A steady drumbeat from whistle blowers and media reports has left veterans and the public wondering what is going on at VA Central Office (VACO) in Washington, DC and VA field facilities nationwide in the Veterans Health Administration (VHA).
Disturbing allegations of outright fraud have surfaced while some unscrupulous VA Medical Center (VAMC) Directors and their management teams designed and implemented schemes to purposefully delay critical health care to veterans. And all of this for their own personal gain.
This methodical scam was devised to dodge VA timeliness standards by stage-managing requests for health care and “cooking the books” to make it appear that health care access stats were within VA guidelines.
For a change, this latest scandal does not directly involve the Veterans Benefits Administration (VBA) adjudication function, but VA’s vaunted health care delivery apparatus.
VHA has 6.7 million veterans enrolled in the system and delivers health care to veterans at 151 VAMCs and 820 clinics.
One of the latest bombshells involves the Carl T. Hayden VAMC in Phoenix, AZ known as the Phoenix VA Health Care System (PVAHCS).
The scandal plagued PVAHCS has demonstrated an obvious pattern of preventable patient deaths due to premeditated scheduling delays for sick veterans.
The allegations center around a shocking scheme to delay health care until appointments could be scheduled aligned with VA timeliness policies.
Allegedly this potentially criminal activity led to 40 or more preventable deaths of veterans at PVAHCS.
Outcomes of delayed care for these patients often proved fatal while many victims of this hideous conspiracy suffered needless pain and anguish before they were eventually treated by VA or died.
With prompt medical intervention, some veterans could have survived and be alive today to spend precious time with family and loved ones.
Over the years, PVAHCS has had a reputation for serious scandals interspersed with periods of corrective realignment. With the advent of this latest disgrace, PVAHCS requires strong management and leadership to change the institutional dishonor and culture of corruption to one of patient-centric heath care for veterans.
WHAT ARE VA TIMELINESS STANDARDS FOR SEEING PATIENTS?
VHA policy states that if a new veteran patient cannot be scheduled and provided clinical appointments within 90 days of the date requested by the veteran, it should be placed on VA’s Electronic Waiting List.
However, specialty consults ordered as follow-up care like diagnostic tests such as X-rays, MRIs, and colonoscopies must be scheduled within 7 days and urgent cases seen in 14 days, while routine cases are to occur within 30 days.
WHAT ARE OFFLINE SECRET WAITING LISTS?
Secret waiting lists are illegally created catalogs of backlogged veterans needing health care. These lists were designed at an undetermined number of VAMCs to fraudulently disguise and hide their inability to schedule and treat patients within VA’s timeliness standards. Instead of being placed on the Electronic Waiting List, they are kept offline, and therefore, do not start the time clock for measurement against VA timeliness standards.
WHY IS MEETING TIMELINESS IMPORTANT TO VAMC DIRECTORS?
Good performance reviews provide a strong financial incentive for Directors in the form of bonuses. Higher financial rewards are awarded to Directors who meet or exceed VHA timeliness goals and reducing patient wait time.
When a Director fails in some of the hundreds of performance standards established by VHA, they are subjected to increased scrutiny and reduced bonuses. Therefore, the incentive is to far exceed the requirements of their respective performance goals.
Regrettably, many Directors are only too eager to succeed by either “hook or crook” creating an unhealthy environment that leads some to cheat the system and thereby cheat veterans.
HOW DOES THE SECRET WAITING LIST WORK?
When a veteran patient requires health care or referrals such as a consult and the wait time is above VA standards, some VAMC leadership teams have concocted schemes where the clinical request is entered into the VA Scheduling Package, a screen shot is taken, the electronic entry is deleted, and an offline paper wait list file is created for the patient.
The secret waiting list is kept separately in Health Administration Service (HAS) and supposedly accessed when a timely appointment becomes available. The patient is then contacted and new entries made into the electronic Scheduling Package that shows the timeliness standard was achieved.
This way the data confirmed that the patient was scheduled and seen within VHA Timeliness Standards even though the patient may have waited many months over the standard for the appointment.
The plot was designed to cheat and capture data in VA’s electronic Scheduling Package that reflected favorably on the VAMC.
Manipulated data was captured and the erroneous information was batched and sent forward up the chain of command for review.
After a period of time, the falsification of timeliness data would then erroneously display a VAMC success story with markedly improved timeliness and service to veterans.
This planned scheme was designed to knowingly trick, deceive, and defraud the system and led to outcomes that included fatalities that could have been preventable deaths.
WHY WERE THESE SECRET WAITING LISTS CREATED AT PHOENIX VAMC?
Reportedly, several years ago a surge of new patients and the departure of medical staff at PVAHCS led to significantly increasing time delays in providing health care to veterans. In many cases, wait times for new patient primary care appointments exceeded 1 year, while referrals for specialty care often took months.
The outcome was quite predictable: the Phoenix VAMC Emergency Room was inundated with patients seeking urgent/emergent care as well as non life threatening events such as script refills and other assorted aliments because they could not be seen in the primary care setting.
Because veterans could not be seen in a timely manner and the authorized Electronic Waiting List would reveal these delays, an illegal “work-around” method was developed to hide real wait times and substitute counterfeit data that was put online.
Claims of malfeasance at Phoenix VAMC led to the launching of a VA Inspector General investigation as well as hearings by the House Veterans Affairs Committee looking into reports of plots to use secret waiting lists to cover up lengthy delays for the provision of health care to approximately 1,500 sick veterans.
Allegations by whistleblowers and deceased veterans’ families assert that as many as 45 veterans died while waiting for health care from the PVAHCS that did not come in time.
WHAT MOTIVATION IS THERE FOR VAMC LEADERSHIP TO FALSIFY WAIT TIMES?
Investigations by the Government Accountability Office (GAO) and VA Office of the Inspector General (VAOIG) have identified incentives for VAMC Directors to obtain sharp reductions in scheduling and appointing backlogs – it is for their own financial gain.
They found that VAMC Director’s Performance Reviews and bonuses are coupled, in part, to meeting VA’s timeliness standards and reducing patient wait times. GAO also established that local VAMCs were manipulating appointment lists to demonstrate they were meeting Department wait time rules.
Ms. Debra Draper, Health Care Director for GAO observed that bonus incentives for Directors and weak oversight make it easy for VAMCs to manipulate their statistics.
She further opined, “There are incentives that may encourage bad or unwanted behaviors. There are weak system designs that really allow for manipulation if that’s what’s desired.”
VA’s field patient Electronic Scheduling Package is decades old and antiquated. It is a fundamental root cause of data manipulation and is well-known as a “tail wagging the dog” system at VAMCs. Consult management and patient appointment scheduling is more difficult and challenging due to a user unfriendly scheduling package.
Clearly the Electronic Scheduling Package has outlived its usefulness and is not a modern scheduling and tracking tool. Scheduling rules in the package are hard to follow and the training of clerks is difficult and problematic at best.
A new, user friendly scheduling package must be designed that incorporates state of the art technology and lends itself to wait time and consult tracking.
Of course, no electronic system can overcome outright corruption and unethical behavior where dishonest managers debase and cheat the system by manipulating data to look good and capture bonus money at the expense of veterans’ health care.
The PVAHCS Director, Ms. Sharon Helman, receives an annual base salary of $169,000 and reportedly received a $9,345 bonus.
CNN has reported that at least 40 patients died at PVAHCS due to delayed health care treatment, and many were placed on the secret waiting list to hide the stats from VACO officials.
They have also reported that internal emails of top PVAHCS officials, including Director Helman, were aware of the waiting list practice and even defended it.
News reports also quoted Director Helman as saying, “I am not aware of any secret list, nor did I direct staff to have a secret list.” Of course, her remarks beg the question, “If you knew about the secret list and did nothing to end its use — is that nothing more than a de facto proclamation supporting its use.
Director Helman as a leader had a duty to know about wait times and dishonest activities at her medical center. If not, she was derelict in her duty if she knew about the secret list and did not take swift, corrective action.
IS THERE PROOF THAT PREVENTABLE DEATHS OCCURRED AT PVAHCS?
Treatment delays for veterans at the PVACHS yielded an estimated of 40-45 who may have died waiting for an appointment. This shocking revelation was brought forward by a recently retired PVAHCS physician, Dr. Sam Foote, who leveled charges at the leadership team about the scheme to “cook the books” by using an offline secret waiting list that would reflect excellent wait time stats.
According to Dr. Foote, the outcome of this conspiracy was to delay access to sick veterans that ultimately led to some preventable deaths.
Some PVAHCS employees have stepped forward and backed up Dr. Foote’s claims, but have remained anonymous to avoid persecution and retaliation from the leadership team that were in on the scam.
WAS EVIDENCE ABOUT FRADULENT WAIT TIME LISTS AT PVAHCS DESTROYED BY VA?
Dr. Katherine Mitchell (a former VA nurse who later graduated from medical school and returned to Phoenix VAMC) became a whistleblower. She provided corroborating testimony backing up Dr. Foote’s allegations about the fraudulent wait list as well as an attempt by PVAHCS staff to destroy the offline paper waiting list.
Dr. Mitchell recently told the Arizona Republic that she and another VA employee uncovered a plan by PVAHCS managers to destroy the falsified wait time records. She then secured the paper documents inside the medical center for safe keeping.
Twelve hours later, the paper records were turned over to a VAOIG staff member who was visiting PVAHCS. These records are purportedly the “secret lists” that contain the 40 veterans who died while waiting for health care.
Previously, Dr. Mitchell had also brought issues concerning the level of care at the PVAHCS Emergency Room to the attention of Director Sharon Helman and as a result, suffered retribution by the VAMC leadership. For bringing forward her concerns about the quality of care in the overworked ER, Dr. Mitchell was transferred, suspended, and reprimanded for her trouble.
Recently, another PVAHCS whistleblower, Mr. Troy Burmesch, a 33-year old Marine combat veteran with two deployments to Iraq, stepped forward and substantiated Drs. Foote and Mitchell’s accusations.
Mr. Burmesch was a Health Administration Services (HAS) employee who opined that the waiting list and the false reports they generated were common knowledge on the PVAHCS campus.
Curiously, Mr. Burmesch’s boss, Brad Curry, the Chief of HAS, terminated his employment with PVACHS ostensibly because he was using too much leave associated with his post-traumatic stress disorder.
ARE THESE DELAYS IN HC DELIVERY A NEW TREND?
VA reports that in 2012, 90 percent of new patients were seen in 14 days while a year later, only 41 percent of new medical patients were seen in 14 days, a reduction of more than 50 percent in timeliness.
VA also reported that in 2011, 95 percent of first-time mental health patients were seen in 14 days, but under a new electronic reporting system, the rate in 2013 was 66 percent.
Based on VA’s own data, the department has struggled to meet their timeliness goals in medical care and mental health. While delays in providing care occur, veterans suffer and preventable deaths occur.
The solution to this nettlesome problem is not to cheat and devise ways to get around reporting accurate data about timeliness standards for health care delivery.
The actions by some dishonest managers to hide and disguise wait times is proven by the VA OIG, it is unconscionable and they should be referred to the Justice Department for criminal prosecution.
HAVE PREVENTABLE DEATHS OCCURRED AT OTHER VAMCs?
In a press conference last Monday, the American Legion National Commander, Daniel Dellinger, noted that VA has acknowledged that 23 veterans in the VHA’s health care system died as a result of delayed care in recent years. These 23 veterans were gastrointestinal patients who died while waiting for VA diagnostic studies, such as colonoscopies, to determine what life-saving treatment modalities should be prescribed.
In a Media Advisory on April 24, 2014, Congressman Jeff Miller, Chairman of the House Veterans Affairs Committee, stated that, “VA preventable deaths linked to mismanagement at VAMCs in Pittsburgh, Atlanta, Columbia, S.C., Augusta, Ga, and Memphis, Tenn. – department executives who presided over mismanagement are more likely to have received a bonus or glowing performance review than any sort of punishment.”
In Pittsburgh, the former Veterans Integrated Service Network Director 4 (VISN) received $63,000 in bonuses despite several patients dying from Legionnaire’s Disease due to poor infrastructure maintenance at the Pittsburgh VAMC. Although these veterans died from preventable deaths, the Pittsburgh VAMC Director, Ms. Terry Wolf, received a glowing Performance Review and a $12,924 bonus the year of the Legionnaires outbreak.
In Atlanta, VAMC Director James Clark was awarded $65,000 in bonuses notwithstanding four preventable deaths. According to the VAOIG, three of these deaths were due to mismanagement.
On Tuesday, May 6, 2014, the Austin-American Statesman reported that a VA scheduling clerk who worked at both the Austin and San Antonio facilities described how scheduling and appointment data was manipulated to hide lengthy wait times for medical and mental health appointments.
The 40-year old VA whistleblower stated he and other clerks were directed to make wait times at the Austin VAOPC and North Central Federal Clinic in San Antonio, “as close to zero days as possible.”
The whistleblower said he and other clerks were able to accomplish this by falsely setting patient’s requests for an appointment to coincide with the next available appointment.
He said that clerks were routinely instructed to not use the Electronic Waiting List because then it would show that veterans were not receiving timely appointment scheduling. He alleged that actual wait times could be as long as three months. He also revealed that he saw similar manipulation while at the Waco VAMC in 2012.
Also this week, findings completed in December 2013 by the VA’s Office of the Medical Inspector surfaced, showing that clerks at the VA Outpatient Clinic (OPC) in Ft. Collins, CO received instructions last year detailing how to falsify appointment records and thereby make it appear the clinical staff was seeing patients within 14 days.
VA investigators found that one half of the 6,000 veterans enrolled in the Ft. Collins OPC did not have necessary medical appointments scheduled. This finding leads to more questions than answers.
For instance, were these approximately 3,000 veterans on the authorized Electronic Wait List or are they languishing on an offline paper list? What was their average wait time? Was the health of any veteran negatively impacted by the delays?
The VA’s Office of the Medical Inspector’s probe into the Ft. Collins waiting list case could not confirm that patients had been injured “due to a lack of specific cases evaluation.”
Once again, the only reason the Ft. Collins falsification allegations are known is owed to the heroism of a whistleblower coming forward.
However, VA officials found that VHA policies were violated and the local VAMC leadership decided violations were less intentional than the result of confusion.
Unbelievably, no disciplinary action was handed out to trainers or managers, but retraining and weekly audits were established for clerks.
WHAT DOES VA SAY ABOUT THE ILLEGAL WAIT LISTS?
VA officials have steadfastly maintained that there is no evidence to substantiate or support the claims of preventable deaths at PVAHCS.
Recently, Dr. Robert Petzel, the VA’s Undersecretary for Health, told the Senate Committee on Veterans Affairs that an investigation five months ago found “no evidence” of a secret waiting list where patients were not getting prompt care of patients dying while waiting for care.
Mr. Mike Davies, VA’s Director of Access stated “other instances of misunderstanding” wait-time tracking requirements “but we have not found any widespread patterns of misunderstanding.”
Mr. Dan Warvi, speaking for VISN 18, addressed the situation regarding the illegal wait lists at PVAHCS stated, “There is no indication that health outcomes were affected. The Medical Center did not identify any intentional violation of the policy on the part of managers or schedulers.”
WHAT’S BEING DONE TO PUNISH THE LEADERS WHO CONCOCTED THIS SCAM?
After days of delay, VA Secretary Shinseki ordered that PVAHCS Director, Sharon Helman, Associate Director Lance Robinson, and Health Administration Services Chief Brad Curry be placed on administrative leave while the VA Inspector General investigates the unauthorized waiting list and dozens of patient deaths.
Chairman Miller, House Veterans Affairs Committee, has worked to capture information regarding the allegations of wait time manipulation and patient deaths at the PVAHCS and asked VA to ensure important evidence is not destroyed. Chairman Miller wrote to VA Secretary Shinseki on April 9, 2014, requesting that VA issue a preservation order to safeguard all documents at PVAHCS.
On April 17, 2014, eight days later, VA’s Office of General Counsel finally issued a 2 page directive regarding legal obligation to preserve evidence relevant to potential litigation.
That works out to 1 page of instructions every 4 days; not exactly a quick turn-around considering the gravity of the situation and official request from a co-equal branch of the government with VA oversight.
Incredibly, several media sources late reported that the Phoenix paper waiting lists were shredded by PVAHCS personnel in an attempt to cover up by destroying evidence before the General Counsel’s April 17th directive.
As noted above, other VAMC leaders have deemed retraining and weekly audits to be the solution to this spreading calamity.
WHY DIDN’T VAMCs USE THE FEE BASIS PROGRAM?
VAMCs have within their annual budgets, a special fund known as the Fee Basis account. Money in Fee Basis is designated for use when VA cannot provide for health care within VA facilities within VA timeliness standards. Under the Fee program, the veteran is referred to a private sector physician to be seen as soon as practicable.
The VA Fee Basis then pays the private physician for health care rendered. Why the management team at PVAHCS did not use the Fee Program to provide desperately needed health care is a mystery.
However, one plausible answer could be the practice of some VISN Network Headquarters to sweep fund control points at the VAMCs under their jurisdiction and accumulate the resources in the General VISN fund to be reprogrammed and redistributed to VAMCs for the purchase items such as expensive medical equipment.
It has been rumored that some VISN Directors and their staff set arbitrary percentages of Fee Basis savings annually for each of their subordinate VAMCs. Then when September 15th rolls around each year, the fund control points can be swept and the resources recaptured for other uses.
Obviously it pays to be very accommodating to the VISN management team because they hand out the performance evaluations and bonuses, financial resources, staffing levels, and future fee dollars.
WERE 1.5 MILLION OUTDTANDING CONSULTS PURGED BY VA?
Since mid-2013, VAMCs have been under pressure from VACO to purge and close upwards of 2 million backlogged consults for health care or diagnostic services. Of the 1.5 million orders cancelled, VACO cannot guarantee that the patients received the intended care or service.
VAMCs were given the authority to cancel unfilled appointments that were greater than 90 days old. As a result GAO reviewed VA’s process of purging the consults and discovered inadequate or no documentation in some patients’ records. The lack of information in the patient’s record regarding why specific consults were purged made it impossible to independently verify whether patients received the care ordered in the consult.
GAO’s Debra Draper stated that “We found closed consults but there was no evidence as to why it was closed. By not having that independent verification or any controls, there isn’t any way of knowing whether they were appropriately closed out.”
Reports in February 2014 showed that VA performed a mass purge of these languishing orders and dumped 40,000 unresolved appointments in Los Angeles and 13,000 in Dallas during a one week period in September 2012.
VA officials have refused to reveal how many of these so-called “administratively closed consults” cancellations have occurred or how many have actually been purged. Whistleblowers in PVAHCS have claimed that upwards of 60,000 overdue medical consults were eradicated from their backlog, leaving one to wonder if there is a correlation between 60,000 purged consults and wait time records falsification at PVAHCS.
In one VA facility, GAO investigated, three in ten patients did not receive the ordered care before the consults were purged.
According to GOS’s Draper, some of the 1.5 million were closed out properly. However, she observed that there is no way to confirm how many consults were appropriately cancelled and that a large proportion of them were “administratively closed” without any sign of appropriate review being accomplished or the patient receiving the needed care.
VA has consistently claimed that consults were closed out after careful, individual reviews. Draper said that is not a claim VA can back up.
So we are back to the old question: ”Can we trust VA in this matter?
WHERE IS THE OUTCRY FROM VA WATCHDOGS?
This week, Daniel Dellinger, the National Commander of the American Legion, called for something that they had not done since 1941 – calling for the resignation of a cabinet-level official.
Commander Dellinger called for the resignations of VA Secretary Eric Shinseki, Undersecretary for Health Robert Petzel, and Undersecretary for Benefits, retired General Allison Hickey in the wake of ongoing reports and findings of fraudulent activities, corruption, general mismanagement, and incompetence at VA.
Dellinger stated, “The existing leadership has exhibited a pattern of bureaucratic incompetence and failed leadership that has been amplified in recent weeks.”
He also opined, “VA leadership has demonstrated its incompetence through preventable patient deaths, long waits for medical care and benefit claims backlog numbering in excess of 596,000 and awarding bonuses to senior executives who have overseen such operations.”
Systematic failed leadership has VA facing other corruption incidents.
At Jackson VAMC in Mississippi, senior top managers stay employed although an Office of Special Counsel report in 2013 implicated them in criminal wrongdoing.
In February, the former Director of the Louis Stokes VA Medical Center in Cleveland, William Montague, pleaded guilty to 64 corruption charges. His sentencing is set for later this month
Director Montague was guilty of crimes including money laundering, wire fraud, mail fraud and conspiring to defraud the VA. The bribery and kickback schemes Montague developed were centered on supplying contractors inside information about VA contracts and projects in exchange for tens of thousands of dollars.
IS THERE A NEW PROGRAM CALLED “FUTURE CARE” IN VA’s FUTURE?
Rumor has it that in some quarters of VHA they are developing a new program called “Future Care” to mitigate patient wait times and to preclude mass consult purging in the future.
The plan uses a new methodology to manage scheduling of appointments, consults, and referrals at some VAMCs. When appointments cannot be scheduled within acceptable timeliness parameters, they will not be scheduled but checked as a hold for clinical and administrative review. Then a separate review would be conducted to verify whether the appointment was urgent/emergent and if so, an electronic appointment would be scheduled.
If the consult was determined to be routine, this group would be shunted into a new category (read holding pattern) called FUTURE CARE until an appointment became available or the health care became more urgent.
Only time will tell if this latest wait list for health care delivery will work adequately or lead to new failures in the provision of timely health care for our nation’s veterans.
SHOULD SECRETARY SHINSEKI STAY, RESIGN, OR BE FIRED?
What in the world is going on at the scandal-plagued Department of Veterans Affairs?
Allegations of widespread bureaucratic corruption, retaliation, gross mismanagement, preventable deaths, and protected and coddled directors who may be clueless and burdened with a self-absorbed sense of entitlement.
VA has now achieved the unenviable reputation of a department that has allegedly cultivated a systemic failure of leadership, outright fraud, compromised patient safety, cover-ups of falsified records, data manipulation, destroyed evidence, unscrupulous and unprincipled behavior at VACO and some field facilities, while benefits backlogs and logjams dishonor the service of our veterans.
Furthermore, these are some of the nicer things being said. Veterans have clearly been put at risk and VA is operating in a crisis mode. This unhealthy atmosphere at VA has been met with a “circle the wagons” mentality that further exacerbates the crisis and sullies the names of those VA employees who strive to achieve excellent service to veterans.
Fortunately, there is a cadre of devoted managers, leaders, and especially rank and file employees at VA that go to work every day and toil to overcome obstacles that get in the way of treating veterans with outstanding service and exemplary care.
Secretary Shinseki is one of the longest serving VA leaders in history. He has presided over a health care and benefits delivery system that has failed in almost every sense of the word except when VA “cooks the books” and manipulates data to look good and demonstrate they are succeeding.
The proof is in the pudding. Failed leadership and lax oversight are the breeding grounds for the scandals that have come to light.
Today, VA is slow to react, has difficulty responding truthfully, and apparently is incapable of carrying out meaningful, corrective action to a multitude of management and leadership failures. Malfeasance seems to be a growing problem Secretary Shinseki seems powerless to come to grips with effectively.
By most accounts, General Shinseki is a decent man who has honorably served his country in combat and received combat wounds that he lives with as a daily reminder of that service. Unfortunately, he presides over a struggling department that is in a protracted state of crisis.
Some say VA is too big to be effectively managed and led efficiently; others say all is well at VA and things will work out in the fullness of time. Both statements are right and both are wrong.
Make no doubt about it — VA is a huge department with competing stakeholders and the constant threat of things flying apart at any time.
With the right leadership, VA is not too big to be the effective steward of the programs designed to assist and restore veterans post military service.
In recent history, VA has been effectively managed with a high degree of integrity by the likes of Harry Walters, Ed Derwinski, Jesse Brown, and Tony Principi. They led VA through very difficult times and tight budgets.
As to the question, “Should Secretary Shinseki stay, resign, or be fired?” He should stay to take swift immediate action on the rampant incompetence and corruption that is undermining veterans’ faith and confidence in the VA system and then — resign.
Why resign? If you believe as do I, that General Shinseki is basically a decent and well-intentioned man, he has proven to be unable to forcefully resolve and fix the stubborn problems forged during his leadership. He, better than most, realizes only new leadership will be able to weed out the rampant mismanagement that has percolated through VA during his tenure.
As a former VA manager in VACO and as a Director in both VBA and VHA, I stand with the sentiments and sharp comments expressed by American Legion National Commander, Daniel Dellinger.
As part of a graceful departure plan, Secretary Shinseki should immediately establishment a top to bottom review and audit of VA’s three Administrations. This would provide his successor with much needed information and serve as the guide to revamp VA and make it responsive to the overall needs of veterans and their families.
He should rethink his mandate for an internal audit of VHA by VA. VHA and VBA have proven themselves to be totally incapable of investigating VA’s widespread culture of corruption and mismanagement.
From bungled health care delivery, to the timely provision of benefits, to criminal acts of directors, and outrageous expenditures for questionable conferences, VA is in a state of disarray that must straight away begin the long turnaround process.
To what extent there has been dereliction of duty in Secretary Shinseki’s chain of command remains to be seen. General Shinseki can salvage a life-time of service to his country and bring VA’s national embarrassment to a swift conclusion by coming to grips with the myriad of unresolved scandals rocking VA.
If Secretary Shinseki does not, the President should quickly relieve the Secretary to restore faith and confidence in the VA that is rapidly migrating from a regional tragedy to a national embarrassment. Veterans and those excellent VA employees deserve no less.
In case we need reminding, government managed health care is not easy and VA is a first-class example of “on again — off again” successes and failures that are harbingers of things to come under a single payer Obamacare scheme.
Unfortunately, it is coming to your town soon.
Shinseki’s leadership at VA has proven that not all 4-star generals make good cabinet secretaries – a Colin Powell he is not.
Mr. Poteet is a former Army gunship pilot with two tours in the Republic of Vietnam; a registered lobbyist for the Veterans of Foreign Wars;Deputy Assistant Secretary for Congressional Affairs; Director of three VA Regional Offices; a VA Medical Center Director; and Executive Director of the President’s Task Force To Improve Health care Delivery For Our Nation’s Veterans. He resides in central Texas with his wife Miriam.
For an earlier piece by Mr. Poteet published on SLD Forum see the following:
“Slow Motion Implosion at the VBA: Or Where Warfighters Become Backlog”
August 10, 2012