Friday, 23 May 2014

The VA Scandal in Brief: Yes, It's Bad

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The emerging cover-up of long waiting periods for care at Veterans Administration hospitals has burgeoned into national news in recent weeks, with “secret waiting lists” being exposed in half a dozen or more locations and President Obama calling for an inspector-general inquiry into the matter. 

The scheme to cover up long waits at VA hospitals worked like this: The local VA administrators in numerous VA hospitals would not officially book an appointment — however direly needed — until an opening in a doctor's schedule came up, essentially keeping a waiting list to get onto the official waiting list. In other instances, the politicians in charge of the facilities would constantly cancel and reschedule appointments in order to make it appear that the overwhelming majority of appointments were made within the VA's stated goal of a 14-day window. This allowed administrators to boast they had moved toward compliance with the 14-day mandate coming out of Washington. “Yes, this is gaming the system a bit,” a supervisor's e-mail sent to Cheyenne, Wyoming, workers acknowledged. "When we exceed the 14 day measure, the front office gets very upset, which doesn't help us." The e-mail had been sent by a VA worker-turned-whistleblower to CBS News May 9.

Despite claims by administrators that waiting times were shorter under the Obama administration, actual waiting times by veterans were often months or longer. American Legion National Commander Daniel Dellinger testified May 15 before Senate Veterans Affairs Committee, “While a veteran might wait more than two weeks for most primary care appointments, specialty care appointments can take many months or even years.”

The scandal — while simmering for months or even years — made national news with an investigation into the Phoenix, Arizona hospital. But in recent weeks various news outlets have reported similar incidents in Albuquerque, New Mexico; Ft. Collins, Colorado; Cheyenne, Wyoming; Austin, Texas; and Atlanta, Georgia. More instances of “secret waiting lists” are expected to be revealed in the coming months. The Atlanta ABC-television affiliate WSB-TV claimed “hundreds” of deaths since 2001 in an investigation. 

Perhaps the biggest break in the story was an April 30 report by CNN, which noted, “The secret list was part of an elaborate scheme designed by Veterans Affairs managers in Phoenix who were trying to hide that 1,400 to 1,600 sick veterans were forced to wait months to see a doctor, according to a recently retired top VA doctor and several high-level sources.... Internal e-mails obtained by CNN show that top management at the VA hospital in Arizona knew about the practice and even defended it.” 

Drew Griffin of CNN interviewed the director of the Phoenix facility, Sharon Helman and the chief of staff, Dr. Darren Deering on May 1, and when Griffin asked Deering, "Have you found instances where veterans are on the waiting list and have died?" Deering replied, "Yes."

CNN noted that “as many as” 40 deaths are attributable to the Phoenix hospital alone and that as late as May 23 of this year, veterans are still waiting as long as 55 days for an appointment.

The day after CNN's April 30 broadcast, Phoenix VA Director Sharon Helman, Associate Director Lance Robinson, and a third person were put on administrative leave by President Obama. Dr. Robert Petzel, under secretary for health in the Department of Veterans Affairs, resigned May 16. Some have called for the firing of Secretary of Veterans Affairs Eric Shinseki over the issue, even an increasing number of Democrats in Congress.

The care of veterans — and even active duty military personnel — has long been plagued with scandal, from a scathing 2001 General Accounting Office report on care of veterans to the 2007 Washington Post exposé on unsanitary conditions at Walter Reed Army Medical Center. Even corruption with local hospitals making fraudulent claims is nothing new. A 2010 internal VA memo published by the American Legion revealed that the deputy under secretary for health operations and management told VA employees: “It has come to my attention that in order to improve scores on assorted access measures, certain facilities have adopted use of inappropriate scheduling practices sometimes referred to as ‘gaming strategies.’”

Supporters of the current system tout polls (such as a Rand Corporation 2004 study) that demonstrate veterans have usually rated VA care higher than that given to the general public. But it should hardly be surprising that people would rate something they get for free higher than something for which they'd otherwise have to pay thousands of dollars.

President Obama has long made a cause out of health care for veterans, saying in a March 19, 2009 speech still featured on the White House website: “We also owe our veterans the care they were promised and the benefits that they have earned. We have a sacred trust with those who wear the uniform of the United States of America. It's a commitment that begins at enlistment, and it must never end. But we know that for too long, we've fallen short of meeting that commitment. Too many wounded warriors go without the care that they need. Too many veterans don't receive the support that they've earned."

Conservative columnist Ben Shapiro has noted that Obama and his supporters have often touted the VA as a model to follow in setting up ObamaCare. But if waits of months or years is the standard for health care, is it really better actual care than a private system when under ObamaCare many Americans will see their health care premiums double?

President Obama has attempted to put a good face on the scandal, claiming in a May 21 press conference, “We have made progress over the last five years. We’ve made historic investments in our veterans. We’ve boosted VA funding to record levels. And we created consistency through advanced appropriations so that veterans organizations knew their money would be there regardless of political wrangling in Washington.”

Likewise, White House Press Secretary Tim Carney noted May 21 that problems with VA care predated Obama: “I think the president made clear that the issue of problems in the VA with access to health benefits has been with us as a country for a long time and has been exacerbated by the fact that we are at the backend of a more than decade-long period of war, where we’ve seen a significant increase in our veterans — in the number of veterans and in the number of veterans who need disability benefits and health services.  And that has been a challenge for the VA for a long, long time — certainly for the past decade or more.  So that’s, as he said today, the President said today, that’s not a new issue.” 

Clearly, veterans need to receive their contracted health care benefits. But if one can expect long waits regardless of the party in charge in Washington, is expanding VA care to encompass the entire nation really a good idea?

Photo of the Phoenix VA Health Care Center: AP Images

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