Confirming problems flagged by whistleblowers and investigators, a review of the troubled Veterans Affairs health care system ordered by President Obama shows that medical care for veterans is plagued by "significant and chronic system failures."
A summary of the review, issued by deputy White House chief of staff Rob Nabors on Friday, said, "The Veterans Health Administration (VHA) needs to be restructured and reformed. It currently acts with little transparency or accountability with regard to its management of the VA medical structure," adding that a "corrosive culture" has injured morale and negatively affected the speed of health care.
The review also found that employees had manipulated wait times to appear shorter than they actually were.
Nabors, along with acting VA Secretary Sloan Gibson met with Obama Friday evening to go over the latest developments in the efforts to improve VA health care facilities and address longstanding complaints from veterans about substandard care and long wait times for appointments.
The VA has been under intense scrutiny since the spring, when allegations surfaced that as many as 40 veterans died while waiting for care at a Phoenix VA facility. Since then, a number of Department of Veterans Affairs officials, including VA Secretary Eric Shinseki, have resigned as problems with veterans care have been exposed.
"This afternoon I spoke with President Obama about the actions we've taken to accelerate access to care and to get Veterans off of wait lists and into clinics," Gibson said in a statement. "We greatly appreciate and welcome Rob Nabors' insight and leadership as we work to strengthen the Department of Veterans Affairs (VA). We know that unacceptable, systemic problems and cultural issues within our health system prevent Veterans from receiving timely care. We can and must solve these problems as we work to earn back the trust of Veterans."
The review makes several recommendations, including hiring more doctors, nurses and trained administrative staff.
Despite outrage from veterans, staff turnover, calls for reform and promises to take swift action, the situation at the Department of Veterans Affairs is not so different from when allegations of deaths related to long, covered-up appointment wait times first surfaced in April. Or when evidence of improper scheduling and long wait times arose in 2005 under President George W. Bush.
With Congress away until after the July 4 weekend and partisan rancor stoked by House Speaker John Boehner’s threats to sue Obama for executive overreach, prospects for a VA reform bill remain murky.
Sen. Bernie Sanders, I-Vt., and Sen. John McCain, R-Ariz., proposed a reform bill in June that would essentially double VA spending. Sanders, who excoriated Republicans for blocking a veterans bill in February, has been especially outspoken about the need to increase resources for health care, education and family benefits.
The bill passed in the House would also increase spending, but there is no agreement on how to pay to fix the broken system. As fights last year over the debt ceiling, the federal budget and the annual defense spending bill have shown, getting to a compromise could take a long time and still leave many veterans without better care.
Nabors and Gibson have both been heading efforts to review and improve VA health care. Obama tasked Nabors with a comprehensive review of the scheduling procedures that a VA inspector general’s office interim report found health care to be broken system-wide. The report found that 1,700 veterans Phoenix-area veterans were left off the official appointment waiting list in that city's health system.
Two days after the IG report was released, Shinseki resigned and was replaced by Gibson. There is not yet a nominee to replace him.
Shinseki’s post is not the only one waiting to be filled. On Wednesday, the VA announced that two top officials, the general counsel and the official in charge of health care, would leave the department. As the Air Force Times reported Thursday, two nominees to top VA posts have been waiting months to be confirmed.
Just this week, the Office of Special Counsel (OSC) submitted a letter to Obama detailing examples of widespread failures in VA health care facilities, from scheduling issues to contaminated water supplies. The letter also accused the VA of labeling such failures as “harmless errors” to avoid investigating further. The OSC currently has more than 50 pending whistleblower complaints over VA care.
One of the examples cited by the OSC was that of a VA mental health care facility, at which two veterans waited years before receiving comprehensive examinations from a doctor.
On Friday, the head of the Iraq and Afghanistan Veterans of America called on Obama to sit down with veterans groups and listen to what they think can be done to improve care and restore faith in VA institutions.
"The president needs to hear firsthand from leaders within the VSO community and meet with vets outside the Beltway to hear the challenges our community is facing," Paul Rieckoff, IAVA's CEO and founder, said in a statement. "A well-informed leadership is key to rectifying the egregious corruption plaguing the VA. We hope to work with the Administration to help lay the path forward for a 21st Century VA our veterans deserve."