VA Doctors Tried to Blow Whistle

Jun 2, 2014

Air Force veteran Marc Schenker of Fort Lauderdale gave up waiting for the VA hospital in Miami to repair his hernia. He had it done at a private-sector hospital and charged it to Medicare.

Schenker is one of many veterans who contacted the New York Times last week to say they like the quality of VA care but hate the wait.

“It’s frustrating and infuriating that there are so many dedicated doctors who work for the VA but it seems impossible to get to them,” Schenker, a Vietnam veteran, told the newspaper. "They’re serving too many people.”

Don't blame doctors for the long waits for appointments at Veterans Affairs hospitals, nor for alleged attempts to hide them through a double set of books. They tried to warn everyone.

The same  information came out in a 2009 federal lawsuit filed by three doctors and an administrative employee against the VA Medical Center in Pinellas County, now called the C.W. "Bill" Young VA Medical Center.

As the Tampa Bay Times reports, the plaintiffs testified the hospital had two sets of books, one that showed short waits and one -- not in writing -- that had the real waits, which often ran into months. A jury awarded the Young VA employees $3.73 million in damages but that amount was later reduced, the Times said.

And there were many other warnings that somehow were overlooked for years, the Associated Press reported on Saturday. A task force set up by President George W. Bush revealed 11 years ago that 236,000 veterans were waiting six months or more for a first appointment or an initial follow-up.

And the number of returning veterans from the Iraq and Afghanistan wars has only grown since then. Since 2005, the VA's inspector general has issued 19 reports on long waits for treatment. The Senate held a hearing on the problem two years ago, in which a former hospital administrator said the record-manipulation was developed so that managers could win bonuses. 

Last week, a VA inspector general report on the Phoenix hospital found 1,700 veterans were "at risk of being lost or forgotten." The fallout led to Congressional furor and the resignation of VA Secretary Eric Shinseki.

The series of reports over the years also raises questions about whether Congress should have done more to solve the problems that have so grabbed the nation's attention in recent weeks.

"Anyone in Congress who thinks they've done enough for the VA is simply deluding themselves," Democratic Sen. Jay Rockefeller of West Virginia said in response to Shinseki's resignation. "Year after year, when members of Congress have had the opportunity to provide legitimate funding increases for the VA, they've done just enough to skirt by."

Pointing to the Bush task force report from 2003, Joseph Violante, legislative director for Disabled American Veterans, said the problem of access to health care has been known for a decade.

"In our mind, a lot of the problem that is taking place on the health care side is due to a lack of sufficient funding, and that's Congress's jurisdiction. We think they've fallen short over the years," Violante said.

Rep. Jeff Miller of Florida, the chairman of the House Committee on Veterans Affairs, said money is not the problem at the VA. He notes that the president has traveled the country touting the spending increases that have occurred in VA's budget during his presidency.

Spending for VA medical care has nearly doubled in less than a decade, from $28.8 billion in 2006 to $56 billion last year.

"They can't even spend the money that we appropriated to them. If money could have solved this problem, it would have been solved a long time ago," Miller said. "It is manipulation and mismanagement that has created the crisis that exists today."

Miller, who became chairman of the House Committee on Veterans Affairs in 2011, makes the case that the investigations that have been undertaken by the VA's inspector general and the Government Accountability Office were generally conducted at the request of members of Congress. When he has sought to follow up about whether the VA was meeting investigators' recommendations, Miller said he has been stonewalled.

The committee has had an acrimonious relationship with VA leadership and even developed a section on its website called "Trials in Transparency" that list some of the more than 100 requests for information made by the committee that it says are still outstanding.

The problems in Phoenix, Miller said, came to light because of his committee's work with a whistleblower that VA would not pay attention to, Dr. Samuel Foote, who retired after spending nearly 25 years with the department.

Foote said up to 40 veterans may have died while awaiting treatment at the Phoenix hospital and that staff, at the instruction of administrators, kept a secret list of patients waiting for appointments to hide delays in care. He believes administrators kept the off-the-books list to impress their bosses and get bonuses. The IG said that while its work was not complete, it had substantiated significant delays in access that negatively impacted the quality of care at the Phoenix hospital. The IG has not substantiated whether any veterans in Phoenix died due to a delay in treatment.

But it's clear that media reports citing a specific number of 40 veteran deaths gave a human element to the story that triggered greater urgency from the public, veterans groups and lawmakers. In a matter of weeks the American Legion went from being a strong supporter of Shinseki to asking for his resignation.

"For some reason, something triggered the media's appetite for this story when we've been asking VA to participate and give us information. I don't know if it was the number of 40 veterans," Miller said.

As he gave his final speech as VA secretary, Shinseki acknowledged that he once viewed the department's problems concerning wait times as limited.

"I no longer believe it. It is systemic. I was too trusting of some, and I accepted, as accurate, reports that I now know to have been misleading with regard to patient wait times," he said.