The people who run the Puget Sound Veterans Affairs hospitals weren’t hiding the ball last spring during the national scandal over treatment delays for sick veterans. It appears they were hiding a different ball.
The VA system as a whole lacks the capacity to handle the surge of vets now seeking care from it, some of whom have been forced to wait for months to see specialists. Many hospitals and clinics are slammed and incapable of meeting the unrealistic national goal – adopted in 2011 – of seeing patients in 14 days or less.
The delays, which have sometimes lasted months, have been linked to the deaths of dozens of veterans who couldn’t get in fast enough. It turned out that some VA administrators were cooking the books to make themselves look good and perhaps collect bonuses in the bargain. They were pressuring to schedulers keep secret lists to conceal the actual dates when patients had called to request appointments.
When federal investigators took their first look at the VA hospitals in Seattle and Lakewood, the two Puget Sound facilities came off relatively well. The waits were long – an average of 59 days for new patients – but the auditors didn’t turn up specific instances of deception.
They did, however, suggest that the VA hospitals in Lakewood, Seattle, Portland and Spokane needed a closer look.
Part of that closer look was a survey of schedulers, who were asked several key questions. One was designed to ferret out the use of separate lists to evade the computer system that records and dates appointment requests. The Puget Sound hospitals did well on that score.
But another question focused on dates requested by veterans: “Do you feel you receive instruction from the facility to enter a desired date other than the date a veteran asks to be seen?”
A full third – 33.33 percent – answered yes. If a third of the schedulers are being told to enter false dates, something is very, very wrong. Even 15 percent would be scandalous, assuming the intent is to cover up delays and inefficiency. Investigators are presumably giving this practice a hard look.
One problem here is that 14-day goal. It creates temptation to conceal actual performance. At some sites, the goal simply can’t be met, mainly because of understaffing.
Congress has acknowledged as much; the House and Senate have just settled on a rescue package that – among its other provisions – appropriates $5 billion to hire more VA doctors, nurses and other professionals.
The new funding is part of the fix. Another part should be hard questions about whether the VA is the logical place to offer vets all their health care.
The VA medical system is well-suited to deal with PTSD, war wounds and other injuries specific to combat and military service. For ordinary illnesses, civilian clinics and hospitals may be more logical. They certainly tend to be easier for most veterans to get to. With 21st century medical information systems, it should be possible to coordinate individual care.
The immediate priority should be ridding the system of deception and people who’ve fostered it. When veterans’ lives are at stake, deceit is intolerable.