Mandatory Verification of dependents

[broncovet]

I received a letter from VA with a "mandatory verification of dependents".  (Form 21-0538).  A couple years ago, I received a "proposed reduction" (to remove my spouse).  

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Has anyone else been harassed by VA repeatd  RE verification of dependents?  

A year or so before that, I also received a proposed reduction to remove my spouse as a dependent.  

I have been married since 2006, never seperated, always living with my spouse.  This is the THIRD TIME VA insists on Verifying my spouse, when for 18 years, I have continiously been married.  

EACH time I wrote VA a letter, and had my spouse do likewise, that we continue to be married.  

I feel like Im being "targeted" by VA, when I have done nothing wrong.   Worse, it sounds like VA is "making an assumption" that all Vietnam Era Vets are drug addicts or alcoholics, and/or spouse abusers who dont care about their spouse/family and abandon them.  

As someone once said, 

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Are you being paranoid if VA "really is" spying on you, or following you?  

I dont really believe, however, VA is following me, because, if they were, they would likely find my wife by my side and would stop this BS.  

ONE possibility:  A few weeks ago, I was at the VA and they had a table set up to VOTE on whether you wanted to continue receiving care at the VA or be able to get care in the community.  

I voted "in the community" because, at least some of the time, private health care is superior to that offered by VA.  Im quite sure VA does not like this, they would rather Veterans "not have a choice" in their health care, mainly because Veterans who opt to get their health care "in the community" vs VAMC health care would direct funding (aka money) away from VA.  

"IF" VA health care is so much better than private care, like they often boast, why would it trouble VA that we were given the choice?  Isnt it true that many go to VA because they dont have a choice?  Is the VA health care system a "prison" where we have no choice?    I think we should be able to choose our health care options, and not have a VA administrator in Washington make those choices for us.  

[brokensoldier244th]

1 hour ago, Lemuel said:

But the fight about entitlements continues.  SMC-T  The rewrite of law by the secretary is an example.

It is the funding overall that is the problem.  My home care visits are shutting down because the contractor is not getting paid enough to pay the employees.  So, our care is worse than the hold up of your paycheck. We lose services even to the death of us. Subject to the budget fight but those contractors have to eat the losses and thus quit.  So much for privatization. 

Yes, I get my benefits compensation check while they are fighting instead of having to wait like you do for yours. But we both get the check.

All I was pointing out is that the money for benefits comes from somewhere else insulated from budgetary pressures, for now, at least. The rates set by SSA, VA, Medicare, Medicaid, ChampVA etc- not my monkeys, and I or my dependents use some of those so I'm not unaware of some of the challenges.

[Lemuel]

6 hours ago, broncovet said:

I received a letter from VA with a "mandatory verification of dependents".  (Form 21-0538).  A couple years ago, I received a "proposed reduction" (to remove my spouse).  

A year or so before that, I also received a proposed reduction to remove my spouse as a dependent.  

I have been married since 2006, never seperated, always living with my spouse.  This is the THIRD TIME VA insists on Verifying my spouse, when for 18 years, I have continiously been married.  

EACH time I wrote VA a letter, and had my spouse do likewise, that we continue to be married.  

I feel like Im being "targeted" by VA, when I have done nothing wrong.   Worse, it sounds like VA is "making an assumption" that all Vietnam Era Vets are drug addicts or alcoholics, and/or spouse abusers who dont care about their spouse/family and abandon them.  

As someone once said, 

I dont really believe, however, VA is following me, because, if they were, they would likely find my wife by my side and would stop this BS.  

ONE possibility:  A few weeks ago, I was at the VA and they had a table set up to VOTE on whether you wanted to continue receiving care at the VA or be able to get care in the community.  

I voted "in the community" because, at least some of the time, private health care is superior to that offered by VA.  Im quite sure VA does not like this, they would rather Veterans "not have a choice" in their health care, mainly because Veterans who opt to get their health care "in the community" vs VAMC health care would direct funding (aka money) away from VA.  

"IF" VA health care is so much better than private care, like they often boast, why would it trouble VA that we were given the choice?  Isnt it true that many go to VA because they dont have a choice?  Is the VA health care system a "prison" where we have no choice?    I think we should be able to choose our health care options, and not have a VA administrator in Washington make those choices for us.  

The problem with community care is the same as MEDICARE advantage plans.  The contractors are essentially Medicare advantage plans.  I just got a copy of the bill paid by Tricare for my home care.  The bill was paid three months after submitted.  Why? 

Short term interest rates are higher than long term interest rates.  Of course borrowing rates are much higher than CD rates.  So TRICARE makes money by delaying and the community care service I selected had to go out of business.

So far I have not been denied a community care specialist.  Just getting a bill for the radiologist who read the CT scan.  And that has happened more than once.  The provider that provides the service will not accept VA and MEDICARE rates.

We need a 1992 LA Times Fanie Medic.  Contractors for where you work or where you live.  Contract areas small enough that if you do not like your provider, you can go across the line to a better one.  And your contractor would have to pay flat rate to the other contractor.  If the contractor received too many patients going to other providers, his contract could be broken.

If the contractor does better than average on morbidity reports, especially those from the morgue, then they would get a bonus.  If they do worse than average of similar demographic contracts, they would be subject to losing their contract. 

Get the economic incentives pushing the desired outcome.  Not the way it is now with the economic incentive to have a worse outcome.  The worse you are the more you or your insurance, no matter which insurance provider you have, pays.

The VA was neutral until the bonuses for management.  The bonuses provide counter incentive to desired outcome.  Will anyone ever look at the programs and change this?  Not as long as the AMA and big pharma occupy K Street.

[broncovet]

Lemeul

    You posted:  

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The problem with community care........

    You then cited your opinions on interest rates, contractors, bonuses, etc.  

        For you, my advice would be to choose VA care for as long as you think its better.  

However, not everyone shares your opinions on medicare, VA care, who is likely to win the Superbowl, or pretty much everything.  You should get to choose whether you go to VA, not a politicain you have never met, that has no idea about your medical needs, how far it is to the nearest VA clinic, or how those people at the VA have treated you in the past.  

     But why must those choices be made for me?    I am 100 percent certain that Im not the only one who prefers community care to VA care.  Why is it the VA is "threatened" by our choice?  Is it so awful that VA "raise their standards" so that more Veterans choose VA care?    When there is no choice, there is compacency.   

     I do not insist that you buy. a Tesla, Porsche, or Chevrolet.  You pick the one that works the best for you and your budget.  Indeed, on a decision as important as health care, I also want to be able to chose to take my health care to the Cleveland Clinic, VAMC in my home town, or to Doc K who is an old school family doctor I grew up with.  Please explain why you would even want to make medical choices regarding my health and my family.  I do not want to choose your care provider because I know far less about your health care needs than you do.  

[ShrekTheTank]

I like having choices.  For me and where I currently live the VA medical is amazing.  But this is my experience and i know other VA loactions that are horrible.

I think we all need choices as there is no perfect model to take care of every person.

I know we are from different generations,  and healthcare has changed so much over the years.  We all get things in our head about an experience we had 30 years ago.  We don't want that to happen again, so we choose to never go down that road again.  

Also every medical care loaction will have it's own issues.  I had a horrible opperation, where I was sent home without even knowing where I was yet and the meds had not worn off.  The VA here went above and beyond as they had the nurse who sent me home.  

I had a galblader surgery and went in at 10 am and was home by 1 pm.  Just so you know, this is not good.  I do not remember getting dressed, and I had blips of going to the car.  I remember telling my wife i an going to throw up.  There was a Panera bag from her begal that morning, I grab it and tossed my cookies into it.  My wife was worried out of her mind as she knew it was not good to throw up after surgery.  I made it home and down a flight of stairs, that my wife said she thought I was going to fall the whole time.  After I got home I threw up 4 more times that night.  My wife called the VA and told them what had happened, and I had everyone from the hospital calling me to see what had happened.  The main doctor over the VA hospitial asked my wife if he could come and check on me at my home.  He came by and checked on me to and said he thought I was ok at this point.  They then called every few hours of the next 4-5 days to make sure.   

I know they messed up because of a bad nurse, but in my mind they did the right thing by doing something abou it.  

I have also had over 30 surgeries with no problems.  

If this would have gone the other way, I would have been looking for another place to go.  

[Lemuel]

4 hours ago, broncovet said:

Lemeul

    You posted:  

    You then cited your opinions on interest rates, contractors, bonuses, etc.  

        For you, my advice would be to choose VA care for as long as you think its better.  

However, not everyone shares your opinions on medicare, VA care, who is likely to win the Superbowl, or pretty much everything.  You should get to choose whether you go to VA, not a politicain you have never met, that has no idea about your medical needs, how far it is to the nearest VA clinic, or how those people at the VA have treated you in the past.  

     But why must those choices be made for me?    I am 100 percent certain that Im not the only one who prefers community care to VA care.  Why is it the VA is "threatened" by our choice?  Is it so awful that VA "raise their standards" so that more Veterans choose VA care?    When there is no choice, there is compacency.   

     I do not insist that you buy. a Tesla, Porsche, or Chevrolet.  You pick the one that works the best for you and your budget.  Indeed, on a decision as important as health care, I also want to be able to chose to take my health care to the Cleveland Clinic, VAMC in my home town, or to Doc K who is an old school family doctor I grew up with.  Please explain why you would even want to make medical choices regarding my health and my family.  I do not want to choose your care provider because I know far less about your health care needs than you do.  

I guess I did not make myself clear.  VA medicine used to be better here and in other places I used it.  Like LA Downtown clinic.  West LA had problems with researchers but was otherwise o k for treatment.  Long Beach was a no go especially for PTSD.   San Diego was great.  Washington, DC was passable.  Nothing is always perfect but it is better to believe your care is perfect then you are more likely to have a better outcome.

And choice gives you more options.  But our choices are getting fewer.  I firmly believe my wife was essentially killed because of her age and the MEDICARE Advantage Plan provided to her by the VA.  If she had just used her MEDICARE part b card and ignored CHAMPVA, she would have gotten to see a neurologist and not have died in status epilepticus after a cardiologist reduced her seizure med without getting an EEG telemetry or minimally consulting a neurologist.  So goes the world, let die and learn.  That was on me.  The knowledge was in my head, it did not come out until too late.

The rant in the previous paragraph comes from an article pointing out MEDICARE Part B is better that the Advantage Plans because, like HMOs, the MEDICARE Advantage Plans cut services to make money off their clients.

The problem is fee based medicine without choices.  You only get that if you are wealthy enough to pay for it or pay the co-pay to get it.  A better plan would be a socialized medicine like the VA used to be in big city areas.  You could fire your primary care.  And you could see your primary in an urgent care situation or an on duty physician that would consult your primary care.  Your primary was your primary specialty need.  

Then in the late 1990s, if you were old, your primary care became geriatrics.  Before the first decade of this century was out, primary care became either a Physicians Assistant or a Nurse Practitioner.  As indicated, we no longer get top care in the VA.  It depends upon how full of themselves the almost a Doctors are.  If they pick up the phone and call a specialist occasionally, then you have a good one.  If they wait to send you to a specialist for Rocky Mountain Spotted Fever confirmed by a lab test, you better get the hell away from them and got to another VA or private clinic.  It's basic, and every corpsman I ever knew, knew you had to treat a blood infections ASAP with the appropriate drug.  If you did not know which drug, you picked up the phone.  Even the pharmacist could tell you and get the treatment started.  So much for the contractor at the Scottsbluff, NE VAOPC.  Perhaps you saw the article about three Americans dying in Mexico because of untreated Rocky Mountain Spotted Fever.  Or perhaps it went by you because you did not know that tick born disease is endemic to the western U S.

So, yes bad experiences color my opinion.  And so does the good ones.  That being said it is good to discus our opinions of the medical service we are getting and where to get the best possible.  Choice is no advantage if you do not have information to make the choice and the where with all to make the choice.

[Lemuel]

3 minutes ago, Lemuel said:

I guess I did not make myself clear.  VA medicine used to be better here and in other places I used it.  Like LA Downtown clinic.  West LA had problems with researchers but was otherwise o k for treatment.  Long Beach was a no go especially for PTSD.   San Diego was great.  Washington, DC was passable.  Nothing is always perfect but it is better to believe your care is perfect then you are more likely to have a better outcome.

And choice gives you more options.  But our choices are getting fewer.  I firmly believe my wife was essentially killed because of her age and the MEDICARE Advantage Plan provided to her by the VA.  If she had just used her MEDICARE part b card and ignored CHAMPVA, she would have gotten to see a neurologist and not have died in status epilepticus after a cardiologist reduced her seizure med without getting an EEG telemetry or minimally consulting a neurologist.  So goes the world, let die and learn.  That was on me.  The knowledge was in my head, it did not come out until too late.

The rant in the previous paragraph comes from an article pointing out MEDICARE Part B is better that the Advantage Plans because, like HMOs, the MEDICARE Advantage Plans cut services to make money off their clients.

The problem is fee based medicine without choices.  You only get that if you are wealthy enough to pay for it or pay the co-pay to get it.  A better plan would be a socialized medicine like the VA used to be in big city areas.  You could fire your primary care.  And you could see your primary in an urgent care situation or an on duty physician that would consult your primary care.  Your primary was your primary specialty need.  

Then in the late 1990s, if you were old, your primary care became geriatrics.  Before the first decade of this century was out, primary care became either a Physicians Assistant or a Nurse Practitioner.  As indicated, we no longer get top care in the VA.  It depends upon how full of themselves the almost a Doctors are.  If they pick up the phone and call a specialist occasionally, then you have a good one.  If they wait to send you to a specialist for Rocky Mountain Spotted Fever confirmed by a lab test, you better get the hell away from them and got to another VA or private clinic.  It's basic, and every corpsman I ever knew, knew you had to treat a blood infections ASAP with the appropriate drug.  If you did not know which drug, you picked up the phone.  Even the pharmacist could tell you and get the treatment started.  So much for the contractor at the Scottsbluff, NE VAOPC.  Perhaps you saw the article about three Americans dying in Mexico because of untreated Rocky Mountain Spotted Fever.  Or perhaps it went by you because you did not know that tick born disease is endemic to the western U S.

So, yes bad experiences color my opinion.  And so does the good ones.  That being said it is good to discus our opinions of the medical service we are getting and where to get the best possible.  Choice is no advantage if you do not have information to make the choice and the where with all to make the choice.

My gall bladder surgery in San Diego did not go well but was properly taken care of also.  They kept me three days in the hospital.  They have to make sure the blockage is clear whether they bypass it or remove it before they send you home.  With the three X surgery, usually you can go home the same day but you need some observation time before that and minimally be clear of the anesthesia effects.  Someone must have been concerned about your surgery, went to see you and the Nurse Practitioner had already sent you home.  Learned a lesson at your expense.  Glad the surgeon was concerned enough to check up on you and follow up.  (my reading the tea leaves from what you said)