WASHINGTON — Veterans Affairs Secretary Eric Shinseki insisted today that he’s “mad as hell” about the wait list scandal and reported deaths of dozens of veterans seeking care, but his undersecretary suggested that VA employees who cooked the books might not even lose their jobs.
Senate Veterans Affairs Committee Chairman Bernie Sanders (I-Vt.) stressed that he wanted to save a hearing on the scandal for a later date, and instead declared the hearing should be about “what is going well and what is not going well” in VA healthcare.
In the second panel of the hearing, Sanders asked the leaders of major veterans organizations one by one if their members were, for the most part, satisfied with VA healthcare. The trending answer was yes — once veterans got through the gantlet of trying to get an appointment.
“There is no question to my mind that VA healthcare has problems, serious problems. But it is not the case that the rest of healthcare in America is just wonderful — everybody walks in, gets immediate care, gets great care, at no cost. It’s all affordable,” said Sanders, who is a proponent of universal healthcare. “That’s not the world we live in.”
Sen. Patty Murray (D-Wash.), the past chairwoman of the committee, stressed that the “recent allegations are not new issues.”
“They are deep, system-wide problems and they grow more concerning every day,” Murray said. “…The GAO reported on VA’s failures with wait times at least as far back as the year 2000. Last Congress, we did a great deal of work around wait times, particularly from mental healthcare. The inspector general looked at these problems in 2005, 2007 and again in 2012. Each time they found schedulers across the country were not following VA policy. They also found in 2012 that VA has no reliable or accurate way of knowing if they are providing timely access to mental healthcare.”
“The lack of transparency and the lack of accountability is inexcusable and cannot continue on. The practices of intimidation and cover-ups has to change, starting today, giving bonuses to hospital directors for running a system that places priority on gaming the system and keeping their numbers down, rather than provide care to veterans has to come to an end,” she continued. “But, Mr. Secretary, it can’t end with just dealing with a few bad actors or putting a handful of your employees on leave. It has to go much further and lead to system-wide change.”
Shinseki said “veterans should feel safe in using VA healthcare.”
“Any allegation, any adverse incidents like this, makes me as — makes me mad as hell. I could use stronger language here, Mr. Chairman, but in deference to the committee, I won’t,” he said.
“If any allegations are true, they’re completely unacceptable to me, to veterans, and, I will tell you, the vast majority of dedicated VHA employees who come to work every day to do their best by those veterans. If any are substantiated by the inspector general, we will act.”
To rectify the crisis, the secretary said, “VA will continue to aggressively develop and sustain reliable systems and train employees to detect and prevent healthcare incidents before they happen.”
When Sanders asked Shinseki if he was aware of VA employees “cooking the books” — shifting veterans onto secret waiting lists to make their stats for appointment times look better — Shinseki replied, “I’m not aware other than a number of isolated cases where there is evidence of that.”
He told Ranking Member Richard Burr (R-N.C.) that last Friday he put on administrative leave an employee in Fort Collins, Colo., revealed to have written an email on ways to “game the system.”
The secretary also said that a December report from the Cheyenne Medical Center and Fort Collins clinic — which found the “medical center’s business office training included teaching them to make the desired date the actual appointment, and if the clinic needed to cancel appointments, they were instructed to change the desired date to within 14 days of the new appointment” — just came to his attention “recently.”
Murray noted that an undersecretary warned her at a 2012 hearing that “gaming is so prevalent, as soon as new directives are put out, they’re torn apart to find out how to get around the requirement.”
“And the standard practice at the V.A. seems to be to hide the truth in order to look good. That has got to change once and for all,” she said. “And I want to know how you’re going to get your medical directors and your network leaders to tell you, whether it’s through this survey or in the future, when they have a problem and will work with you to address it, rather than pursuing these secret lists and playing games with these wait times.”
“Senator, if there’s anything that gets me angrier than just hearing allegations is to hear you tell me that we have folks that can’t be truthful because they think the system doesn’t allow it,” Shinseki retorted.
“This review will not work if those people who are telling you the information do not tell you the truth,” Murray noted of the VA’s plan to survey employees in its investigation.
Sen. Johnny Isakson (R-Ga.) said it was not a rush to judgment, but lawmakers were clamoring for “a rush to accountability.”
“While we need to complete the I.G.’s report and find out every problem where things are wrong, we’ve had 50 I.G. reports since 2013,” he said. “And in those reports, we’ve found repeatedly, over and over again, where there has been a gaming of the system, where the system is more important than the patient.”
VA Undersecretary for Health Robert Petzel told the committee that they were working “very hard… to spot out these inappropriate uses of the scheduling system and these abuses.”
“What do you do when you uncover one? Surely, you’ve uncovered one. What — what do you do to hold them accountable?” Isakson asked.
“The individuals are, as you mentioned, held accountable. I can’t give you an example specifically, but if someone were found to be manipulating inappropriately the scheduling system, they would be disciplined,” Petzel replied.
“Would they lose their job?”
“I don’t know whether that’s the appropriate level of punishment or not,” said the VA official.
Shinseki jumped in, telling Isakson that he was “focused on scheduling” but overall VA management “involuntarily removed” 3,000 employees in each 2012 and 2013 “for either poor performance or misconduct.”
Pressed later by Sen. Mark Begich (D-Alaska), Shinseki said, “There is a process here, Senator. Let me not get out ahead of it.”
Sen. John Cornyn (R-Texas), one of those in the upper chamber who has called for Shinseki’s resignation, doesn’t sit on the committee yet in a statement slammed the secretary’s refusal to commit to harsh disciplinary action for those found responsible.
“Contrary to the secretary’s dismissive attitude, the VA will not continue to operate in no-man’s land and there will be consequences if these reports are found to be true,” Cornyn said. “If 40 veterans died while waiting for care on a secret list and if reports in Texas are true, individuals must be fired, the secretary will have no choice but to resign, and there must be a top-to-bottom revamping of this dysfunctional agency.”
At the hearing, Sen. Richard Blumenthal (D-Conn.) raised “sort of the elephant in the room.”
“Isn’t there evidence here of criminal wrongdoing, that is, falsifying records, false statements to the federal government?” Blumenthal said. “And wouldn’t it be appropriate to ask for assistance from the Federal Bureau of Investigation or some other, similar agency, given that the I.G.’s resources are so limited, that the task is so challenging and the need for results is so powerful?”
“…In my judgment, there is more than sufficient reason to involve other investigative agencies here in light of the evidence, more than allegations, but evidence, of potential false statements to the federal government, and the need for timeliness and promptness in results to restore trust and confidence.”
Even though Sen. John McCain (R-Ariz.) doesn’t sit on the committee, Sanders allowed him to join the hearing since the allegations of wait list deaths began at the Phoenix VA.
“At a town hall forum I hosted in Phoenix last week, the families of four veterans who passed away in recent months stood before a crowded room to tell their stories. With tears in their eyes, they described how their loved one suffered because they were not provided the care they needed and deserved. They recalled countless unanswered phone calls and ignored messages, endless wait times, mountains of bureaucratic red tape, while their loved one suffered debilitating and ultimately fatal conditions,” McCain said.
“Congress must provide VA administrators with greater abilities to hire and fire those charged with caring for our veterans. Most importantly, we must give veterans greater flexibility in how they get quality care in a timely manner, rather than continue to rely — to rely on a department that appears riddled with systemic problems in delivering care,” he said.
“How we care for those who risk everything for us is the most important test of a nation’s character. Today, we are failing the test.”