American Elephants


Poor Care at VA Hospitals Cost 1,000 Veterans Their Lives by The Elephant's Child

Veterans Medical Care

The problems at Veterans Affairs extended far beyond long wait lists. A report today showed the department is plagued with poor care that has cost up to 1.000 veterans their lives, and left American taxpayers on the hook for nearly $1 billion in malpractice settlements since 2003.

Senator Tom Coburn reports that “the problems at the VA are worse than anyone imagined.” Dozens of veterans have died while stuck on secret waiting lists at a VA facility in Phoenix. An inspector general’s investigation has found widespread misuse of secret wait lists in a number of facilities.

Senator Coburn’s report, titled “Friendly Fire: Death, Delay and Dismay at the VA,” argues that problems go back well beyond the Phoenix scandal and run far deeper than phony wait lists and scheduling practices designed to demonstrate that managers were meeting their performance goals. His report details dreadful cases.

A Philadelphia vet went in for a tooth extraction. Doctors went ahead despite his dangerously low blood pressure. On the way home from the operation, he had a stroke and was paralyzed. A vet in South Carolina had to wait nine months for a colonoscopy. By the time he had the procedure, he was diagnosed with stage three  cancer. The VA admitted  that had he been treated earlier his case might not have been so severe. Another veteran had annual chest X-rays, but doctors never spotted a growing lesion in his lung. It ultimately killed him.

Some legislators recommended more financing, as usual, but the problem can be traced back to bad management and lax working standards, not to lack of money. In one finding, Coburn said, VA doctors average about half the workload that private-practice primary care physicians do.  He added:

Female patients received unnecessary pelvic and breast exams from a sex offender.  The VA is way behind on processing disability claims and constructing facilities. Some VA health care providers have lost their medical licenses, but the VA hid that information from patients. The federal government has paid out $845 million for VA medical malpractice settlements since 2001.

A security chief, Richard Meltz, head of security at the Bedford VA Medical Center pleaded guilty in January in involvement in what the FBI called “two sadistic kidnapping, rape and murder conspiracies.” He also advised two others on how to avoid being tracked, such as not using toll roads, and where to dump bodies.

The FBI says it has opened a criminal investigation of the Veterans Affairs Department. The Bureau’s Phoenix office has joined an ongoing review by the VA inspector General.

Somme of the reasons for the chronic problems include a bonus system that rewarded managers for meeting goals regarding access to treatment. The audit findings, covering 731 VA facilities nationwide and based on interviews with more than 3,700 staff members, said a 14-day goal instituted by the Obama administration, for providing care to newly enrolled veterans proved “simply not attainable” due to growing demand and lack of capacity. “Imposing this expectation the field before ascertaining the resources required represent an organizational leadership failure.

The audit portrayed 57,436 newly enrolled veterans facing a minimum 90-day wait for medical care, 63,869 veterans who enrolled over the past decade requesting an appointment that never happened. A patient who had been admitted for “significant and chronic mental health issues” lived in the 106 bed facility for eight years before he received his first psychiatric evaluation.

Well meaning bureaucrats had no other way to measure the effectiveness of VA Hospital care—than wait times, so they gave them 14 days maximum wait time for a veteran to be seen by a medical professional. That’s the way it works in large government bureaucracies.



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!



Obama Was Warned About VA Hospitals 5 Years Ago! by The Elephant's Child

wounded-veterans-waiting-AP

Investors and the Washington Times both reported that Obama was warned about the Veterans Administration’s wait time and treatment schedule five years ago, contrary to Jay Carney’s claim that they just learned about it.

On April 9, 2009, with his Secretary of Department of Veterans Affairs (VA) Eric Shinseki by his side, President Obama said, “As long as I’m commander-in-chief, I promise that we will work tirelessly to meet that mission and make sure that all those who wear this nation’s uniform, know this when you come home to America, America will be there for you.”

True, he has significantly increased VA funding on his watch. This upcoming fiscal year Obama requested a 3% boost for the Veterans Affairs budget. Obama’s fiscal 2015 budget request points out he has increased the VA discretionary budget by 35.2% since 2009. The question amid this scandal is just how this taxpayer money was spent.

Just months before the president made his pledge to veterans, VA officials warned the Obama transition team that the wait-times reported by VA hospitals were not to be trusted, and that bureaucrats might be cooking the books to make performance look better— and bonuses more likely.

According to records reviewed by the Washington Free Beacon, the VA has spent $489 million to upgrade conference rooms, buy drapes and purchase office furniture during the past 4½ years. Though it doesn’t seem to be a matter of the budget.

On Fox & Friends, Monday, Dr. Margaret Moxness who was employed at the Huntington VA Medical Center in Charleston, W.VA. from 2008 to 2010, said she was told by superiors to put patients off for months on end, even after she told them her patients needed immediate care. At least two of her patients committed suicide while the waited for care between appointments. She left the VA after memos she sent to superiors were ignored.

In Dayton, a Daily News report said its investigation of a database of claims paid by the VA showed that the words “delay in treatment” were used 167 times.

The notable firing of the second-in command person in the VA doesn’t really impress anybody when it is learned that he had already announced his retirement this summer. They tried that trick before, and it didn’t work.

This is very odd.  It seems to be a system-wide — slowdown, lack of personnel, what? and long term. It has been going on for years, and whistle-blowing doctors complain of orders from “superiors.” We have a remarkable lot of corruption in government agencies, and no one seems to care—until it is made public that people are dying for lack of care.

Cover-ups sometimes work for a while, but policies become more scandalous when the cover-up falls apart. Better to fess-up in the first place, and face the music.

ADDENDUM: The White House responded to the Washington Times report on VA wait times.  They acknowledged Monday that President Obama was warned of problems in the VA years ago and said “that was why he asked Congress repeatedly for more money to try to improve care for veterans” Uh huh.

Press secretary Jay Carney said the problems extended back before Mr. Obama’s term. (He hasn’t gotten over trying to blame everything on Bush). Full investigation. Critics should wait. President right on top of everything. This isn’t what I meant by fessing-up. Has Obama ever been to blame for anything? Didn’t think so.




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