American Elephants


Desperately Seeking Scapegoats! by The Elephant's Child

Veterans Medical Care

Why am I not surprised? A long list of Democratic Senators are now calling for the resignation of Veterans Affairs Secretary Eric Shinseki. The theory is that if you get rid of the guy in charge, then you can assign the whole scandal to him, and put the rest of it in the nevermind file.

The Senators demanding General Shinseki’s resignation completely, coincidentally, just happen to be those who are all up for reelection in November. Once the inspector general’s preliminary report came out, with the stunning wait-times at the Phoenix VA of 115 days, and “systemic” problems at VA medical facilities the Senate’s most vulnerable Democrats jumped promptly on the bandwagon.

You have Democratic Senators Mark Udall of Colorado, John Walsh of Montana and Kay Hagan of North Carolina who released separate statements that the Secretary must go. Al Franken of Minnesota, Jeanne Shaheen of New Hampshire, Mark Begich of Alaska, Mary Landrieu of Louisiana. The Senators were joined by Rep Scott Peters of California, Bruce Braley of Iowa and Ron Barber of Arizona. Three Republicans who are influential on military affairs, House Committee on Veterans Affairs Chairman Jeff Miller (R-FL), House Armed Services Chairman Buck McKeon (R-CA) and Sen John McCain said Shinseki must step aside.

If General Shinseki were to depart today, it would not fix anything. The problems predate his tenure. Assigning the scapegoat role to General Shinseki might well be used as an excuse to avoid a real housecleaning, prison sentences for the guilty and a deep analysis that considers whether or not a government-run health care system can adequately address the needs of our veterans.

The VA has some remarkable expertise in medical needs specific to military veterans. Advances in the technology of prosthesis, in ptsd care, have responded to injuries in an age of IEDs. The veterans dying because of wait-times seem not to be the young healthy vets of Iraq and Afghanistan, but of older vets with cancers and tumors needing immediate attention which never came. It sounds like the medical staff is caring and skilled, but the tests and scans their patients need—wait months for scheduling. Their complaints cannot get past hospital administration, and nothing changes.

The problems seem to lie in the administrative ranks, and in the union. The fiddling with requests for appointments and treatments reach far beyond one hospital, which would seem to point to some collaboration among hospitals. Sloth, indifference, greed, corruption and deceit— bonuses, promotions. It is the Civil Service System that is the culprit—the bureaucracy. Bruce Walker sums up the possibility of reform:

The Civil Service was created more than a century ago to prevent an incoming administration from firing government employees and replacing them with party operatives who helped to win the election. However noble the original intention of this change may have been, the practical effect was that Civil Service employees became almost impossible to fire.

We’ve had a lot of scandals, but no one has yet gone to prison that I know of. They get parked in something called “administrative leave.” at full-salary.

So far more than 40 hospitals have been implicated, and a full criminal investigation may actually happen. In Phoenix an estimated 1,700 veterans and their families were wrongly placed in waiting list purgatory. The inspector general’s interim report reveals “that delays, hidden by the fraudulent manipulation of records have long been business as usual throughout the health care system charged with serving nearly 9 million veterans.”

The Center for Investigative Reporting last year found that after the VA’s July 2012 promise to shrink its benefits backlog “right now” — coming in the midst of the presidential campaign — long waits actually increased by about 18,000 over roughly the next six months.

Americans care about their veterans, and aren’t going to stand for mistreatment.


If You Want The Truth, Talk To The Doctors Who Trained at VA Hospitals! by The Elephant's Child

A watchdog report from the VA’s independent inspector general focuses on the Phoenix VA Health Care System in Arizona, where wait times for patient appointments were improperly reported, but it also  points to widespread scheduling problems throughout the VA health care system. The report said “Our reviews at more VA medical facilities…have confirmed that inappropriate scheduling practices are systemic,” the report said. The inspector general said it had identified potential criminal and civil violations, and is coordinating efforts with the Justice Department.

According to an article in the Wall Street Journal by Dr. Hal Scherz, a pediatric urological surgeon at Georgia Urology and Children’s Healthcare of Atlanta, and member of the faculty of Emory University Medical School,  members of Congress who are attempting to get to the bottom of this, instead of calling  for the resignation of General Shinseki, should be talking to the doctors who trained there.

There are 153 VA hospitals, most of them are affiliated with the country’s 155 medical schools, and they play an integral role in the education of young physicians. These physicians have borne witness to the abuses and mismanagement, and when they attempt to fight against the entrenched bureaucracy on behalf of their patients, they meet fierce resistance.

Most doctors have their personal VA stories. In my experience at VA hospitals in San Antonio and San Diego, patients were seen in clinics that were understaffed and overscheduled. Appointments for X-rays and other tests had to be scheduled months in advance, and longer for surgery. Hospital administrators limited operating time, making sure that work stopped by 3 p.m. Consequently, the physician in charge kept a list of patients who needed surgery and rationed the available slots to those with the most urgent problems.

Proponents of the Affordable Care Act have long used the VA to showcase the benefits of federally planned and run health care. Doctors know otherwise—and it is no surprise that a majority of them have opposed a mammoth federal regulatory apparatus to control health care in this country. The systemic problems with the VA bureaucracy are a harbinger of things to come.

He suggests providing veterans with federally issued insurance cards, allowing them to receive their care in the community, where it can be delivered more efficiently and far better.

Clean out the swamp. Send appropriate bureaucrats to prison, and fix this national embarrassment directly and promptly. Let’s not have any more of our honored veterans die of neglect and inattention. 115 day wait for an appointment indeed!




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