The inadequacy of the nation's health care system for veterans exploded into full view Monday with a new report revealing that tens of thousands of patients have languished on waiting lists at the Department of Veterans Affairs. The report, coming weeks after allegations that veterans died while awaiting treatment, provides a more thorough and troubling picture of systemic problems within the VA health care system. Congress should respond with new money to hire doctors and expand VA facilities, and the department also needs to become more efficient and accountable.
The audit of 731 VA facilities, including several in Florida, found that the VA's appointment booking process was "overly complicated" and confusing to clerks and supervisors alike. The constant shortage of doctors and other frontline workers made the VA's goal of seeing patients within a 14-day window "simply not attainable," auditors found. In interviews with nearly 4,000 employees, investigators found that scheduling staff often hid those delays by falsifying the records of appointment dates. Thirteen percent of those interviewed said they were told by their bosses to enter false appointment dates — a practice in place at three-fourths of the facilities the investigators visited. The pressure exerted on staff to make the wait times appear more favorable than they are is so pervasive, auditors found, that the VA should re-examine its entire performance system to come up with realistic goals.
The problems with scheduling and followup were so chronic, routine and widespread, the VA found, that more than 57,000 patients are still awaiting an appointment after at least three months. The department will return to dozens of facilities for further review, including the C.W. Bill Young VA Medical Center in Pinellas County and two other Florida centers to confront what it described as an "overarching environment and culture which allowed this state of practice to take root."
The agency's internal review comes as the Senate prepares to vote on a bipartisan deal that would provide $500 million for the VA to hire physicians and authorize 27 new VA facilities in 18 states. The new money would help the agency catch up on its backlog. And expanding the VA secretary's authority to fire poor administrators would shake up a bureaucracy that has a vested financial interest in falsifying its performance record.
The Senate bill, though, includes a provision allowing veterans to see a private provider if they live more than 40 miles from a VA facility or cannot see an agency physician in a timely manner. Spinning off this case load would raise questions about the continuity of care for veterans who often require specialized care. The department should use this opportunity to address its issues and assess whether its clinical operation is appropriately staffed and located across the country. The VA also needs to examine whether its professional staff is carrying an adequate case load. Without answers to these questions, how can Congress determine whether the VA is adequately funded?
Monday's report underscores the widespread hurdles to access that have existed for years, while the Senate legislation recognizes the cost of addressing these long-deferred needs. But the audit and earlier reports on service delays are only a start. The agency and Congress need a complete picture of the operation, and they must be committed to putting reforms in place so the VA's performance meets the nation's obligations. Our military veterans deserve better.