Editorial | Audit reveals sorry state of veterans’ health care

June 12, 2014 

The following editorial appeared Wednesday in the Dallas Morning News:

The thought of our sclerotic Congress shaken into bipartisan action to offer some short-term help to the Veterans Affairs health care system might prove a rare bright spot in an otherwise dismal tale of government failure.

A department-wide audit, prompted by reports of horrific wait times, fraud, cover-ups and even death, confirms many of the allegations. The headlines were bad enough: 57,000 U.S. veterans have waited 90 days or more for a simple appointment; another 64,000 apparently were forgotten entirely, never scheduled after enrolling in the system.

Even worse, 13 percent of schedulers at the 731 hospitals and outpatient clinics surveyed say supervisors told them to falsify appointment schedules to make wait times appear shorter.

This is not some faraway story. In Texas, four of our VA facilities ranked among the nation’s 10 worst for new patients seeking mental health care: Amarillo, El Paso, Harlingen and Dallas, all with waits of 50 days or longer. Harlingen also had 85-day waits for primary care appointments and a 145-day average wait, the nation’s worst, for patients seeking specialist care.

[In South Carolina, the Dorn VA Medical Center in Columbia was listed as the sixth worst among all VA hospitals for access to a primary-care doctor, at 76.75 days.]

The VA’s fundamental problem has been its inability to keep up with an increasing (Iraq, Afghanistan) and aging (World War II, Korea, Vietnam) veteran population. Its solution of a headquarters-mandated 14-day maximum for patient visit waits led to the type of organized fraud revealed first in news reports and then confirmed by VA audits. The agency is right to disengage that wait target from performance evaluations and administrator bonuses.

Credit for the compromise bill headed to a vote in the Senate should go to John McCain, the Arizona Republican, and Bernie Sanders, the Vermont independent. Their version cobbles together proposals that would make it easier to fire VA officials for misconduct; allow veterans to see doctors outside the VA network if they experience long waits; lease 26 new VA facilities in 18 states; and use $500 million to hire more doctors and nurses.

The Senate bill, assuming it passes into law, does offer some help. VA Secretary Eric Shinseki resigned May 30, another necessary step but far from a comprehensive fix to a systemic breakdown.

In the latest audit, the VA’s inspector general is blunt: “This behavior runs counter to our core values. The overarching environment and culture which allowed this state of practice to take root must be confronted head-on.”

And it is far more difficult to repair culture, as we’ve learned with other hospital systems here in Dallas, than it is to build new clinics or hire more doctors. Those are needed, yes, but what the new VA leadership must find and rip out is the systemic rot that led anyone to believe such neglect and fraud were acceptable.

This would be true regardless of the patient population; no one deserves such treatment. That it happened to men and women who sacrificed so much for their country is shameful and must not stand.

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