After Disastrous Audit Shinseki Steps Down

Last week President Obama was noncommittal about the ongoing scandal at Veterans Affairs hospitals throughout the country. In a press conference he prefaced his remarks with things like “if these allegations prove to be true” and the “possibility that folks intentionally withheld information“ and the “possibility that somebody was trying to manipulate the data.” But now, there’s nowhere to hide. The New York Times reports:

In the first confirmation that Department of Veterans Affairs administrators manipulated medical waiting lists at one and possibly more hospitals, the department’s inspector general reported on Wednesday that 1,700 patients at the veterans medical center in Phoenix were not placed on the official waiting list for doctors’ appointments and may never have received care.

The scathing report by Richard J. Griffin, the acting inspector general, validates allegations raised by whistle-blowers and others that Veterans Affairs officials in Phoenix employed artifices to cloak long waiting times for veterans seeking medical care. Mr. Griffin said the average waiting time in Phoenix for initial primary care appointments, 115 days, was nearly five times as long as what the hospital’s administrators had reported.

Those eye-popping numbers bear repeating. Seventeen hundred patients were sloughed into a secret waitlist and never received care. The average waiting time for initial appointments was 115 days. Five times as long as reported! And the most astounding part of it all – this report just covered the VA in Phoenix.

How could something like this happen? Why on earth would VA bureaucrats go to such lengths to hide veterans who weren’t receiving care? Why not just ask for help? The Office of Inspector General (OIG) report has a hint.

“A direct consequence of not appropriately placing veterans on EWLs (electronic wait lists) is that the Phoenix HCS leadership significantly understated the time new patients waited for their primary care appointments in their FY 2013 performance appraisal accomplishments, which is one of the factors considered for awards and salary increases,” the report says.

Unfortunately, the practice was not confined to Phoenix, but appeared to be a systemic problem in VAs across the country. The OIG is looking into 42 medical centers (up from 26 last week) and is already noting that they are “finding that inappropriate scheduling practices are a systemic problem nationwide.”

Perhaps the most damning thing in the report is the OIGs reiteration that this is not the first time they’ve found problems at the VA.

“The issues identified in current allegations are not new,” the report states. “Since 2005, the VA Office of Inspector General has issued 18 reports that identified, at both the national and local levels, deficiencies in scheduling resulting in lengthy waiting times and the negative impact on patient care.”

Eighteen reports in the last nine years. And yet only now are we getting any degree of humility. In a recent USA Today post Shinseki explained that he was directing VAs to give veterans “the care they need and deserve.” He also promised to conduct a nationwide audit, place wrongdoers on administrative leave, and accelerate care. But this is less about what Shinseki has done in the last month than what he has done in the last five years. After all, the budget for the VA has increased by 78 percent in the last six years, the largest of any Cabinet agency in Obama’s tenure.

Despite the agency’s growing resources the problems at VAs continued to grow unabated. That’s unacceptable. It’s unconscionable. And it demands action.

Update: Finally, the chorus of criticism coming from Congress, the media and veterans’ groups has proved too much – Secretary Shinseki has issued his resignation. The question remains why it took this long.