk, it doesn’t even come across as a good pep rally. Saying this a vet means nothing. When your drs, first belittled me in front of student interns, I told many of this treatment. YOU started this downward spiral, ive nothing to lose now, I’m going to hell and you’re coming with!

    • William Martin June 2, 2017 at 12:39

      You are totally correct about the distribution of Social Securirty vs IU payments. It the same old privileged principal, you take away earned benefits from the minority’s group”, the Vets on IU is a small percentage of Vets receiving benefits. This budget cut is unacceptable and I hope our VSO’d can work something out for the IU Vets…

    • Mary Carol Raines June 2, 2017 at 14:29

      I too am concerned about the loss of IU. Not only affects the veterans but the spouses as well. We were this compensation was permanent. The Congress gets paid for life and excellent health care. The veterans have put their life on the line. My husband was forced to retire at 62 due to his health so he was not able to get full SS benefits. Please don’t do this to us now!

    • Richard Rust June 6, 2017 at 20:51

      Got that right .. George
      how bout seeing an knowing You have TBI an then Notice TBI removed an CTE added
      TBI is CTE in a way but Both r still different Illness’s , Your now on 3 PCP in a Year
      an gets to Point that You get an MRI an 1 Dr. say’s You have had Seizures an then
      a month later getting a thing in the mail that I’m seizure free and All this started once
      I complained about the Dental Care .. a Dentist who said to Me You’ve been here 5 x’s this Yr.
      If I see You again I’m going to pull All your teeth then does a filling which is what the other 5 appointments we’re
      simply filling’s next day I notice tooth was still lose He just filled when I called to be seen again to re-glue or ?
      I was told to lay back look’s at my Tooth an does examination which He just did .. 2 days before !!! an say’s You have another Cavity .. in 2 days ” don’t think so ” an pulled All my teeth .

  50. Zachary Forester June 2, 2017 at 10:13

    Very concerned about stopping IU when eligible for SS. SS payments is based on contribution. A disabled vet determined to be IU at age 23 will not contribute much into SS, so very little SS monthly entitlement. And older vet determined to be IU at age 60 could not work or lose IU. So, he will get reduced monthly SS because he did not contribute to age 65 or 67. Either way, the vet gets screwed.

  51. SOCRATES June 2, 2017 at 10:07

    I find it amazing that in this time of crisis the VA transfers a non effective director of the DC medical center to a high ranking position at VA Central Office.

  52. Jack Bain June 2, 2017 at 00:43

    It is my experience that things are getting worse at the VA. Our clinic had two doctors quit so with one doctor left they cancelled appointments. Then 2 months later I got a call from Tri-West setting an appointment at a local doctor. Sure, see a local doctor who doesn’t have your computer file in front of him and you have to explain your history to him and your meds. This will be the fifth doctor I see to try and figure out my 24/7 headache, they say it isn’t agent orange and not Camp Lejeune water. Said I needed surgery over a year ago but not doing it. When I ask about it, no response. The VA is not improving.

  53. James R Godfrey June 1, 2017 at 19:49

    The Va choice program is a joke if you find a doctor in the program the ones I called said they would not see no more veterans​ because they haven’t been payed for the ones they seen.The Va Hospital in Columbia SC is the rudest place to go 30 percent work 70 percent walk around and do nothing I got good care in Greenville SC when on Augusta Rd every 3 months I was seen but when moved to new location nice building a lot of space less people working took almost ayear to get seen now I m on a six month program being seen

    • david mills June 3, 2017 at 12:38

      what color ar the 70% walking around ?

      • Bikenstein June 6, 2017 at 13:02

        I had to quickly get used to the staff socializing and realize that I was the second priority of the day. I even had to wait a good five minutes to see a patient advocate while one staff member finished his flirting game. He did seem to cut it short (about an additional 2 minutes) after he noticed I was waiting.

  54. Larry morello June 1, 2017 at 16:59

    Please fix this please help us

  55. Lawrence Fortune May 31, 2017 at 21:44

    The VA medicine from my experience in the past has varied in some cases. For instance, I have notice at times some may work alright at times, and some might not work well at all. For instance I was a blood pressure medication that was working real well all of a sudden they change it. I started having trouble with my blood pressure again. The one they replaced it with seem to be a weaker one. It was the same name, same brand, same strength, it was just weaker. When asked about it, the doctors, and pharmacy or the VA said they have no control over the medication.

    • James Barrett June 2, 2017 at 11:59

      I apologize to you Lawrence as I could not figure out how to post only reply to your post.

      I have been trying to get outside approval to see a neurologist for my back since my local VA doesn’t have one on staff for over three years and I cannot even get a no. Just no answer at all. Does anybody help me?

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