by Leah Lacure
In a hearing on Thursday, May 15, entitled, “The State of VA Health Care,” the members of the Senate Veterans Affairs Committee emphasized the importance of determining and correcting the failings of the veterans’ health care system. Overwhelming attention to this issue stems from reports that veterans’ hospitals in Phoenix, Arizona, and possibly other cities, have been “gaming the system” by falsely reporting wait times of those seeking care – ultimately resulting in the preventable deaths of at least 40 veterans due to extended wait times. Committee Chairman Bernie Sanders (I-VT) asserted that providing veterans with quality care is not only a responsibility, but a moral obligation of the Committee and the Department of Veterans Affairs.
The hearing featured three panels of individuals relevant to the issue discussed. The first panel included Eric Shinseki, Secretary of Veterans Affairs, and Robert Petzel, MD, Under Secretary for Health. Both men expressed concern for the allegations and their effects on veterans’ abilities to feel secure in the quality of health care provided to them. However, Secretary Shinseki also stressed the importance of allowing the Inspector General to finish an unbiased review before jumping to conclusions regarding who is to blame and deciding how to correct the situation. Shinseki stated, “If these allegations are true, they are completely unacceptable—to Veterans, to me, and to our dedicated VHA employees. If they are substantiated by the Office of the Inspector General (OIG), responsible and timely action will be taken.” To this, Senator Patty Murray (D-WA) responded, “This is absolutely critical: this review will not work if those people who are telling you the information do not tell you the truth.” Since then, whistleblowers within the hospitals have already reported attempts by their colleagues to conceal evidence of secret wait lists, and Secretary Shinseki has come under fire for his leadership at the VA.
The second panel consisted of leaders of several organizations devoted to veterans’ advocacy, including the National Commander of the American Legion, Daniel Dellinger, and the Executive Director for Policy and Government Affairs of Vietnam Veterans of America, Rick Weidman. While these leaders acknowledged the high quality of care provided at many veterans’ hospitals, they reiterated concern for the recent allegations against the VA and the grave repercussions they have had on the veteran community. Dellinger and Weidman expressed a range of frustration regarding shortfalls in funding for VA construction and medical care, as well as oversight failures in the Department of Veterans Affairs.
Senator Johnny Isakson (R-GA) and Sen. Mike Johanns (R-NE) inquired about whether optional access to the private health care system for specialized health concerns would benefit veterans, given the capacity and access issues addressed by the second panel. Carl Blake, National Legislative Director of Paralyzed Veterans of America, responded that although this could potentially benefit veterans, it is not necessarily the desired outcome, as veterans would simply prefer to have access to the VA. Additionally, Dellinger and Joseph Violante, National Legislative Director of Disabled American Veterans, articulated concerns that providing payment for veterans to seek private care would undermine the structure of the VA by allocating its resources into the private sector rather than to hiring new clinicians and would, in essence, be “robbing Peter to pay Paul.”
Several members of the panel cautioned against a rash decision to dismantle the VA in favor of a new alternative, citing the specialized and quality care the VA does provide. Panelists specifically distinguished the problem as an access problem rather than a quality of care problem. Referring to President Barack Obama’s promise to address problems of the VA within his term, VFW National Legislative Service Deputy Director, Ryan Gallucci, stated,
Today we ask not only for the President to live up to his word, but we implore Congress to do the same. We cannot sit on our hands and wait for the system to slowly improve. The situation that is unfolding across the country demands immediate, decisive action. The mission of VA Health Care is far too important and, as veterans, advocates and users of this system, we will not allow it to fail.
Veterans Affairs Acting Inspector General, Robert Griffin, served on the third and final panel of the hearing. In his testimony, he addressed the two primary questions on which the investigation will focus: whether the facilities’ wait lists purposely omitted names of veterans awaiting care and at whose direction, and whether the deaths of these veterans were in fact related to delays in care. The investigation will use seven methods to uncover these answers: interviewing staff with knowledge of scheduling processes as well as interviewing whistleblowers, collecting and analyzing documents related to scheduling and enrollment, reviewing medical records of patients whose deaths may be related to the alleged transgressions, reviewing performance ratings and awards of senior facilities staff, reviewing complaints to the OIG hotline related to delays in care, reviewing prior investigations relevant to this issue, and reviewing massive amounts of email and other documents pertinent to this review. Griffin asserted his opinion that OIG is the appropriate entity to conduct the review and offered to inform Congress of his findings throughout the review process, so long as this information would not jeopardize any criminal investigation arising from the review.
Although Sen. John McCain (R-AZ) is not a member of the Veteran Affairs Committee, he was granted permission to speak during the opening testimonies because his constituents were among those directly affected by the alleged scandal that unfolded in the Phoenix veterans’ hospital. He stated,
Clearly, the VA is suffering from systemic problems in its culture that require strong, reform-minded leadership and accountability to address. At the same time, Congress must provide VA administrators with greater abilities to hire and fire those charged with caring for our veterans. Most importantly, we must give veterans greater flexibility in how they get quality care in a timely manner rather than continue to rely on a department that appears riddled with systemic problems in delivering care. How we care for those who risk everything for us is the greatest test of a nation’s character. Today, we are failing that test.
For this very reason, AMAC has proudly supported legislation to increase transparency and accountability within the VA. In March, AMAC supported Rep. Jeff Miller’s (R-FL) “VA Management Accountability Act,” (H.R. 4031) a crucial piece of legislation that seeks to strengthen the VA and tackle the systematic weaknesses that have plagued the department for far too many years. Specifically, H.R. 4031 would give the Secretary of the VA the power to remove or demote employees whose work performances warrant punitive action. AMAC believes that the VA has an obligation to America’s veterans to see that its own bureaucratic vulnerabilities do not impede its ability to fulfill its basic responsibilities to provide adequate care to the brave men and women who have dutifully served our country.
A steadfast advocate for our veterans, AMAC continues to finds the recent allegations surrounding the VA to be particularly alarming and disturbing. While AMAC acknowledges that veterans have specific health care needs that may need to be addressed by veterans’ hospitals, we strongly urge Congress to consider the suggestions of many of the panelists that would provide veterans flexibility of choice in receiving private care when VA care is not readily available. AMAC shares the bipartisan concerns of the Senate Veterans Affairs Committee regarding this particular incident of failed oversight and negligence in leadership and is repulsed by the debilitating effects of a system that restricts this oversight by inhibiting the firing and hiring processes of VA hospitals.
Since this hearing, Under Secretary for Health, Robert Petzel, MD, has resigned from his position. Even so, AMAC expects the Obama Administration, Congress, and the VA to continue investigating the outrageous and horrific reports of corruption within VA hospitals and the tragic losses of life that have allegedly occurred as a result. Currently, the Administration has refused to remove Secretary Shinseki from his post at the VA, but continues to assert that an investigation will be ordered. AMAC will continue to monitor this issue as the investigation unfolds.
 United States Senate Committee on Veterans’ Affairs, Hearing on the State of VA Health Care, 2014, 113th Cong., 2nd sess., Washington, DC: Veterans’ Affairs Committee Website.
 “VA watchdog says federal prosecutors involved in scandal probe, charges possible,” FoxNews.com. Fox News, May 15, 2014, http://www.foxnews.com/politics/2014/05/15/shinseki-va-testimony-watchdog/. (accessed May 19, 2014).