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Phoenix, AZ's VA health care campus
Phoenix VA Hospital
A White House-ordered audit of 731 Department of Veterans Affairs hospitals and outpatient clinics has found 57,436 military veterans who requested a VA appointment hadn't obtained one by 90 or more days later. In addition, the audit—which was run on an accelerated schedule by deploying 400 employees to the task—discovered another 63,869 who, over the past decade, signed up with the VA and requested a medical appointment but never got one.

The VA has set 14 days as the maximum it should take for a first appointment. An interim report released last week found that in Phoenix, Arizona, VA employees concealed the fact that they were not coming close to that goal. And they provided fake tallies for how quickly appointments were being made, tallies that figured in performance reviews and bonuses. The revelations about Phoenix were nothing new. An internal VA memo evaluating practices in 2008 found widespread failure to see veterans in a timely matter, something that was concealed via secret logbooks and other shenanigans that it called "gaming strategies."

Of the latest confirmation of what's been reported for years, Kristina Wong writes:

The audit also says a 14-day goal for seeing first-time patients was unattainable given the growing demand among veterans for healthcare and poor planning, and that 13 percent of VA schedulers reported supervisors telling them to falsify appointment dates to make waiting times appear shorter.

"As of today, VA has contacted 50,000 Veterans across the country to get them off of wait lists and into clinics. Veterans deserve to have full faith in their VA, and they will keep hearing from us until all our Veterans receive the care they’ve earned," said VA Acting Secretary Sloan Gibson Monday.

Gen. Eric Shinseki, who President Obama appointed as secretary of Veterans Affairs with the charge of fixing the long waits and other assorted VA issues, lost his job because of the problems in Phoenix that also occur elsewhere in the VA system. Some of his severest critics were the austerity-mongers who love to vote to send military personnel overseas but aren't eager to approve an ample enough VA budget to take care of any vast increase in the number of veterans seeking care.

Here are the worst wait times for seeing a primary care physician for the first time, as reported by the Associated Press: Honolulu, Hawaii: 145 days; VA Texas Valley Coastal Bend HCS, Harlingen, Texas: 85 days; Fayetteville, North Carolina: 83 days; Baltimore HCS, Maryland: 81 days; Portland, Oregon: 80 days;  Columbia, South Carolina: 77 days; Central Alabama Veterans HCS, Montgomery, Alabama: 75 days; Providence, Rhode Island: 74 days; Salt Lake City, Utah: 73 days; Richmond, Virginia: 73 days.

Appointment delays for specialists and for mental health are similarly lengthy. The worst of the lot for mental health is in Durham, North Carolina, at 104 days.

Originally posted to Meteor Blades on Mon Jun 09, 2014 at 12:57 PM PDT.

Also republished by Daily Kos.

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Comment Preferences

  •  Tip Jar (21+ / 0-)

    Don't tell me what you believe, show me what you do and I will tell you what you believe.

    by Meteor Blades on Mon Jun 09, 2014 at 12:57:29 PM PDT

  •  Were there no audits (2+ / 0-)
    Recommended by:
    Mr Robert, worldlotus

    of the performance reporting before now? That would seem like a pretty basic management control feature that should have been in place.

  •  stochastic death panels /nt (3+ / 0-)
    Recommended by:
    whl, cotterperson, hbk

    Warning - some snark may be above‽ (-9.50; -7.03)‽ eState4Column5©2013 "If we appear to seek the unattainable, then let it be known that we do so to avoid the unimaginable." (@eState4Column5)

    by annieli on Mon Jun 09, 2014 at 01:03:19 PM PDT

  •  "Support our troops" my ass (6+ / 0-)
    Recommended by:
    Mr Robert, Vetwife, whl, Smoh, hbk, OooSillyMe

    This country has been reduced to a handful of empty soundbites with no real meaning.

    “In the beginning there was nothing, which exploded.” Terry Pratchett

    by 420 forever on Mon Jun 09, 2014 at 01:06:22 PM PDT

  •  145 days?! (7+ / 0-)

    What on Earth is going on in Honolulu?

    This is so frustrating. So much of this could be fixed if the VA had some damn funding. They need new hospitals and twice as many doctors to see all their patients in a timely manner.

    Two hundred fifty years of slavery. Ninety years of Jim Crow. Sixty years of separate but equal. Thirty-five years of racist housing policy. Until we reckon with our compounding moral debts, America will never be whole. - Ta-Nehisi Coates

    by moviemeister76 on Mon Jun 09, 2014 at 01:18:14 PM PDT

    •  Lack of facilities relative to population. (8+ / 0-)

      It's why the Sunbelt and South lead the way in wait times: they're hit with millions of snowbirds, many of them veterans, and the infrastructure has yet to catch up.

      Meanwhile, VA hospitals in, say, Minneapolis have zero wait times and lots of empty beds.

      http://www.vox.com/...

      Visit http://theuptake.org/ for Minnesota news as it happens.

      by Phoenix Woman on Mon Jun 09, 2014 at 02:26:55 PM PDT

      [ Parent ]

      •  I was thinking the same (3+ / 0-)
        Recommended by:
        Smoh, Vetwife, hbk

        I go to the Durham VA hospitals sometimes when I need to see a specialist for non-emergency issues. The wait times are very long if it's not an emergency. But it's not like anyone there is slacking off. Durham hospital is packed from the time it opens to the time it closes. The parking is an absolute nightmare because of it.

        The clinic thing is a mess, too. Fayetteville is about 90 minutes from my house, but the clinic in my city has much better wait times. And I think it's because Fayetteville has a higher population of retired vets who live close to Ft. Bragg.

        Two hundred fifty years of slavery. Ninety years of Jim Crow. Sixty years of separate but equal. Thirty-five years of racist housing policy. Until we reckon with our compounding moral debts, America will never be whole. - Ta-Nehisi Coates

        by moviemeister76 on Mon Jun 09, 2014 at 02:50:15 PM PDT

        [ Parent ]

      •  I doubt it's just the sun (3+ / 0-)
        Recommended by:
        Meteor Blades, Vetwife, hbk

        A state like Minnesota also has almost all of its population covered by health insurance even before Obamacare plus a leading public health system.  

        If you really need to see a doctor you aren't going to wait months unless you have no money and there are no other options.  In Minnesota, you'd have other options.  

        I read somewhere awhile back that snowbirds return to Minnesota as they age because while it may be chilly we do have social services, and alas, state income taxes to fund them.

      •  This (2+ / 0-)
        Recommended by:
        Smoh, hbk

        In Milwaukee, given the fact we have a huge hospital, a relatively static population, and a large teaching hospital a few miles away.  I can usually get an appointment within the week.  

  •  More hot air from Congress, (6+ / 0-)

    when I suspect what is needed is more funding to deal with the increased # of patients due to the GWOT.

    We can go into (more) debt to pay defense contractors, but when it comes to flesh & blood soldiers wounded in service to this country, well, that's too expensive.  What screwed up priorities Congress (and the White House; after all the Prez submits a budget request) has.
     

    Republicans: If they only had a heart.

    by leu2500 on Mon Jun 09, 2014 at 01:42:54 PM PDT

  •  Wanna know just how screwed up it all is? (11+ / 0-)

    CONGRESS KNEW !!!  Don't let people tell you different or lay the blame completely on Shinseki.  CONGRESS KNEW and there is too much waste.......no oversight and lip service and no funding for some REAL needs.   Congress knew.   Florida has the largest population of veterans in the entire country... They also have a lot of bad decision makers in the regional area...  their priorities are wrong.. I believe I said that on camera NATIONWIDE bakc in November.
    I am working right now as I type with a news organization again.  

    Just how much Koch do Right Wingers want in their life? . United Veterans of America

    by Vetwife on Mon Jun 09, 2014 at 02:00:51 PM PDT

  •  Supply & Demand (9+ / 0-)

    The only way to meet the demand from all of the Veterans is to increase the supply of medical providers.

    Republicans voted down increasing the budget to the VA for hiring more doctors and building more facilities.

    Privatizing the VA will only create more waste, fraud, and abuse that fleeces taxpayers.

    This blood belongs on the hands of republicans for both promoting endless wars and not having any intention of paying for the medical services required to help the soldiers returning from the battlefield.

    So while I admit that the problems that were uncovered at the VA are a real scandal (because bonuses were given to liars), the fact remains that $$ is the answer to this problem.  It is simply not possible to meet the increased demand for medical services without increasing the supply of medical providers.

  •  It's not a funding problem: (3+ / 0-)
    Recommended by:
    shigeru, AlexDrew, Smoh
    The VA's budget has been exploding, even as the number of veterans steadily declines. From 2000 to 2013, outlays nearly tripled, while the population of veterans declined by 4.3 million.

    Medical care spending — which consumes about 40% of the VA's budget — has climbed 193% over those years, while the number of patients served by the VA each year went up just 68%, according to data from the VA.

    From 2008 to 2012 alone, per-patient spending at the VA climbed 27%. To put that in perspective, per capita health spending nationwide rose just 13% during those years.

    And per-enrollee spending for Medicare went up only 10%, government data show.

    Some will argue that the increase in health spending was the direct result of all those wounded warriors coming back from Iraq and Afghanistan.

    But these vets aren't driving VA costs higher.

    A Congressional Budget Office report found that they cost $4,800, on average, in 2010 compared with $8,800 for other veterans who used the system.

    It also found that while these Iraq and Afghan vets account for 7% of those treated, they were responsible for only 4% of its health costs.

    •  How about Priorties? Wanna see how many (1+ / 0-)
      Recommended by:
      meg

      bonuses were paid out for poor performance?  How about inflated salaries?  How about cutting programs so the administrators could be greedy?   How about Millions and Millions spent on an Orlando excursion for what was supposed to be training but helicopter rides and other nonsense was spent.. How about sending veterans to private facilities and paying that facility through the nose rather than staff their own.. or hire more doctors... Oh I know the problem !!!! Damn staright I do and Congress threw money at a problem rather than make sure funding was going to the right places.

      Just how much Koch do Right Wingers want in their life? . United Veterans of America

      by Vetwife on Mon Jun 09, 2014 at 02:32:32 PM PDT

      [ Parent ]

      •  why can't the VA medical facilities simply rollove (0+ / 0-)

        Into Medicare? It would be fluid, and vets could get help everywhere...why the need for a separate health care system? May need to juice up the pscych help with PTSD, but,still why two separate,redundant systems?

        “The only way evil flourishes is for good people to do nothing.” Edmund Burke

        by soaglow on Mon Jun 09, 2014 at 03:44:48 PM PDT

        [ Parent ]

        •  That will not work... Most vets have wayyy (0+ / 0-)

          too many problems and specialty problems and caused by war trauma.   The dental, the vision could be and IS in some areas farmed out BUT veterans go in for a primary and all the special needs are there... Right there.   They have problems just getting to one facility.   Plus ....there is  80 percent payout and for 100 percenters and catastrophic injuries if adjudicated... it is all funded... no co pay and meds are mailed out.... Plus the PTSD thing is a huge issue.  I have seen hospitals NOT want to even treat PTSD patients... As many are not trained on how to deal with flashbacks and startle reaction.   They also have a comaradity that promotes healing while they have a bond with another and only a Vet could understand.   War injuries are just different.. Very hard to explain.

          Just how much Koch do Right Wingers want in their life? . United Veterans of America

          by Vetwife on Mon Jun 09, 2014 at 04:08:01 PM PDT

          [ Parent ]

    •  Except the # of ELIGIBLE vets has gone UP (8+ / 0-)
      Recommended by:
      meg, Vetwife, Delevie, lgmcp, Mayfly, QuelleC, Smoh, hbk

      The number has gone from 400,000 to over 918,000, as Meteor Blades stated a few weeks ago:

      http://m.dailykos.com/...

      Visit http://theuptake.org/ for Minnesota news as it happens.

      by Phoenix Woman on Mon Jun 09, 2014 at 02:33:42 PM PDT

      [ Parent ]

    •  my experiene is that a % of (0+ / 0-)

      the VA employees just don't give a shot and a smaller % are antagonistic to veterans. Better than it was in 1971 when a high percentage hated VN vets and showed it.

      Cause? IMHO the VA is a dumping ground for military and MIC cronies and is used to reward services rendered, but for those who have no other discernible talent.

      There are a few good, caring folks at the VA but by and large indifference and sloth is the best one can hope for.

      And I am Kilrain of the 20th Maine. And I damn all gentlemen. Whose only worth is their father's name And the sweat of a workin' man Steve Earle - Dixieland

      by shigeru on Mon Jun 09, 2014 at 02:44:47 PM PDT

      [ Parent ]

      •  experience (0+ / 0-)

        And don't give a shit.

        And I am Kilrain of the 20th Maine. And I damn all gentlemen. Whose only worth is their father's name And the sweat of a workin' man Steve Earle - Dixieland

        by shigeru on Mon Jun 09, 2014 at 02:56:48 PM PDT

        [ Parent ]

      •  No that is not quite true..Veterans work in the VA (2+ / 0-)
        Recommended by:
        hbk, shigeru

        The top dogs in the medical center may not care but the nurse or aid, or clerk for the most part are overwhelmed and doing a good job.   They do as they are told.   The problem is not the staff not caring... it is the beauracrats and bonus taking administrators.

        Just how much Koch do Right Wingers want in their life? . United Veterans of America

        by Vetwife on Mon Jun 09, 2014 at 04:11:27 PM PDT

        [ Parent ]

        •  agree about the nurses, doctors and (0+ / 0-)

          counselors in general. however, the schedulers, admin staff don't seem to care in the main. without going into details I will leave it at that.

          one of Shinseki's attempts was to get shrinks to increase to 6 patients a day from the current 3 or 4. compared to a std of 9 in regular counseling. and btw the hours of operation of VA clinics and so forth are from 8 to 4, M-F, excluding all federal and state holidays. most civilian facilities are open from at least 8 to 6. And open Saturdays.

          And I am Kilrain of the 20th Maine. And I damn all gentlemen. Whose only worth is their father's name And the sweat of a workin' man Steve Earle - Dixieland

          by shigeru on Mon Jun 09, 2014 at 05:37:15 PM PDT

          [ Parent ]

    •  Budget went up 50% (2+ / 0-)
      Recommended by:
      Vetwife, hbk

      VA budget did increase by 50% in recent years, but demand for services increased by more than 100%.  Dying (veterans) costs more and there are more dying veterans as % of population than the public in general.  Plainly and simply - nearly half of all veterans are over age 65, while the same is not true of the general public.

      Your statistics should not exist in a vacuum.

      Just like Medicare, as the baby boom generation (and veteran progenitors that created this generation) gets older, demand for medical services increase.  The greatest costs for medical care comes at end of life - the parents of the baby boom generation fit this profile and are increasing medical costs for veterans.  As already mentioned, % of veterans over age 65 is about 4-times greater than general population - this is driving increase in VA costs.

      Further, IN ADDITION TO aging parents of baby boomers and the baby boomers themselves, the soldiers returning from recent wars have an outsized demand for medical services due to the outsized numbers of lost limbs and PTSD from the wars in the Middle East.  This skews the very statistics you outlined since the end of the wars in the Middle East correspond to the timeframe you outlined.

      In simple English, VA costs have increased at an increased rate because of aging veterans (who do not represent general public statistics).  While this has occurred, the VA did not increase budgets to meet the demands of new veterans returning home from two wars.

      Moreover, cost per veteran has nothing to do with ability to provide services to those in need.  You cannot point to any logical statistic or idea that can rationalize the inability of thousands of people waiting for medical care that does not address ability to provide such services.  In other words, you have offered nothing that addresses supply of medical care to meet the demand.

      Your statistics are meaningless without any understanding as to how and why both costs and demand have increased beyond the general population.

      •  Inflation-adjusted, the budget did not rise... (2+ / 0-)
        Recommended by:
        Vetwife, hbk

        ...193% (2000-2013) as claimed by Investors.com in the link that valion posted. If you calculate inflation, the budget rose  116% in those years, a period of relatively low overall inflation but rapid health care inflation. In the same period, the total number of veterans served annually rose from 3.8 million to 5.7 million. And as you note, aging veterans with greater needs are driving VHA costs, $52 billion for the current most recent fiscal year. But, in the long run, as those older veterans dwindle, they will be replaced by post-9/11 veterans who are much fewer but whose medical needs are likely to be greater given the level of brain trauma and wounds that would not have been survivable in previous conflicts.

        Don't tell me what you believe, show me what you do and I will tell you what you believe.

        by Meteor Blades on Mon Jun 09, 2014 at 03:34:50 PM PDT

        [ Parent ]

        •  And this is why you are a journalist, (1+ / 0-)
          Recommended by:
          Meteor Blades

          and I am merely an informed blogger.

          Personally, I try to avoid the 'inflation-adjusted' return argument, because too many people find it to underscore the notion of 'figures don't lie, but liars can figure'.

          That having been said, I did find the reply to my original post too be misleading, since the period looked at by that blogger was from 2008-present.  And as we both know, healthcare spending on the general public during this period was the lowest it had been since the previous three decades, while both the aging veteran population and returning veterans created an outsized demand on the VA.

          In other words, the reply to my original post from the other blogger was cherry-picked data that has little to do with what is going on at the VA.

          Not surprisingly, that blogger has not replied to either of us.

          Keep up the good work - I enjoy your Diaries.

    •  Your link is to Investorsdot.com (2+ / 0-)
      Recommended by:
      Meteor Blades, Vetwife

      This is not a progressive site to say the least.

      Whether their points are valid....they also say the inequity in wages is a bunch of hooey.

  •  i am a priority one. i.e. supposed to get (2+ / 0-)
    Recommended by:
    QuelleC, Smoh

    all services quickly and free due to mental and physical injuries. I moved and had to see a doctor. So far 60 plus days to have a doctor assigned. This is not even waiting for an appointment but waiting to be assigned a doctor so I can get on an appointment  waiting list.

    And I am Kilrain of the 20th Maine. And I damn all gentlemen. Whose only worth is their father's name And the sweat of a workin' man Steve Earle - Dixieland

    by shigeru on Mon Jun 09, 2014 at 02:36:11 PM PDT

  •  As bad as the VA situation is (4+ / 0-)
    Recommended by:
    meg, Vetwife, QuelleC, Smoh

    it is not any different in the rest of the medical field.  My wife called a specialist today for an appointment - now booking into February 2015.  I had to cancel an appt with a dermatologist - rescheduled to November.  This is the greater Boston area where there are many more large hospitals than other similar sized areas.

    •  Exactly. Appointments 3 months out (1+ / 0-)
      Recommended by:
      QuelleC

      are not unusual, for specialists or to establish with a new primary.  Usually once you're established you can see an NP or PA quicker, but for physician appointments, they're way out there.  And that's BEFORE they start bumping and rescheduling you.

      "The extinction of the human race will come from its inability to EMOTIONALLY comprehend the exponential function." -- Edward Teller

      by lgmcp on Mon Jun 09, 2014 at 02:43:43 PM PDT

      [ Parent ]

    •  Again true !!! (0+ / 0-)

      Just how much Koch do Right Wingers want in their life? . United Veterans of America

      by Vetwife on Mon Jun 09, 2014 at 02:45:48 PM PDT

      [ Parent ]

    •  I didn't want to butt in (1+ / 0-)
      Recommended by:
      Vetwife

      but thank you for pointing that out.  I just paid my third ACA premium.  I've said here before my hypertension has been untreated for six years and there is no primary care doctor seeing a new patient until November.  I chose the larger network in this area.  They're also trying to say they won't see me unless I show up with $100 for something they allege they wrote off over ten years ago.  When I tried to discuss that they told me if I'm so "impatient" I should go to the ER because "clinics don't handle this."  Um, clinics don't handle trying to get seen for untreated chest pains?  

      I support the health care we were able to get 100% and I feel so lucky my adult son and I have it, but there is no healthcare for me anytime soon.  

    •  Has anyone said why the wait is so long? (1+ / 0-)
      Recommended by:
      Vetwife

      New Republic: So are the left-wing blogs as bad as the Tea Party ones in this case? -------------------------Chuck Schumer: Left-wing blogs are the mirror image. They just have less credibility and less clout.

      by AlexDrew on Mon Jun 09, 2014 at 03:20:49 PM PDT

      [ Parent ]

      •  We need DaNang in here to explain the wait (0+ / 0-)

        in detail...  The hours could be extended for primary care but the wait time is WE NEED MORE DOCTORS.  We need more facilities .  We need more staffing .  DaNang has the numbers per hour though per patient and it does not add up.

        Just how much Koch do Right Wingers want in their life? . United Veterans of America

        by Vetwife on Mon Jun 09, 2014 at 04:14:07 PM PDT

        [ Parent ]

  •  My spouse ... (1+ / 0-)
    Recommended by:
    Vetwife

    had to wait more than 90 days for an appointment with a specialist more than once during a life-threatening situation, and we have a gold-standard policy.

  •  VA hospitals never never should be privatized. The (3+ / 0-)
    Recommended by:
    Meteor Blades, Vetwife, hbk

    goal of a US government VA hospital is to serve veterans. The goal of a privatized VA hospital is to skim off the cream for the CEO.

    Second, it is interesting to me that the government agency that Congress is most stingy with ( and I mean most stingy with for generations) is the Veterans' Admin.

    Talk big about "honoring our veterans for their service," and then short-change them on commitments made.

    In Georgia, acting the fool with a gun is not only legal, it is encouraged by the governor and the state legislature.

    by Mayfly on Mon Jun 09, 2014 at 03:04:40 PM PDT

  •  These women and men swore faith and allegiance, (0+ / 0-)

    pledging their lives in defense of the rest of us and our loved ones.

    Anyone who disrespects these warriors after they become hurt, maimed, or handicapped; or who neglects their widows, their widowers, or their orphans...

    Fix this, Mr. President, loud and clear, so that we may target those who don't get out of your way.

    Sunday mornings are more beautiful without Meet the Press.

    by deben on Mon Jun 09, 2014 at 03:05:43 PM PDT

  •  Couldn't a lot of vets go to civilian doctors? (0+ / 0-)

    I ask because every year my brother travels from his summer home in Canada to his winter home in a Florida and on the way he stops at the West Haven VA hospital for an annual physical.  
    These appointments have to be exactly on the day he's passing through and he never has a problem.  Now he is a Vietnam vet, he served on a Navy ship in the war zone, but he was neither physically nor mentally injured by that service.  He went on to a full career in construction so he has Medicare and is not poor.  
    I can't help wondering how many vets like him qualify for civilian medical care but clog up the VA system depriving more recently returned vets of badly needed specialty care?  
    I have said to him, if I were him, I'd get the hell out of the way of other, drastically ill vets, but he says, he deserves it and he's going to keep using it.

    Freedom of speech, in my view, does not mean the freedom to buy the United States government -- Bernie Sanders

    by OnePingOnly on Mon Jun 09, 2014 at 03:25:37 PM PDT

    •  The majority do. And that number will probably... (2+ / 0-)
      Recommended by:
      hbk, Vetwife

      ...increase under ACA.

      As for your brother, follow-up appointments are easier and quicker to get, according to various sources. It's those first-time visits (and specialist visits) that are delayed.

      Don't tell me what you believe, show me what you do and I will tell you what you believe.

      by Meteor Blades on Mon Jun 09, 2014 at 04:11:16 PM PDT

      [ Parent ]

      •  Unemployed and / or homeless Veterans (0+ / 0-)

        which would need civilian doctors the most, can't afford to go to them, as they have no additional health insurance which would cover the costs and pay for civilian's doctor  services. I think a Veteran is completely dependent on VA hospital and VA outpatient facilities.

        As far as I know a Veteran can't get additional healthcare coverage under the ACA program, as they are already sufficiently being served by the VA services and VA healthcare benefits. At least that is the information I got.

        We know a hell of a lot, but we understand very little. Manfred Max-Neef

        by mimi on Tue Jun 10, 2014 at 09:26:25 AM PDT

        [ Parent ]

  •  Palo Alto VA (0+ / 0-)

    Can only speak to my experience at the Pale Alto, Ca VA which has actually been stellar.  I've not been hospitalized but have seen a couple of specialists with almost zero wait time.  Plus super thorough service.  

    "Men go and come, but earth abides." George R. Stewart

    by mojavefog on Mon Jun 09, 2014 at 09:12:13 PM PDT

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