Veterans Affairs and Death by Bureaucracy

by Arnold Ahlert

 

There may finally be a scandal engulfing the Obama administration that even Democrats and their media collaborators can’t obfuscate. What happened at the VA facility in Phoenix, AZ, where employees created two sets of waiting lists to make it seem patients were being treated in a timely manner—and as many as 40 veterans allegedly died while languishing on the secret list—is an anomaly. Six more whistleblowers from around the nation have stepped forward, alleging the Department of Veterans Affairs (VA) facilities they worked at also "cooked the books."

The despicable subterfuge, allegedly occurring in at least seven VA Medical Centers in Arizona, Colorado, Pennsylvania, Georgia, Texas, North Carolina and Illinois is as simple as it was heartless. The official waiting list is the one that ostensibly met the VA’s policy, implemented by Secretary of Veterans Affairs Eric Shinseki in 2010. It set a 14-day time limit to provide care for a veteran making an initial application for an appointment. Yet by the agency’s own admission, only 41 percent of new VA medical patients were seen within that period in 2013, down from 90 percent in 2012.

Hence, the secret lists, which contained the names of veterans waiting to get on the official list. In Phoenix, as many as 1,400 to 1,600 veterans were forced to wait for months before they could see a doctor. "The scheme was deliberately put in place to avoid the VA’s own internal rules," said Dr. Sam Foote, a 24-year Phoenix VA physician who blew the whistle on the scam in that facility. He and other sources further noted that VA officials instructed the staff to avoid using the computer system to make appointments. When a veteran requested an appointment, staff were instructed to do a screen capture, print out the info, and dump the computer file "so there’s no record that you were ever here," Foote explained.

A second VA in Fort Collins, CO also falsified their lists, according to findings by the VA’s Office of Medical Inspector. But there, where as many as 6,300 veterans waited months to be seen, if clerical staff allowed records to reveal veterans waited longer than 14 days for an appointment, they were placed on a "bad boy list" as punishment.

Sadly, none of this is new. During last Thursday’s Senate Veterans Affairs Committee hearing, Sen. Johnny Isakson (R-GA) quoted from a previously undisclosed nine page memo written in 2010. In it, a VA administrator described the various ways healthcare officials "gamed the system" to hide delays in medical treatment. And according to an Army Times, editorial, a December 2012 report by the Government Accountability Office (GAO) revealed that "four VA medical centers nationwide hid wait times, fudged data and backdated appointments for the purpose of fabricating compliance with department timeliness goals." The paper further notes in the 18 months since that report was released, the VA "is still widely failing in its charge to provide timely medical care for the nation’s veterans as demand for those services grow."

The AT editorial also called on Shinseki to "step down," noting that despite his selfless service to the nation, his "behind-the-scenes" leadership style makes him the wrong person to engineer the "comprehensive, system-wide rebuild" the VA desperately needs.

Last Thursday, in his own testimony before the Committee, Shinseki buttressed the paper’s contention, characterizing the current state of VA healthcare as "a good system," and denying the link between long waits and the deaths of veterans. "It’s one thing to be on a waiting list, and it’s another thing to conclude that as a result of being on the waiting list, that’s the cause death," he contended.

Perhaps so, but mathematical probability suggests otherwise. Over 300,000 claims to the VA have been pending for 125 days or longer, meeting the VA’s official definition of "backlogged." Nonetheless, the VA, and the White House as well, are apparently staying with the "no causal connection" motif for now. Thus, Shinseki’s assistant, Dr. John Daigh, echoed his boss’s contention, insisting the "conclusion between patient harm and death has so far been a tenuous connection." White House Press Secretary Jay Carney was equally skeptical regarding the Phoenix scandal. "You’re saying there’s a suggestion that something terrible happened in Phoenix, and that’s under investigation; all we know is it’s a suggestion," he said during a Friday press briefing. "We should just accept allegations as true without investigating them?"

Yet even as Carney was speaking, it was announced that Under Secretary for Health in the Department of Veterans Affairs Dr. Robert Petzel had tendered his resignation. Some in the media tried to portray that resignation as a "political casualty," but a 2013 press release on the VA’s website revealed Petzel was due to retire this year, "as planned."

That’s probably a good thing. Like Shinseki, he also refused to commit to firing anyone responsible for maintaining the secret waiting lists, telling Sen. Johnny Isakson (R-GA) at Thursday’s hearing that he didn’t know "whether that’s the appropriate level of punishment or not."

His and Shinseki’s contentions were seemingly at odd with those of Richard Griffin, the department’s acting inspector general. He admitted that a review of the VA’s seeming indifference towards veterans could lead to criminal charges. "My staff is working diligently to determine what happened in Phoenix and who should be held accountable," Griffin said, adding that the investigation is expected to be completed sometime in August.

Veterans groups have no interest in waiting to see what unfolds. On Thursday, the Iraq and Afghanistan Veterans of America (IAVA) and the Project on Government Oversight (POGO) took matters into their own hands. They launched VAOversight.org, a website aimed at giving VA officials and veterans the opportunity to expose any other scandalous behavior occurring in the system. "It takes a lot of courage to step forward and put one’s career at risk," said POGO’s executive director Danielle Brain in a statement. "Whistleblowers shouldn’t have to go it alone. We can help whistleblowers hold the VA accountable, and keep the focus on solutions rather than attempts to hunt down those who voiced concerns."

The site contains detailed training regarding how to get around the Obama administration’s intense anti-leak efforts. POGO communications director Joe Newman explained the necessity for such training. "What we’ve seen with the Obama administration is the lengths they will go to try to keep things in house," he said.

Newman continued. "The thing that makes the Obama administration really stand out is the use of the Espionage Act. They’ve invoked it seven times [against leakers] and that’s more than every other administration combined when it comes to going after people who have leaked to the media," he explained.

In fairness to the VA, the problems it is dealing with are monumental in scope. It has 152 hospitals and 817 outpatient clinics attempting to service an unprecedented amount of claims resulting from the wars in Iraq and Afghanistan, as well as the Obama administration’s 2010 expansion of eligibility criteria for veterans of all wars. A record-setting 1 million new claims were filed in Obama’s first year in office, a number that climbed to 1.3 million in 2011, before falling to 1.04 million claims received last year. The more than 970,000 Iraq and Afghanistan veterans who have filed disability claims have taken the total number of veterans enrolled in the VA system to 8.57 million, and the number of outpatient visits at its facilities has increased from 46.5 million in 2002 to 83.6 million in 2012.

On the other hand, budget outlays appear to have kept pace with the surge, rising from $73.1 billion in 2006 to $153.8 billion this year.

"I am amazed this is still happening, given the big increase in resources that the department has received," said Phillip Carter, a former army officer who researches veterans’ issues at the Center for a New American Security in Washington.

What hasn’t kept pace is the bureaucracy itself, especially with regard to technology. Until last year, it had no way to process claims digitally. And as U.S. News and World Report revealed, the same kind of sclerotic bureaucracy that has dogged ObamaCare was in play here as well. "Since 2008, the Departments of Defense and Veterans Affairs have spent over $1 billion to create an integrated electronic health record. Four years and $1 billion later, not a single line of code has been implemented," the magazine revealed.

Moreover, the coding system they do have for processing claims is unnecessarily complex. Ronald Abrams, joint executive director for the National Veterans Legal Services Program gave lawmakers a hint how complicated last year. "The regulation dealing with [traumatic brain injury] is so complicated that some people call it the ‘Da Vinci Code,’" he said. More workers were hired to address the issue, but training them takes two years—due to the complexity of the process.

And then, there are the bonuses. In this case, there’s a strong possibility that bonuses based on performance created a perverse incentive to lie. Germaine Clarno, employed as a VA social worker and employee representative in Chicago, alleges there are multiple secret waiting lists at the Hines VA Medical Center used by officials there "to make numbers look better for their own recognition and for bonuses." In Phoenix, $843,000 in bonuses was awarded to approximately half the system’s 3,170 workers from 2011 to 2013, despite the aforementioned deaths of veterans unable to get treatment in a timely manner.

If two Democratic senators are any indication, that party is fully intending to distance itself from any obfuscation by the VA or the Obama administration. At Thursday’s hearing, Sen. Richard Blumenthal, (D-CT), said there was "solid evidence of wrongdoing within the VA system," and Patty Murray (D-WA) told Shinseki that "the standard practice at the VA seems to be to hide the truth."

Republicans are even blunter. Rep. Blake Farenthold (R-TX) has filed a resolution urging President Obama to fire Shinseki, due to his "poor oversight" and "an unwillingness or inability to change the culture of falsifying documents at the Department of Veterans Affairs."

What the president plans to do is unknown at this point, but if Attorney General Eric Holder is any indication, the administration seemingly believes it can weather yet another burgeoning scandal. Last Tuesday, Holder announced he has no plans to investigate the allegations against the VA. "Well, obviously these reports if they’re true are unacceptable, and the allegations are being taken very seriously by the administration. But I don’t have any announcements at this time with regard to anything that the Justice Department is doing," Holder told reporters at a press conference.

In the meantime, two more whistleblowers came forward on Friday. "What really bothered me was that this delay was a direct result of this extremely low sense of caring for the patient," said Dr. Jose Mathews, chief psychiatrist for the VA Medical Center in St. Louis starting in Nov 2012. He alleged that doctors treating veterans with post-traumatic stress disorders and other acute mental health issues were only working a few hours a day, even as the facility was reporting that its productivity was the highest in the nation. "They all got bonuses — that’s the sad part. Because in reality we were not really doing a good job, but it shows up on paper as if we are," Mathews told Fox News.

Dr. Richard Krugman accused the VA facility he oversaw in southeast Texas of cutting costs—by delaying life-saving colonoscopies.

Both men were fired from their jobs. "I was treated like an animal. I was treated like a leper. I was treated like, how dare you attack me, or how dare you say what you’re saying," said Krugman. The Office of Special Counsel found none of Krugman’s claims to be substantiated, but noted that they were forced to rely on an internal investigation—conducted by the VA itself.

In the end, one reality cannot be denied: while the political machinations, the hearings, the media stories and the investigations play themselves out, men and women who served this nation—and in many cases paid an extremely heavy price for that highly honorable commitment—are getting the short end of the stick. The very least this nation owes our veterans is timely healthcare, not a litany of excuses and stonewalling from a dysfunctional and very likely corrupt bureaucracy. One like every other government bureaucracy, where self-preservation matters above all else.

If there is little else Americans learn form this scandal, it should be noted that this is the true face of government-run healthcare, in all its "individual be damned" glory. If the government can treat 8.57 million veterans this shabbily, imagine how they will treat Americans forced to enroll in ObamaCare.

Arnold Ahlert

Source: http://www.frontpagemag.com/2014/arnold-ahlert/veterans-affairs-and-death-by-bureaucracy/

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