Vets will get to pay more of the bill, about $1.1 billion
Fri Feb 11, 2005 03:06
64.140.158.43
Vets will get to pay more of the bill, about $1.1 billion
This can be found also at: http://www.theangryvet.com/weblog/00000014.htm
Well, it is finally here, budget season in DC, otherwise known as hunting season. The targets are wide and varied this year, including the VA. Although some will argue that given the austere budgets others will have to do with, the VA Budget is generous. So the call from others might be to veterans, pipe down, you’ve got more than your fair share. However, if anyone actually reviewed the numbers, the growth in the VA budget is still actually less than what the VA needs to take care of America’s veterans.
In its budget, the Bush White House states the following significant new initiatives. They are:
1. Assess an annual enrollment fee of $250 for all Priority 7 and 8 veterans
2. Increase pharmacy co-payments from $7 to $15 for veterans who have a greater ability to absorb these co-payments – Priority 7 and 8 veterans
3. Eliminate co-payments for veterans receiving hospice care and former Prisoners of War
4. Allow VA to pay for emergency room care received in non-VA facilities for enrolled veterans.”
Of course, for a different perspective the VA budget is filled with obvious and buried lowlights:
1. Community Health will, despite a rise of over $900 million, actually see a decrease in service funds since the increase in spending is $ 424.8 million less than payroll and inflation changes dictate.
2. Goals for VA Compensation claims processing increased from 90 days in FY2005 budget request to 125 for both FY2005 and FY2006 (a 38.8% increase in goal), thus meaning the VA expects it to take around four months at best for a disability claim to process.
3. Vets will get to pay more of the bill, about $1.1 billion more, according to a statement by Senator Kit Bond (R-MO). This will happen due to increased co-pays and annual enrollment fees.
4. A continued rise in the number of Unique Patients per Medical Care Personnel. This parameter has risen from 20.81 Unique Patients per Medical Care Personnel in 2000 to an expected 26.86 Unique Patients per Medical Care Personnel in 2006 (a 29% increase in this workload statistic).
5. The VA will continue to suspend enrollment of new Priority 8 veterans.
6. In the odd, the budget calls for management savings to take care of the funding needs for the VA Medical Care budget. The White House budget claims that it will realize “additional management savings of $590 million in 2006 that will partially offset the overall cost of health care.” However, the budget will actually see a dramatic 8.8% (273 additional personnel) increase in Department Management personnel. For my the record, it is my hope that these people are all extremely efficient managers, who can double as worker bees, if needed.
Community Health Programs - When an increase not an increase?
This seemingly impossible possibility occurs in the FY2006 budget in regards to community-based health care. Although the budget calls for an overall increase of $975.2 million, it points out that “of the $975.2 million increase, $1.4 billion is required for payroll and inflation changes over the 2005 estimate to support the Medical Care business line.” Thus $424.8 million less will be available for items not included in the “payroll and inflation changes” noted. The only logical conclusion is that other unknown areas within community-based health care will have to do with significant less, $424.8 million less. Before Congress bites off on this portion of the bill, they should ask for an explanation as to what cuts in services will have to be done to save the $424.8 million.
Compensation
In a seeming admission of defeat in trying to win the Compensation claims battle, the VA has changed its Key Measure goal on the timeliness of Compensation claims. For years the goal has been to try to get the average days to process such claims down to 100. The new budget goal is to reduce this measure to 125 vice the 90 days of the 2005 budget. However, even with the new goal of 125, the VA still anticipates taking around 145 days in both 2005 and 206.
In reality, the best the VA has been able to do since 1993 was 133 in 1997 under then Secretary Jesse Brown. Since then the average days have varied from that low in 1997 to the high of 223 in 2002. In early 2004 and later the official position was that the VA could obtain the goal of 100 days on average. Yet the VA was not able to reduce the number of average days below 166 in 2004. The administration’s VA budget partially blames a court ruling in September of 2003 that affected claims for the first part of 2004. However, given the fact that all of those affected claims should be gone, other facts need to have helped the Administration to determine a more judicious goal.
Co-Pays and Fees
It’s time for round 2 of the “Making Veterans Pay” battle, the VA budget assumes that Congress will pass an increase in drug co-pays and an annual enrollment fee. Considering the President’s loss on this issue last year, the fact that we are at war, and the fact that Republicans are already speaking up against it, including Missouri’s Senior Senator Kit Bond, it appears unlikely that this will pass. However, since it may not pass, then a $1.1 billion dollar budget gap must be filled. That means a serious change to the VA budget one way or another.
Medical Staffing
Of particular concern is the loss of medical care personnel. In the budget, 91.6% of the jobs lost (4,051) will be from the medical care pool. This will represent a loss of 1.9% in medical care personnel at a time when the number of VA unique patients will be on the rise by an estimated 49,000 patients (a 1.0% increase). This additional imbalance of medical staffing that began in 2001 will cause the number of patients per medical staff to rise from 20.81 in 2000 to 26.86 in 2006 (a 29% increase in the number of patients per medical staff).
In a review of the patient to medical staff ratio, it becomes clear by simple math analysis that if the correct and most efficient ratio was in fact 20 to 1, the number of VA medical staff would have had to rise from 183,396 in 2000 to 260,050 in 2006. This would have resulted in an increase of 69,186 medical staff, a 36.2% rise that would have matched the same 36.2% rise in unique patients.
In reality, I am sure that some economy of scale and some practice management could have been used to prevent such a necessary rise to take care of the dramatic increase in patients. However, it does not take a Yale graduate to do the simple math that a 5.6% increase in staffing would have a difficult time in keeping up with a 36.2% rise in patients. Additionally, although I am not sure what the most efficient number of patients per medical staff would be, it also does not take a Harvard Business School Graduate to figure out that if you significantly increase patients (since 2000) and marginally increase staffing, you will increase patient waiting time, decrease patient satisfaction, and overall effectiveness. The results of such a hospital management business practice could lead to hurried appointments, improper follow up, and increases in medical errors.
So for the VA’s medical budget, someone in Congress once again needs to ask some tough questions. Does the budget reflect less labor intensive medicine to account for the changes? Does the budget reflect a coming change of rationing VA medical care further than the denial of benefits to new Category 8 veterans? Does the budget reflect a dream that cannot be obtained and thus setting up the VA for a dramatic shortage in a time of war?
Priority 8 Veterans
“The 2006 budget request assumes that enrollment of new Priority 8 veterans will remain suspended.” Per this simple statement in the VA budget, the enrollment new of Category 8 Veterans remains suspended. Category veterans are those veterans “with no service-connected conditions with incomes above the geographically adjusted means test threshold.”
And Finally, the Odd
On page 1-6 of the VA budget, the VA states that “the budget request includes additional management savings of $590 million in 2006 that will partially offset the overall cost of health care. These savings will be achieved through improved standardization policies in the procurement of supplies, pharmaceuticals, and other capital purchases, as well as in other operational efficiencies.” Yet when you look at the bottom line, the budget calls for a rise of 273 (8.8% in Departmental Management personnel versus a drop of 4,051 (-1.9%) if non management personnel.
Correction for the Record
In a White House release dated August 16, 2005, title Honoring Our Commitment to America’s Veterans, the White states that “since 2001, President Bush's budget requests have allowed the VA to enroll 2.5 million more veterans in health care services
In reality, according to VA records the rise in VA Unique Patients only rose 1,019,025 vice the claimed 2,500,000 during this period of time. A slightly larger increase of 1,195,139 occurred under President Clinton. Many feel that a large part of this 2.1 million surge in VA patients was due in a large part to the 1998 law that opened the doors to Category 8 veterans. It is the contention of these people that too many Category 8 veterans have already entered in the system. Because of this, in 2003 the Bush administration put a hold on new Category 8 enrollees. And as noted earlier, this restriction continues through today and is also included in the President’s 2006 budget.
-The Angry Vet
===================================
Citizenship check for licenses OK'd
Bill passed in House also empowers
security secretary to 'waive all laws'
http://wnd.com/news/printer-friendly.asp?ARTICLE_ID=42801
This can be found also at: http://www.theangryvet.com/weblog/00000014.htm
Well, it is finally here, budget season in DC, otherwise known as hunting season. The targets are wide and varied this year, including the VA. Although some will argue that given the austere budgets others will have to do with, the VA Budget is generous. So the call from others might be to veterans, pipe down, you’ve got more than your fair share. However, if anyone actually reviewed the numbers, the growth in the VA budget is still actually less than what the VA needs to take care of America’s veterans.
In its budget, the Bush White House states the following significant new initiatives. They are:
1. Assess an annual enrollment fee of $250 for all Priority 7 and 8 veterans
2. Increase pharmacy co-payments from $7 to $15 for veterans who have a greater ability to absorb these co-payments – Priority 7 and 8 veterans
3. Eliminate co-payments for veterans receiving hospice care and former Prisoners of War
4. Allow VA to pay for emergency room care received in non-VA facilities for enrolled veterans.”
Of course, for a different perspective the VA budget is filled with obvious and buried lowlights:
1. Community Health will, despite a rise of over $900 million, actually see a decrease in service funds since the increase in spending is $ 424.8 million less than payroll and inflation changes dictate.
2. Goals for VA Compensation claims processing increased from 90 days in FY2005 budget request to 125 for both FY2005 and FY2006 (a 38.8% increase in goal), thus meaning the VA expects it to take around four months at best for a disability claim to process.
3. Vets will get to pay more of the bill, about $1.1 billion more, according to a statement by Senator Kit Bond (R-MO). This will happen due to increased co-pays and annual enrollment fees.
4. A continued rise in the number of Unique Patients per Medical Care Personnel. This parameter has risen from 20.81 Unique Patients per Medical Care Personnel in 2000 to an expected 26.86 Unique Patients per Medical Care Personnel in 2006 (a 29% increase in this workload statistic).
5. The VA will continue to suspend enrollment of new Priority 8 veterans.
6. In the odd, the budget calls for management savings to take care of the funding needs for the VA Medical Care budget. The White House budget claims that it will realize “additional management savings of $590 million in 2006 that will partially offset the overall cost of health care.” However, the budget will actually see a dramatic 8.8% (273 additional personnel) increase in Department Management personnel. For my the record, it is my hope that these people are all extremely efficient managers, who can double as worker bees, if needed.
Community Health Programs - When an increase not an increase?
This seemingly impossible possibility occurs in the FY2006 budget in regards to community-based health care. Although the budget calls for an overall increase of $975.2 million, it points out that “of the $975.2 million increase, $1.4 billion is required for payroll and inflation changes over the 2005 estimate to support the Medical Care business line.” Thus $424.8 million less will be available for items not included in the “payroll and inflation changes” noted. The only logical conclusion is that other unknown areas within community-based health care will have to do with significant less, $424.8 million less. Before Congress bites off on this portion of the bill, they should ask for an explanation as to what cuts in services will have to be done to save the $424.8 million.
Compensation
In a seeming admission of defeat in trying to win the Compensation claims battle, the VA has changed its Key Measure goal on the timeliness of Compensation claims. For years the goal has been to try to get the average days to process such claims down to 100. The new budget goal is to reduce this measure to 125 vice the 90 days of the 2005 budget. However, even with the new goal of 125, the VA still anticipates taking around 145 days in both 2005 and 206.
In reality, the best the VA has been able to do since 1993 was 133 in 1997 under then Secretary Jesse Brown. Since then the average days have varied from that low in 1997 to the high of 223 in 2002. In early 2004 and later the official position was that the VA could obtain the goal of 100 days on average. Yet the VA was not able to reduce the number of average days below 166 in 2004. The administration’s VA budget partially blames a court ruling in September of 2003 that affected claims for the first part of 2004. However, given the fact that all of those affected claims should be gone, other facts need to have helped the Administration to determine a more judicious goal.
Co-Pays and Fees
It’s time for round 2 of the “Making Veterans Pay” battle, the VA budget assumes that Congress will pass an increase in drug co-pays and an annual enrollment fee. Considering the President’s loss on this issue last year, the fact that we are at war, and the fact that Republicans are already speaking up against it, including Missouri’s Senior Senator Kit Bond, it appears unlikely that this will pass. However, since it may not pass, then a $1.1 billion dollar budget gap must be filled. That means a serious change to the VA budget one way or another.
Medical Staffing
Of particular concern is the loss of medical care personnel. In the budget, 91.6% of the jobs lost (4,051) will be from the medical care pool. This will represent a loss of 1.9% in medical care personnel at a time when the number of VA unique patients will be on the rise by an estimated 49,000 patients (a 1.0% increase). This additional imbalance of medical staffing that began in 2001 will cause the number of patients per medical staff to rise from 20.81 in 2000 to 26.86 in 2006 (a 29% increase in the number of patients per medical staff).
In a review of the patient to medical staff ratio, it becomes clear by simple math analysis that if the correct and most efficient ratio was in fact 20 to 1, the number of VA medical staff would have had to rise from 183,396 in 2000 to 260,050 in 2006. This would have resulted in an increase of 69,186 medical staff, a 36.2% rise that would have matched the same 36.2% rise in unique patients.
In reality, I am sure that some economy of scale and some practice management could have been used to prevent such a necessary rise to take care of the dramatic increase in patients. However, it does not take a Yale graduate to do the simple math that a 5.6% increase in staffing would have a difficult time in keeping up with a 36.2% rise in patients. Additionally, although I am not sure what the most efficient number of patients per medical staff would be, it also does not take a Harvard Business School Graduate to figure out that if you significantly increase patients (since 2000) and marginally increase staffing, you will increase patient waiting time, decrease patient satisfaction, and overall effectiveness. The results of such a hospital management business practice could lead to hurried appointments, improper follow up, and increases in medical errors.
So for the VA’s medical budget, someone in Congress once again needs to ask some tough questions. Does the budget reflect less labor intensive medicine to account for the changes? Does the budget reflect a coming change of rationing VA medical care further than the denial of benefits to new Category 8 veterans? Does the budget reflect a dream that cannot be obtained and thus setting up the VA for a dramatic shortage in a time of war?
Priority 8 Veterans
“The 2006 budget request assumes that enrollment of new Priority 8 veterans will remain suspended.” Per this simple statement in the VA budget, the enrollment new of Category 8 Veterans remains suspended. Category veterans are those veterans “with no service-connected conditions with incomes above the geographically adjusted means test threshold.”
And Finally, the Odd
On page 1-6 of the VA budget, the VA states that “the budget request includes additional management savings of $590 million in 2006 that will partially offset the overall cost of health care. These savings will be achieved through improved standardization policies in the procurement of supplies, pharmaceuticals, and other capital purchases, as well as in other operational efficiencies.” Yet when you look at the bottom line, the budget calls for a rise of 273 (8.8% in Departmental Management personnel versus a drop of 4,051 (-1.9%) if non management personnel.
Correction for the Record
In a White House release dated August 16, 2005, title Honoring Our Commitment to America’s Veterans, the White states that “since 2001, President Bush's budget requests have allowed the VA to enroll 2.5 million more veterans in health care services
In reality, according to VA records the rise in VA Unique Patients only rose 1,019,025 vice the claimed 2,500,000 during this period of time. A slightly larger increase of 1,195,139 occurred under President Clinton. Many feel that a large part of this 2.1 million surge in VA patients was due in a large part to the 1998 law that opened the doors to Category 8 veterans. It is the contention of these people that too many Category 8 veterans have already entered in the system. Because of this, in 2003 the Bush administration put a hold on new Category 8 enrollees. And as noted earlier, this restriction continues through today and is also included in the President’s 2006 budget.
-The Angry Vet
===================================
Citizenship check for licenses OK'd
Bill passed in House also empowers
security secretary to 'waive all laws'
http://wnd.com/news/printer-friendly.asp?ARTICLE_ID=42801
- Bush's Budget: The War on Working People Continues —Action Center, Fri Feb 11 03:34
- The Greatest Crime of Historic Time —Victor Connor, Fri Feb 11 03:13
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