More 'forgotten' veterans have died waiting for care

In a new revelation in the growing Veterans Affairs' scandal, the organization's acting head says that an additional 18 veterans whose names were kept off an official electronic VA appointment list have died.
AP Wire
Jun 7, 2014
Acting VA Secretary Sloan Gibson said he would ask the inspector general to see if there is any indication those deaths were related to long wait times. If so, they would reach out to those veterans' families.
 
"I will come personally and apologize to the survivors," Gibson said Thursday.
 
Gibson's remarks during a visit to Phoenix were the latest related to the scandal over long patient waits for care and falsified records covering up the delays at VA hospitals and clinics nationwide.
 
Gibson's announcement came as senior senators reached agreement on the framework for a bipartisan bill making it easier for veterans to get health care outside VA hospitals and clinics.
 
The 18 veterans who died were among 1,700 veterans identified in a report last week by the VA's inspector general as being "at risk of being lost or forgotten." The investigation also found broad and deep-seated problems with delays in patient care and manipulation of waiting lists throughout the sprawling VA health care system, which provides medical care to about 9 million veterans and family members.
 
Gibson said he does not know whether the 18 new deaths were related to wait times but said they were in addition to the 17 reported last month.
 
Richard Griffin, the VA's acting inspector general, told a Senate committee three weeks ago that his investigators had found 17 deaths among veterans awaiting appointments in Phoenix. Griffin said in his report last week the dead veterans' medical records and death certificates as well as autopsy reports would have to be examined before he could say whether any of them were caused by delays in getting appointments.
 
The bill announced Thursday by Senate Veterans Affairs Committee Chairman Bernie Sanders, I-Vt., and Sen. John McCain, R-Ariz., would allow veterans who wait 30 days or more for VA appointments or who live at least 40 miles from a VA hospital or clinic to use private doctors enrolled as providers for Medicare, military TRICARE or other government health care programs.
 
It also would let the VA immediately fire as many as 450 senior regional executives and hospital administrators for poor performance. The bill resembles a measure passed last month by the House but includes a 28-day appeal process omitted by the House legislation.
 
The bill is a response to a building national uproar over veterans' health care since a retired clinic director went public in April with accusations that management at the Phoenix VA had instructed staff to keep a secret waiting list to hide delayed care and that as many as 40 patients may have died while waiting for appointments.
 
Veterans in Phoenix waited an average 115 days for appointments — five times longer than the Phoenix VA had reported, Griffin said. Investigators also have found long waiting times and falsified records covering them up at other VA facilities nationwide, Griffin said. His office is investigating more than 40 of the VA's 1,700 health care facilities nationwide, including 150 hospitals and 820 clinics.
 
McCain said the bill was "a way to help to relieve this terrible tragedy that has befallen our nation's veterans."
 
The bill also authorizes the VA to lease 26 new health facilities in 18 states and spend $500 million to hire more doctors and nurses. Senate leaders said they hoped to bring the legislation to the floor soon but offered no specifics.
 
Meanwhile, President Barack Obama's choice to be the top health official at the VA withdrew his nomination Thursday, saying he feared his confirmation could spark a prolonged political battle.
 
Jeffrey Murawsky, health care chief for the VA's Chicago-based regional office, was nominated last month to be the department's new undersecretary for health care, replacing Robert Petzel, who had been scheduled to retire later this year but was asked to leave early amid a firestorm over delays in patient care and preventable deaths at veterans hospitals.
 
In a statement provided to The Associated Press, Murawsky said his withdrawal was "in consideration of recent events, but most importantly in the best interests of serving our nation's veterans."
 
Obama accepted Murawsky's withdrawal and will move quickly to find a replacement, the White House statement said.
 
Gibson took over the VA temporarily last Friday after former Secretary Eric Shinseki, an ex-Army general, resigned under pressure.

Comments

Straightjacket

This is a national embarrassment. When men and women defend this nation and the republicans and democrats are more focused on their self preservation than the welfare of those they send afar is unfathomable. I hope one day integrity and leadership will return to our political arena and those that do will value more what they contribute than what they take. I cannot see young people signing up for service when the politicians act like self serving children at the party cake eating all they can consume without one valid contribution to the country. How long can the charade last?

Lanivan

Once again, the focus seems to be on turning this situation into a political football and placing political blame, instead of looking at the systemic problems within the VA itself.

The VA is currently struggling with not only a massive influx of returning soldiers from two wars, needing care from spinal, knee, hearing, and brain injuries, and PTSD, and other mental issues, but also aging Korean and Vietnam War vets, who are suffering from chronic diseases, many terminal.

"The issue of wait times has plagued the Veterans Health Administration (VHA) for many years. The Department’s own inspector general has issued 18 reports on the subject since 2005, all warning that veterans were waiting too long for medical appointments. It may just be simple math – the department says that in the past year primary care visits rose 50 percent while the number of primary care doctors went up just 9 present."

http://www.opb.org/news/article/...

The other issue is the cover-up. It seems that many VA hospitals across the country gamed the system in order to comply with performance criteria and reviews, with management not held accountable and allowed to operate with very little oversight, which led to widespread corruption. This has been long in the making, with reports regarding problems going back at least to the 1990's.

In terms of the care provided, the majority of vets say they like the care they receive at VA hospitals, and would choose VA care over private care for the specialized treatments needed for their specific war injuries.

Mystic Michael

I would bet practically anything that the problem with the cover-up began when top VA officials - including those in the Secretary's office - began making unrealistic promises regarding care & performance...without ever receiving the political cover and financial support they needed from Congress in order to actually fulfill those promises.

And Congress, true to form, didn't want to hear about any additional resource requirements. They just wanted to be able to tell their constituents that "...the VA is on top of the problem" and that "...we'll be able to get the mess cleaned up - without having to spend any more of the taxpayer's money". (Not unlike the evidence-free state of complete denial that persuaded Rumsfeld, Wolfowitz & Cheney to take this country to war - with virtually no planning and no budgeting for a post-Saddam Iraq.)

So it was a failure of management - with everybody trying to "delegate" the problem down the pecking order. And since Congress was involved, that has made it ultimately a political issue as well.

So if I'm correct - and I've seen this very same dynamic at work many times - the VA middle managers, i.e. local administrators, etc., were essentially caught between a rock (Iraq?) and a hard place: They could protest to their supervisors that the ambitious promises, combined with the absence of sufficient resources, was a disaster waiting to happen - and thereby get fired for pushing back against authority. Or they could pretend to play along - and thereby keep their jobs. Which of course required a way to cover up the system's failures. And now many of them are the ones paying the price for the ill-conceived policy - even though they had nothing to do with its formation?

I'm not condoning the rampant fraud and lies. Merely pointing out that the first thing to happen when the lip blows off, is to identify and fire the scapegoats, in order to try to take the heat off everyone left. But how many of us have ever taken a giant step backward, looked at the big picture - and asked tough questions about the dysfunctional policymaking & budgeting processes that created these problems in the first place?

Or would we prefer, once again, to use it as yet another pretext by which to reflexively engage in more Obama-bashing? (Somehow, I think I already know that answer to that one.)

truthhurts

what an excuse maker you are. Did we not know for the last decade that we would be at war?

Mystic Michael

I'm guessing that barb was directed at me, yes? If so, you seem to have deliberately missed - or ignored - the point. Either that, or by misinterpreting an analysis as an excuse, you've demonstrated that you simply didn't get it. Did I use too many big words?

Let me try this one more time: Many people, in multiple government offices, share a portion of blame for the VA hospital bungle-up. That includes senior officers at the Pentagon, members of Congress, and senior officials at the Veterans Administration itself. Problem is, no one entity takes responsibility for the effective operation of VA hospitals, and each one has its own self-interest to protect - so the VA hospital system fell through the cracks. Are you with me thus far?

The Pentagon is partly to blame for having started two simultaneous wars, drawing a huge swell of military enlistees - without making adequate provision for their safety & protection, i.e. sending them into battle without enough armor for their tanks, etc. Thus generating not only a huge new swell of veterans, but a huge new swell of WOUNDED veterans. Again Rumsfeld, Wolfowitz, Feith, Pearle & Cheney are chiefly to blame here.

Congress is responsible for funding & oversight. But since their Veteran's Affairs committees are not considered "sexy", the turnover among committee members is constant & ongoing. As a result, veterans' issues are routinely neglected & ignored. The VA isn't allocated the size budget it really needs to do its job - and Congress isn't responsive to its complaints. Terrible, almost non-existent oversight. How about now? Are you still getting this?

Now I'm guessing that some of the most senior VA officials - instead of continuing to fight this battle with Congress that they could not win - cynically ignored it, and allowed people farther down the pecking order to deal with the problems. That would be administrators & others at the regional & local levels. For them, it's like being hired for a job that carries heavy responsibility - with no authority to actually make anything happen. In other words, a classic no-win situation.

So yes, in the abstract, none of those people should have deceived the veterans and deceived the public by playing games with the scheduling process (and the perhaps unrealistic goal, given the denial of needed resources, of a two-week maximum waiting period to see a doctor). And since many of them presumably had no good options, they took the easy way out: they lied. They deceived.

But if you think the problems at the VA are confined to a relatively small group of local & regional managers who decided to go rogue, then you are indeed missing the big picture. Because the problems at the VA are SYSTEMIC. And they are deeply-embedded. And to fix them at the source - not just fire a few people once in awhile to keep up appearances - will take major, systemic change...something that most of the stakeholders thus far have managed to avoid and ignore. Now that the problems have finally blown up in their faces in a major, public way, perhaps we will begin to see the first small moves toward actual reform.

Personally, I'm not holding my breath.

There! Better? Clearer?

truthhurts

nope, sorry to make you write all of that., made for a good read though! I understand most big words, others i look up to increase my vocab.
Lanivan is the biggest excuse maker around--i'd hate to meet her kids, but their probably perfect angels

Lanivan

Ah - before I address your last statement....Are you with the Ottawa Country Sheriff's Department?

Lanivan

It's quite dispiriting to read the following: "In 1995, as part of a broader overhaul, the VA began pressing clinics to cut wait times for new patient appointments to 30 days. But there was no system for tracking which facilities were meeting this target until 2002, when the VA introduced electronic waiting lists to keep tabs on patients who couldn't be seen within a month. Managers who slashed wait times were given bonuses and other perks. This created an incentive to game the system, especially after veterans of the Iraq and Afghan wars began flooding into VA clinics and straining their already stretched resources."

Then the Bush administration, masters of deregulation and lack of oversight, ignored findings of a 2005 VA inspector general's report that documented a raft of violations—including the widespread use of paper lists in place of the electronic ones to hide the glut of veterans awaiting appointments. The report urged the Veterans Health Administration "to ensure the electronic waiting list is complete and accurate" and proposed steps to remedy the problem.

Two years later, another inspector general audit found that the VA had failed to act on these recommendations and that schedulers were still using paper lists and other tactics to mask the backlogs. The report recommended that the VA "establish procedures to routinely test the accuracy of reported waiting times and the completeness of electronic waiting lists, and take corrective action when testing shows questionable differences."

Making systemic changes takes time, energy, will, gumption, and perseverance. Think Congress has what it takes?

Tri-cities realist

MM, and you wonder why some of us want to keep the govt out of health care?

Govt bureaucracies lack accountability by their very nature, they have a monopoly, whereas with the private sector, you have a choice (or used to): if the wait at your doctor is too long, or you don't like the care, you can go see a different doctor.

I know that is clear enough for you to understand.

Harry Kovaire

Don't distract her. She and the mystic are playing "political football."

glarson40

The Battle Creek VA is a poor performer as compared to others. The Grand Rapids clinic seems to do well with resources that they have; however, Battle Creek does not hire doctors, avoids using outside resources, and schedule issues abound.

skyking007

Why not let Veterans be treated at any Hospital if they can not get timely treatment and bill the VA?

Straightjacket

To logical, can't control the kickbacks.

Tri-cities realist

There is a bi-partisan bill in Congress to do just that... Gasp!

Post a Comment

Log in to your account to post comments here and on other stories, galleries and polls. Share your thoughts and reply to comments posted by others. Don't have an account on GrandHavenTribune.com? Create a new account today to get started.