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Are VA’s leadership accountability problems nationwide or isolated incidents?


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  1. I think both the media and even the Legion are missing part of the problem by concentrating only on the appointments flap, which is widespread and chronic. I don't believe it is driven by bonuses, but by fear of getting in trouble, even getting fired.

    The basic problem is a demand by the higher ups to meet increasingly impossible goals that are set without regard for the ability of the treatment centers to meet them, complicated by the lack of any policy to prioritize between veterans care, i.e., a 100% service-connected vet who lost a career by being injured in combat and a Priority 8 veteran who spent two years at a stateside, 8 hour a day clerical position, who has no service connected medical issues, and who could afford private insurance, are served on a first come-first served basis.

    The inability to prioritize internally isn't the biggest problem, however. The biggest problem is that the government has, as usual, promised too much to too many. The VA simply cannot provide the care promised to the number of vets who are eligible.

    The VA has always concentrated on, "him that has borne the battle, and on his widow and his orphan." That has meant, in effect, those injured or harmed by their service. Every vet sacrifices something, if only years away from home at poor pay and a delayed start to his/her career. The gov't, mostly through the VA, has tried to help with the GI Bill, VA loans, career counseling, and various state benefits. VA medical care, however, was mostly available only to vets with service connected injuries or to the impoverished, and that was limited. For example, during a break in service I was 20% service connected, and then received care only for the eye condition that was service connected (1976-80). I was lucky to get back in, and after retirement I was rated at 40% (1993). That entitled me to general medical care. I don't know what < 30% vets were getting at that point, but the care received at the Middleton VAMC in Madison, WI was the best I ever received anywhere. The care even there has declined. Appointments are hard to get, and even the primary care docs, and I have a good one, are rushed and overloaded.

    What happened? The change came, not after the beginning of the wars in Iraq and Afghanistan, but in the late '90's, after Bill Clinton, in 1996, authorized general care for all vets, even Priority 8's. Pres. Bush reversed that decision while he was in office, but Obama re-instated it immediately after he took office. That may be one reason the current administration doesn't want to talk about the problem.

    Priority 8 vets, again, are those who did not come out of the service with service connected conditions, and who had, or could afford, other insurance. Up until then, Priority 8's were eligible for medical care only on a space available basis, and there was precious little available in major population centers, or anywhere else.

    Clinton's decision resulted, I believe, in a doubling of the VA patient population by 1998. The original plan was not totally insane, though it seemed aimed more at buying votes than improving care. The stated idea was, as the VA was expanding to more small, non-residential facilities, the Priority 8's could be served, and their insurance could be charged to help pay for the expansion. The President's order, however, didn't require them to keep their private insurance, and many didn't. The dotcom bubble bursting and the subsequent recession didn't help either, but it resulted, at least in my area, in a lot of older Viet Nam era vets entering the system.
    Add to that the following wars and the 2007 crash and continuing recession everywhere except in DC, Texas and on Wall Street, and the VA medical system is swamped. The population at this point has to be at least triple that which was served pretty well, in most places, in 1996. And the bosses in DC set 14 day appointment goals, 30 day evaluation deadlines, etc.

    If we are not careful we will break the system, and lose thousands of dedicated caregivers who are really doing their best to care for those who "bore the battle". What is to be done? The first step is to recognize not only the misconduct currently getting a lot of news, but the cause of a lot of the misconduct. Fire the bonus seekers; listen to those trying to survive; get a serious re-evaluation of the system done, yes, but also re-evaluate the very purpose of the system and the changes that brought on this crisis.

    The VA must be allowed to bill Medicare, at least for those Priority 8's who are eligible. At this point, the diversion of so many older, sick, non-service connected vets into the VA is a real bonus for the Medicare and Medicaid/Obamacare, who don't pay a penny for those admitted to the VA. Prioritize service connected vets internally in the system, at least for service connected conditions. Close admission to Priority 8 vets. It is probably politically impossible to remove those admitted into the system, but we simply cannot maintain any reasonable levels of care in the VA if all veterans are to be admitted. Congress will not pay for it.

    I believe the opening of VA medical services to Priority 8 vets is the base cause of the current crisis. We have to fix the resulting mis-management, starting at the top, but unless we fix the underlying cause as well, we will have only political results, not better medical care for our wounded and injured warriors.

  2. 3 weeks ago I called my clinic at the Tucson, Az. VA Hospital to let them know this growth in my stomach popped and I was hurting. Almost 2 years ago I was complaining of this growth when it was much smaller. However the Doctor told me the bigger the better. Upon calling the clinic the desk person stated my next appointment isn't until October of 2014. My Wife/Caregiver and I were pissed. Well, now I have a Cancer Screening on the outside and I pray its not Cancer. I also complained of back pain getting worse. Went to a public hospital because VA E.R. was "Full". So TMC also found Kidney Stones dropping and a groin hernia. This is called "Waiting for VA Appointments?" However, my main concern is I'm an OIF Veteran who may have cancer. I hope its a negative test result. Phoenix Ratings Office is also good at delaying fair ratings and dependent status. I have been married over two years now and they have had all documentation for a long time on Veterans Spouse Dependent. Yet they still ignored my 4th attempt to notify. Its all corruption. However, I found the Federal TORT Law which all Veterans need to look up. You may be entitled. Good Luck Brothers and Sister Veterans

  3. I for one can say nothing bad about the VA care i have received i have received only the best of care when diagnosed with kidney cancer stage 1 the va in Louisian is superior to the vets i have talked to and have been envolved with at the VA HOSPITAL IN NEW ORLEANS only the best care and the most polite nurses and doctors i have ever met i thank the VA for my care and hope the rest of the system can be as good as Louisiana VA is RESP.Ronald J. Dupre Sr.

  4. The VA along with the majority of healthcare in the US is extremely corrupt. Both profit and non-profit healthcare systems need audited by EXTERNAL agencies not internal. I worked in healthcare for many years and hold an MBA in Healthcare Administration. Google healthcare fraud and look at the numerous results that show up. Check out the nation wide healthcare audit that was conducted in 2009. It was so bad that they called it off. Over a billion dollars was unaccounted for when the audit was cancelled. Accountability has been forgotten. Morals and ethics are no longer a part of healthcare. Even if you have recieved great care, I guarantee you Medicare or your insurance was overbilled. My wife is a nurse of twenty years and audits physician charts for a living. We can tell you some stories.

  5. What money there is does not go to the DVA or the DOD; it goes to buy votes. DVA places give you a better break in rural areas than in urban areas. They are not so swampped.

  6. The V.A. I go to in OKC saved my life. The care they provided was excellent. My doctors went out of their way to care for me. Primary care, hematology, oncology, endocrinology, orthopedics, ALL treated my with dignity and respect and I loved them all. Then in 2011 EVERYTHING changed. I have been treated with utter contempt. I have had 5 different primary care doctors since then. I cannot understand a thing they say. They don't know who I am or why I'm there but insist there is nothing wrong with me. I have been talked down to, disrespected and treated like I am a burden and a waste of their time. Patient advocates could care less. It has become clear they have an agenda and I have lost all confidence in them. I do not trust them to be anything but shills for this administration. I have had 2 doctors tell me outright that they don't know how long they will be able to hold out because the agenda/policies are at conflict with their belief in providing quality care. They are being forced to violate patient confidentiality/ privacy and their decisions are being overruled by Admin. There has clearly been a change in attitude in the administrative side of the facility. It breaks my heart to say these things but I truly feel I have been betrayed. The doctors that hung in there with me have my utmost respect, yet I never know when the rug is going to be completely pulled out from under me. I am far from the only one who feels this way and the uncertainty and stress is completely unnecessary. Something has got to give.

  7. My experiences mirror yours in many ways. I am sorry this has happened to you or anyone else. It's no way to treat another human being; shame on the VA employees that cater to these actions. Fortunately there are many who care. But can't help because their hands aretied by the system.

  8. I say these things with the knowledge that the threat of retaliation is clear and may make things worse, but it has to be said.


  10. The VA Facility at Northport, NY has been great. The staff was helpful when I was being evaluated, and the level of professional service has been excellent. I have never had better dental care!

  11. I can't comment on every VA Center, as for the one I visit for my health care (Capt. James A. Lovell VA Center in North Chicago)I have no complaints. The care is TOP NOTCH! But This wasn't always the case when my father was confined to a bed there back in the 80's. Back then the staff was very rude, the Doctors very elusive. Couldn't get any info on my dad's condition etc. And the facility was a mess. But with the latest improvements the facility is very much improved. Personally The only ones I hear complaining are Retired Officers or higher ranking SNCO's. They seem to think that their care is more important than everyone else's! And that they shouldn't have to wait more than 5 minutes to be seen.

  12. I will never again enter the doors of a V.A. hospital. I will always blame the V.A. for the death of my father. He came home right after WW2 with health problems caused by WW2 and they did little of nothing to save him.

  13. And what could they have done? How many others were in the same shape as your father. Look at the number of Veterans who were saved during and after Iraq. Time have changed, technologies have gotten better. My dad died when I was 5 years old from Tuberculosis. He died at home, in his bed, because there were so many Veterans in the hospitals they couldn't find a bed for him. Am I bitter about it, No. If you are going to blame the VA for the death of your father, then you might as well blame God for not stopping War in the first place. Take care, and sorry about your loss, but are you sure that is what your father would have wanted you to do?

  14. I am glad he told his position on VA healthcare his father never received. You must have tunnel vision or are privileged. The priority now is for the OIF and OEF veterans. Desert Storm Veterans are being neglected and pushed aside. They are the HOMELESS veterans that are at the bottom ready for DEATH. I know because I am one that was suicidal and ready to live under a rock. But I am fighting back, NO Marine Corps Veterans should be mistreated as I am.

  15. Please do not assume all VAMCs are mismanaged. I have been going to the VAMC in ABQ, NM for over 10 years without having to wait excessively for any appointment which was considered of high importance/critical. Everytime i go in for an appointment, i am treated with respect, care, and compassion. The medical care i receive is top notch.

  16. You are also ONE of the privileged that gets proper care while the rest of us pay with our lives. You need to take a better look at the statistics because no veteran should have to fight this country for benefits. The VSO in my county told hundreds of vets from Korea to Desert Storm that the don't qualify so he needs to be made accountable for his actions. Pueblo, Colorado.

  17. There are always a few employees (in private business and government) that will try to "game the system" for their own personal benefit. The measure of business/agency executives is weather they are able to catch these gamers and what happens to the ones they catch? This cheating was an under-measure of appointment wait times. Falsifying it may have made somebody look good, but that undermines its primary purpose. Long wait times may well result in closer scrutiny by higher ups, but if the facility or clinic is truly overloaded and/or understaffed, then the measurement would result in more resources being allocated locally TO CARE FOR VETERANS. That is, afterall, what the VA Mission is. Who ever did this, and any superiors who knew about it, should be fired. Any "performance bonuses" received as a result of the fraud should also be recovered. After the IG report and the audits, I trust the Secretary to take the right steps to ensure justice is done and that all employees get the message that such fraud will not be tolerated. We should be careful we don't give those who would really like to do away with VA healthcare entirely, an excuse to act.

  18. This is not isolated situation. And problems with VAMC go much deeper than this and IG knows. Ask the question to employee that has been there a while. What happens to a veteran who tells. How far does retaliation go on? Ask the question to the Dr who blew the whistle, What is it exactly that they do in terms of retaliation? Because you had too wait for retirement to tell. Want to straighten VAMC out get in their deep. Americans would be disgusted to know how deep this goes. And if it is not salvageable which it is not even close, until all the dirty laundry is exposed. And I don't believe it can ever be run functionally. Anytime a Dr. doesn't have to be insured, Dr. knows no accountability tax payers pick up tab if one can ever get copies. If its done away with just maybe all that money could be spent on good care. I believe it is set up to not work correctly. And Im not speaking of claims backlog, I knew that would happen with the wars. And the secretary is not scaring them at all, they never have contact. And their is a wealth of information on VA website, but they never pay attention to that. Because they like making there own rules. Im curious all that money they receive for veterans health care, who or what it is actually spent on. I do know I have seen people that not veterans go to a CBOC. Worked for IRS. System is broken, to keep it running is a disservice. Im sorry to have to say all that but I have first hand knowledge.

  19. Exactly. Game the system. When I went to the VA Hospital in Fayetteville to try to get an Id card the counselor informed me that the problem with the VA is that 80% of the people who work there are Veterans. I have a brother who retired from the Navy but never left the military. He thinks everything should be given to Veterans and no one else counts. So if he worked for the VA he would take care of himself and look down on anyone else. While he "gamed" the system he would accuse others of doing exactly the same thing. Regardless of how long you served, the VA is there to help EVERYONE. And in order to help EVERYONE then EVERYONE should cooperate. I didn't go into that interview with a chip on my shoulder acting like they OWED me something. And why do Veterans constantly vote for Republican Tea Bagger Party of Stupid candidates who constantly prove they can't stand the sight of VETERANS? I think someone finally hit the mule in the head and maybe it will start pulling the plow. The General is a good man, just because he doesn't spew anger like draft dodging Rush Limpballs all the time doesn't mean he isn't working to make things better. (Before you respond in anger to my post, remember this, I don' give a shit what you think. I paid my dues.)

  20. Ron
    And you think your brother is the "entitled" one. Problems can't be solved by Lib-looney name calling. Take your hate and apply it where the sun don't shine.

  21. As long as the Republicans think that giving tax breaks to the rich is more important than taking care of Veterans nothing will change.

  22. Democratic policies are long insidious lies with multiple cover ups in every state. Don't be deluded by just your case because I am dying from retaliation from my PCP for wanting answers. You live while the rest of us are DYING! Pueblo, Colorado

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