It was only a matter of time before the political firestorm forced out Eric Shinseki, the Veterans Affairs secretary who resigned Friday. But his departure will not fix the health care scandal at the U.S. Department of Veterans Affairs. President Barack Obama and Congress have to address the broader issues, which include determining how many VA facilities were falsifying records to hide long waiting lists and expanding the system to better meet the needs of military veterans.
While no one questioned the retired four-star Army general's concern for veterans, Shinseki had to go as investigators confirmed a rash of allegations of misconduct at VA facilities. His departure clears the way for a more robust investigation and signals that those responsible for falsifying records and other misconduct will be held accountable.
There are plenty of places to start. An interim report released Wednesday by the VA's inspector general found that 1,700 patients at the veterans medical center in Phoenix — where the scandal first erupted — were kept off a waiting list for care, which "significantly understated" the time veterans waited to get an appointment. A sampling of records also showed that veterans waited nearly five times as long for a primary care appointment as Phoenix administrators had reported, and that two times the reported number of patients were not seen within the 14-day target period.
The inspector general also announced that investigators had broadened their scope to 42 VA medical facilities. The agency has requested state records such as death certificates and autopsy results to help determine whether any delays factored into the fate of veterans who died while on a waiting list. A spokeswoman for the James A. Haley VA Medical Center in Tampa confirmed that the inspector general's office visited the hospital last week, but officials would not say why.
Many veterans complain the problem is not the quality of care but access to it. The VA has an acute shortage of doctors as veterans returning from Iraq and Afghanistan have helped increase demands for appointments to 85 million last year. The agency needs more money for clinical care and a more effective way of removing administrators who do not perform.
Lawmakers should be wary, though, of calls to privatize health care for veterans. Given the severity and unique nature of so many battlefield injuries, there are significant benefits to providing a continuum of care in a network that includes 151 hospitals, 300 veterans centers and 820 locally based outpatient clinics. Having specialists, advanced equipment and support services all under the same house makes more sense than fanning veterans out in all directions. This is an area that Obama's deputy chief of staff should address in a broad review of the VA's health care system he will give next month.
Shinseki apologized Friday for delays in treatment and other VA issues, but there will need to be broader change. Florida Sen. Bill Nelson, a member of the Senate Armed Services Committee, suggested there will have to be a change in culture at the VA. The corruption should be rooted out quickly, but systemic change needed to meet the obligations to the nation's military will take time and money.