This is a Feature, Not a Bug

It looks like the Veterans Administration plan to provide an option for privatized services has resulted in massive cost overruns and delays even worse than the government run VA system.

Imagine that.

In 2014, Congress passed the Veterans Access, Choice, and Accountability Act, which set up a temporary program that outsourced veterans’ care from the Veterans Health Administration (VHA) to private sector providers. In 2018, President Donald Trump signed the VA MISSION Act, which made this outsourcing program permanent and greatly expanded it. Indeed, the legislation set up a parallel private sector network—the Veterans Community Care Program or VCCP—which pays private sector providers to treat more than a third of the nine million veterans enrolled in the VHA.

The Veterans Community Care Program promised to give veterans speedier access to high-quality care if they couldn’t get a timely appointment at the VHA or had to drive too long to get to one. Instead, as many studies have documented, VCCP care is of lower quality than that provided by the VHA. It also takes longer, on average, to get an appointment with a VCCP provider than it does with one at the VHA, and perhaps most importantly, the cost of this private sector program is soaring. Between 2014 and 2024, expenses for veterans’ care in the community quadrupled from $8 billion to $31 billion, accounting for a third of the budget for veterans’ medical services.

One reason for surging costs is that too many VCCP providers are unnecessarily utilizing high-cost tests and procedures and fraudulently billing for care that was never delivered.

Imagine that.  Adding a profit motive led to fraud and cost plus waste?

As a friend of mine is wont to say, "Chaos is job won!"

………

Furnishing veterans with more expensive services might theoretically be justified if it produced better outcomes. Three economists connected to the Bureau of Economic Research tested this hypothesis in a meticulously designed study of dually eligible veterans experiencing a medical emergency. An ambulance transported them to either a VA or private sector emergency department. The results of their respective care revealed that overtreatment was associated with poorer outcomes. Veterans who went to a non-VA facility received more services attached to higher reimbursement rates, for example, a cardiogram or inpatient admission. But rather than improving their lives, veterans brought to private sector EDs had a 46 percent greater chance of dying in the following month than if they’d gone to a VA facility.

(emphasis original)

Of course they were more likely to die.  Private sector profits are not free.  You have to sacrifice veteran's lives in order to support capitalism.

Killing the program is probably too toxic right now, but aggressively pursuing, and prosecuting, fraud, including the actions of executives who create a criminogenic environment, would be a good idea.

If the hedge fund owners of many of these medical practices were frog marched out of their offices in handcuffs, one would find the problems going away.

Support the Troops, Huh?

In 2007, the Worcester Wreath Company had a problem.  They had just lost their contract with L.L. Bean, who had previously been responsible for 90% of their sales.

Their solution was to create a 501(C)3 charity, Wreaths Across America, and then use this charity to aggressively solicit people to put wreaths on dead soldiers graves.

The thing is, Wreaths Across America only buys from the Worcester Wreath Company, and as such, their prices are not what one would call competitive.

The technical term for this is self-dealing, and if the appropriate regulators executed their duties as they are supposed to, this would result in a loss of charity status or perhaps jail time.

Wreaths Across America is a non-profit organization that places wreaths on the graves of military veterans. It's a simple gesture that has proven popular. Wreaths Across America placed 33,000 wreaths in 2007, its first year. This year, the organization expects to place 2.9 million wreaths at 4,225 cemeteries across all 50 states, a spokesperson for the organization tells Popular Information.

According to Wreaths Across America, wreath-laying is a "simple act of gratitude" that "brings together communities and supports local veterans and military families." But while the wreaths provide symbolic support for veterans and military families, the overwhelming majority of the over $30 million raised in the fiscal year that ended in June 2022 goes to Worcester Wreath Company, which produces the wreaths.

Wreaths Across America was founded in 2007 by members of the Worcester family, owners of the Worcester Wreath Company. The creation of the Wreaths Across America occurred around the same time that Worcester Wreath Company lost its contract with L.L. Bean, which accounted for 90% of Worcester Resources' wreath sales. Rob Worcester, a co-owner of Worcester Wreath Company, said that the loss of L.L. Bean's business following a legal dispute left the firm "in dire straights." The wreath-laying charity, he said, "allowed us to get our feet back under us." Rob Worcester's wife is a member of the Wreaths Across America board.

Nothing fishy here:

In fiscal year 2022, $20,605,527 of the money raised by Wreaths Across America went directly to Worcester Wreath Company. Most of the rest of the funds went to marketing, overhead, and staff salaries.

………

Beginning in 2017, Wreaths Across America began soliciting a "request for proposals" (RFP) every three years to supply wreaths. Several members of the non-profit board who are also employees of Worcester Wreath Company, along with Karen Worchester, are formally recused from this process. This, Wreaths Across America says, ensures that "Wreaths Across America receives the most advantageous terms in it's [sic] purchase of wreaths to further it's [sic] charitable purpose."

But for the first RFP, Worcester Wreath Company was the only company that submitted a proposal. "We have certain standards that we look for and for other [companies] to follow that would be difficult,” board chair Wayne Hanson said. Worcester Wreath Company has also won all subsequent RFPs.

But wait, there's more, it appears that Worcester Wreath Company has a dangerous workplace:

………

The Worcester Wreath Company also has a record of workplace safety and labor violations. In May 2022, the federal Occupational Safety and Health Administration (OSHA) fined the company $11,500 in connection with a COVID outbreak that left one employee dead and more than 80 workers sick.

According to records obtained by the Maine Monitor, the company failed to report the wreath worker’s death to OSHA within the required eight hours. It also did not “conduct contact tracing to determine who she had been in contact with.” In addition, an OSHA investigator found that–even after the outbreak–the company refused to enforce its mask policy “despite the CDC’s warnings and guidance regarding the usage of masks in close quarters.” The official concluded that the company’s response was “an act of simple indifference” and pointed out that Worcester Wreath Company had received prior citations in 2017 and 2019 for “failing to maintain illness and injury records.”

“This standard has always been a very-back burner issue for the employer as seen in its prior violations and in the manner it has dealt with the citations with OSHA,” the official wrote.

Worcester Wreath Company received reporting violations again in 2023. In March and April, OSHA imposed $24,000 in penalties against Worcester Wreath for “two reporting violations.” The bulk of this amount, about $22,000, was for “failing to publicly post a report on work-related injuries and illnesses earlier this year” the Maine Monitor reports. Similar to the COVID penalty, this incident was deemed a “willful violation,” meaning that investigators found that the company was acting with “purposeful disregard” or “plain indifference.”

In 2018, the U.S. Department of Labor ordered the company to pay “$55,654.16 in back wages to 95 employees” to resolve overtime violations. The same year, seasonal migrant workers at the company have also claimed that they were subject to “repeated sexual harassment by a crew boss contracted by Worcester Wreath Company.” The workers allege they were fired and kicked out of employer-owned housing for raising these concerns.

It appears that the Fox News darlings, both Karen and Morrill Worcester are regularly on the cable network, have been using public money, 501(C)3 donations (including the wreath purchases) are tax deductible as a marketing tactic for their own for profit purposes.

In the non-profit world, this is supposed to be a, "No-No."

It isn't, one only need to look at the the supposedly non-profit charter schools set up around the country, or the various foundations set up by silly-con valley tech bros.

The unwillingness of the IRS and the DoJ to pursue this sort of fraud is a real and serious prob lem.

And in a Spectacular Own Goal

One of the most decorated soldiers in Australian history, Ben Roberts-Smith, was accused of murder and other war crimes in a series of stories in The Sydney Morning Herald, The Age, and The Canberra Times, and filed a defamation suit against the papers and the reporters.

Given the state of Australian deformation laws, which hew fairly close to their English antecedents, tend to favor the the plaintiffs, but the corporal forgot the most important rule of defamation cases, don't be blatantly guilty of what you came is deformation:

A defamation case by war veteran Ben Roberts-Smith against three newspapers has been dismissed, after a judge found defences of substantial or contextual truth had been established over alleged unlawful killings and bullying.

The Victoria Cross recipient sued The Sydney Morning Herald, The Age, The Canberra Times and three journalists in the Federal Court over a series of stories published in 2018.

Mr Roberts-Smith said they contained false allegations of war crimes in Afghanistan, bullying of his former Special Air Service Regiment (SAS) colleagues and domestic violence against a woman in a Canberra hotel room.

Publisher Nine Entertainment relied on a truth defence, and both sides called current and former SAS witnesses.

Justice Anthony Besanko on Thursday ruled the publisher had established the substantial truth of the imputations linked to allegations of unlawful killings in Afghanistan, and had established the contextual truth of imputations linked to allegations of bullying and domestic violence.

A second imputation of bullying was also found to be substantially true.

Oops.

His reputation has been destroyed, but on the basis of what has been shown, I think that the Australian military establishment should take a far closer look at the behavior of Roberts-Smith and his unit with an eye toward making the investigation a criminal one.

Great Googly Moogly

White House Doctor, Rear Admiral Ronny Jackson, has been accused of being an abusive manager, over-prescribing drugs, and being drunk at work:

President Trump acknowledged Tuesday that Dr. Ronny L. Jackson, his nominee to lead the Veterans Affairs Department, is in serious trouble amid accusations that as the White House doctor he oversaw a hostile work environment, improperly dispensed prescription drugs and possibly drank on the job.

………

Members of Mr. Tester’s staff said that they had been given several credible accounts of Dr. Jackson being intoxicated during official White House travel. In several cases, they said, he had apparently grabbed his medical bag and was “attempting to assert himself,” to show he was in charge.

On one trip during Barack Obama’s presidency, White House staff needed to reach Dr. Jackson for medical reasons and found him passed out in his hotel room after a night of drinking, Tester aides said. The staff members took the medical supplies they were looking for without waking Dr. Jackson.

The frightening thing is that this would make him one of Donald Trump's more qualified nominees.

Best Memorial Day Speech Ever

Joe Biden.

There appears to be a correlation between "gaffe prone" and honest.

New GI Bill and Unemployment Extension Signed Into Law

This is good news and good policy, though Bush thanking himself and John McCain for the bill is particularly disingenuous, when both of fought against this tooth and nail.

Dems Propose Millionaire Tax to Fund Veterans' Benefits

It's good policy, though I would go further and make the rich pay for the whole war, and good politics, because it forces Republicans to vote against veterans benefits or vote for a ½% increase on taxes for couples earning more than $1 million.

Heh.

Signs of the Apocalypse: The WaPo Editorial Board Gets TWO Right in the Same Year

This time, they are going after the Republicans, and McCain for killing improvements in the GI bill.

The got one right 2½ weeks ago too, in addition to one in 2007.

H/t Brad Delong.

Bush Screwing Veterans Again

Yes, Bush and His Evil Minions^™ are claiming that Veterans not entitled to mental health care in a federal lawsuit in San Francisco.

I guess that PTSD must be an existing condition or something.