VETERANS CORNER: Not much has changed at the VA

Veterans Administration facility at Togus. (Internet photo)

by Gary Kennedy

Well, as I promised here is part three of VA series. Not much has changed at the VA, Togus; the doors to Veteran Services are still closed/locked, the pool, gym are still off limits to all veterans except paying employees. Veterans are giving up. They now tend to meet in small groups in various places such as the veterans home, once per month and also the canteen at VA on certain days and times. It seems everything is becoming secret. I have been thanked on multiple occasions for the information provided in this column.

I was in communication with a veteran employee this past week and was told that veteran suicide conversations were up. It doesn’t take much outside of norm to aggravate veteran anxiety. Many of those who haven’t served don’t have a clue what some veterans go through. Thank God there are some of us willing to answer the need of those in pain. Unfortunately, many of those in need of help are not reaching out to VA but to other veterans. For some reason many vets feel safer with other vets, especially during these times of inadequacies within the system.

In just two years with the Wuhan Virus the veteran has been alienated from what they consider norm. I have had two veterans this summer who contacted me via a third party to see if I knew why they were not eligible to be seen at VA Togus. They said they were told they make too much money. I basically said, “I don’t care if you make a million dollar per year. If you were injured in the military you qualify for help.” And now they have it. Don’t settle or give up, the common sense answers are available. We are a fraternity and we always come to a brother or sister’s aid, singly or collectively. Don’t let China, Russia, Iran or Ukraine get you down. We will get through this entire fiasco together; even in our declining years.

I promised I would explain VA’s billing procedure as of late and why I believe it’s doomed to failure. I am going to extrapolate from an actual bill to try to show you how I see it. Let’s say you go to hospital X for a procedure which entails anesthesia, MRI, contrast and miscellaneous supplies. This procedure also required a doctor of anesthesia, a regular doctor, perhaps a PAC and a couple of nurses. This as you know, probably already guessed, is a total spinal procedure which requires the use of an MRI machine as well as these professionals for more than four hours. We must not forget that there is also a recovery room involved.

The total was $12,234.69 of which insurance paid $871.00.

Although there appears to be some redundancy and repetition; the bill is accurate according to my phone conversation with Community Care. They will get back to me as they seemed to agree with me; the payment to services is greatly deflated compared to asking fees. This example shows no Medicare as there is none. In some cases other insurance companies will be billed to recoup some of the initial fees.

In the past I was told that the VA was paying between 35 percent and 51 percent of valid billings. This was last year so I decided to check it out. I spoke with a doctor in Portland and I will paraphrase his position on this matter. He said, this is a professional office and as such I must hire professional employees. These employees expect a wage comparable to their abilities and education. VA’s new policies are so limited and restrictive so that I can’t afford to take VA referrals. I don’t pay patients to come here.

When I did the math he was spot on as was his office manager. So what does that tell us? Are we talking quantity verses quality. Some are locked in, as are some colleges, as they request and accept federal money. That is the reason veterans go to University of Maine not Bowdoin. (Example Only) The one Ivy League exception is Maine Maritime Academy which accepts federal funds. I don’t want to mislead you. You can still receive a great education in the University System.

So, I have given you a medical example which evolved into an educational one. The one thing that confuses me is, we have been hiring some fantastic doctors recently in orthopedics, neurology, primary care, etc., yet our halls remain empty and more and more veterans are being farmed out. Work at home has become common practice.

Basically the evolution of billing has evolved from billing of two years ago. We were dealing with service payments of between 35-51 percent. Now we are looking at around 29 percent payment of the doctors/hospital asking fees. How long will the system tolerate these sort of forced fees? In my opinion the dam will break sooner or later, and the price paid will be the veterans. We need honest political interplay not the games that the government is now playing. If you love our veterans than deal with them from your heart. They were there when you needed our shares protected. I hate to say it but the way things are going we might need the veterans of tomorrow, they may be facing this again.

All your comments have been evaluated and appreciated. Please keep your interplay alive. We advocates, both private and at VBA, want to be there for you. God bless and keep you. As long as there is speech and pens your needs will not go in vain.