Thursday, April 24, 2014

Coming Soon to a Hospital Near You

While President Obama keeps taking victory laps over the latest sign-up totals for his health care program, realists are taking a longer view.  Beyond the questions of how many individuals actually have a policy (and are paying for it), there's the over-arching issue of what happens when the system is fully implemented.

If you want a glimpse of the future, look no further than the Veteran's Administration health care program.

CNN has been doing some terrific reporting on the subject in recent months, and what they've found is stunning to say the least.  In some cases, veterans have waited months for an appointment, or to receive routine proceedures like a colonoscopy.  All too often, the results have been fatal; delays in care have led to the deaths of dozens of veterans across the country, including more than 40 at the Phoenix VA hospital.

"..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 an elaborate scheme designed by Veterans Affairs managers in Phoenix who were trying to hide that 1,400 to 1,600 sick veterans were forced to wait months to see a doctor, according to a recently retired top VA doctor and several high-level sources."
"Internal e-mails obtained by CNN show that top management at the VA hospital in Arizona knew about the practice and even defended it.
Dr. Sam Foote just retired after spending 24 years with the VA system in Phoenix. The veteran doctor told CNN in an exclusive interview that the Phoenix VA works off two lists for patient appointments:
There's an "official" list that's shared with officials in Washington and shows the VA has been providing timely appointments, which Foote calls a sham list. And then there's the real list that's hidden from outsiders, where wait times can last more than a year."
VA rules require that vets receive "timely" care, normally within 14-30 days.  But faced with a giant backlog, the Phoenix VA created a secret appointment list that led veterans to believe they would soon see a doctor.  Instead, many languished on the secret list for up to a year, and when confronted with the scam, officials shredded the evidence, according to Dr. Foote:
"Officials at the VA, Foote says, instructed their staff to not actually make doctor's appointments for veterans within the computer system.
Instead, Foote says, when a veteran comes in seeking an appointment, "they enter information into the computer and do a screen capture hard copy printout. They then do not save what was put into the computer so there's no record that you were ever here," he said."  Dr. Foote estimates that 1,400-1,600 veterans are still on the secret list.
Earlier this year, CNN reporters Scott Bronstein and Drew Griffin found similar problems at VA medical centers in South Carolina, Georgia, Florida and Texas.   One of the horror stories they uncovered involved an Army veteran whose experiences with the VA left him battling for his life:
"Barry Coates is one of the veterans who has suffered from a delay in care. Coates was having excruciating pain and rectal bleeding in 2011. For a year the Army veteran went to several VA clinics and hospitals in South Carolina, trying to get help. But the VA's diagnosis was hemorrhoids, and aside from simple pain medication he was told he might need a colonoscopy.
"The problem was getting worse and I was having more pain," Coates said, talking about one specific VA doctor who he saw every few months. "She again examined me and gave me some prescriptions for other things as far as pain and stuff like that and I noticed again she made another comment -- 'may need colonoscopy.'
"Finally about a year after first complaining to his doctors of the pain, Coates got a colonoscopy and doctors discovered a cancerous tumor the size of a baseball.
The now 44-year-old veteran is undergoing chemotherapy in an effort to save his life."
According to CNN, at least 82 veterans across the country have died due to delays in receiving healthcare from the VA. 
Think about that for a moment, then ask yourself: why does Eric Shinseki still have a job?  The Secretary of Veterans Affairs (and former Army Chief of Staff) has been praised for reducing the backlog of claims that have clogged the VA system.  Perhaps he should pay a little more attention to another fundamental issue--ensuring that veterans have access to the health care benefits they've earned. Not surprisingly, Secretary Shinseki has refused to discuss the "secret waiting lists" and other health care delays with CNN. 
Yet, criticism of Shinseki has been muted.  As The New York Times noted last year, the VA Secretary still enjoys support from many veterans groups and key members of Congress.  Will that support now fade, amid these shocking revelations about a failed system that (quite literally) killed more than 80 veterans, or will the secretary remain above the fray?  It's worth noting that the retired general became something of a hero on the left a decade ago, through his criticism of the war in Iraq.  Put another way: would a VA secretary in a Republican administration--without Shinseki's anti-war credentials--survive the recent revelations that have rocked the VA and its leadership.
But the problem goes beyond General Shinseki.  At last report, the director of the Phoenix hospital was still on the job, along with staff members who maintained that "secret" waiting list.  The Washington Free Beacon reports the hospital administrator, Sharon Helman, received a $9,000 bonus for her work last year, in addition to a base salary of $169,000.  In all, senior leadership at the
Phoenix VA medical center received over $700,000 in pay and bonuses last year. 
Perhaps that's not so surprising when you consider that the VA recently "re-hired" a senior administrator who was forced to resign from a post after a DUI crash.  An investigation by WRC-TV in Washington revealed that Jed Fillingim, a VA financial manager, resigned his post in Mississippi in November 2010, five months after a wreck that killed one of his colleagues.  Police reports indicate that Fillingim drank heavily in the hours before the crash, but didn't submit to a blood alcohol test until five hours after the wreck.  No charges were filed in connection with the accident, after police determined that the victim, Amy Wheat, departed the moving vehicle "on her own." 
But in early 2011, Fillingim rejoined the VA in a similar capacity at a facility in Georgia.  So far, the agency hasn't explained why he was re-hired. 
While the VA has been the source of many horror stories through the years, some still insist that its health care system could be a "model" for the rest of us.  Barely two years ago, the prestigious Journal of the American Medical Association (JAMA) praised the VA for its "patient-centered" approach to health care.  Wonder if JAMA would consider a follow-up piece and ask the families of those deceased veterans about the "patient-centered care" their loved ones received. 
It's bad enough that our veterans are suffering under this failed system, but the VA's many woes have implications for the rest of us.  Wait until Obamacare is fully implemented.  Fewer doctors and rationed care--almost inevitable under the new system--will produce conditions similar to the VA network, where patients often wait weeks (or even months) to see a doctor. 
And remember: the VA health care network sees just over 8 million patients a year, at 1700 facilities across the country.  Imagine the VA problems in a system that will treat hundreds of millions of Americans every year. 
The "future" of government-run health care is on display at your local VA medical center.  And it might just kill you.     
ADDENDUM:  Sadly, it looks like the VA scandal is revealing even more horror stories about veterans who weren't treated--or received poor care--and the bureaucrats covered it up.  Fox News is reporting that Phoenix VA Director Sharon Helman was linked to another cover-up, in her previous job as head of the VA center in Spokane, Washington. 

During a one-year period, from July 2007 to July 2008, at least 22 veterans committed suicide in the area served by the Spokane center, but officials reported only nine suicides at 34 attempts.  The discrepancy between those totals was never fully explained and Helman left the Spokane facility in 2010 to run the VA hospital in Hines, Illinois, the largest in that state.  After her departure, Ms. Helman was praised by Washington state politicians--and the local newspaper--for her "superb leadership."  We couldn't find a single mention of the suicide epidemic, and the glaring disconnect between the VA's totals and the number of veterans who actually took their lives. 

Now, Ms. Helman is facing an even bigger scandal in Phoenix, one that can't be easily "explained away."  It seems rather obvious that Helman's days with the VA are numbered, but it raises more questions about the agency at its promotion practices.  Why was she hustled off to Vines after the suicide reporting scandal in Spokane, then promoted again to run the VA complex in Phoenix? 

It's time for some bureaucratic spring-cleaning at the VA, beginning with Eric Shinseki in D.C.           


1 comment:

boinky said...

and if you like the VA, just look at medical rationing at the federally run Indian Health service hospitals. Been there, done that, got in trouble for pushing against the bureaucrats...