On August 4th, the VA announced that it would extend approvals on a list of treatments performed by third-party vendors up to a year. Where approvals had been limited to 90 or 180 days, one would now be good for twelve months.
The Department of Veterans Affairs today announced it will improve Veterans’ access to health care by extending the length of new VA community care authorizations to one year for 30 standardized types of care.
It’s been a month, but the bureaucracy isn’t responding as promptly as you’d like to think it could. The authorization process did not change, just the length of the approval. And with authorizations lasting twelve months instead of one (which is what I’ve heard is often the case), the people at the VA who handle them should discover exponentially more time as additional vets receive 12-month approvals. Rather than doing twelve or three or two a year for every veteran for every treatment plan, you only do one.
But this is the VA. A giant bureaucracy that isn’t predisposed to streamlining or the potential to cut the hassles or bullshit. Less paperwork might mean fewer non-productive staff. No agency wants to fire “government” workers. It leads to lower budgets, but the goal is to increase budgets, especially on busy work. The incentive, therefore, has always been to drag heels or complicate the process. And while we’d like to think everyone at the VA is focused on Veterans’ health and needs, that’s clearly not the case, not then and not now.
Not at street level.
Stories
We’ve shared a few ugly tales about how the VA operates (you can find them in our archive), but we’ve got more.
The VA would rather prescribe drugs for pain management, even if it gets vets addicted or makes them suicidal, than embrace non-pharmaceutical interventions. Not all vets want drugs, nor could or should they have them. Addiction to painkillers is common, and when they can’t get them, they resort to street drugs and whatever is required to get them. At some point, death is easier than the pain, and that is part of the reason why there are so many warfighters who commit suicide.
It sounds harsh, but the VA has no incentive to save those lives because each one lost makes their job easier.
There are pain management alternatives, but they each require authorization under pain management, which is a covered 12-month community care service. Without the approval, vets with debilitating pain have to pay out of their own pocket for non-pharmaceutical treatments (and hope they get the VA to reimburse them) or suffer, which leads them back to drugs they didn’t want to take, but that the VA will hand out like candy on Halloween.
I’ve heard that the VA has also reduced reimbursement rates for some community care services, which means vendors have less incentive to assist veterans outside the VA system. They can’t make up the cost of service. It is also a matter of record that the VA is titanically slow and difficult about paying reimbursements, which leads providers to stop treating vets because they can’t wait a year or more to get reimbursed.
And while it has been a month since the August fourth letter, there are still previously approved treatments (things vets were getting) that are approved for 12-month authorizations that are not being given.
To summarize, vets who were on treatment plans for conditions that are approved for community care and 12-month authorizations may not get them.
The VA is paying less for services and slow-walking reimbursements, which decreases access to outside services that the VA authorizes but does not provide.
This bureaucratic and financial run-around adds a mental health/emotional burden on top of the existing issues for which Vets are seeking treatment.
All the while, the VA is ready to hand you a prescription like Oxycodone or SSRIs, both of which have serious long-term side effects. All told, it gives the appearance that they don’t want to treat you, they just want you to leave them alone, and if their treatment makes you suicidal, problem solved.
That’s harsh, and it is not likely universal. Still, if we consider the number of Veteran suicides, if anyone is serious about working that problem, a better, more responsible, and accountable Veterans Affairs is the place to start.
