Single-Payer VA Healthcare Fails America’s Veterans
By any measure, those that serve in America’s military are the best of the nation. They sacrifice life and limb to defend the United States. They deserve the best medical care when they return home. However, numerous investigations over the past several years have exposed a systemic cancer of mismanagement and neglect in the federal department tasked with that care.
The Department of Veterans Affairs (VA) has been held up by proponents of a single-payer healthcare system as a superior model in contrast with non-VA systems and even the Affordable Care Act (ACA or Obamacare). In a January 27, 2006 piece for The New York Times, columnist Paul Krugman boasted that the VA is a “success story” and “one of the best-kept secrets in the American policy debate.” In a November 13, 2011 column, he again showcased the VA as a “huge policy success story,” using it in his defense of socialized medicine. Philip Longman wrote a 2007 book entitled, “Best Care Anywhere: Why VA Health Care Is Better Than Yours.”
The façade of the supposedly utopian healthcare system began to finally crack on September 6, 2013, when the VA Office of Inspector General (OIG) published its investigation of Williams Jennings Bryan Dorn Veterans Medical Center in Columbia, South Carolina, where six deaths were tied to delays. The report found that despite the fact that taxpayer money was given to fix the problem in September 2011, the center still had 700 delays for appointments deemed “critical.” On November 20, 2013, CNN published a report stating veterans are “dying needlessly because of long waits and delayed care at U.S. veterans hospitals.” Following that report, House Veterans Affairs Committee Chairman Jeff Miller (R-Fla.) began an investigation and Rep. John Barrow (D-Ga.) said Congress had, “a duty to make sure that the veterans who serve get the best health care possible. And it is very obvious that for too long and for too many folks that hasn’t happened.”
A January 30, 2014 CNN report exposed allegations that in 2010 and 2011, diagnosed cancer patients waited months for basic medical screenings like colonoscopies or endoscopies. Ten veterans were confirmed to have died in the South Carolina and Georgia region due to long wait times while another 7,000 in those states were found to still be on waiting lists. Five veterans died in the Florida region. In the Rocky Mountain region, two veterans died. In the Texas region, “seven vets or their families were sent disclosures about adverse events and serious injuries suffered because of delayed care.”
Finally, CNN’s April 23, 2014 bombshell investigative report galvanized the public to this growing scandal. The report stated that “at least 40 U.S. veterans died waiting for appointments at the Phoenix Veterans Affairs Health Care system, many of whom were placed on a secret waiting list.” The secret list was part of the Phoenix VA’s attempt to conceal the fact that between 1,400 and 1,600 veterans were forced to wait countless months to receive an appointment. Whistleblower VA Dr. Sam Foote exposed the existence of an “official” list that Phoenix officials shared with Washington, showing a rosy reality where the VA provided timely appointments. On the secret list, some waiting times lasted more than a year. The VA’s internal rules require appointments to be scheduled within 14-30 days.
In an attempt to quell the scandal, then-VA Secretary Eric Shinseki accepted the resignation of VA Under Secretary for Health Dr. Robert Petzel on May 16, 2014. Shinseki’s statement harbored bizarrely defensive language: “most veterans are satisfied with the quality of their VA health care, but we must do more to improve timely access to that care.” It was at that point that CAGW got involved and began a campaign to force Shinseki himself to resign.
Indeed, Shinseki could not escape the verdict of a May 28, 2014 OIG report citing 18 previous OIG reports that stated, “at both the national and local levels, deficiencies in scheduling resulted in lengthy waiting times and the negative impact on patient care.” After the report, President Obama demanded and received Shinseki’s resignation on May 30.
Subsequent reviews of the department reiterated the disarray and mismanagement at the VA. An internal White House review found a “corrosive culture” at the VA damaged morale and contributed to “significant and chronic system failures.”
An internal VA audit was released on June 9, 2014, revealing the staggering scope of the department’s failures. Investigators found “57,436 newly enrolled veterans facing a minimum 90-day wait for medical care; 63,869 veterans who enrolled over the past decade requesting an appointment that never happened.” The findings covered 731 VA facilities nationwide.
Former Proctor & Gamble CEO Robert McDonald took over leadership of the troubled department on July 30, 2014. While one could hope that new leadership from the private sector would help rescue the badly troubled VA, McDonald has, at best, tinkered around the edges of the system without making any significant change.
McDonald has been marred by the same mistakes all too common throughout the VA’s history. He claimed on NBC’s Meet the Press on February 15, 2015 that 60 employees were fired as a result of the wait-list scandal. The department then clarified that the number was 14. But, internal documents from provided to the House Veterans Affairs Committee in April revealed that the number was only three.
At the National Press Club on November 6, 2015, McDonald claimed that the updated number of scandal-induced firings was 300. However, based on the VA’s own data, just 24 of those 300 faced actual or proposed discipline. On December 9, 2015, VA Deputy Director Sloan Gibson even claimed that the term “accountability” did not mean firing people.
Throughout the scandal, VA officials attempted to brush off, hide, and minimize problems to make the system appear better than advertised. As the outrage grew, new VA leaders embellished the response to hide the fact that little has changed. They even continued to receive bonuses: From 2010-2014, every single senior VA executive was rated “fully successful” and received a performance bonus. This is par for the course in the purest form of single-payer healthcare there is in the United States.
Unfortunately, the wait-times scandal is not an isolated problem. The department is facing pervasive mismanagement in other areas. During a September 22, 2015 Senate Homeland Security and Governmental Affairs Committee hearing, Chairman Ron Johnson (R-Wisc.) diagnosed the VA’s “culture problem with whistleblower retaliation.” Cases of reprisal against those willing to blow the whistle on the department’s fiascos skyrocketed by 75 percent, from 405 in fiscal year (FY) 2013 to a projected 712 for FY 2015.
While the VA has no problem punishing those that try to do right for the taxpayers, an NBC 4 investigation published on December 4, 2015, revealed that the agency does little to punish clear cases of misconduct like sleeping or having sex on the job. In one case, a “worker was arrested for distribution of heroin off-the-job, but was allowed to return to work.” The department demoted and transferred two senior executives embroiled in a $400,000 job transfer scam but admitted it didn’t have the “legal authority” to recoup the scheme’s spoils.
Despite the evidence of a department in crisis, one major presidential candidate is parroting the Chip Diller-like claims of “all is well.” Former Secretary of State Hillary Clinton flatly stated on October 23, 2015 that the VA scandal has “not been as widespread as it has been made out to be.” She blamed an “ideological agenda” for the numerous calls for major reform.
In reality, the scandal was widespread and systemic. The rampant mismanagement and misconduct displays a pattern of bureaucratic behavior that should be cause for a wholesale transition to a full voucher system, which would allow veterans to choose the best (and fastest) care for them.
