Spring 2000. Pre-Obama. Pre-Twin Wars....In the General Accounting Office report, "VA Needs Better Data on Extent and Causes of Waiting Times” the auditors concluded that “although VA has begun to collect data systematically on waiting times for outpatient care, it has yet to develop reliable national waiting time data. In the meantime, thousands of eligible veterans await primary care.”
IN 2000! Pre-Afghanistan. Pre-Iraq. It only got worse, much worse, after that.
BOTTOM LINE: Embattled VA Secretary Eric Shinseki is dealing with a 14 year old problem. But GOP outrage would lead the uninformed to assume that the Obama administration is at fault start to finish.
UPDATE 10:26 AM 5/30/14: WASHINGTON —
President Obama said Friday that Veterans Affairs Secretary Eric Shinseki will resign in the wake of systemic problems with the health care for veterans. Obama said he regretted accepting the resignation, but "the VA needs new leadership" and he agreed with Shinseki that he has become a distraction. "We don't have time for distractions," Obama said. "We need to fix the problem." http://www.usatoday.com/...
Sen. John McCain, R-Ariz., Rep. Jeff Miller, R-Fla., chairman of the House Committee on Veterans Affairs, and other GOP have been crying for Shinseki's head and now Democrats in tight re-election bids are now joining in.
In February the GOP had a chance to show its REAL support for Vets. The Comprehensive Veterans Health and Benefits and Military Retirement Pay Restoration Act of 2014 was supported by every major veterans' organization. The Paralyzed Veterans of America stated that "This legislation marks one of the most comprehensive bills to ever be considered in the Senate or House." The PVA went on to state that, "If enacted, S. 1982 would accomplish some of the highest priorities for Paralyzed Veterans and its members."
On February 26, 41 Senate Republicans voted against the bill. McCain vote "No." The House Committee chaired by Miller did not move to put the measure on the House floor.
But the GOP was the voice of hypocrisy long before February of this year.
Begin with these startling numbers: Since the U.S. went to war in Afghanistan in 2001 and Iraq in 2003, about 2.6 million members of the Army, Navy, Marines, Air Force, Coast Guard and related Reserve and National Guard units were deployed in the two wars theaters of operation, according to the Department of Defense. More than a third were deployed more than once. Half of that number served three or more tours. 2.7 million served in Vietnam.
The newest Inspector General's report that those crying for action keep citing points out that since 2005, the IG has issued 18 reports that identified “deficiencies in scheduling resulting in lengthy waiting times and the negative impact on patient care.” The report also cites the projections based on the wars in Afghanistan and Iraq made by the Defense Department that made it clear that the VA required a complete overhaul of services if it was to cope with that massive influx of new veterans and their families. The reports noted that Bush administration efforts in this area had been minimal.
The Bush administration, while making supportive noises did little. In fact, the VA was deprived of budget increases throughout the Bush years. AND the VA fudged the facts during those years too...
“If you dug deep, you would undoubtedly find references to inappropriate scheduling activity and gaming the system at VA offices as far back as you want to track it,” Jim Strickland notes. Strickland is a Vietnam-era veteran and advocate who runs VAwatchdog.org, which uncovered a document-shredding scandal at the Detroit VA in 2008.
Strickland said Detroit staff would take claims coming in the door from veterans, but “they would not process them. Instead, the claims were shredded. We found out about this because of a veteran whistle-blower at that VA. It’s the same kind of thing we are reading about now across the country. ... It's been going on at VA for years and years.”
In addition to the 18 past reports from the IG, there are at least 30 from the GAO that point to chronic, systemic problems at the VA dealing with issues related to access, claims processing, diagnosis, and delivery of services.
In its 2005 audit, the IG concluded that managers at VA hospitals were telling schedulers to create false wait times. The IG wrote, “Schedulers did not follow established procedures when selecting the type of appointment and when entering the desired appointment date into VistA. In some cases, supervisors instructed schedulers to create appointments contrary to established scheduling procedures.”
In 2007, the IG said the VA had failed to address the issues it had cited in 2005 and that the accuracy of reported waiting times could still “not be relied on and the electronic waiting lists at those medical facilities were not complete.” Further the IG declared that "Waits for service are growing exponentially, a direct result of the size of the force in two war theaters."
A primary motivation for VA executives to manipulate wait times was to receive bonuses and advancements, which was true as far back as 2007, when the agency was caught in a related scandal.
When the issues of long wait times became widely publicized the VA implemented a system of metrics to ensure proper scheduling took place. Once the system was in place, it didn’t take long for the various offices to figure out how to game the system rather than do their job.
“It’s safe to say this (situation) has a timeline going back to at least 2000. It’s not something new.” said Thomas Bandzul, legislative counsel for Veterans and Military Families for Progress and past associate counsel for Veterans for Common Sense,
President Barack Obama's critics have hammered him for failing to fix the dysfunctional agency. But he joins a line of U.S. presidents going back to Calvin Coolidge who have struggled to reform the bureaucracy meant to care for those who served in America's armed forces.
The agency has had dozens of scandals, been investigated time and again and reorganized at least six times. BUT....the Bush years set new records for creating conditions (think two wars) guaranteed to crash the VA.
MORE BELOW THE FOLD
President George W. Bush pledged to clean up the agency only to be inundated with new claims of incompetence and complaints about a lack of service as a result of the wars in Iraq and Afghanistan.
“Veterans’ claims are often poorly handled, and many veterans are not treated as well as they should be by the healthcare bureaucracy,” Bush said at the swearing-in of Anthony Principi as secretary of VA. “Tony and his department will set new goals for better service.” Principi was later implicated in an audit that found a California company he headed had overcharged the VA some $6 million under a long-term contract to conduct physical evaluations on veterans applying for disability benefits.
In 2007 Robert Nicholson Bush's second Secretary of Veterans Affairs put in place measures that were supposed to reduce waiting times from 30 days to 14 days by 2011. Those measures, his successor James Peake later conceded, were difficult to sustain, and may have inspired VA staff to “game the system” to make it appear that treatment was being given in a timely manner. In fact an audit in 2009 found that the actual waiting time was 6 months and that reductions in wait times were largely paper fictions.
The current problems at VA are “neither new nor unusual,” said Diane Zumatto, national legislative director of American Veterans (AMVETS).
“There can be no doubt the VA suffers from deep-seated, systemic problems and neither the department nor its employees believe that they are actually accountable to either the veterans they serve, or the American people who pay their generous salaries,” said Zumatto, a veteran herself.
Zumatto described the agency as akin to “the mythical hydra,” the multi-headed monster, and said that when problems arise, the solution is to “either throw money at it or chop it off. Before we know it, more problems pop up to take its place."
"Now is the time to slay the VA hydra by effectively changing its culture," she said.
Why has the VA plagued one administration after another and vexed every Congress since 1921?
1) It is huge. 300,000 employes and a $164 billion budget.
2) It is among the most politically influenced agencies in the entire government.
3) Its client base fluctuates dramatically according to the vagaries of war.
Is funding the issue?
News reports cite the rapid increases in its budgets in the Obama years. True. A $20 billion increase. But that was after years of tight scrimping. Best estimates say that another $100 billion would be a good start in catching up on long deferred improvements.
Such as?
1) Automation of its access and processing system which is still largely a paper based structure.
2) More doctors and other medical personnel. (If every veteran were being seen now by the current medical staff the patient load would be twice the national average.)
3) An expansion of the contract system connecting it to other medical providers in their systems.
4) A triage system that identifies which veterans are best served by the specializations in VA hospitals and clinics; or who could be served just as effectively outside the VA system.
5) A significant increase in mental health related services- an area where the nation as a whole is lacking.
Sources and Further Reading:
http://www.ibtimes.com/...
http://www.nationaljournal.com/...
http://www.gao.gov/...
http://www.mcclatchydc.com/...
http://www.va.gov/...