Veterans should have better health care options

So, Veterans Affairs Secretary Eric Shinseki resigned this past week as a result of the scandal over veterans dying while waiting to receive treatment at a Phoenix VA hospital.

Nevada Sen. Dean Heller’s strongly worded call for his ouster surely tipped the scales. “The Department of Veterans Affairs Inspector General’s report provides a very disturbing view of what has been confirmed as a systemic problem at the VA. …” Heller said. “It is time for a leadership change at the VA at the highest level.”

The inspector general report indeed called the VA’s problems “systemic.”

“Allegations at the Phoenix HCS (health care system) include gross mismanagement of VA resources and criminal misconduct by VA senior hospital leadership, creating systemic patient safety issues and possible wrongful deaths,” concludes the executive summary.

The problem is not just systemic, it is endemic and pandemic.

You may keelhaul the captain of a sinking rust bucket, but you are still aboard a sinking rust bucket.

The problem lies not in who is heading this system, it is the system itself — pure socialized medicine. It is a bureaucracy that like any other organism has at its base the objective of self-preservation. No matter who you put in charge it will fail eventually, as it has done so over and over again between brief periods of improvement after one crisis or another.

The inspector general found that the Phoenix VA hospital staff lied about its waiting list, claiming veterans waited on average 24 days for their first primary care appointment, when the average was 115 days. There were 1,400 vets on the official waiting list, but another 1,700 had been excluded from the list.

A subsequent audit issued on the dayShinseki resigned revealed that 64 percent of 216 VA facilities reviewed had tampered with waiting lists.

A year ago, Obama was warned by the House Veteran Affairs Committee about “management failures, deception and lack of accountability permeating VA’s health-care system.”

Back in the 1980s the VA crisis was heart surgery. While investigating cardiac surgery deaths, it was found that there were “errors in operative technique” in 38 percent of cases.

In 1945 the head of the VA hospital system resigned after a series of news reports about shoddy treatment.

In 1947 a government commission found waste and inadequate care in the VA system.

In 1976 an investigation of a Denver VA hospital found some veterans’ surgical dressings were rarely changed.

In 1984 VA officials were accused of misusing $40 million set aside to help veterans with readjustment problems.

In 1986 the inspector general found 93 VA physicians had sanctions against their medical licenses, including suspensions and revocations.

In 1993 a blue-ribbon panel reported “unacceptable delays.”

In 2001 veterans were waiting two months for primary care and specialty appointments despite a goal of less than 30 days.

In 2007 some senior VA officials received bonuses of up to $33,000 despite a backlog of hundreds of thousands of benefits cases. That same year a commission reported “delays and gaps in treatment and services.”

Today the bureaucrats are still cooking the books in order to make themselves eligible for “awards and salary increases.”

Throwing more tax money at the problem is not the answer.

John Merline reported recently in Investor’s Business Daily that from 2000 to 2013, VA spending nearly tripled, while the population of veterans declined by 4.3 million.

The VA’s health care spending alone, which consumes about 40 percent the VA budget, climbed 193 percent during that time, though the number of VA patients increased only 68 percent, Merline’s research of VA data found.

Nevada has had its share of VA woes. The VA Medical Center in North Las Vegas  cost $1 billion to build — twice what a private hospital costs — and took four years longer than scheduled. It opened with too small of an emergency room and no ambulance drop-off ramp.

This past fall a blind Navy veteran writhed in pain in the North Las Vegas VA emergency room for six hours without adequate pain relief and left without treatment or tests. Such lengthy waits and lack of care are not uncommon.

Be thankful that when FDR signed the GI Bill in 1944 he did not create a system of veterans’ colleges or we’d have colleges as bollixed as the VA hospitals.

It is time to dismantle the VA health care system and just give veterans vouchers to use wherever they wish.

 

Thomas Mitchell is a longtime Nevada newspaper columnist. You may share your views with him by emailing thomasmnv@yahoo.com. Read additional musings on his blog at http://4thst8.wordpress.com/.

 

Comments

  1. Charles Sena says:

    To: Director, VA Sierra Nevada Health Care System

    In regards to the article printed in the Reno Gazette-Journal dated June 7, 2015 that highlighted areas of concern when it comes to quality care for our Veterans. The report submitted by the Office of Inspector General (OIG) associated to The Sierra Nevada Veterans Health Care System in Reno found that they were lacking quality indicators, Stroke, Colonoscopy and ER Physician coverage. The Findings by the OIG inspectors lacked the true situation for quantitate analysis for the quality of care within the Reno Medical Center.
    This is not the only disgrace that was noted in the June article. The response from “Rep. Mark Amodie R-Nevada stated that he was generally satisfied with the findings” and “I think our facility is doing a pretty good job of attempting to meet the needs of our veterans”. It’s clear that the Congressman has no clue what type of care our veterans are NOT receiving and maybe he should have taken the time to meet the patients at the VA hospital and determine the facts for himself. All you have to do is take the time to talk and listen to our Veterans to understand something is very wrong at our Reno-VA Hospital.
    As a concerned veteran at the hospital, I find myself wondering how this report missed items such as; vital care needs, quality outcomes, statistics, LOS, Clinical Pathways, and Ancillary Services related to Rehabilitation that our veterans need. In my 40 years of healthcare experience it’s difficult to understand the lack of patient care plans. The things that we take for granted in a Regional Healthcare Network, be it Profit, Non-Profit or University care is missing for our Veterans. A careful review would have found a lack of documentation by the physicians and lack of follow up with our veterans. There is no closure with our Veterans just opened questions regarding clinical plans and findings. If you take the time to speak with the Veterans they will tell you they have no idea what is wrong with them and why they don’t get to see the Attending physician regarding their diagnosis. The key is to make sure our veterans have the opportunity for a quality of care that rivals regional hospitals.
    There are patients that have a length of stay (LOS) of more than 1,000 days for stroke and zero chance for rehabilitation by way of Physical, Speech or Occupational Therapy. Their lack in dietary needs for patients who have had a stroke is disgraceful and outrageous. Patients who have lost feelings as a result of strokes or other disabilities are dependent on feeding themselves with these restrictions. Many of the VA patients lack dentures and can’t eat what Dietary provides lacks consideration on the type of food and how it is prepared is lacking.
    As a patients stated, “he is forced to eat like a dog”. This patient described eating a pork chop was impossible given his lack of teeth and unable to cut the meat with his disabilities that resulted from his stroke. As the patient said he just had to “Stick it with a fork and hope for the best”. These patients are dehydrated, malnutrition and lack necessary food substance in their body or improper absorption of vital food sources. These are not isolated cases but prevalent within the Community Living Center (CLC) in the Reno VA system. Patients have requested dietary to provide them with meals that they can eat. The patients lack of dentures and their limitations of having only one hand to feed themselves has continued as if nothing can be done. Which leads to the question, who is cooking the food and who is listening to the Veterans concerns when there are these issues. If you visit some of these patients you will find outside food, snack, drinks and other home items that they have to substitute for hospital meals. I am only addressing those who have limited abilities and can’t help themselves.
    All of these patients are Veterans who have served their country and rely on the VA Healthcare system for their care. The patient population in this unit include Veterans from WWII to the present. Most of the patients seen in this unit are seniors who choose the VA for their care. However, the expectations for care at our VA hospital lacks the resources to meet the needs of these patients. To subject these patients to a failed healthcare system because it’s better and more cost effective to keep them in a bed and forgo the Rehab is inexcusable and indefensible. These patients if given the opportunity can lead a relative normal and productive life. No hospital would let a patient linger for 200-1,000 plus days in a healthcare system. These patients would be moved to a rehabilitation hospital where quality of life can be restored and not impeded.
    It’s complicated and unreasonable to think every hospital can meet the needs of every patient. But the things listed here are correctable by listening to the patients with concerns. There are still many issues related to the other findings of the OIG report. If you can’t handle common issues, then it falls on the health system to find the solution and implement the policy for quality of care and outcome.

    Charles J. Sena
    775-830-1968

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