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Systemic fraud at the VA ‘crime syndicate’

Systemic fraud at the VA 'crime syndicate'

Remember that Inspector General report President Obama said he was waiting for, before he weighed in on the mushroom cloud of scandal hanging over the Department of Veterans Affairs?  The report he needed to read before making any decisions, because the previous eighteen reports issued over the past decade just weren’t good enough for him?

Well, Report Number Nineteen is out, and Barack Obama will once again be astonished to learn what the Obama Administration (which he has absolutely no connection to, or responsibility for) has been up to.  The IG speaks of a “systemic problem with clinics lying about treatment records,” according to Fox News.  In fact, it’s so systemic that hardly anyone in the VA bureaucracy can be trusted – the Inspector General’s teams are hitting clinics with surprise inspections, to head off efforts at shredding and/or fabricating more paperwork to throw investigators off the trail.

The VA Office of Inspector General released its interim report on Wednesday, as part of its ongoing probe into whether veterans died as a result of under-reported delays. While not reaching any conclusion on what led to those deaths, the office released troubling statistics regarding the embattled Phoenix VA facility suggesting workers under-stated wait-times in order to make their internal figures look good.

The office, in its preliminary findings, determined that veterans in Phoenix waited an average of 115 days for a primary care appointment — far longer than the VA’s official statistics showed. Such inappropriate scheduling tactics, according to the report, may be the basis for claims of “secret” waiting lists.

On the heels of the report, House Veterans Affairs Committee Chairman Rep. Jeff Miller, R-Fla., called for Shinseki to “resign immediately,” joining other top lawmakers who have demanded the same. So far, President Obama has stood by his VA secretary.

The report released Wednesday focused on the Phoenix VA facility, while noting that reviews at a “growing number” of facilities have exposed inappropriate scheduling practices throughout the VA system. According to the office, the investigation has now expanded to 42 VA medical facilities nationwide.

The IG’s office released figures showing the Phoenix office “significantly understated” the amount of time patients waited for appointments.

“To date, our work has substantiated serious conditions at the Phoenix” center, the report said.

How serious were conditions at Phoenix?  Over half of the veterans waiting for a primary-care appointment were left off the official rolls.  The average wait time reported by the clinic was 24 days; add back in those 1,700 deleted patients, and the real number jumps to 115 days.

It’s going to be tough to pawn this off on “rogue low-level employees,” like the IRS scandal.  As the IG report points out, average patient wait time is “one of the factors considered for awards and salary increases” for clinic leadership.

It’s not just the Phoenix hospital administrators playing this game.  The Daily Beast ran an eye-popping report on the  Texas VA, where administrators were compared by one whistleblower to a “crime syndicate”:

Emails and VA memos obtained exclusively by The Daily Beast provide what is among the most comprehensive accounts yet of how high-level VA hospital employees conspired to game the system. It shows not only how they manipulated hospital wait lists but why—to cover up the weeks and months veterans spent waiting for needed medical care. If those lag times had been revealed, it would have threatened the executives’ bonus pay.

What’s worse, the documents show the wrongdoing going unpunished for years, even after it was repeatedly reported to local and national VA authorities. That indicates a new troubling angle to the VA scandal: that the much touted investigations may be incapable of finding violations that are hiding in plain sight.

“For lack of a better term, you’ve got an organized crime syndicate,” a whistleblower who works in the Texas VA told The Daily Beast. “People up on top are suddenly afraid they may actually be prosecuted and they’re pressuring the little guys down below to cover it all up.”

“I see it in the executives’ eyes,” the whistleblower added. “They are worried.”

As well they might be, but the even higher-level officials who created a system designed to reward fraud and punish honesty have much to answer for as well:

There’s enormous pressure to report favorable wait times for VA patients, the Texas whistleblower explained, even if those wait times are completely false.

“If [VA] directors report low numbers, they’re the outlier. They won’t stay a director very long and they certainly won’t get promoted. No one is getting rewarded for honesty. They pretty much have to lie, if they don’t they won’t go anywhere,” the whistleblower added. Weighted more heavily than other performance measures, the wait time numbers alone “count for 50% of the executive career field bonus, which is a pretty powerful motivator.”

Though VA hospitals may be struggling with increasing patient loads and inadequate resources—including too few medical providers—they are punished for acknowledging those problems. The VA’s current system appears to reward executives’ accounting tricks that mask deep structural issues and impede real solutions.

Even well-documented cases of paperwork fudging were dismissed by the VA system’s internal auditors, and there were plenty of complaints from whistleblowers to be blown off.  As the Daily Beast summarizes the situation, “the Inspector General found that manipulated appointments were widespread and hid significant delays, but the report doesn’t seem to have led to a single VA official being disciplined or officially held responsible for gaming the system.”

Calls for a criminal investigation by the Justice Department are mounting.  The Daily Beast includes one from Paul Rieckhoff, founder and CEO of Iraq and Afghanistan Veterans of America.   Rep. Jeff Miller of the House Veterans Affairs Committee also asked for a criminal probe, saying “wait time schemes and data manipulation are systemic throughout VA, and are putting veterans at risk in Phoenix and across the country.”

John McCain also joined the chorus on CNN:

Sen. John McCain, an Arizona Republican, told CNN’s Wolf Blitzer that inspector general Richard Griffin’s initial findings were terrible and said it was “about time” the Justice Department launched its own investigation.

He also said embattled VA Secretary Eric Shinseki should probably resign, which the Cabinet officer has said he has no plans to do.

“I haven’t said this before, but I think it’s time for Gen. Shinseki to move on,” McCain said.

There have been calls from other members of Congress for him to step down over the scandal, but McCain’s voice on military matters carries enormous weight considering his experience as a combat veteran, a Vietnam prisoner of war, and his work in the Senate on related issues.

The L.A. Times adds calls for a criminal investigation from Sen. Richard Blumenthal (D-CT) of the Senate Veterans Affairs Committee, and Rep. Adam Kinzinger (R-IL), who served in Afghanistan and Iraq.

Then you’ve got the people who think the problem can be solved by pouring more money into a corrupt system, like Sen. Bernie Sanders (I-VT), chairman of the Veterans Affairs Committee.  This attitude is, frankly, delusional.  The VA system might indeed need more money, even though its funding has been dramatically increased over recent years, but that discussion cannot even begin until the current system is reformed – probably junked entirely and replaced with a more accountable, efficient privatized system, the way ObamaCare should be.  No one should be under any illusions that firing Secretary Shinseki would fix everything.  What kind of official culture produces a swarm of administrators, at numerous facilities, who saw nothing wrong with destroying and modifying records to make themselves look better… at risk to the lives of ailing military veterans?

We just celebrated Memorial Day, a day upon which American civilians vow to stand behind the volunteer military that sacrifices so much to defend our way of life.  And yet, we’ve got a VA system that’s been unsatisfactory for years, and is now mired in the most despicable corruption.  Nothing is sadder than listening to people who think the current President should be given a pass because previous Presidents didn’t fix the system either.  Won’t Barack Obama’s successor be able to say the same thing?  How many generations are we supposed to let that game of finger-pointing continue?

It’s painfully obvious that the system itself is dangerously flawed… and it’s a fine representation of bloated, dishonest Big Government, an echo of the same tales of wasted money and aristocratic administrators we hear from every agency.  Practically everyone in America wants to do right by our veterans.  That’s going to take more than just increasing funding, and maybe collecting a couple of high-level scalps.  It’s time to demand better for those who serve, and to ask why a titanic government that spends billions it doesn’t have on various Ruling Class agendas can’t do better with respect to one of its core duties: taking care of the people who pledged their lives in our defense.  It’s time for the American people to put our mouths where our money is.

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