Push grows for Shinseki to go as veteran care flaws found

Pressure grew on U.S. Veterans Affairs Secretary Eric Shinseki to resign as an internal report found “systemic” scheduling problems that have stymied health care for veterans, and lawmakers held a rare nighttime hearing Wednesday to vent their frustration with the agency.

“Where in the world is the urgency” to fix the deficiencies? U.S. Rep. Jackie Walorski, an Indiana Republican, asked a trio of VA officials at a session that lasted four hours and ended shortly before midnight in Washington, D.C. “I have more questions tonight than I did when I walked in here.”

The Veterans Health Administration is the nation’s single largest health system, with more than 53,000 independent practitioners providing care to more than 8.3 million veterans each year.

Much of the furor at the House Veterans Affairs Committee hearing was sparked by an inspector general’s report Wednesday on allegations that some VA hospitals kept phony waiting lists to hide long delays in providing health care. Richard Griffin, the department’s acting inspector general, wrote that in reviewing 42 VA medical facilities, his office documented repeated instances of waiting lists being manipulated.

At the Phoenix VA facility that first focused widespread attention on the agency, as many as 1,700 veterans were “at risk of being lost or forgotten” when that hospital left them off an official list of patients waiting to see a doctor, according to the report.

The official list showed that veterans waited just 24 days for their first primary-care appointment, the report said. A more complete list—whose existence was secret and which included more veterans who sought care—showed the average wait-time was 115 days, according to the report.

An additional report found the VA's Eastern Area Fiduciary Hub in Indianapolis was "not timely processing allegations of misuse of beneficiary funds, conducting field examinations, and processing some incoming mail."

The report cited backlogs in processing mail as long as 486 days and 30 days on average. "As a result, the general health and well-being of beneficiaries are placed at increased and unnecessary risk," the report said.

Democratic calls

The report said a 2010 VA study first disclosed many of the practices that manipulated patient wait times.

In a potentially significant political development, growing numbers of Democrats joined Republican colleagues in urging Shinseki to resign in the wake of the new report.

Democrats now pushing for Shinseki to step down include some facing competitive races in November: Sens. Mark Udall of Colorado, Kay Hagan of North Carolina, Al Franken of Minnesota and John Walsh of Montana. They were joined by three House Democrats who won tight races in 2012: Reps. Kyrsten Sinema and Ron Barber of Arizona and Scott Peters of California.

The Veterans for Foreign Wars also Wednesday called for Shinseki’s resignation, which has previously been urged by the American Legion. The two groups are the largest U.S. fraternal organizations for veterans.

The inspector general’s report expanded the unfolding scandal that has put the White House on the defensive and spurred the nighttime committee hearing.

Three officials

Republican and Democratic panel members took turns hammering the three Department of Veterans Affairs officials, who told them that a list of veterans in Phoenix awaiting care had been destroyed in 2012 or 2013. The panel has subpoenaed documents from the VA related to the list, which includes at least 40 veterans who died while waiting for care, said Rep. Jeff Miller, a Florida Republican and the committee chairman.

Rep. Phil Roe, a Texas Republican, asked Thomas Lynch, the VA assistant deputy undersecretary for health for clinical operations and management, how he could “look at yourself in the mirror while you’re shaving every morning and not throw up,” given the problems in care for veterans that have come to light.

Lynch, who recently visited the VA facilities in Phoenix, told Roe he is focused on finding solutions to the lengthy waits and that, “I take my job seriously.”

Measures faulted

Lynch defended the quality of VA health care. Even so, he said performance measures that rewarded officials for short wait times undermined the agency’s focus on what should have been its priority—efficiently serving veterans.

“Our performance measures have become our goals, not tools to help us understand where we needed to invest resources,” he said. “We undermined the integrity of our data when we elevated our performance measures to goals.”

He told lawmakers the VA’s health system needed additional capacity and more physicians.

“There’s the potential that we have lost true north,” Lynch said, when asked by Miller if the VA had a suffered from a “failure of leadership.”

The inspector general’s report prompted Miller to call for Shinseki’s resignation. He “is a good man who has served his country honorably, but he has failed to get VA’s health-care system in order despite repeated and frequent warnings from Congress, the Government Accountability Office and the IG,” Miller said in a prepared statement.

‘Completely oblivious’

“What’s worse, to this day, Shinseki—in both word and deed—appears completely oblivious to the severity of the health-care challenges facing the department,” Miller said.

President Barack Obama found the inspector general’s report “extremely troubling,” White House Press Secretary Jay Carney said Wednesday in an e-mailed statement. Carney reiterated Obama’s call last week for the VA to improve care immediately and not wait for investigations to conclude.

“The president agrees with that action and reaffirms that the VA needs to do more to improve veterans’ access to care,” Carney said, without commenting on calls for Shinseki’s ouster.

Obama has said he will punish any officials responsible for covering up delays. He assigned Rob Nabors, his deputy chief of staff, to conduct a broader review of veterans’ health care to be delivered next month.

Shinseki’s response

Shinseki, a retired U.S. Army four-star general who was wounded in Vietnam, said his department will “aggressively and fully implement” recommendations in the report, including one to take “immediate action” to provide health care to veterans left off official waiting lists.

“I have reviewed the interim report, and the findings are reprehensible to me, to this department and to veterans,” Shinseki said in a statement.

The report deepened a political backlash from both parties over VA operations.

“This has been occurring for four years without action to make it stop,” Sinema said in an interview. “I think we’ve seen a lack of leadership on this issue.”

Democratic Reps. John Barrow of Georgia, Rick Nolan of Minnesota, Joe Garcia of Florida and Nick Rahall of West Virginia previously sought Shinseki’s resignation. All are in election races expected to be competitive this year.

Outside groups are beginning to cite the VA scandal as an election issue. Crossroads GPS, a Republican-aligned nonprofit advised by former President George W. Bush aide Karl Rove, said it spent $450,000 on a week-long advertisement in an Alaska Senate race.

Begich ad

“A national disgrace. Veterans die waiting for care that never came,” the 30-second spot began. “Sen. Mark Begich sits on the Veterans Affairs committee. His response? ‘If there’s a problem, they need to fix it.’”

The ad concluded: “Tell Sen. Begich, when veterans are dying, it is a problem.” Begich, a Democrat, won the Alaska Senate seat in 2008.

A former Army chief of staff, Shinseki was among Obama’s first choices to head a federal agency. At the time, Shinseki was known for being one of the only generals willing to contradict the Bush administration over the Iraq War when he told Congress in 2003 that several hundred thousand troops may be needed to control the country.

Shinseki resigned from the military after then-Defense Secretary Donald Rumsfeld said the prediction was exaggerated. About 1.5 million Americans served in Iraq, including more than 4,400 who died and another 32,200 who were wounded.

Senator John McCain, an Arizona Republican who, like Shinseki, is a wounded Vietnam veteran, told CNN Wednesday that it’s time for Shinseki “to move on” from the VA post.