Editorial: VA health system continues to need bandaging

A month ago USA Today published the results of a months-long investigation of the Department of Veterans Affairs that found the agency covered up mistakes and misdeeds by doctors, nurses and staffers, often by cutting secret severance agreements and then writing large severance checks.

“In some cases, agency managers do not report troubled practitioners to the National Practitioner Data Bank, making it easier for them to keep working with patients elsewhere,” the newspaper reported. “The agency also failed to ensure VA hospitals reported disciplined providers to state licensing boards.”

This past week Nevada senior Sen. Dean Heller, a Republican, joined with Joe Manchin, a West Virginia Democrat, to introduce a bill that prohibits such behavior by requiring the VA to report major adverse actions to the National Practitioner Data Bank and state licensing boards within 30 days. It would also prohibit the VA from signing settlements with fired or dismissed VA employees that allow the VA to conceal serious medical errors or purge negative records from personnel files.

“The investigation’s findings are downright shameful, and we need action immediately to ensure that the VA does not hide medical mistakes or inadequate care,” Heller, a senior member of the U.S. Senate Veterans’ Affairs Committee, was quoted as saying in a press release announcing the bill. “That’s why Senator Manchin and I introduced legislation that demands transparency and accountability from the VA and puts a stop to concealing serious medical errors through settlements with fired or dismissed VA employees. It is our responsibility to stand up for those who put their lives on the line for this country and provide them with the world class medical care they expect and deserve. The VA lists integrity as its first core value, and VA employees make the promise to act with high moral principle and adhere to the highest professional standards. Our legislation will make sure of it by holding the VA’s feet to the fire so that the veterans the agency exists to serve have trust in their caretakers.”

Heller noted that the nation has 21 million veterans and 300,000 of those live in Nevada. He noted that the VA’s mission statement reads: “To care for him who shall have borne the battle.” But in recent years, the senator noted, the VA hasn’t always lived up to that mission statement.

In 2014 VA Secretary Eric Shinseki resigned as a result of the scandal over veterans dying while waiting to receive treatment at a Phoenix VA hospital. The inspector general report called the VA’s problems “systemic.”

The inspector general found that the Phoenix VA hospital staff lied about its waiting list, claiming veterans waited on average 24 days for their first primary care appointment, when the average was 115 days. There were 1,400 vets on the official waiting list, but another 1,700 had been excluded from the list.

A subsequent audit issued on the day Shinseki resigned revealed that 64 percent of 216 VA facilities reviewed had tampered with waiting lists.

This latest scandalous revelation is nothing new to the VA. In 1945 the head of the VA hospital system resigned after a series of news reports about shoddy treatment. In 1976 an investigation of a Denver VA hospital found some veterans’ surgical dressings were rarely changed. In 1986 the inspector general found 93 VA physicians had sanctions against their medical licenses, including suspensions and revocations. In 2007 a commission reported “delays and gaps in treatment and services.”

In 2012 the VA opened a new hospital in North Las Vegas. It cost $1 billion, four times the original budget, and took six years to build. The emergency room was too small and had to be doubled in size a year and half later. The hospital is many hours away for rural Nevada veterans.

While Heller’s bill is needed to stanch the latest hemorrhage, perhaps it is past time  for Congress to disband the VA health care system and just give veterans vouchers for the doctors and hospitals of their choice.

A version of this editorial appeared this week in some of the Battle Born Media newspapers — The Ely Times, the Mesquite Local News, the Mineral County Independent-News, the Eureka Sentinel,  Sparks Tribune and the Lincoln County Record.

Newspaper column: Close VA hospitals and give veterans vouchers for private care

So, Veterans Affairs Secretary Eric Shinseki resigned this past week as a result of the scandal over veterans dying while waiting to receive treatment at a Phoenix VA hospital.

Nevada Sen. Dean Heller’s strongly worded call for his ouster surely tipped the scales. “The Department of Veterans Affairs Inspector General’s report provides a very disturbing view of what has been confirmed as a systemic problem at the VA. …” Heller said. “It is time for a leadership change at the VA at the highest level,” as reported in this week’s newspaper column in The Ely Times and the Elko Daily Free Press and Mesquite Local News.

The inspector general report indeed called the VA’s problems “systemic.”

North Las Vegas VA Medical Center

The problem is not just systemic, it is endemic and pandemic.

You may keelhaul the captain of a sinking rust bucket, but you are still aboard a sinking rust bucket.

The problem lies not in who is heading this system, it is the system itself — pure socialized medicine. It is a bureaucracy that like any other organism has at its base the objective of self-preservation. No matter who you put in charge it will fail eventually, as it has done so over and over again between brief periods of improvement after one crisis or another.

The inspector general found that the Phoenix VA hospital staff lied about its waiting list, claiming veterans waited on average 24 days for their first primary care appointment, when the average was 115 days. There were 1,400 vets on the official waiting list, but another 1,700 had been excluded from the list.

A subsequent audit issued on the day Shinseki resigned revealed that 64 percent of 216 VA facilities reviewed had tampered with waiting lists.

A year ago, Obama was warned by the House Veteran Affairs Committee about “management failures, deception and lack of accountability permeating VA’s health-care system.”

In 1945 the head of the VA hospital system resigned after a series of news reports about shoddy treatment.

In 1976 an investigation of a Denver VA hospital found some veterans’ surgical dressings were rarely changed.

In 1986 the inspector general found 93 VA physicians had sanctions against their medical licenses, including suspensions and revocations.

In 2007 a commission reported “delays and gaps in treatment and services.”

Today the bureaucrats are still cooking the books in order to make themselves eligible for “awards and salary increases.”

Be thankful that when FDR signed the GI Bill in 1944 he did not create a system of veterans’ colleges or we’d have colleges as bollixed as the VA hospitals.

Read the entire column at Ely or Elko or Mesquite.

Replacing head of VA is like rearranging deck chairs

So, Sen. Dean Heller has joined the chorus of calls for ousting VA Secretary Eric Shinseki, saying:

“The Department of Veterans Affairs Inspector General’s report provides a very disturbing view of what has been confirmed as a systemic problem at the VA. Poor management must not be allowed to stand in the way of providing quality care for veterans in Nevada and across the country. I have great respect for Secretary Shinseki’s service to our nation and the sacrifices he has made, but the problems within the Department for which he is responsible cannot be ignored. It is time for a leadership change at the VA at the highest level.”

Replacing the captain of a sinking rust bucket still leaves you with a sinking rust bucket.

That OIG report does appear to show “systemic” problems with the VA. “Allegations at the Phoenix HCS health care system) include gross mismanagement of VA resources and criminal misconduct by VA senior hospital leadership, creating systemic patient safety issues and possible wrongful deaths,” concludes the executive summary.

“To date, we have ongoing or scheduled work at 42 VA medical facilities and have identified instances of manipulation of VA data that distort the legitimacy of reported waiting times,” the report also says. That’s up from the previously reported 26.

The VA is pure socialized medicine. No happen who you put in charge it will fail eventually, as it has done so over and over again between brief periods of improvement after one crisis or another.

Back in the 1980s the crisis was heart surgery. While investigating cardiac surgery deaths, it was found that there were “errors in operative technique” in 38 percent of cases.

In 2007, The Washington Post reported on shoddy treatment and conditions at Walter Reed Military Hospital. Though it is military and not VA, it too is socialized medicine on display. One story reported:

“While the hospital is a place of scrubbed-down order and daily miracles, with medical advances saving more soldiers than ever, the outpatients in the Other Walter Reed encounter a messy bureaucratic battlefield nearly as chaotic as the real battlefields they faced overseas.

“On the worst days, soldiers say they feel like they are living a chapter of ‘Catch-22.’ The wounded manage other wounded. Soldiers dealing with psychological disorders of their own have been put in charge of others at risk of suicide.”

In 1945 the head of the VA hospital system resigned after a series of news reports about shoddy treatment.

In 1986 the OIG found 93 VA physicians had sanctions against their medical licenses, including suspensions and revocations.

Today the problem in the Phoenix VA hospital is that 1,700 veterans were waiting for their first primary care appointment but were not on the electronic waiting list. The bureaucrats were cooking the books in order make themselves eligible for “awards and salary increases.”

The inspector reports:

“To review the new patient wait times for primary care in FY 2013, we reviewed a statistical sample of 226 Phoenix HCS (health care system) appointments. VA national data, which was reported by Phoenix HCS, showed these 226 veterans waited on average 24 days for their first primary care appointment and only 43 percent waited more than 14 days. However, our review showed these 226 veterans waited on average 115 days for their first primary care appointment with approximately 84 percent waiting more than 14 days. At this time, we believe that most of the waiting time discrepancies occurred because of delays between the veteran’s requested appointment date and the date the appointment was created. However, we found that in at least 25 percent of the 226 appointments reviewed, evidence, in veterans’ medical records, indicates that these veterans received some level of care in the Phoenix HCS, such as treatment in the emergency room, walk in clinics, or mental health clinics.”

It is time to dismantle the VA health care system and just give veterans vouchers to use wherever they wish.

 

VA hospital system needs to be dismantled

Be thankful that when FDR signed the GI Bill in 1944 he did not create a system of veterans colleges or we’d have colleges as bolloxed as the VA hospitals.

Perhaps veterans would not be dying while waiting for admission as happened in Phoenix with 40 veterans when the hospital falsified records to cover up lengthy delays in treatment.

The fault lies not with VA Secretary Eric Shinseki. The fault lies with the socialized system. It has never worked as well as private health care and never will.

The VA shouldn’t just outsource more veteran health care to private hospitals and clinics, as Shinseki approved this weekend, it should just give veterans vouchers and let them choose where to use them. It worked for higher education.

The VA Medical Center in North Las Vegas reveals symptoms of what is wrong. It cost $1 billion — twice what a private hospital costs — to build and took four years longer than scheduled. It opened with too small of an emergency room and no ambulance drop-off ramp.

IBD chart

And it is not too little spending. John Merline reports in Investor’s Business Daily this week that from 2000 to 2013, VA spending nearly tripled, while the population of veterans declined by 4.3 million.

“Medical care spending — which consumes about 40% of the VA’s budget — has climbed 193% over those years, while the number of patients served by the VA each year went up just 68%, according to data from the VA,” Merline writes.

CNN put together a history of the VA that shows the system has never worked the way the statists thought it would. Here are a couple of highlights:

1921 — Congress creates the Veterans Bureau to administer assistance to World War I veterans. It quickly devolves into corruption, and is abolished nine years later under a cloud of scandal.

1930 — The Veterans Administration is established to replace the troubled Veterans Bureau and two other agencies involved in veterans’ care.

1945 — President Harry Truman accepts the resignation of VA Administrator Frank Hines after a series of news reports detailing shoddy care in VA-run hospitals, according to a 2010 history produced by the Independent Institute.

1947 — A government commission on reforming government uncovers enormous waste, duplication and inadequate care in the VA system and calls for wholesale changes in the agency’s structure.

1976 — A General Accounting Office investigation into Denver’s VA hospital finds numerous shortcomings in patient care, including veterans whose surgical dressings are rarely changed.

1984 — Congressional investigators find evidence that VA officials had diverted or refused to spend more than $40 million that Congress approved to help Vietnam veterans with readjustment problems, the Washington Post reports at the time.

1986 — The VA’s Inspector General’s office finds 93 physicians working for the agency have sanctions against their medical licenses, including suspensions and revocations, according to a 1988 GAO report.

1991 — The Chicago Tribune reports that doctors at the VA’s North Chicago hospital sometimes ignored test results, failed to treat patients in a timely manner and conducted unnecessary surgery.

2000 — The GAO finds “substantial problems” with the VA’s handling of research trials involving human subjects.

2001 — Despite a 1995 goal to reduce waiting times for primary care and specialty appointments to less than 30 days, the GAO finds that veterans still often wait more than two months for appointments.

2007 — Outrage erupts after documents released to CNN show some senior VA officials received bonuses of up to $33,000 despite a backlog of hundreds of thousands of benefits cases and an internal review that found numerous problems, some of them critical, at VA facilities across the nation.

2013 — The former director of Veteran Affairs facilities in Ohio, William Montague, is indicted on charges he took bribes and kickbacks to steer VA contracts to a company that does business with the agency nationwide.

January 2014 — CNN reports that at least 19 veterans died at VA hospitals in 2010 and 2011 because of delays in diagnosis and treatment.

The word is systemic.

You could add to the above the six-hour wait in the emergency room of the VA Medical Center in North Las Vegas by a blind veteran who was writhing in pain. Apparently such lengthy waits are not uncommon.

Sandi Niccum is shown slumped in a hospital waiting room on one of her last days. She was blind and in severe pain. (Courtesy Dee Redwine via R-J)