Discussion: House Bill Would Speed VA Firings As Outcry Grows

Discussion for article #222997

Republicans, as always, have it backwards. The VA doesn’t need more accountability. It needs more money.

Of course cheating is wrong and there’s no excuse for it. So Congress should avoid promoting it. Congress set the VA up for failure with a crushing workload, inadequate resources, and a regime of unattainable metrics.

Merit pay is like paying people to exaggerate their successes. Termination threats are like asking people to cover up their mistakes. Pay people a fair and adequate base salary. Hire enough of them to do the work. If you give people no incentive to say otherwise, administrators will be happy to explain why their doctors can’t see 30 patients an hour.

That the VA has problems has never been a question. Arizona is a retirement mecca for veterans. As such the VA facility in Phoenix is no doubt particularly challenged in funding and staffing. The “secret list” was more than likely a well intended form of triage. If the situation was in fact so dire (more than 40 deaths!), why didn’t the “former clinic director” take action while he had the power to effect change. Is it a coincidence that the timing of his release of this information comes with republican attempts to bolster their party’s chances in the upcoming midterm elections?

Just a question-why have a separate health care system for veterans? Why not provide all the VA-eligible folks and dependents with government-paid health insurance through the exchanges? There might be a need for clinics to treat specific service-related ailments like PTSD and for rehabilitation from combat injuries, but veterans with cancer, heart disease, diabetes, etc. can be treated at a general medical facility.

Pay a fair and adequate salary? That is the problem, so we should give them more than the $700 million dollars the staff of ONE HOSPITAL earned over the last three years? That would solve the problem?

“Total compensation, records show, topped $700 million over the past three years and exceeded $240 million in 2013 alone. Salaries make up about half the Phoenix VA’s annual budget, with doctors and nurses making up just a quarter of the Phoenix VA staff.”

“Staff salaries, according to the records, reach as high as $357,528 for doctor executives and $147,724 for nurse staff. The average Arizona doctor makes just over half of what the top-paid Phoenix VA doctors make, according to federal stats.”

The problem with the VA is similar to most of the problem with Government agencies, the money goes into the pockets of the government employees and not to actually fund the purpose of the agency.

That’s one of the dumbest thing I’ve ever read on TPM, and that’s saying something. Yes, most funding at VA Medical Centers goes to pay for staffing the hospitals, the clinics, the Emergency Room, the counseling centers, the retirement home, the hospice. That does fund the purpose of the agency. Which is to provide medical services to veterans.


Lovely. Congress can ‘rush’ to pass a bill for more FIRINGS but not more MONEY to add staff to help these veterans. A typical short sighted bill. We send them to WAR but forget what happens when they come home. I know…we’ll cut funding…it bs and everyone knows it.

This is another IRS/Shirley Sherrod type ginned-up thing from the Republicans. Dumbass reporters are taking all these loaded accusations and smearing federal workers with no evidence at all. Here is the report they are all referencing VA HEALTH CARE Reliability of Reported Outpatient Medical Appointment Wait Times and Scheduling Oversight Need Improvement (note: its a pdf)

They’ve cherry-picked some pretty mundane details and blown them up into FRAUD!!! ABUSE!!! In fact, the report shows PROGRESS in reducing wait times over the past 15 years. They interviewed 17 (out of 50,000 schedulers making more than 80 million appointments) and described some vagueness in terminology (desired appointment day), an outdated tracking system, understaffing and high turnover, and a number of other problems that are typical of a large organization, especially a massive health care system, and recommended some avenues of improvement. As ANY GAO report would do, ever. That’s their purpose, and there are hundreds of thousands of GAO reports.

It’ll all come out in the wash, but meanwhile, the media and GOP will ride yet another ginned up scandal. Of course all the dumbass reporters go along for the ride. Sigh.

My response dumbass was to their solution to the problemm which was to PAY THE EMPLOYEES MORE!!! The EMPLOYEES of the ONE HOSPITAL made 700 MILLION DOLLARS over the last three years. So how are they not be PAID A FAIR SALARY!!! Idiot!

Add more MONEY, the have enough MONEY for staffing already. The staff was paid 150% more than those in like position in the private workforce. If you just paid them the same as the private workforce, it would free up about 100 million dollars a year to hire additional staff.

If that’s the case, then put them on government salaries which are NOT 150% above what the private workforce pays. This is the VA…a government agency. Are you SURE what you ‘cite’ is correct? If it is then it is because they have hired government contractors. THAT can be remedied. We don’t work on the PROBLEMS. We work on the political points.

Phoenix VA Health Care System has an operating budget of $450 million a year, and has 478 health providers plus thousands of ancillary staff, maintenance staff, administrative staff, and thousands of volunteers.

The Phoenix VA Health Care System (PVAHCS) -- comprised of the Carl T. Hayden Veterans Affairs Medical Center and seven clinics-- is categorized as a Clinical Referral Level 1 facility. The facility serves more than 80,000 Veterans in central Arizona including the rapidly expanding metropolitan Phoenix area. The VA Medical Center provides acute medical, surgical, and psychiatric inpatient care, as well as rehabilitation medicine, and neurological care, and has a more than $450 million annual operating budget.The facility operates the Buckeye VA Health Care Clinic, Globe-Miami VA Health Care Clinic, the Northwest (Surprise) VA Health Care Clinic, Payson VA Health Care Clinic, Southeast (Mesa) VA Health Care Clinic, the Show Low VA Health Care Clinic and the Thunderbird (NW Phoenix) VA Health Care Clinic. The PVAHCS provides support to one Readjustment Counseling Center and the VA National Memorial Cemetery of Arizona. PVAHCS is affiliated with The University of Arizona College of Medicine. Training agreements are maintained in all of the major clinical specialties, and the facility is allocated 73 resident positions. The Medical Center is also affiliated with several schools offering a full range of Allied Health training programs.   There are more than 322,002 Veterans who reside in the facility's primary service area.

700 million dollars over three years = $233,333,333, okay? They didn’t (derp) all make 700 million dollars, see, they divided all that money up into normal salaries, lots of them ranging from beginning scheduler to the head honcho. Get it? It isn’t like a mom-and-pop operation. Grow up.

The staff is not paid 150% of what the equivalent salary in private health care systems. In fact, they are paid less. Doctor Executives that run the hospital are not the equivalent of an “average doctor” anywhere in the country. In fact, doctors that run hospitals in the private sector make millions of dollars in salary, get it?

You are almost criminally stupid when it comes to reading and comprehension. Is that why they call you a jarhead?

You obviously can’t read. The budget was 450 million dollars out of which 240 million went to employee compensation. Over the last three years 700 million dollars was paid to the STAFF. If this was a private hospital and these were private doctors, nurses, adminstrators, etc… you liberals would be screaming, but since it is Government you make excuses.

Once again you don’t have any clue what you are talking about just defending Government like a good progressive.

Nurses were being paid a $147,000 a year, do nurses in private hospitals are getting paid $147,000 dollars a year? No, the average salary for a nurse in Arizona is $53,000 a year. Chaplins were being paid $100,000 per year. Does the average Chaplin in other hospitals get paid a $100,000 per year? No, they make around $50,000 per year.

So were are not just talking about just Doctor vs Doctor which according the Federal Government’s own audit, they were earning 150% more than other doctors in Arizona.

The fact is, if this was a private hospital it would go out of business and you liberals would be calling for a DOJ investigation and would be using it as why the Government needs to take over health care in this country but since it is the Government you defend it and claim what they need is more taxpayer money.

Please provide a credible link to your information. I think you are full of bullshit.

No, more money total by hiring enough people and building out enough beds to do the job. More money to the same people would obviously do no good, since they’re clearly far over capacity. The cheaters should obviously be fired, and their replacements should be paid flat salaries with no incentive or bonus pay.

Everyone who’s worked under a bonus incentive structure will know what I’m talking about: the office becomes a giant clusterfail around bonus time. If quarter’s end is near and the sales team is just a couple of units shy of quota, the bonus incentive works as intended. People will move heaven and earth to book that one last sale that puts their team into bonus territory. But once the quota is met, or if it’s clearly distant enough to be futile, people start blowing off customers and shuffling transactions into the next quarter. Might as well book it where it counts.

Everyone who’s worked under a punitive incentive structure will know what I’m talking about, too. People who are afraid to be fired for their mistakes are more likely to cover up than report honestly. The toxically inaccurate data then feeds back negatively upon management, as poor decisions are made based on wrong information.

In the VA we see both. Managers lied about their performance to get bonuses. Congress underfunded the agency because the data showed everything to be great. I’d be all in favor of spending more money on a good faith effort to improve the quality and speed of service. But the most vocal critics turn out to be the stingiest budgeteers, and also the biggest proponents of bonuses and merit pay.