Not first warning on 'gaming' VA patients

KEVIN FREKING Associated Press Published:

WASHINGTON (AP) -- The report this week confirming that 1,700 veterans were "at risk of being lost or forgotten" at a Phoenix hospital was hardly the first independent review that documented long wait times for some patients seeking health care from the Department of Veterans Affairs and inaccurate records that understated the depth of the problem.

Eleven years ago, a task force established by President George W. Bush determined that at least 236,000 veterans were waiting six months or more for a first appointment or an initial follow-up. The task force warned that more veterans were expected to enter the system and that the delays threatened the quality of care the VA provided.

Two years ago, a former hospital administrator told senators during an oversight hearing that VA hospitals were "gaming the system" and manipulating records to make it appear that wait time standards, the criteria for awarding manager and executive bonuses, were being met.

Since 2005, the department's inspector general has issued 19 reports on how long veterans have to wait before getting appointments and treatment at VA medical facilities, concluding that for many, sufficient controls don't exist to ensure that those needing care get it.

In 2007, the VA inspector general told the Senate Committee on Aging that "schedulers at some facilities were interpreting the guidance from their managers to reduce waiting times as instruction to never put patients on the electronic waiting list. This seems to have resulted in some 'gaming' of the scheduling process."

That's virtually identical to language in a 2010 VA memorandum, and again in the latest inspector general's report this week that led dozens of members of Congress to call for VA Secretary Eric Shinseki to resign. He abided by those wishes Friday, telling Obama that he had become a distraction as the administration tried to address the VA's troubles.

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 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' jurisdiction. We think they've fallen short over the years," Violante said.

Rep. Jeff Miller, the chairman of the House Committee on Veterans Affairs, said money is not the problem. He notes that the president 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."

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