V.A.: A culture of fear and intimidation

Three writers at CNN describe how doctors were scared to talk about the deceitful practices at the V.A.:

Last fall, six doctors in Columbia, South Carolina and Augusta, Georgia, came forward to describe to CNN how delayed colonoscopies and endoscopies had led to the death of as many as 20 veterans. None would appear on camera.

None would even allow us to quote them. But they begged CNN to tell the story.

One doctor would meet only privately in an unpopular, seedy restaurant where he felt certain no one would recognize him.

Another doctor only met with us and spoke in a dark, outside location where no one could see him.

Another doctor asked us to only speak through a third-person intermediary, providing documents that could not be traced but that could be authenticated to provide us reliable sourcing.

On background, CNN began conversing with one of the doctors who was so frightened of retaliation that he asked that we text him on a private, untraceable cell phone using coded language. And he asked that any phone calls or e-mails had to start with the words "Tender Vittles," as a way to identify it was "safe" to move ahead with him.

Several of the doctors, we were told, had tried to tell administrators of their concerns that patients were being harmed by delays and that some had died or suffered serious injuries.

But we were told those doctors were treated harshly by administrators who did not want to hear of the complaints.

All the doctors confirmed to us that VA officials had posted warnings in the hospital's halls and elevators that no VA employees could speak with the media or divulge details of what went on inside the hospital. The warnings, the doctors said, included details about laws that could be violated and penalties that employees could face, including financial reparations and even jail time, if they were to speak out publicly, and if the hospital suffered financial losses as a result.

Just like the fear in Columbia and Augusta, the source in Phoenix was scared to trust us.

We were told to meet at a bar in a strip mall 20 miles outside of downtown. No cameras, no notes and the pounding rock music was so loud, it is doubtful even a hidden microphone would have worked. But it was here we heard the entire story of the secret list in Phoenix.

The employee would not allow us to use a name, a position, even a length of service. And we are deliberately leaving out his/her gender. The VA employee remains scared to this day, but everything said inside the seedy bar has proved to be true.

Please read more here.

The VA: "A systematic lack of integrity"

Glenn Reynolds writes:

Now that the VA has erupted in scandals involving phony wait lists, and people dying because of treatment delays, an audit reveals a "systemic lack of integrity" in the system. According to the auditors, "Information indicates that in some cases, pressures were placed on schedulers to utilize inappropriate practices in order to make waiting times appear more favorable."

In other words, they cooked the books. And what's more, they did it to ensure bigger "performance bonuses." The performance may have been fake, but the bonuses were real. (One whistle-blower compared the operation to a "crime syndicate.")

VA patients were stuck with the VA. If wait times were long, they just had to wait, or do without care. In a free-market system, a provider whose wait times were too long would lose business, and even if the employees faked up the wait-time numbers, that loss of business would show up on the bottom line. That would lead top managers to act, or lose their jobs.

In the VA system, however, the losses didn't show up on the bottom line because, well, there isn't one. Instead, the losses were diffused among the many patients who went without care -- visible to them, but not to the people who ran the agency, who relied on the cooked-books numbers from their bonus-seeking underlings.

The absence of a bottom line doesn't reduce greed and self-dealing — it removes a constraint on greed and self-dealing. And when that happens, ordinary people pay the price. Keep that in mind, when people suggest that free-market systems are somehow morally inferior to socialism.

Please read more here.

"It wasn't a secret at all."

The V.A.'s practice of zeroing out appointments and substituting new dates was standard practice, David A. Fahrenthold writes:

One great test of any bureaucracy is whether it can effectively deliver bad news to the top of its chain of command.

In recent years, the VA health system started to fail that test.

In some cases, local officials’ bonuses depended on the numbers looking good. So, at some point years ago, they began asking clerks to change the numbers — with practices like “zeroing it out.” Cheating was made easier by the VA’s ancient computer systems, designed decades ago.

“They would say, ‘Change the “desired date” to the date of the appointment,’ ” said one employee knowledgeable about scheduling practices at a VA medical center. The employee, who spoke on the condition of anonymity for fear of retaliation, decided to go along with those requests. Fighting the order to lie wasn’t worth it.

This week, federal auditors provided stark evidence of the problem that VA’s leaders had missed. The auditors had studied 226 veterans who got appointments at the VA medical center in Phoenix. The official data showed they waited an average of 24 days for an appointment. In reality, the average wait was 115 days.

Now, VA’s leaders have been faced with a startling failure. The bureaucracy below them wasn’t telling them the truth about wait times. The numbers system they set up to go around the bureaucracy wasn’t, either.

The only answer, now, has been to send people out to VA clinics to talk to schedulers, face to face. Before the auditors went out, they were warned they might hear evidence that clerks had been cheating the system.

“If this occurs, remain calm,” the VA counseled auditors in a memo. It suggested follow-up questions. “Have you brought this to anyone’s attention? If needed, follow up with: What has been the response?”

Read more here.

Solutions please: no more faux outrage

Allen West asks:

if the Obama administration, indeed government itself, is having a problem handling veterans healthcare, which is less than two percent of our American population, how do you think they’ll handle trying to manage the entire country’s healthcare?

He then outlines five things he would do if he were in charge. Read more here.

A scandal, or just a problem in progress?

So is the V.A. scandal a scandal, or a "problem in progress?" Ace of Spades asks:

Is this, per the drooling Nancy Pelosi, a problem that just snuck up on us in the last couple of years as veterans have returned from Afghanistan and thus a scandal to be laid at the feet of George W. Bush, or is this, per the frothing Rachel Maddow, a problem that's been going on forever and therefore no scandal at all?

It can't be both, Progressives.

But the Progressives reply,

Oh yes it can be both, or neither, or one or the other, or the other or the one, as current political needs might dictate, and our position may change on this six times by Sunday.

Remember Vietnam? Those vets are the ones using the most V.A. medical services now. Read more here.

Scott Whitlock reports that in the one month since the

VA story broke on April 23 with the news that as many as 40 veterans seeking treatment at one Phoenix facility died while on secret waiting lists, CBS has provided the most coverage, 48 minutes and 46 seconds. NBC allowed 44 minutes and 53 seconds and ABC came in last with a scant 16 minutes and 44 seconds. None of the networks bothered covering the story until May 6, almost two weeks after it broke. (This is despite heavy investigative reporting by Fox News and CNN.)

Read more here.

Al Qaeda terrorists imprisoned at Guantanamo are treated far better than our own veterans

J.D. Gordon writes:

Al Qaeda terrorists at Guantanamo are treated better than our vets.

Despite the fact that Al Qaeda terrorists carried out the Sept. 11 terror attacks, killing 3,000 people in America, the admitted co-conspirators and their roughly 150 fellow jihadists at Gitmo have approximately 100 doctors, nurses and health care personnel assigned to them.

Doctors and medical personnel are at their beck and call. Got a cold, a fever, a toothache, a tumor, chest or back pain, mental health issues, PTSD? No problem, come right on in. Military doctors are waiting to see you.

The VA and Gitmo eligible patient-to-health care provider ratios speak volumes.

While the Gitmo ratio is 1.5 to 1, for America’s 9 million veterans receiving VA health care and 267,930 VA employees, the ratio is 35 to 1.

In late 2008, when Obama was president-elect, he and his staff were warned not to trust the wait times reported by VA health care facilities. But instead of fixing the problem, their focus was closing Guantanamo and improving the comfort of detainees. Even though they already lived under some of the best prison conditions ever seen.

Read more here.

Government healthcare: incompetent, disgraceful, and quite possibly criminal.

Roger L. Simon writes:

With veterans dying while waiting lists are falsified, it’s hard to see government healthcare as anything but incompetent, disgraceful and quite possibly criminal.

But it’s not just healthcare, although it’s certainly prominent, important and symbolic. The Obama administration has been the best advertisement for libertarianism across the board in recent memory. Government can’t handle anything, not even the one thing it should handle, the common defense. (It better get it together on that one with Russia and China making a new alliance that might be stronger and more powerful than ever.)

Read more here.

Should he resign?

Kevin Williamson thinks that the honorable thing for President Obama to do about the scandals at the Veterans Affairs hospitals is to resign.

Other heads of government have resigned for less. President Obama presented himself to the public as an authority in the field of health-care management and as an executive who not only would insist upon but also would in fact achieve the highest standards in transparent, honest, competent government. He has failed, comprehensively. An honest man acknowledges his failures.

Perhaps it is the case that he did not know how bad things were in the VA system. Set aside the question of whether he should have known, for instance by finding the time to take the occasional meeting with General Shinseki, a task the president had not undertaken in more than two years. Sitting behind the Resolute desk means taking responsibility for the totality of the executive branch of the U.S. government, which includes a great many things that are outside of one’s immediate knowledge or control.

President Obama clings to his sad little throne even more desperately than does General Shinseki. Faced with evidence of the incompetence of his administration, the president pronounced himself outraged, vowed that he would not tolerate it, would not stand for it — he in fact did everything except take responsibility for the actions of his government. The dishonesty and malpractice he vowed never to tolerate were, after all, the actions of his own administration, and the fact that they (may have) happened at some degree of separation from his own sacred person is hardly a defense. We made the head of the VA a cabinet-level position in order that the secretary might report directly to the president. The president, however, must be paying attention. President Obama was not.

It may not be fair, exactly, but one aspect of big-time leadership is that one must bear responsibility even for that which is not necessarily one’s fault. The responsibilities of the presidency did not descend upon an unsuspecting Barack Obama while he was going about his own inexplicable business in Chicago; he sought the office, twice, offering promises about what kind of a man he is, and what kind of leader — and he has failed to deliver.

Read more here.

WHOA UP, PEOPLE!

For the past 48 hours, I've been hearing "VA REFORM" incessantly. I'm hearing it from Republicans, Democrats, and talking heads. It's the buzz word!

WHOA UP, PEOPLE! Just remember who is in the White House and who is in the Senate. There is nothing in the world that Obama and Harry Reid would rather do than TAKE THINGS AWAY FROM VETERANS. Is this the time we want to so see the VA system, such as it is, opened up for "REFORM"? I'm thinking that's the way we'll let the fox in the henhouse. If the door is opened, Republican's only control the House, and even a GOP Senate is not all that reliable under Boehner's leadership. He's just as liable to see big bucks he can filch out of the VA program and go for the cuts as the Dems in the Senate. After all, "reform" can be cuts just as easily as improvements. So, just because Obama, Shinseki and the big dogs in VA are in trouble isn't a reason for us to get all giddy and think, "Ah Ha! We have them by the ying yang and can get what we want. Nope. Remember that these people do not respond to shame and system failure as you and I might. What we see as failure of the VA system, for Obama and Shinseki, may very well meet the exact goal they have in mind. If the VA System is bad enough, might not the goal be to do away with it entirely and pull it into the BOOB-AM-CARE CIRCLE, SUBJECTING VETERANS TO THE SAME PROGRAM AS ALL THE OTHER PEASANTS?

You saw the lack of passion in Boob-ama's remarks of 2 days ago about the VA. HE DIDN'T EVEN REALLY ACKNOWLEDGE THAT THERE IS A PROBLEM. He now has it being investigated to see if there is a problem. That investigation, to him, means seeing what the political fallout is for him if he does something as opposed to nothing. He's said he's "Madder'n Hell!" about this VA scandal. Well, so what's new. Wasn't that the same response in a half dozen other screw-ups he's presided over. What does it mean that he's "Madder'n Hell"? Is he mad because another of his failures got exposed? Or, is it because some veteran's actually died as a result of his Administration letting them go unattended.
Colonel Curtis D. Dale, PhD, USAF (Ret)

Heads need to roll, says a Democrat

A Democrat from Georgia is not impressed with the President's response to the V.A. scandals.