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May 19, 2014

"I Was Not, I Am Not" Aware of All Those Reports on VA Wait Times

So, from the earlier post about the wait list problems at the VA, we have VA Undersecretary Petzel testifying that he was notified of the problem in 2010:

...Petzel acknowledged to lawmakers that he had seen a 2010 memo titled 'Inappropriate Scheduling Practices,' which described failures in several of the VA's 21 service regions.

Shinseki, seated next to him, insisted that 'I was not, I am not' aware of it.

Now, we find out that the White House was notified of the problem in 2008... by the Bush transition team:

The Obama administration received clear notice more than five years ago that VA medical facilities were reporting inaccurate waiting times and experiencing scheduling failures that threatened to deny veterans timely health care — problems that have turned into a growing scandal.

Veterans Affairs officials warned the Obama-Biden transition team in the weeks after the 2008 presidential election that the department shouldn’t trust the wait times that its facilities were reporting.

...Mr. Shinseki, a disabled veteran, has headed the department since the beginning of Mr. Obama’s first term, when the VA report identified many of the problems.

The briefing materials do not reveal any concerns about outright fraud in manipulating waiting times, but they make repeated references in summarizing past audits and reviews about data accuracy.

“This report and prior reports indicate that the problems and causes associated with scheduling, waiting times and wait lists are systemic throughout the VHA,” officials told the incoming administration.

So we have a guy who, in 2008, was notified of a "systemic problem" in the department he has just been put in charge of. Systemic problems generally don't go away on their own.

Then, in 2010, another report mentions the same problem. And the guy at the top testifies that he "was not aware" of it (whatever "it" is).

In the comments to the earlier post, Rex comments:

... it's really hard, if not impossible, to go into the top job of any large organization and find out what's really going on and actually committing change. One has to recruit spies at the lower levels, as well as fostering a climate of doing the right thing. Hiring excellent subordinates is also necessary.

Well, the VA Secretary can only go down a couple of levels in hiring. And it appears that he didn't hire the right people. And he certainly didn't recruit spies at the lower levels.

Wouldn't have done him much good if he had. Unless he was willing to make a public stink.

VA hospitals have been underfunded for at least 30 years. When I was still practicing law in the early 80's, I had occasion to visit a VA hospital to interview a client. No A/C (in the South!), floors were not as clean as the decks in your average warship, nurses were scarce, and the doctors barely spoke English. Nothing much has changed, nor will it, until the government is willing to spend equivalent amounts of money that private or non-profit hospitals spend.

I agree with all of this. If the charge were, "You failed to fix a systemic problem that has been going on for years", I would vote to acquit. What bothers me here is that we have people we hired to run things telling us that they didn't even know there was a problem.

I have a problem with that. If you've previously been notified of a "systemic problem", then it's your job to pay attention. Telling Congress that you had no idea what was going on (whether in regard to the 2010 report alone or the entire problem is not clear) doesn't fly.

Posted by Cassandra at May 19, 2014 06:34 PM

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Looks like Shinseki is using the Karpinsky defense... "I'm in charge but I'm not responsible."

Posted by: Pogue at May 19, 2014 08:04 PM

I would even go so far, personally, as to provide for "You didn't even try to fix a systemic problem that has been around for years" because this is Xerxes, Lord of the Lies, and his visceral hatred for America's military is obvious and well-known, hence, why would any serious person *expect* him to try and fix it.
Besides, Bush didn't fix it either. Isn't that the meme still?

Posted by: DL Sly at May 19, 2014 08:06 PM

Too true by half Sly

Posted by: CAPT Mike at May 19, 2014 09:43 PM

Shinseki, seated next to him, insisted that 'I was not, I *am* not' aware of it.

Wait, the guy next to him just said that there were problems and Shinseki insists that he, in that current moment, is *still* not aware of them?

That's some pretty remarkable short term memory loss, right there. Maybe he should go see a VA doctor to get that treated.

Posted by: The Most Interesting President in the World at May 20, 2014 08:05 AM

Not credible.
Gosh, I get madder every time I see this.

Posted by: CAPT Mike at May 20, 2014 10:03 AM

I bet Gen. Shinseki thought he was getting a sinecure when he took the job. Along with his retired pay, he must be making a pretty penny. Did you know that when generals retire they start making more than when they were on active duty? That's because their pay is capped while on active duty but not in retirement.

Posted by: Rex at May 20, 2014 03:21 PM

I find it frustrating that the White House and the media keep drifting away from the falsified wait lists to the problem that there's a waiting period at all. The waiting period is sort of old news, though shameful. As soon as the news came out that Obama had been notified of the waiting period problem in 2008, I knew it would be only microseconds before we started to hear that he inherited the problem from Bush.

What he didn't inherit from Bush was VA staff who falsified records to buff up the apparent wait-list periods, and who have yet to be fired or even thoroughly investigated.

"Heckuva job, Brownie."

Posted by: Texan99 at May 20, 2014 03:52 PM

I find it frustrating that the White House and the media keep drifting away from the falsified wait lists to the problem that there's a waiting period at all.

I will probably irritate someone by saying this, but any time there's no cost to medical care, there's going to be a waiting period. That's not the problem so much as "inappropriate" triage and outright fraudulent accounting.

I used to say that the biggest problem public schools have is that they can't turn anyone away. That's true to a large extent with the entire military medical system - we could never get appointments and there were ALWAYS more people wanting care than there were doctors to provide it.

I gave up early and just got a doctor out in town so when I needed care, it was available. This isn't the fault of the folks working in military health care. It's the way the system is structured.

I couldn't get drugs that were the standard of care in the civilian world and had been for years. I had to go before a medical board to get approved for silly things. I never even had a six week checkup after the birth of our second child, and didn't see a doctor until I was 4 months pregnant either :p

Great care if something's really wrong with you, but I would never depend on it.

Posted by: Cass at May 20, 2014 04:53 PM

That's some pretty remarkable short term memory loss, right there. Maybe he should go see a VA doctor to get that treated.

I hear there's a waiting list... :p

Posted by: Cass at May 20, 2014 04:54 PM

This is the archetype for the future of Medical Care in America.

Single payer, managed by the government. When enough insurance companies, doctors and hospitals are villainized, what would be the expected outcome.

Low quality, low morale, poor treatment.

But, it's what the "People" want.

Coming soon.....EVERYWHERE! By popular acclaim.

Posted by: Don Brouhaha at May 20, 2014 05:35 PM

Just hafta say, if anyone in my boat tried that kind of obvious lie, we would disqualify him on the spot, take his Dolphins, and send him away for disciplinary action.
Saw that exactly once, some silly kid 'radioing' (faking) simple log entries. Gone in an hour. This administration has no shame.

Posted by: CAPT Mike at May 20, 2014 10:46 PM

"...take his Dolphins,..."

Well that sounds painful.

Posted by: Evil Twin at May 20, 2014 11:24 PM

If Shinseki knew about it (and I suspect he did) then he needs to go for covering it up. If he didn't know about it for the past four #^%*#%& years then he needs to go for being an incompetent administrator.

Frankly, I want (but doubt I will ever see) prosecutions over this.

Posted by: MikeD at May 21, 2014 08:59 AM

When I was on active duty and the kids were young, we'd have to wait for 2-3 hours to see a PA at the Camp Lejeune base hospital. If I was in uniform, I'd be seen within 30 minutes.

By the time my son was on active duty, his dependents couldn't use base medical facilities, but had to use CHAMPUS (now TRICARE) for all their medical needs. And that was also managed care; it took my DIL 6-9 months to get the one-of-a-kind-in-the-area approved to treat her. What a hassle!

That's why it's always amazed me that the folks who want single-payer health care refuse to understand that the care will be RATIONED.

Posted by: Rex at May 22, 2014 09:52 PM

I have rarely if ever needed a doctor until the past few years, except for when we were stationed at Parris Island. I started getting migraines and they gradually got worse until I was getting them several times a month and they were so bad that I was literally bedridden and throwing up for 2-3 days at a time.

I don't like to go to the doctor, but when it gets to the point where your husband has to take you to the emergency room because you haven't kept anything (even a sip of water) down for 3 days, I'm going to go out on a limb and call that a big deal requiring some sort of medical treatment.

I did my research and asked for a new drug (Imitrex/sumatriptan) that was in all the articles. Was told "We never get anything 'new' until it's been around for 3-4 years" and they prescribed narcotics for me.


Took them for a while, threw the bottle away after 2 weeks, went back to the doc. Again, am told "no way - we don't have that". Get another scrip for ergotamine (I kid you not). Tried that for a while until I started throwing up even when I didn't have a headache. Went back to the doc. Lather, rinse, repeat.

A few weeks later I'm sitting at the dining room table with an insurance salesman and we start talking about military medical care (he's retired military). I mention my problems and he says, "You're kidding me! My wife has been on Imitrex for 2 years now and gets her scrips filled right at Beaufort Naval Hospital!"


I call them and am (again) told "We don't have that." This is now maybe the 5th time I have asked about it, and now I *know* I'm being lied to or at best am dealing with professional level incompetence. At this point we have orders to move to California (29 Stumps). When I get there, I ask about Imitrex and they tell me, "Yes we have it, but your case will have to go before a medical board and you'll have to prove you've tried everything else and it hasn't helped."

Keep in mind that this was the mainstream drug of choice for migraines. So I'm with Rex:

"...it's always amazed me that the folks who want single-payer health care refuse to understand that the care will be RATIONED.

Posted by: Cass at May 23, 2014 03:07 PM