An initial investigation by the VA's Inspector General confirms sordid allegations of rampant records manipulation designed to hide chronic failures within the Phoenix-based system, as originally reported by CNN. A snippet from the report:
To date, our work has substantiated serious conditions at the Phoenix HCS. We identified about 1,400 veterans who did not have a primary care appointment but were appropriately included on the Phoenix HCS’ EWLs [electronic wait lists]. However, we identified an additional 1,700 veterans who were waiting for a primary care appointment but were not on the EWL. Until that happens, the reported wait time for these veterans has not started. Most importantly, these veterans were and continue to be at risk of being forgotten or lost in Phoenix HCS’s convoluted scheduling process. As a result, these veterans may never obtain a requested or required clinical appointment. A direct consequence of not appropriately placing veterans on EWLs is that the Phoenix HCS leadership significantly understated the time new patients waited for their primary care appointment in their FY 2013 performance appraisal accomplishments,which is one of the factors considered for awards and salary increases.
That's a total of 3,100 Phoenix-area veterans in limbo, more than half of whom were off the books. And don't miss that last sentence, which affirms that at least part of the motive behind this scheme was financial. Bureaucrats were more interested in protecting their pay increases and performance bonuses than protecting the veterans in their care. That appalling reality isn't a new revelation, but it's still arresting to see it described in black and white, from the government's own watchdog. As you're by now well aware, Phoenix wasn't an isolated "bad apple" event. Abuses along the same lines are under investigation at dozens of VA facilities, with allegations surfacing from coast to coast. Back to the Phoenix report:
To review the new patient wait times for primary care in FY 2013, we reviewed a statistical sample of 226 Phoenix HCS 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.
A New York Times reporter boils the key numbers down:
Phoenix VA said 43% of 226-vet sample had to wait more than 14 days for appointment. IG found real number was 84%.
— Jonathan Weisman (@jonathanweisman) May 28, 2014
And therein lies the heart of the scandal. The "official" data produced by this local system -- which was deliberately and thoroughly cooked -- showed an average wait time of less than a month, with a majority of patients obtaining an appointment within two weeks. In reality, the average wait time was nearly four months, with the vast majority of patients being forced to wait longer than the target range of two weeks. The discrepancy, the report states, is mostly due to the practice of concealing the true date an appointment request was filed. Another important takeaway, as flagged by Allahpundit: "The IG also took care to note that, of the 42 VA facilities where his teams are now gathering evidence, none received advance notice that they were coming. Why? Because he’s worried about 'the risk of destruction of evidence, manipulation of data, and coaching staff on how to respond to our interview questions.'" A frantic after-the-fact cover up isn't a hypothetical concern; a whistleblower in New Mexico recently told the Daily Beast that evidence destruction was already underway at his facility in Albuquerque. The same reporter published a damning follow-up story today:
Emails and VA memos obtained exclusively by The Daily Beast provide what is among the most comprehensive accounts yet of how high-level VA hospital employees conspired to game the system. It shows not only how they manipulated hospital wait lists but why—to cover up the weeks and months veterans spent waiting for needed medical care. If those lag times had been revealed, it would have threatened the executives’ bonus pay. What’s worse, the documents show the wrongdoing going unpunished for years, even after it was repeatedly reported to local and national VA authorities. That indicates a new troubling angle to the VA scandal: that the much touted investigations may be incapable of finding violations that are hiding in plain sight. “For lack of a better term, you’ve got an organized crime syndicate,” a whistleblower who works in the Texas VA told The Daily Beast. “People up on top are suddenly afraid they may actually be prosecuted and they’re pressuring the little guys down below to cover it all up.” “I see it in the executives’ eyes,” the whistleblower added. “They are worried.”
That is precisely why the administration's "we're investigating" posture is so inadequate in this case. The misconduct at play has been routinely reported, at both the local and national levels, resulting in...nothing. We've been beating that drum for days. The dots were glowing bright red, dating back to at least the 2008 presidential transition, yet they were not connected. At some point, that becomes willful inaction, and it's a failure that isn't going to be rectified by more investigations. Sure, the heightened scrutiny may finally induce some action this time around, but what happens to the people who were alerted to these problems for years, and didn't respond? All of this is just too much for a growing number of members on Capitol Hill. Sen. John McCain had been holding off on calling for Sec. Shinseki's resignation. No more:
I'll leave you with Hot Air's soon-to-be latest addition, Noah Rothman, flaying inevitable "Voxplanation" of the VA scandal -- which focuses on criticizing Republicans, naturally.
UPDATE - The dam is creaking. A prominent Democratic Senate nominee and a sitting Senate Democrat have decided to cut and run from Shinseki. (Hagan just piled on, too). They won't be the last ones to do so. Also, oof:
Please, somebody make sure the president reads the papers tomorrow http://t.co/GirSCRJyRa
— Ron Fournier (@ron_fournier) May 28, 2014