This past week the Department of Veterans Affairs reluctantly released to USA Today quality of care rankings — one to five stars with one being the poorest and five the best — for its 146 VA medical centers. The VA health facilities in Las Vegas and Reno warranted only two stars each, placing them solidly in the bottom third in the rankings.
At about the same time the agency also released Inspector General reports on wait time manipulation at facilities in eight states, including one for the mental health division of the VA Southern Nevada Healthcare System in Las Vegas.
The IG has been looking into wait time manipulation for the past couple of years after it was learned a number of VA medical centers lied about how long veterans were delayed in receiving medical care.
In 2014 it was revealed that the VA hospital in Phoenix was claiming veterans waited an average of 24 days for their first primary care appointment, when the average was actually 115 days. There were 1,400 vets on the official waiting list, but another 1,700 who were not even included on that list. Some died waiting to be seen by a doctor.
A subsequent audit found 64 percent of VA facilities had tampered with waiting lists.
The recent report on the Las Vegas waiting list said the inspection was launched following a complaint by a former VA mental health staffer who said he and others were directed by their boss to schedule the next available mental health appointment date as a vet’s desired appointment date, even when that was untrue.
He said he was told to do this “so the numbers looked good” and it appeared there was no waiting.
The IG interviewed 11 VA employees and reviewed emails.
Though many staffers denied being pressured to manipulate the wait times, most admitted the methodology of recording desired appointments had this effect.
The report said of one staffer: “He stated that he was told the only acceptable wait time for appointments was zero days. He said he was told by a lead MSA (medical support assistant) to cancel appointments for veterans with wait times and reschedule them using the next available appointment date as the veterans’ desired date so that the wait times appeared to be zero. … He said this was done to make the wait times appear shorter than what they actually were.”
Still another staffer said she was handed a list of 50 patients by her boss and told the appointments had been scheduled improperly. The wait times varied from 45 to 60 days. She was told the patients agreed to the appointment date, so the appointment date should be recorded as the desired date, making the wait time zero.
The report concluded, “The investigation determined that some MSAs were not scheduling appointments correctly because of confusion over the scheduling directive, incorrect information from coworkers, and incorrect information received during previous training. Several of the MSAs interviewed indicated that they were directed by supervisors to manipulate scheduling data.”
Though the report was referred to the VA’s Office of Accountability Review back in February, there was no indication any disciplinary action was taken.
The local VA released a statement to the Las Vegas newspaper saying, “The VA Office of Accountability reviewed the … findings and concluded there were no accountability issues that warranted action and that revised training addressed the scheduling deficiencies discovered.”
The problem is that the VA health system is socialized medicine, pure and simple. A bureaucracy, like any other organism, has at its base the objective of self-preservation, not the objective to provide quality service.
No matter who President-elect Trump may appoint to head the agency, it will fail, as it has done so over and over again over the decades.
Nevada has had more than 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.
For rural vets it is too long a drive to Reno or Las Vegas.
It is time to dismantle the VA health care system and give veterans vouchers to use at whatever doctor or hospital they wish. — TM