As many thoughtful Americans will spend some part of today remembering the enormous sacrifices made by our veterans, this particular Memorial Day can hardly remain removed from the series of highly disturbing revelations surrounding the Department of Veterans Affairs (VA) scandal. The sad treatment of America’s servicemen and women has only been exacerbated by their Commander-in-Chief’s cold response, with dishonest claims that the President only learned about VA problems in the news and that he needs more time to “review” the situation.
That was his assessment following his meeting with VA Secretary Eric Shinseki last Wednesday. And while the president expressed faith in Shinseki’s ability to investigate and reform the VA, that faith stood in stark contrast to the American Legion’s viewpoint. The nation’s largest veteran’s group called for the Shinseki’s resignation along with those of his top two administrators. “His patriotism and sacrifice for this nation are above reproach,” said American Legion national commander Daniel Dellinger. “However, his record as head of the Department of Veterans Affairs tells a different story. It’s a story of poor oversight and failed leadership.”
President Obama isn’t there yet. “Well, we have to find out first of all what exactly happened,” Obama said Wednesday in response to a question asking why as many as 40 veterans could have died awaiting treatment at the VA in Phoenix. He continued:
And I don’t want to get ahead of the IG report or the other investigations that are being done. And I think it is important to recognize that the wait times generally — what the IG indicated so far, at least, is the wait times were folks who may have had chronic conditions, were seeking their next appointment, but may have already received service. It was not necessarily a situation where they were calling for emergency services. And the IG indicated that he did not see a link between the wait and them actually dying. That does not excuse the fact that the wait times in general are too long in some facilities. And so what we have to do is find out what exactly happened.
Really? Shortly after the 2008 election, VA officials warned the Obama-Biden transition team about VA failures regarding waiting times and appointment scheduling. “This is not only a data integrity issue in which [Veterans health Administration] reports unreliable performance data; it affects quality of care by delaying — and potentially denying — deserving veterans timely care,” the officials wrote. In 2010, an internal VA memo revealed that officials again warned of “inappropriate scheduling practices” to cover up excessive waiting times for veterans seeking appointments.
Even more telling, the VA has already admitted that the deaths of 23 veterans were linked to delays in endoscopy screenings looking for possible gastrointestinal cancer in 76 patients. Twenty-seven different VA hospitals were involved, the worst offender being William Jennings Bryan Dorn veterans hospital in Columbia, S.C. Delays in screenings for 20 patients resulted in six deaths.
Rep. Jeff Miller (R-FL), chairman of the House Veterans Affairs Committee characterized those deaths as “heartbreaking,” but noted that no one had been held accountable, despite the fact that “most” of the deaths occurred in 2010 and 2011. Miller had even more ominous news to deliver last Thursday. “We’ve received some information and some tips that will make what has already come look like kindergarten stuff,” he told CNN.
If such realities truly matter to Obama, his prepared remarks following his meeting with Shinseki were hardly inspiring, especially regarding accountability. “First, anybody found to have manipulated or falsified records at VA facilities has to be held accountable,” he warned. “The inspector general at the VA has launched investigations into the Phoenix VA and other facilities, and some individuals have already been put on administrative leave.”
Administrative leave hardly cuts it, and members of the House of Representatives were more than up to the task of addressing that reality. The “2014 VA Management Accountability Act” that would give VA Secretary “greater authority” to dismiss the poor performers in the Senior Executive Service “in the same manner a member of Congress can remove a member of their staff,” passed that chamber by a 390-33, veto-proof majority. “President Obama is known for talking about accountability without ever holding anyone accountable,” House Majority Leader Eric Cantor said before the vote.
On Thursday, the Democratically-controlled Senate blocked the bill. Senate Majority Leader Harry Reid noted it was “not unreasonable,” but said he wants to wait for Senate Veterans’ Affairs Committee Chairman Bernie Sanders (I-VT) to work on his own version. Sanders objected to the House legislation, insisting more time was needed to study some of the bill’s provisions. He promised to look at this bill and other pieces of legislation beginning some time in June.
House Speaker John Boehner (R-OH) castigated such political tone-deafness. “As we head into the Memorial Day weekend, I am disappointed, and frankly shocked that Senate Democratic leaders chose to block legislation that would hold VA managers accountable,” he said in a statement. “As we head home to honor the men and women who have sacrificed so much for our freedom, it’s fair to ask why Senate Democrats won’t stand up for more accountability?”
Perhaps they’re taking their cues from the president. It was Obama who spoke in banal generalities, noting that veterans “are the best that our country has to offer,” and while people “are angry and want swift reckoning…we have to let the investigators do their job and get to the bottom of what happened.” Obama also attempted to distance himself, Shinseki and the rest of his administration from the scandal, insisting VA malfeasance “has been a problem for decades, and it’s been compounded by more than a decade of war. That’s why when I came into office, I said we would systematically work to fix these problems, and we have been working really hard to address them.”
How hard? Last Monday White House Press Secretary Jay Carney claimed the White House learned about the fiasco in Phoenix from CNN reports disseminated in April.
As for the allegations regarding the deaths of 40 veterans at that facility, the acting VA inspector general claims that 17 of them cannot be attributed to excessive wait times. “We didn’t conclude, so far, that the delay caused the death,” said Richard Griffin at a Senate hearing last Thursday. “It’s one thing to be on a waiting list, it’s another for that to be the cause of death.”
Perhaps, but such a statement is disingenuous. Cause of death is invariably attributable to a medical condition. Thus it would seem that determining how badly a particular medical condition was exacerbated—to the point of death—by a lack of timely care is a highly subjective exercise. Griffin cautioned that the investigation remains large in scope. “Part of this review could lead to criminal charges being brought,” he warned.
The main whistleblower at the Phoenix VA was Dr. Sam Foote, who wrote a piece in the New York Times explaining why he became one. “I knew about patients who were dying while waiting for appointments on the V.A.’s secret schedules, and I couldn’t stay silent,” he writes, further noting he got no response to two letters he wrote to the VA inspector general. And while he has “faith” the current investigative team is doing a good job in Phoenix, he has “very little” confidence in the internal V.A. inspection conducted by Shinseki through the Veterans Integrated Service Network. “The difference is between trained investigators from the Department of Justice whose job it is to ferret out waste, fraud and abuse — lying to them can trigger criminal penalties — and V.I.S.N. office workers who ask a few questions of clinic staff members who may be afraid to speak the truth out of fear of retribution,” he explains.
He offers an alternative solution:
have Debra A. Draper, the director of the Health Care Government Accountability Office, conduct an anonymous electronic survey of primary care providers, nurses and clerks at every V.A. hospital and clinic across the nation to find out what they think the real new and returning patient waiting times are. Then her team should give the hospital administrators a one-week amnesty period to report their own version of the waiting times. If the numbers match, then you have reliable data. If they don’t, then send the inspector general out to audit them. If the hospital administrators have fudged their data, fire them and prosecute them to the maximum extent under the law.
Unfortunately, he suspects that idea will go nowhere. “Any scandal that befalls the V.A. necessarily lands on the party that is in the White House,” he explains. “As this is an election year, we can expect that there will be significant pushback to delay and limit the discovery of negative information — which is why I expect my suggestions to be vehemently opposed by the White House and the V.A.’s upper management.”
Add Senate Democrats to the list. Despite calls for Shinseki’s ouster from Republicans and the American Legion, not a single Democratic Senator jumped on the bandwagon. Sens. Jeff Merkley (D-OR) and Kay Hagan (D-NC), both of whom are in tight reelection races, demanded that “those responsible” be “held accountable,” but such generalities are unlikely to mollify veterans and their supporters.
In the meantime, the hits keep on coming. At Malcom Randall VA Medical Center in Gainesville, Fl. an audit team discovered a list of veterans awaiting followup appointments being kept on paper instead of in the computer system. Three members of the supervisory staff have been put on paid leave pending the investigation’s outcome. At the Huntington VA Medical Center in Charleston, W.Va., a doctor employed from 2008-2010 claimed she was also told to delay appointments. Dr. Margaret Moxness claimed this was done even as she told supervisors they needed immediate care. She alleges two patients committed suicide in the interim. “They don’t really experience what the doctors and nurses are experiencing, which is the suffering and the pain and the death,” she said.
That brings the list of those who have stepped forward to eleven—not counting the 310 submissions as of May 19 to the encrypted website run by the Project on Government Oversight (POGO) and the Iraq and Afghanistan Veterans of America, who are in the process of soliciting VA “horror stories” from the public, veterans, and VA employees who comprise “less than 10 percent” of those submissions. Yet even 5 percent means another 15 or 16 VA employees may have more insight to offer on the deception and fraud being perpetrated by the VA.
On Saturday, the administration did offer one common sense solution to the backlog of appointments, announcing that it will allow veterans to receive more care at outsized facilities. “VA has redoubled efforts to provide quality care to veterans and has taken steps at national and local levels to ensure timely access to care,” the department said Saturday in a statement.
This then is the current state of affairs on Memorial Day. And while ongoing investigations are warranted, the notion that the president and/or Secretary Shinseki can’t begin a massive shakeup of this agency beginning right now is utterly absurd. Equally absurd is the president’s “I only learned about this scandal when the public did” excuse. It is the same one he used following revelations about the Fast and Furious gunrunning scandal, and the IRS’s unwarranted scrutiny of tax-exempt conservative groups, and it grows as stale as it does incredulous.
It is more than a little ironic that the VA’s failure to see veterans in a timely manner is exactly the wait-and-see attitude embraced by the president and the VA Secretary. Perhaps both men should be asked how many more veterans will experience “the suffering and the pain and the death” such bureaucratic torpor produces in the interim. It is a question that hangs over this Memorial Day like a shroud.
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