Trump says he spoke to General Motors CEO over Ohio plant closure

Checkerboard Strangler said:

In 1994 the Gingrich Congress made several rule changes in how some things are funded, including the VA.
The VA physical plant budget is NON-discretionary spending, meaning if the VA spends all the money it needs for building maintenance, remodeling etc in a given year, it is guaranteed to get that same amount or even more the next year.

....

That might actually be a great idea because it might do away with a lot of unneeded duplication, and it might bring a lot of valuable and important resources into the VA system to the benefit of both VA and military hospitals. It will also eliminate a lot of duplicate patient health care information as well, and streamline the info system so that it can work more smoothly.

It might also FINALLY put an end to the "discretionary versus non-discretionary" spending merry go round that the VA has to deal with every year.
The military system has never allowed Congress to play that game, and the VA system shouldn't have to.

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Again, you ramble a lot but say nothing much. You want to compare the VA with private prisons? I've known my way around a few prisons in my social work days... if you are trying to make points by arguing that federally run prisons are better? Yeah... keep on walking because that is nonsense. :roll:

And YES, the VA care budget is discretionary for the very reasons described in that report I linked. Waste, fraud, abuse... You've never seen waste until you've seen the inside of a non-discretionary budget. My point stands regardless of how much you want to rant about it. The issue with the VA is not budgetary, it is management. It's money problems are poor management and waste. Your opinion is understandable for someone who has been all but taken hostage by the system that both mistreats its mission, its budget, and often its patients. It would be nice if there was an alternative, but that will require change, and government systems loathe options.

And, again, both mandatory AND discretionary spending have been increasing under Trump. Mandatory spending is up 18% since the 2017 budget, Discretionary is up 25%.. and it is TRUMP destroying the VA? You're fooling yourself. Again, the VA is destroying the VA. They keep getting more money and wasting more money and then convincing people that their problem is not enough money. Stop accepting their excuses. It isn't the money, it is budget management, which is the problem in pretty much every government agency in the US.

jmotivator said:

And YES, the VA care budget is discretionary for the very reasons described in that report I linked. Waste, fraud, abuse... You've never seen waste until you've seen the inside of a non-discretionary budget.

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But you didn't actually READ that report, did you?
(Which, by the way, only refers to issues at the WASHINGTON DC VAMC, hence its title being:
Critical Deficiencies at the Washington DC VA Medical Center

Inadequate Staffing and HR Deficiencies

~~~~~~~~~~~~~~~~~~~~~
HELLO, WHAT WAS I JUST TALKING ABOUT EARLIER???
I think it was "inadequate staffing" while pianos, artwork, walkways, gardens, atriums and extensive remodeling continue apace. That's what I meant about a GOOD LOOKING CORPSE, but here you are, Jmotivator...ignoring his own report!!! :lamo

You're ****ing brilliant.
~~~~~~~~~~~~~~~~~~~~~

The HR review focused on current and past Medical Center HR operations and recruitment
efforts. The OIG team interviewed current, former, and acting HR personnel; the Acting
Associate Director of the Medical Center; and other Medical Center managers and staff with
knowledge relevant to HR. The team also reviewed Medical Center staffing data and external
reports discussing Logistics Service and SPS staffing deficiencies, including
• VHA and Medical Center HR policies, procedures, and directives;
• Calendar years 2015 and 2016 Resource Management Committee minutes;
• Issue briefs and reports to the VISN describing department vacancies, HR
operations, and recruitment gaps; and
• Authorized and actual staffing data, organizational charts, and documents that
described filled and vacant positions for selected services from 2013 to 2017.

SOURCE: Critical Deficiencies at the
Washington DC
VA Medical Center submitted by Jmotivator - THANK YOU!!

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jmotivator said:

My point stands regardless of how much you want to rant about it. The issue with the VA is not budgetary, it is management. It's money problems are poor management and waste. Your opinion is understandable for someone who has been all but taken hostage by the system that both mistreats its mission, its budget, and often its patients. It would be nice if there was an alternative, but that will require change, and government systems loathe options.

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Your point just blew up in your face, call the bomb squad.

That (*above) ^^^ is the poster child for "rambling and not saying much" because I countered you point by point and all you have is your opinions, nothing concrete. When the VA needs to hire more physicians, lab techs, surgeons, nurses, buy more medical supplies, pay for pharmaceuticals, then that's what it needs, not lame excuses about how that constitutes "Waste, fraud, abuse..."

The Phoenix VA experienced a quadrupling of its caseload and was turned down by Congress when it asked for staff and expansion money. That's not the entire reason the Phoenix scandal erupted but it's more than half the reason.
They quite simply did not have enough staff to meet their caseload and they were told to sit and spin.

The so called "Waste, fraud, abuse..." is in all the vanity construction projects being rolled out EVEN AS the VA is begging for more personnel to meet veterans medical needs. You're full of ****. Period.

And private prisons SUE states when their beds aren't full, which creates perverse incentives.
Again, you're full of ****, a bitter ex-social worker who couldn't cut it. I know a few ex-social workers.
Don't make excuses for your burnout by victim blaming.

jmotivator said:

And, again, both mandatory AND discretionary spending have been increasing under Trump.

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VA HEALTH CARE discretionary spending is up under Trump? SHOW ME.
I'll take your proof directly to Walt Dannenberg because he's not getting the necessary budget to hire that second SCI neurologist that they need so badly.

jmotivator said:

Mandatory spending is up 18% since the 2017 budget, Discretionary is up 25%.. and it is TRUMP destroying the VA? You're fooling yourself. Again, the VA is destroying the VA. They keep getting more money and wasting more money and then convincing people that their problem is not enough money. Stop accepting their excuses. It isn't the money, it is budget management, which is the problem in pretty much every government agency in the US.

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It IS the money, specifically the WAY the MONEY IS BEING SPENT.
It's being spent on vanity projects to increase the real estate value of the properties instead of on adequate staff, supplies and assets.
And I just PROVED it using one of your own reports.
Ready to get your ass kicked some more?

PLEASE BRING IT ON.

Checkerboard Strangler said:

Your point just blew up in your face, call the bomb squad.
Etc. etc.

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Do me a favor and tell me where did I ever argue that the VA wasn't under staffed? Did you actually read the report? I'm guessing not. Long story short: The VA problems aren't monetary, they are managerial.

My whole point to you is that the VA is mismanaged, and that staffing deficiencies are a product of mismanagement, not a lack of money.

You want to keep throwing money at bad management thinking it will eventually work better. It doesn't. It wastes more.

And no, it wasn't the mandatory spending/discretionary spending split that was the problem.. as I have already pointed out, discretionary increased at a much higher rate. The problem was in how the VA wasted that discretionary budget.

And when was the VA not a basket case? Trump pushed for and got a record budget for the VA through 2020... but he's your villain who is destroying the VA? Yeaaah, right... :roll:

jmotivator said:

Do me a favor and tell me where did I ever argue that the VA wasn't under staffed? Did you actually read the report? I'm guessing not. Long story short: The VA problems aren't monetary, they are managerial.

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No, they don't have the BUDGET. The word "managerial" used here, by you, is utter NONSENSE.
"We need another neurologist"
"There's no budget, we have to make do with one"

"Uh ohhh, we're understaffed due to managerial mismanagement. I guess everything's excused now."

---Except that's not how it works, except in the mind of someone who cannot accept FACTS.

jmotivator said:

My whole point to you is that the VA is mismanaged, and that staffing deficiencies are a product of mismanagement, not a lack of money.

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Staffing deficiencies at the VA, like when the Long Beach VA went for TWO years without an SCI neurologist, are due to LACK of money to HIRE one. Money to PAY the NEUROLOGISTS. They do work for money, in case you didn't realize that.

jmotivator said:

You want to keep throwing money at bad management thinking it will eventually work better. It doesn't. It wastes more.

And no, it wasn't the mandatory spending/discretionary spending split that was the problem.. as I have already pointed out, discretionary increased at a much higher rate. The problem was in how the VA wasted that discretionary budget.

And when was the VA not a basket case? Trump pushed for and got a record budget for the VA through 2020... but he's your villain who is destroying the VA? Yeaaah, right... :roll:

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Where's that proof I asked you for? You didn't point out jack ****.
Next I'll call up our old buddies at the Dallas VA, where we used to live and get the testimony submitted to Congress by Jackie Richardson of the Dallas PVA, who was a thorn in the side of Congress every year since 1994, when he started taking them to task for destroying the VA's ability to hire staff as needed in the first place.

All I need is to find out where it is in the Congressional Record.

Interestingly, 1996 was the year that the Dallas VA actually GOT its SCI facility BUILT, because the 1994 budget allowed for the construction. But it wasn't until 1998 that they got their own SCI staff neurologist.
And the SCI nurses (all twelve of them in 1996) were holding BAKE SALES to raise money to buy stuff like BANDAGES.
WHY? Because Congress wouldn't give them the MONEY to HIRE a neurologist...OR SUPPLIES.

Trump pushed through a record VA budget for the VA "THROUGH 2020"? Excellent, first thing Obama did was the same thing, but as usual it had to be run through Uncle Newt's VAHC-discretionary/VAPP-non-discretionary machine first, just like every VA budget since Newt invented the process in 1994.

Let's see how many atriums, walkways, art exhibits and other fluffy construction awards get handed out while the VA keeps begging for doctors. Maybe Phoenix VA will FINALLY get their very own MRI machine instead of having to wait while a MOBILE MRI travels around four of the flyover states like it has for the last ten years.

Keep coming back empty handed and with more of your fact free opinions, and I'll keep kicking your ass from here to Kingdom Come. I'll do it every day for the next six months if need be. I'll do it every day for the next six years if need be.

WHERE'S that PROOF I ASKED YOU FOR?

VA HEALTH CARE discretionary spending is up under Trump? SHOW ME.

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You haven't got it because all you have is OPINIONS, you DON'T HAVE proof or you would have trotted it out with more of your indignant snorting and harumphing.

Checkerboard Strangler said:

No, they don't have the BUDGET. The word "managerial" used here, by you, is utter NONSENSE.
"We need another neurologist"
"There's no budget, we have to make do with one"

"Uh ohhh, we're understaffed due to managerial mismanagement. I guess everything's excused now."

---Except that's not how it works, except in the mind of someone who cannot accept FACTS.

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No, that is EXACTLY how a government run organization works. They have an annual budget, and into that budget they fit their acquisitions. If they budget for 1 neurologist then they have 1 neurologist unless they can make room in the budget for another, regardless of need, if the money isn't there the new hire never happens. WHY that money is not there to hire a new neurologist is the question... and the answer is because of poor management and waste.

Staffing deficiencies at the VA, like when the Long Beach VA went for TWO years without an SCI neurologist, are due to LACK of money to HIRE one. Money to PAY the NEUROLOGISTS. They do work for money, in case you didn't realize that.

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The funny thing about your argument is that, really, what your statement implies is that the neurologist was overlooked in one budget year, since, unlike a private enterprise, that kind of decision only happens once a year... meaning that action tends to wait until the year AFTER the problems start, and even then it has to be budgeted for the next fiscal year.

When a government manager tells you they "need money" it is because the budgets are written in September, and any new acquisitions happen in October from a line item in September. The problem is that the system creates waste and mismanagement like you wouldn't believe. A Government system can't move money from one area of the hospital to another because of a need, they are required by law to follow the yearly budget. If one part of the VA is being under utilized, and you aren't being served in another... well, tough. They'll take it up in next year's budget.

Where's that proof I asked you for? You didn't point out jack ****.
...

WHERE'S that PROOF I ASKED YOU FOR?

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Blah blah blah. Pounding the table doesn't do a damn thing for your argument.

Trump signs the largest VA budget ever

Here is the VA page on how the budget is broken down, and historical comparsion:

https://www.va.gov/budget/docs/summary/fy2020VAsBudgetFastFacts.pdf



That is the request, but Trump has signed it into law.

Edit: Whatever money you THINK Obama got for your wife is an illusion. What made that neurologist hire possible was just the yearly shuffle of the VA budget.. THAT might have freed up some budget for the Neurologist, but Obama had little to do with that.

sjmay said:

Here ya go,

List of vocational colleges in the United States - Wikipedia

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None of them teach robotics

sangha said:

None of them teach robotics

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And? You think there's only going to be ONE field they can go into?

Cmon man....seriously?

jmotivator said:

No, that is EXACTLY how a government run organization works. They have an annual budget, and into that budget they fit their acquisitions. If they budget for 1 neurologist then they have 1 neurologist unless they can make room in the budget for another, regardless of need, if the money isn't there the new hire never happens. WHY that money is not there to hire a new neurologist is the question... and the answer is because of poor management and waste.

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No..again you're WRONG, because if the budget for that staff is DISCRETIONARY, it ultimately falls to the purse strings in the House whether or not the money is even made available.
If they budget for a second neurologist in a NON-DISCRETIONARY (mandatory) scheme, then the money is made available. If they budget in a discretionary scheme, it MIGHT NOT BE MADE AVAILABLE, because it is discretionary. You seem to not have an adequate understanding of how discretionary spending works in Congress. It should more accurately be termed WHIM-based spending because it is largely based on the WHIMS of the House leadership, and it is used as a political football.

That's how you wind up with a place like Phoenix which was begging for more staff and never got enough until management got caught fudging numbers while veterans were dying.

And by YOUR logic, that Long Beach VA SCI neurologist should have been budgeted the NEXT YEAR but it took TWO years, just for the ONE neurologist. Why? Because Congress REFUSED the budget for the one SCI neurologist. Would you like for Dr. Dannenberg to confirm this for you? It might take a while but I am sure he will oblige me.

That 2020 budget? That's the Democratic controlled House you can thank. The Democrats are in control of the House, so the Democrats pushed the budget through. You're welcome.

jmotivator said:

The funny thing about your argument is that, really, what your statement implies is that the neurologist was overlooked in one budget year, since, unlike a private enterprise, that kind of decision only happens once a year... meaning that action tends to wait until the year AFTER the problems start, and even then it has to be budgeted for the next fiscal year.

When a government manager tells you they "need money" it is because the budgets are written in September, and any new acquisitions happen in October from a line item in September. The problem is that the system creates waste and mismanagement like you wouldn't believe. A Government system can't move money from one area of the hospital to another because of a need, they are required by law to follow the yearly budget. If one part of the VA is being under utilized, and you aren't being served in another... well, tough. They'll take it up in next year's budget.

Blah blah blah. Pounding the table doesn't do a damn thing for your argument.

View attachment 67252875

Taken from the VA's own budgeting press release.

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That does not reflect adequate discretionary spending, only an increase in it, which would be understandable given the fact that since 2014 there's been a tsunami of incoming Iraq-Afpak disabled veterans, and the budget increases shown are in fact NOT adequate to meet the need. As a matter of fact, if one looks closely at the graphs, one might even deduce that there is a slightly DOWNWARD trend in the last two years of the Obama administration when compared to the first years after.



Do you want to BLAME OBAMA for this while you're at it, even though it's a Republican controlled House in charge of the purse strings during those years? (Boehner-Cantor House)

You're on a mission to promote abolition and/or privatization of the VA because you believe it is not improved, cannot be improved, and could be better done in the private sector.

And each argument that you bring up, I have knocked down and I will continue to knock them down.
So keep bringing them, this is fun!

By the way, would you like to know how the VA stacks up against the private sector right now, today?

But compared with the rest of the U.S. health-care system, VA’s performance is pretty impressive. As a Rand review of the literature concluded, study after study has found that the “quality of care delivered by VA is generally equal to or better than care delivered in the private sector.” This has been true since VA underwent a structural transformation in the mid-1990s.

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Interestingly, even as a liberal and very vocal supporter of the quality care at the VA, I am supportive of efforts to share services with the private sector in remote and rural areas which are by nature UNDERSERVED BY the VA due to long distances and travel times, which is supported by the above article that I linked to.

VA has a long history of partnering with private medical schools and purchasing care in the community. Especially in rural areas, VA often lacks the facilities and personnel to offer vets timely, convenient, high-quality care. In such circumstances, joining with local private providers to create integrated networks of care makes both clinical and fiscal sense.

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The VA can improve the record of care for veterans in outlying areas by partnering with local private sector facilities and services, and they should do so.

But even the Veterans Choice Act is FAILING to solve that problem.

Veterans who face a wait of more than 30 days are eligible for the Choice program, but critics have complained that the system is overly bureaucratic and still places limits on veterans’ access to private-sector doctors at taxpayers’ expense.

But the new GAO research says that Choice participants can face waits of up to 70 days to receive care, due to bureaucratic requirements and deadlines. Officials there said VA’s decision not to put stricter timelines for patient requests lead to an average of 51 days for veterans to receive care in late 2016.

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That doesn't mean it can't be remedied, but so far, not so much.

Checkerboard Strangler said:

No..again you're WRONG, because if the budget for that staff is DISCRETIONARY, it ultimately falls to the purse strings in the House whether or not the money is even made available.
If they budget for a second neurologist in a NON-DISCRETIONARY (mandatory) scheme, then the money is made available. If they budget in a discretionary scheme, it MIGHT NOT BE MADE AVAILABLE, because it is discretionary. You seem to not have an adequate understanding of how discretionary spending works in Congress. It should more accurately be termed WHIM-based spending because it is largely based on the WHIMS of the House leadership, and it is used as a political football.

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Wrong. That isn't how a federal budget works. Maybe you are thinking about earmarks? Anyway, what you said is bull****. The individual departments write up their budgets and filter them up the chain, and the house only makes large scale budgetary changes... do you honestly think that the House and Senate sit with green eyeshades and dither over budgeting a neurologist in a single VA hospital? :roll:

Answer: Absolutely no, they don't. That budget is determined by the VA itself, and handed up the line. If the Congres then comes back with a lower gross budget then it falls back on the department management to figure out what to cut and what not to cut in their submitted budget.

That's how you wind up with a place like Phoenix which was begging for more staff and never got enough until management got caught fudging numbers while veterans were dying.

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Absolutely false. You are wholly clueless of the federal budgeting system and you should stop pretending like you know what you are talking about.

And by YOUR logic, that Long Beach VA SCI neurologist should have been budgeted the NEXT YEAR but it took TWO years, just for the ONE neurologist. Why? Because Congress REFUSED the budget for the one SCI neurologist. Would you like for Dr. Dannenberg to confirm this for you? It might take a while but I am sure he will oblige me.

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Because that is the way a federal budget works. Dr. Dannenberg is lying to you. There is absolutely no way in hell that the Congress, when faced with a $4 TRILLION budget is talking about whether Dr. Dannenberg in the Phoenix VA is getting a new neurologist. Zero.

Here is what would have happened: Dr. Dannenberg wants a new neurologist, and asks for a position to be created, management above him adds the cost in, if they see it as necessary, and hand their combined budget up the line.. and on and on until the VA has a total budget request that they pass to the president and it is included in the budget request. When Congress approves the budget the VA either gets what it asked for or it doesn't and the loss, if there is one is unpacked as the budget is broken back into branches, offices, and departments, and then the final budget for Dr. Drannenberg shows up and he decides if the money he got is enough for that new neurologist. He decides no, but tells you "****in' REPUBLICANS!" because he doesn't want you bitching at him.

That 2020 budget? That's the Democratic controlled House you can thank. The Democrats are in control of the House, so the Democrats pushed the budget through. You're welcome.

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HA! Typical! No, the bill was signed in June 2018 and funded VA through 2020... that was the Republicans.

That does not reflect ... first years after.

(picture)

Do you want to BLAME OBAMA for this while you're at it, even though it's a Republican controlled House in charge of the purse strings during those years? (Boehner-Cantor House)

You're on a mission to promote abolition and/or privatization of the VA because you believe it is not improved, cannot be improved, and could be better done in the private sector.

And each argument that you bring up, I have knocked down and I will continue to knock them down.
So keep bringing them, this is fun!

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If you look at that graph more carefully you will realize that it blows your irrational argument out of the water. Discretionary spending increased every year listed there. The reason for the decline under Obama is the MANDATORY SPENDING that you are bitching about.

I guess now is the time where you start searching desperately for a way to pretend that mandatory spending was real problem all along? :roll:

Moral of the story: Dr. Dannenberg didn't want you mad at him and filled your head with bull**** on how the Phoenix VA budgets for staff, and you built an entire bull**** narrative around that lie that the facts simply don't support.

No, Republicans didn't cut discretionary spending under Obama.

No, Trump isn't destroying the VA

No, Dr. Dannenberg isn't a truthful man.

No, you don't understand federal budgeting

No, you shouldn't pretend like you know things because of personal anecdotes.

jmotivator said:

Wrong. That isn't how a federal budget works. Maybe you are thinking about earmarks? Anyway, what you said is bull****. The individual departments write up their budgets and filter them up the chain, and the house only makes large scale budgetary changes... do you honestly think that the House and Senate sit with green eyeshades and dither over budgeting a neurologist in a single VA hospital? :roll:\

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Stop right there with the bull**** and the pretzel making.
I didn't say anything about individuals with green eyeshades.

And your response...

When Congress approves the budget the VA either gets what it asked for or it doesn't and the loss, if there is one is unpacked as the budget is broken back into branches, offices, and departments, and then the final budget for Dr. Drannenberg shows up and he decides if the money he got is enough for that new neurologist.

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...casually overlooks, and in true right wing fashion, abrogates and absolves lawmakers in Congress, many of whom are even physicians, of their responsibilities in deciding whether to approve the budgets that the VA sends them.
As it happens, when these lawmakers are pressured by lobby groups and think tanks who have a money incentive to grab some of the cash cow that is today's VA, they respond accordingly, and the VA suffers. But of course, you're going to sell me some Mister Smith Goes to Washington bull****, as if that doesn't happen.

Yeah, no green eyeshades, however if you don't think, or rather, KNOW for a FACT, that these gross figures aren't gone over in committee, then you're the one lying to yourself, and expecting others to swallow it. You do understand that budgets for departments and federal agencies are discussed in congressional committees, yes? If you don't, it's you who doesn't understand how federal budgeting works.

Keep it up, keep twisting what I am saying in your desperate attempt to right your sinking ship.
I've noticed that the more I bring facts into the discussion, the more condescending your tone is getting.
That's great, you'll just get more facts shoved down your throat as time goes by.

The mood in Washington is to privatize EVERY ASPECT of government, and the VA is no exception, no Dr. Dannenberg needed to suss that out. CVfA and all those private sector medical outfits that have Trump's ear and the ear of the Republicans are working their privatizing magic as we speak.
And the way that they do it is to first soften up the public agency in order to lower its performance, and to strangle efforts at reform.

You did win ONE though:

HA! Typical! No, the bill was signed in June 2018 and funded VA through 2020... that was the Republicans.

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You're right, my bad, good catch.

The rest, not so much, the privatization drive continues as long as the only folks with Trump's ear are those in favor of privatization. Next you're going to tell me that CVfA isn't an advocate for that.

We've been VA patients for TWENTY YEARS, and you think your condescending nonsense about the VA Long Beach director patting us on the head is going to pass.
Keep it up, J...you're looking more and more like a pissant with an axe to grind with every post.
And you're not even a VA patient. Amazing.

Checkerboard Strangler said:

Stop right there with the bull**** and the pretzel making.
I didn't say anything about individuals with green eyeshades.

And your response...

...casually overlooks, and in true right wing fashion...

The mood in Washington is to privatize EVERY ASPECT of government, and the VA is no exception, no Dr. Dannenberg needed to suss that out. CVfA and all those private sector medical outfits that have Trump's ear and the ear of the Republicans are working their privatizing magic as we speak.
And the way that they do it is to first soften up the public agency in order to lower its performance, and to strangle efforts at reform.

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You said that your doctor said that CONGRESS didn't approve the neurologist... are you ready to admit that that is bull****? I'm willing to give Dr. Dannenberg some credit and chalk it up to you putting words in his mouth, but if he told you what you said he did then he is LYING to you. And as I showed you in the VA budget, based on your own argument, the VA got a substantial increase in discretionary funding EVERY year in the time frame you said Congress was denying you a neurologist. So, since the money was ALWAYS increased that pays for neurologists, it wasn't Congress, or the Republicans, or Trump who was denying you ANYTHING, it was the VA priorities that prioritized new money to things other than that neurologist.

That's the facts.

You're right, my bad, good catch.

The rest, not so much, the privatization drive continues as long as the only folks with Trump's ear are those in favor of privatization. Next you're going to tell me that CVfA isn't an advocate for that.

We've been VA patients for TWENTY YEARS, and you think your condescending nonsense about the VA Long Beach director patting us on the head is going to pass.
Keep it up, J...you're looking more and more like a pissant with an axe to grind with every post.
And you're not even a VA patient. Amazing.

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I'm not being condescending, I know that the Congress doesn't waste time dithering over individual hires in a government that employs MILLIONS OF PEOPLE. Individual hires are the decision of the LOCAL agencies and offices, not Congress. If your doctor told you that Congress declined to hire a neurologist for your VA hospital then absolutely he is blowing smoke up your ass.

[THIS IS WHERE YOUR RESPONSE TO THE DISCRETIONARY SPENDING INCREASES SHOULD HAVE BEEN]

Huh... why'd you cut that part out? :roll:

You did win ONE though

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I won two, and on the third point above, regarding who rejected that neurologist, you are going to lose. VA management, likely very close to "ground level", delayed that hire, not Congress. Any lack in funding in the SCI was also not Congress' fault, but rather a reflection of priorities within the VA under the Obama administration on how to spend the ever increasing discretionary budget for the VA.

jmotivator said:

You said that your doctor said that CONGRESS didn't approve the neurologist...

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That's not what I said.

jmotivator said:

So, since the money was ALWAYS increased that pays for neurologists, it wasn't Congress, or the Republicans, or Trump who was denying you ANYTHING, it was the VA priorities that prioritized new money to things other than that neurologist.

That's the facts.

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An increase substantial enough to do away with 1600 doctor vacancies?
Not according to this.

Like many issues that plague the VA healthcare system, this one is linked to underfunding. Working for VA as a licensed physician does not pay the kind of money that licensed physicians are content to earn.

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"You're paying medical center directors less than individual physicians in a marketplace where those folks can make four, five, or six times that amount" in the private sector, he said. "[If you] change that ... those folks are going to figure out a lot of answers [to the VA's problems]."

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Subcommittee chairman Neal Dunn, MD (R-Fla.), discussed a recently released report from the VA's Office of Inspector General on clinical and non-clinical personnel shortages at VA facilities. "Many VA facilities struggle to hire custodians, police officers, and human resource professionals just as they struggle to hire doctors and nurses," said Dunn. "To no one's surprise, the report found wide variety of staffing needs ... and consistent challenges due to a lack of quality applicants, an inability to compete with the private sector, and high turnover problems ... The VA can't function without high-performing, appropriately staffed facilities."

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Do you still want to insist that the VA is receiving adequate funding? Still want to continue with your victim blaming anti-government nonsense?

jmotivator said:

I'm not being condescending,

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Yep, you are being condescending, and you're convinced that everything is solely due to the concept that the government cannot do anything right, which contradicts studies that I posted that say you're wrong.

I cut out all the parts where you're arguing with a cardboard cutout.
The VA is not receiving enough money to hire enough doctors, lab techs, nurses, or even researchers, or even JANITORS.
But they're getting more than enough money to do remodeling projects. It's been that way ever since Gingrich made health care budgets discretionary and as long as they remain dicretionary, the VA can submit budget requests till they are green in the face but Congress will just tell them they're not going to get enough money.

If the health care budget is MANDATORY spending, the problem will be resolved, it's as simple as that.
Make the plant and building budget discretionary, they can do without remodeling the lobbies and atriums every other year.
It is as simple as that.
Having it the other way around is pure insanity, as I pointed out many many pages ago.

There isn't a single hospital budget model on earth in the outside world where staffing budgets and equipment come secondary to remodeling the buildings.

Checkerboard Strangler said:

That's not what I said.

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What are you saying, then, because I have watched you build a house of cards where you blame discretionary budgets for lack of money for a neurologist whne, as I have showed, discretionary budgets never stopped increasing, which neans that lackof budget for a neurologist is due to VA priorities, and the decision falling much closer to Dr. Dannenberg's office floor than to the House floor.

An increase substantial enough to do away with 1600 doctor vacancies?

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That is government, bud. You want a government run health care you get a government run healthcare. Why do some of my colleagues in IT work for half of what they could get paid contracting privately in the same department? Benefits, stability, job security, retirement... all the things that attract any government employee. In fact, when you consider all of that, a VA doctor, in equivalent dollars, isn't that far off of the private practice physician making more on paper.

Also, the Disabled Veterans example of a Cardiac surgeon appears to be an anecdote, assuming they even used a real world example (they probably didn't). The average pay of a Cardiac surgeon in the US is $369,000 (range $122k-$615k)... VA pay for a Cardiac Surgeon is $282.4K (range $232k - $328k). So, like any government job, a early to mid career cardiac surgeon would find rather competitive pay at the VA, and by the time the money is better in the private sector they will have built a nice federal retirement plan.

Moreover, the shortage at the VA mirrors the doctor shortage in the private sector.The VA isn't short doctors because of pay, it is short on doctors because the country is short on doctors.

Do you still want to insist that the... blaming anti-government nonsense?

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Yes. Also, you should probably make a habit of checking the sources rather than just posting a lobbying group's un-sited claims as if they are fact. It took me two minutes to pull up actual comparative numbers.

Yep, you are being condescending, ... which contradicts studies that I posted that say you're wrong.

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You keep using that word "condescending" ... I don't think it means what you think it means.

I cut out all the parts where you're arguing with a cardboard cutout.
... Congress will just tell them they're not going to get enough money.

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And I am telling you that they are. Here is the other funny thing about government budgets. When a position is actually approved, it has had a budget set aside for it. If there are 1,600 unfilled doctor positions at the VA, the positions have been budgeted. The reason they aren't filled is because of a shortage of doctors, not a lack of budget.

And JANITORS? Are you freaking kidding me? You don't know what the **** you are talking about, CBS. Janitorial staff is almost certainly contracted out, and if they actually have salaried janitors on staff then they would be the jewel of the Janitorial world... high paying (comparatively) janitorial jobs with a retirement plan don't grow on trees. :lol:

If the health care budget is MANDATORY spending, ...

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Again, stop pretending like you understand these things. You don't. I mean, you'd think you'd have learned to drop that nonsense once it was pointed out to that that in the period you are complaining about it was MANDATORY BUDGET that was cut while DISCRETIONARY BUDGET was increased. How does mandatory budget decrease if Congress can't change it? *(Hint: They can change it and you look foolish)

Make the plant and building budget discretionary, they can do without remodeling the lobbies and atriums every other year.

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Nope, not that simple. When there is no mandatory budget for facilities you end up with lack of beds, dilapidated facilities, old equipment... etc. etc. And you'd be here bitching about the hole in the wall and why congress you mandate facilities upkeep.

As for why facilities budgets go to pianos and atriums is a larger conversation for why federal budgets are so ****ed up.

Having it the other way around is pure insanity... pages ago.[/URL]

There isn't a single hospital budget model on earth in the outside world where staffing budgets and equipment come secondary to remodeling the buildings.

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You up to speed on hospital budgeting, are ya? :roll:

But the hilarious thing about your line of argument here is that you think the private sector budgets better... but are pissed that the VA is drifting to privatized medicine. :shock: :lamo

jmotivator said:

What are you saying, then

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I don't even know if it matters to you what I am saying.
You're so bent on "winning" something rather than actually learning what's happening at the VA that you'll twist anything you can into a talking point.
It will take me hours, maybe even more, to unpack all the bull****, just for starters.

Walt Dannenberg, VA Long Beach director, just for an example...you twisted yourself into knots trying to act like I got a personal sit down with the guy where he patted me on the head and said that the mean people in the green eyeshades in Congress said he couldn't have a neurologist, or two of them.

Walt COULD be ANY VA director, it just happens he's the one I see when there's something going on that involves VA policy.
He's pretty involved. At one of the meetings, the subject of the two year SCI neuro vacancy came up.
His answer was that when the VA submitted its budget, Congress pretty much said that "this is what you're getting and we can't afford to give you more, no matter how much you need".

I did not record the meeting, so that's not his verbatim answer, but suffice it to say that the VA told Congress what they need, Congress came back with a number which was insufficient.

How you manage to twist that into me "building a house of cards where you blame discretionary budgets for lack of money for a neurologist whne, as I have showed, discretionary budgets never stopped increasing, which neans that lackof budget for a neurologist is due to VA priorities" is absolutely incredible.

VA committee members in Congress know how much the VA needs in order to hire doctors.
They know because they've been giving the VA its budget for decades, so it's nothing new.
When special interests pressure those committee members to pursue an agenda that punishes the VA and helps private sector medical, money changes hands and the committee members do the bidding of the special interests instead, and the VA is told to be happy with what they get instead.

And when it comes to "the decision falling much closer to Dr. Dannenberg's office floor", it ALSO amounts to Dr. Dannenberg being told to be happy with what HE is getting, too.

And you KNOW that, because you're so informed when it comes to federal budgeting.
But you're not interested in how to help the VA do a better job, you're interested in proving that there is a smoking gun called VA mismanagement which is responsible for the VA not having adequate staff, because "government can't do anything right" and "the VA should be privatized" so all those nice disabled vets can get a voucher, (one that shrinks every year) a kick in the teeth and a great big smiley "THANK YOU FOR YOUR SERVICE!" as they navigate through a system which focuses on profits by denying care instead of results.

This is what I have to deal with? From the likes of a person who has never used the VA in their entire life.
So yeah, it's going to take a long time for me to unpack your bull****.
In the meantime, wifey and I have a VA appointment today...the VA is going to reevaluate the power wheelchair she is using and make a determination on whether it is time to give her a new one, one which does a better job for her.
Most likely the answer will be YES, and she will get a new one.

And the most amazing part of all of this is, I am not solely blaming Republicans.
When George W. Bush was President, he appointed Anthony J. Principi as SecVA.
The guy is a total Republican drone, and yet he did an incredible job.

For the first time in a long time, we had a SecVA who really did their best to turn the quality of service around and see to it that disabled veterans got what they needed.

Anthony Principi - Washington Post editorial - April 10, 2018

VA isn’t broken. But it’s in desperate need of change.

Checkerboard Strangler said:

I don't even know if it matters to you what I am saying.
You're so bent on "winning" something rather than actually learning what's happening at the VA that you'll twist anything you can into a talking point.
It will take me hours, maybe even more, to unpack all the bull****, just for starters.

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you were the one who brought up "winning".

Walt Dannenberg, VA Long Beach director, just for an example...you twisted yourself into knots trying to act like I got a personal sit down with the guy where he patted me on the head and said that the mean people in the green eyeshades in Congress said he couldn't have a neurologist, or two of them.

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Funny, because that is generally the intention of appear-to-authority name drops like the one you attempted.

Walt COULD be ANY VA director, it just happens he's the one I see when there's something going on that involves VA policy.
He's pretty involved. At one of the meetings, the subject of the two year SCI neuro vacancy came up.
His answer was that when the VA submitted its budget, Congress pretty much said that "this is what you're getting and we can't afford to give you more, no matter how much you need".

I did not record the meeting, so that's not his verbatim answer, but suffice it to say that the VA told Congress what they need, Congress came back with a number which was insufficient.

How you manage to twist that into me "building a house of cards where you blame discretionary budgets for lack of money for a neurologist whne, as I have showed, discretionary budgets never stopped increasing, which neans that lackof budget for a neurologist is due to VA priorities" is absolutely incredible.

VA committee members in Congress know how much the VA needs in order to hire doctors...

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Again, if there is a vacant position at the VA it is because there is a FUNDING stream dedicated to it. If there is a need with no vacancy it is because the VA chose not to open a position. It's that simple. Your lobbyist pamphlet that masquerades as research created a false impression of a surgeon who makes $350k at the VA leaving the VA, or not accepting a job, when they could make $700k in private insurance.

That bull**** comparison has no more bearing on reality than saying that privately employed surgeon making $200k could be making $350k working for the VA. It's just nonsense.

The shortage of doctors at the VA is the same as the shortage of doctors in the private sector. You have built a series of falsehoods that don't mesh with the facts that you use to justify your belief that your experiences are caused by the evil Republicans and Trump. They aren't. In fact, your argument is easily disproven with the data and some actual knowledge of how government budgets work.

jmotivator said:

you were the one who brought up "winning".

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No, in all honesty, I brought up "kicking your ass", which isn't winning at all, because there is no payoff for me.
I don't "win" anything, not DP notoriety, not a better experience at the VA, and most likely you continue through the rest of your life believing what you believe right now, that the VA cannot possibly do a decent job.
And DP members don't win either, because this abortion is sitting in the middle of a thread about GM, because you had to inject comments about the VA in a thread not even VA related.
What do I win? Not a thing.

jmotivator said:

Funny, because that is generally the intention of appear-to-authority name drops like the one you attempted.

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Oh yeah, a VA head is a name drop. Was he on the red carpet or at the Oscars?

jmotivator said:

Again, if there is a vacant position at the VA it is because there is a FUNDING stream dedicated to it.

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Made available because a Congress decided to supply sufficient money to "opening said funding stream"...or NOT.

jmotivator said:

The shortage of doctors at the VA is the same as the shortage of doctors in the private sector.

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Many VA medical personnel are veterans themselves, and choose to work at the VA because it's a great way to transition out of the military and into a residency training program, and obviously a great way to serve their brothers and sisters in uniform.

In the editorial by Principi referenced above, the former SecVA echoed my earlier recommendation to MERGE DoD and VA healthcare systems. That's because he was talking about it from the first day he took over the VA.
That would save money, increase efficiency, allocate more resources where needed, and even in some cases allow VA to utilize underused DoD medical facilities or vice versa, which could also be a cost saving measure.
Unlike YOU, I actually LISTEN and try to LEARN. I listened to Mr. Principi when I interviewed him for my little VA Wheelchair Games video project. (which he graciously consented to appear in)
Dallas Team - Wheelchair Games Long Beach CA 2003 on Vimeo

"Third, consider fully integrating the health-care systems for the VA and Defense departments. The cost of running the two systems, which serve the same people at different points in their lives, now costs taxpayers more than $125 billion annually. The ongoing effort to move the health-care systems of both departments onto the same electronic medical record system is encouraging, but that is only the first step.

We need integrated management systems, increased purchasing clout for pharmaceuticals and medical supplies, jointly developed community-provider networks, and the opportunity to share high-cost medical equipment and health-care facilities. All of this will save taxpayers money and allow both systems to refocus their efforts on providing world-class care."
----Anthony J. Principi, SecVA 2001-2005

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ALL IGNORED so far by Congress. Apparently if the DoD gets involved with veterans health care, especially DISABLED veterans health care, it won't be so easy for opportunistic Congress critters to use the VA as their punching bag anymore.
Suddenly those partisan hacks will find themselves going up against the eight hundred pound gorilla, instead of the health care equivalent of The US Post Office.
They might even find a few members of Joint Chiefs of Staff breathing down their necks.

Checkerboard Strangler said:

No, in all honesty, I brought up "kicking your ass", which isn't winning at all, because there is no payoff for me.
I don't "win" anything, not DP notoriety, not a better experience at the VA, and most likely you continue through the rest of your life believing what you believe right now, that the VA cannot possibly do a decent job.
And DP members don't win either, because this abortion is sitting in the middle of a thread about GM, because you had to inject comments about the VA in a thread not even VA related.
What do I win? Not a thing.

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Boy, for someone who is "winning" you sure have abandoned an awful lot of talking point. :roll:

Oh yeah, a VA head is a name drop. Was he on the red carpet or at the Oscars?

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Is that a requirement for an appeal to authority fallacy? Nope. You pulled his name and pretended that he gave an example that couldn't be refuted. It could, because what you attributed to Dr. Dannenberg is utter nonsense.

Made available because a Congress decided to supply sufficient money to "opening said funding stream"...or NOT.

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Again, false. Stop pretending that you know what you are talking about. If there is a position at the hospital then it has funding. That is how the process works. If there is no position at the hospital then the HOSPITAL chose not to open a position.

Many VA medical personnel are veterans themselves, and choose to work at the VA because it's a great way to transition out of the military and into a residency training program, and obviously a great way to serve their brothers and sisters in uniform.

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Absolutely. And?

In the editorial by Principi referenced above, the former SecVA echoed my earlier recommendation to MERGE DoD and VA healthcare systems. That's because he was talking about it from the first day he took over the VA.
That would save money, increase efficiency, allocate more resources where needed, and even in some cases allow VA to utilize underused DoD medical facilities or vice versa, which could also be a cost saving measure.

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Well, Principi agrees with me, based on that article, that the VA is mismanaged. Glad to see it. Granted, he was only acting secretary for 4 months 26 years ago... but still.

Oh hey, by the way, guess who also has a doctor shortage? (Hint: It's initials are D.O.D.)

But yeah, we'll take the DOD that has a doctor shortage, and the VA that has a doctor shortage, and we will "MERGE" them (in all caps) and TA DA! No doctor shortage! :roll:

Unlike YOU, I actually LISTEN and try to LEARN. I listened to Mr. Principi when I interviewed him for my little VA Wheelchair Games video project. (which he graciously consented to appear in)

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There is your narcissism shining through. My disagreement with you doesn't mean I don't "listen and learn". :roll:

Also, is that 30 second clip saying "hooray for the VA Wheelchair Olympics" the "interview" he gave? If not, can you tell what point in the video the full interview is?

ALL IGNORED so far by Congress. Apparently if the DoD gets involved with veterans health care, especially DISABLED veterans health care, it won't be so easy for opportunistic Congress critters to use the VA as their punching bag anymore.
Suddenly those partisan hacks will find themselves going up against the eight hundred pound gorilla, instead of the health care equivalent of The US Post Office.
They might even find a few members of Joint Chiefs of Staff breathing down their necks.

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You still don't know what you are talking about. You are a great example of the problems with state run healthcare, you assume that it can be as nimble as the private system, or should be, and yet you don't have the foggiest notion of how huge bureaucratic government programs actually function. You want something it will NEVER be able to provide.