Every year, Americans set aside the last Monday in May to remember the men and women who died while serving in the U.S. armed forces. This Memorial Day, we're troubled by reports that our surviving veterans are dying while waiting to see a doctor.
Worse, there's good reason to believe that health facilities overseen by the U.S. Department of Veterans Affairs have been lying about those long delays.
Whistleblowers who'd worked for the VA health system in Phoenix complained last year that the facilities maintained a secret list of patients awaiting care — some of them for up to 21 months — and moved them to an official list shortly before their appointment dates to hide the delays. Forty patients died waiting, The Arizona Republic reported.
Since then, reports of similar bookkeeping schemes have surfaced at VA facilities in at least 10 states. Veterans Affairs Secretary Eric Shinseki has ordered an audit of the entire system. Investigators have visited Hines VA hospital near Maywood, where a union official says secret wait lists are "regular, normal business." Hines officials say that's not so.
The VA's inspector general says there's no evidence so far that delays in treatment caused the deaths of patients who were awaiting care in Phoenix. That's small comfort. It's clear that those patients — and thousand of others who did not die — waited unacceptably long to see a doctor, and that the ailments for which they sought treatment weren't diagnosed or treated in the meantime.
Patients and their families have testified that their pleas for expediency often went unanswered.
In April, the VA acknowledged that since 1999, at least 23 patients nationwide have died of gastrointestinal cancers after long waits for screenings that would have detected their tumors earlier.
The patient backlog isn't new. The Government Accountability Office warned of dangerously long wait times at VA facilities as early as 2001. The lying isn't new, either. In 2007 and 2010, the VA's auditor general found that hospitals and clinics were gaming the scheduling system to disguise delays. In 2012, the GAO called the VA's wait-time reporting "unreliable."
The VA health system is the largest in the country, with 1,700 facilities, including 152 hospitals, serving 8.8 million veterans. Twelve years at war, an aging population of Vietnam veterans and President Barack Obama's pledge to improve and expand access have overwhelmed the system.
In 2010, when VA health care costs were about $48 billion, the Congressional Budget Office projected they'd be $69 billion to $85 billion by 2020.
Given the ballooning demand, it's not surprising that hospitals and clinics have trouble meeting the VA's targeted 14-day waiting time for appointments. But falsifying documents to hide the delays is counterproductive and unforgivable.
Understating those waits defuses any sense of urgency about addressing the backlog. It's especially unconscionable — and possibly criminal — that those misrepresentations allowed administrators to collect performance bonuses. Some of those people could end up in jail. All of them should be fired.
What about Shinseki? The American Legion — the nation's largest veterans group — wants him out. So do a lot of members of Congress.
It's hard to defend him. Despite increasing enrollment, the backlogs have gone down on his watch — if you believe the VA's numbers, that is — but there's no excuse for the deceptive scheduling scams to have continued after being called out multiple times. But firing him would be another phony fix. A change at the top won't make the delays go away or hold accountable those who did cook the books.
The president and Congress need to think long and hard about the promises this nation makes to its troops and how it will fulfill them.
Surveys consistently show veterans are very satisfied with the quality of care they get from the VA, once they get it. The aim should be to make sure they don't languish awaiting treatment.
The fastest and most effective solution would be to give them the flexibility to seek help through private medical systems when the VA can't see them soon enough, as Sen. John McCain has suggested. That could lead to giving veterans broad access to the private health system for primary care and narrowing the focus of the VA system to the specialized care it does best, such as treatment of traumatic injuries.
The immediate task is to see that those most in need of care get it first.
It should be unthinkable that a veteran could survive the horrors of war only to die of cancer for want of a colonoscopy.
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