The Pronk Pops Show 263, May 19, 2014, Story 1: Single Payer Government Monopoly on Health Care = Socialized Medicine = A VA Hospital Preview of Death Panels — Delay, Deny, and Lie — The Unacceptable Obama Administration! — Vote The Political Elitist Establishment (PEEs) Out of Office for Incompetence — Part 1 — Videos
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Pronk Pops Show 263: May 20, 2014
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Pronk Pops Show 258: May 9, 2014
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Pronk Pops Show 207: February 10, 2014
Pronk Pops Show 206: February 7, 2014
Pronk Pops Show 205: February 5, 2014
Story 1: Single Payer Government Monopoly on Health Care = Socialized Medicine = A VA Hospital Preview of Death Panels — Delay, Deny, and Lie — The Unacceptable Obama Administration! — Vote The Political Elitist Establishment (PEEs) Out of Office for Incompetence — Part 1 — Videos
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VA Probe Exposes Scandal at Multiple Locations
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Whistleblower expands VA wait-list fraud to eighth facility
BY ED MORRISSEY
Add yet another VA facility to the deadly wait-list fraud scandal. The Daily Beast heard from a whistleblower in the Albuquerque VA organization that the same kind of wait-list fraud alleged at seven other facilities occurs in New Mexico as well. Veterans have to wait months to get medical attention, and any investigation may already be too late for some of them:
Add Albuquerque, New Mexico’s to the growing list of VA hospitals accused of keeping secret waiting lists to hide delays for veterans seeking medical care. And it may already be too late to get to the truth and find out what harm, if any, was done to veterans there—VA officials are already destroying records to cover their tracks, a whistleblower inside the hospital tells The Daily Beast. …
“The ‘secret wait list’ for patient appointments is being either moved or was destroyed after what happened in Phoenix,” according to a doctor who works at the Albuquerque VA hospital and spoke exclusively with The Daily Beast. “Right now,” the doctor said, “there is an eight-month waiting list for patients to get ultrasounds of their hearts. Some patients have died before they got their studies. It is unknown why they died, some for cardiac reasons, some for other reasons.”
There’s no proof yet that veterans died while waiting for treatment, like what allegedly happened in Phoenix. But the doctor says it’s quite possible that some veterans would still be alive if they hadn’t been pushed through a record-keeping trap door that buried their requests for medical care.
On March 19, 2014, for example, a patient with a deteriorating heart condition requested to see a doctor. The patient was finally seen only days ago, on May 16, when they were admitted to the hospital for decompensated heart failure. “A near miss” as the VA doctor familiar with the case described it. “He could have died before being seen.”
That patient was fortunate. It remains to be seen whether all of the patients affected by the alleged wait-list fraud in Albuquerque were as fortunate. They certainly weren’t in Phoenix.Stars and Stripes notes that treatment delays have been listed as factors in more than 100 deaths, although over a time frame that begins in 2001:
As controversy swirls around the Veterans Administration over deaths caused by delayed care, an investigation by the Dayton Daily News found that the VA settled many cases that appear to be related to delays in treatment.
A database of paid claims by the VA since 2001 includes 167 in which the words “delay in treatment” is used in the description. The VA paid out a total of $36.4 million to settle those claims, either voluntarily or as part of a court action.
The VA has admitted that 23 people have died because of delayed care, and is facing accusations that hospital administrators are gaming the system to conceal wait times, including using a “secret list” at the VA in Phoenix. …
The Dayton VA in 2009 paid out $140,000 for a 2006 claim that was described as “Failure/Delay in Admission to Hospital or Institution; Medication Administered via Wrong Route; Failure to Order Appropriate Test.”
A pending $3.5 million claim from March 2013 was filed by a man who says delayed treatment of his wife’s cervical cancer resulted in her death in March 2012. The names of the veteran and her widower were redacted.
Issues with access and treatment delays have been around for decades at the VA. That’s the reason why VA Secretary Eric Shinseki imposed the 14-day wait list metric in 2009, when he took over the Department of Veteran Affairs. The move was supposed to correct the chronic problem of timely access for many veterans. Instead, VA facilities across the country appear to have engaged in widespread and suspiciously similar fraud, and no one at the VA from Shinseki on down seems to have bothered to do anything about it — and have lied about knowledge of the issue to boot.
That’s enough for Dana Milbank, who called this weekend for Shinseki to be canned:
Eric Shinseki has served his country honorably as a twice-wounded officer in Vietnam, as Army chief of staff and finally as President Obama’s secretary of veterans affairs.
But his maddeningly passive response to the scandal roiling his agency suggests that the best way Shinseki can serve now is to step aside.
Reports have documented the deaths of about 40 veterans in Phoenix who were waiting for VA appointments — the latest evidence of widespread bookkeeping tricks used at the agency to make it appear as though veterans were not waiting as long for care as they really were. The abuses have been documented over several years by whistleblowers and leaked memorandums, and confirmed by a host of government investigators.
That’s bad enough. Worse was Shinseki’s response when he finally appeared before a congressional committee Thursday to answer questions about the scandal. He refused to acknowledge any systemic problem and declined to commit to do much of anything, insisting on waiting for the results of yet another investigation.
Shinseki did not cover himself in glory in Senate testimony last week. One indication of how big the problem has become was the abrupt dismissal of Robert Petzel, who was already on his way out for retirement in September. However, his replacement turns out to be even more problematic:
The person nominated two weeks ago to replace the VA’s outgoing undersecretary for health was responsible for supervising one of the hospitals at the center of the current scandal.
Dr. Jeffrey Murawsky was nominated on May 1 to replace Dr. Robert Petzel as undersecretary of health at the Department of Veterans of Affairs. Petzel’s “resignation” was officially announced today, although his impending retirement was first announced last September.
Murawsky is currently the network director–effectively the CEO–of the VA region that includes the Edward Hines, Jr. VA Hospital in Chicago. Before he moved up the VA hierarchy, he worked as a manager at the hospital.
Hines Hospital was the seventh facility to face allegations of wait-list fraud. Murawsky seems better suited to be the target of the investigation rather than the man running it. It’s time to clean house entirely at the VA.
http://hotair.com/archives/2014/05/19/whistleblower-expands-va-wait-list-fraud-to-eighth-facility/
He KNEW! Obama told of Veterans Affairs health care debacle as far back as 2008
–
The Washington Times
The Obama administration received clear notice more than five years ago that VA medical facilities were reporting inaccurate waiting times and experiencing scheduling failures that threatened to deny veterans timely health care — problems that have turned into a growing scandal.
Veterans Affairs officials warned the Obama-Biden transition team in the weeks after the 2008 presidential election that the department shouldn’t trust the wait times that its facilities were reporting.
“This is not only a data integrity issue in which [Veterans Health Administration] reports unreliable performance data; it affects quality of care by delaying — and potentially denying — deserving veterans timely care,” the officials wrote.
The briefing materials, obtained by The Washington Times through the Freedom of Information Act, make clear that the problems existed well before Mr. Obama took office, dating back at least to the Bush administration. But the materials raise questions about what actions the department took since 2009 to remedy the problems.
In recent months, reports have surfaced about secret wait lists at facilities across the country and, in the case of a Phoenix VA facility, accusations that officials cooked the books to try to hide long wait times. Some families said veterans died while on a secret wait list at the Phoenix facility.
Last week, Dr. Robert Petzel, undersecretary for health in the Department of Veterans Affairs, resigned. His boss, Secretary Eric K. Shinseki, told Congress he will stay despite growing calls for his resignation.
Mr. Shinseki, a disabled veteran, has headed the department since the beginning of Mr. Obama’s first term, when the VA report identified many of the problems.
“Should they have known? Absolutely, they should have known,” said Deirdre Parke Holleman, executive director of the Washington office for the Retired Enlisted Association, a veterans group, which has not taken a position on whether Mr. Shinseki should resign. “These are problems that should have been dealt with.”
PHOTOS: Eye-popping excuses in American political scandals
In particular, the 2008 transition report referred to a VA inspector general recommendation to test the accuracy of reported waiting times.
Such tests, the report noted, could prompt action if results reveal “questionable differences” between the dates shown in medical records and dates in the Veterans Health Administration’s scheduling system. It’s unclear whether that recommendation was adopted because VA officials have not responded to request for comment.
In Phoenix, officials are looking into whether as many as 40 veterans died while waiting for treatment, with “secret wait lists” used to conceal the delays. Speaking in the Republicans’ weekly address over the weekend, Sen. John McCain, Arizona Republican, said the scandal began in his home state but it has since “gone nationwide.”
“Altogether, similar reports of lengthy waiting lists and other issues have surfaced in at least 10 states,” he said.
Acting VA Inspector General Richard J. Griffin told Congress last week that his office has opened multiple investigations into “reports of manipulated waiting times” in Phoenix as at other facilities.
He said his investigation also aims to find out whether officials in Phoenix purposely left off the names of veterans waiting for care on electronic waiting lists and, if so, whether any veterans died because of the delays in care.
Problems with electronic waiting lists also merited mention in the presidential briefing report.
Audits of outpatient scheduling and patient waiting times completed since 2005 have identified noncompliance with the policies and procedures for scheduling, inaccurate reporting of patient waiting times and errors in [electronic waiting lists],” the briefing papers state.
Briefing reports typically are prepared by career federal employees before a change in power, giving incoming administrations detailed looks at agency operations. The VA report notes that little was done to address the problems surrounding scheduling and wait time accuracy during the George W. Bush administration.
“Although VHA has recognized the need to improve scheduling practices and the accuracy of wait times data
, no meaningful action has been taken to achieve this goal today,” officials wrote.
In fact, officials added, nine recommendations arising from inspector general audits from 2005 to 2007 were not implemented by 2008 when officials prepared the report for the incoming administration.
Jim Nicholson, who served as VA secretary during the latter half of the Bush administration, could not be reached for comment.
The briefing materials do not reveal any concerns about outright fraud in manipulating waiting times, but they make repeated references in summarizing past audits and reviews about data accuracy.
“This report and prior reports indicate that the problems and causes associated with scheduling, waiting times and wait lists are systemic throughout the VHA,” officials told the incoming administration.
Testifying to Congress last week, Mr. Shinseki said most veterans are satisfied with their health care, “but we must do more to improve the timely access to that care.”
The American Legion has called on Mr. Shinseki and Allison Hickey, VA undersecretary for benefits, to resign.
“They are both part of VA’s leadership problem,” American Legion Commander Daniel Dellinger said in a statement Friday. “This isn’t personal. VA needs a fundamental shift in leadership if it is to defeat its systematic lack of accountability.”
http://www.washingtontimes.com/news/2014/may/18/obama-warned-about-va-wait-time-problems-during-20/
Exclusive: VA Scandal Hits New Hospital
Add Albuquerque, New Mexico’s to the growing list of VA hospitals accused of keeping secret waiting lists to hide delays for veterans seeking medical care. And it may already be too late to get to the truth and find out what harm, if any, was done to veterans there—VA officials are already destroying records to cover their tracks, a whistleblower inside the hospital tells The Daily Beast.
Last month, word broke that the Department of Veterans Affairs hospital in Phoenix kept a secret waiting list that allegedly led to dozens of preventable deaths. The VA’s inspector general was brought in to investigate the charges and hasn’t yet found any deaths in Phoenix linked to wait times, but his investigation is ongoing. Since then five other facilities have come under fire, leading to calls for VA Secretary Eric Shinseki to step down. And now there’s Albuquerque’s. The evidence for this new secret list may be hard to track down, however.
“The ‘secret wait list’ for patient appointments is being either moved or was destroyed after what happened in Phoenix,” according to a doctor who works at the Albuquerque VA hospital and spoke exclusively with The Daily Beast. “Right now,” the doctor said, “there is an eight-month waiting list for patients to get ultrasounds of their hearts. Some patients have died before they got their studies. It is unknown why they died, some for cardiac reasons, some for other reasons.”
There’s no proof yet that veterans died while waiting for treatment, like what allegedly happened in Phoenix. But the doctor says it’s quite possible that some veterans would still be alive if they hadn’t been pushed through a record-keeping trap door that buried their requests for medical care.
On March 19, 2014, for example, a patient with a deteriorating heart condition requested to see a doctor. The patient was finally seen only days ago, on May 16, when they were admitted to the hospital for decompensated heart failure. “A near miss” as the VA doctor familiar with the case described it. “He could have died before being seen.”
The Albuquerque VA did not respond to requests for comment but Ozzie Garza, director of the VA Regional Office of Public Affairs, provided this statement to The Daily Beast: “We are not familiar with the allegations but will call immediately for an external review as we take all allegations seriously.”
“When everyone found out the IG was doing the audit, the word I heard was ‘Make sure nothing is left out in the open,’” the VA doctor said. “And that ranged from make sure there’s no food out to make sure there’s no information out in the open.” The doctor is not involved in the scheduling process and was unsure of how exactly VA officials would purge the secret wait lists but has heard it discussed among colleagues.
As VA officials reacted nervously to news of an impending audit, the doctor described hearing officials involved in scheduling patient appointments say, “The database had been removed or renamed.” To cover their tracks the doctor said they decided, “Instead of calling it a wait it would be called something like a precedence list.”
On March 19, a patient with a deteriorating heart condition requested to see a doctor. The patient was finally seen on May 16, when they were admitted to the hospital for decompensated heart failure.
When another of the doctor’s colleagues, a physician in a managerial position at the Albuquerque VA, saw the initial story about secret wait lists break he heard him say, “I always knew that Phoenix was better than us at playing the numbers game.”
Secret waiting lists may not be the only problems at the Albuquerque VA, in fact they may only be an accounting trick to mask the deeper issues.
Veterans with heart problems are waiting an average of four months to see a cardiologist at the Albuquerque VA, according to the doctor there who has access to patient records.
There are eight physicians in the cardiology department. But at any given time, only three are working in the clinic, where they see fewer than two patients per day, so on average there are only 36 veterans seen per week. That means the entire eight-person department sees as many patients in a week as a single private practice cardiologist sees in two days, according to the doctor.
For perspective, 60% of cardiologists reported seeing between 50 and 124 patients per week, according to a 2013 survey of medical professionals’ compensation conducted by Medscape. On the low end, the average single private practice cardiologist who participated in the study saw more patients in a week than the Albuquerque VA’s entire eight-person cardiology department.
In some cases, a long wait to see a doctor is just another routine inconvenience of the sort people expect in a large bureaucracy, but other times it can be a matter of life and death.
One veteran’s heart troubles were serious enough that a physician requested they be seen in the next available slot on January 8, 2014. Over three months later, the patient was seen in late April.
A patient whose initial blood test on December 8, 2013 suggested he might have a brain tumor waited until April 28 2014 before he was seen again. Another veteran, diagnosed with gangrene, was referred for surgery so doctors could try to salvage his limb or amputate it if necessary—it’s 36 days after he was initially supposed to see the surgeons and he’s still waiting now.
A second source inside the Albuquerque VA, a medical technician, said the facility provided high quality care. But the technician acknowledged it could take a long time before veterans get in the door to receive it.
The list of patients waiting for tests grew so long in one department that the technician became disheartened and stopped checking it around Christmas of last year. “I honestly stopped doing that because it just overwhelmed me personally,” the technician said.
The VA’s Office of Inspector General began investigating the Albuquerque medical center last year, according The Albuquerque Journal, after employees there reported that appointments were being manipulated to conceal patients’ actual wait times. That would mean that the inspector general, and the VA itself, knew about allegations of corruption there long before the Phoenix story broke in April.
Rep. Jeff Miller, chairman of the House Committee on Veterans’ Affairs, has been beating the drum about wait times and advocating reform since before the latest crisis put the VA back in the spotlight. “VA’s delays in care problem is real and has already been linked to the recent deaths of at least 23 veterans,” Miller told The Daily Beast.
Yet it wasn’t until the latest VA scandal broke nationally—months after the inspector general first investigated claims that are strikingly similar to what was later reported in Phoenix—that Albuquerque’s came back into focus. The status of the initial investigation still hasn’t been made public.
Last week, New Mexico Senator Tom Udall requested a new investigation into his state’s VA hospitals. Udall called for the audit after his office received dozens of complaints from veterans about long wait times at the VA, and reports that Albuquerque’s schedulers were forging appointment records.
New Mexico is now the seventh state where allegations have emerged about VA medical facilities cooking the books. As new incidents continue to display the same features uncovered in past cases, the details are revealing a common language of bureaucratic corruption communicated across state lines between different VA facilities.
Yet, even as evidence builds of a systemic problem within the VA, the department itself has been slow to acknowledge it and even slower to act. In his testimony before the Senate last week, VA Secretary Shinseki referred to the six cases that had been revealed up to that point as “isolated incidents.”
Veterans, for their part, are divided over the proper response; many believe that the actual care provided by the VA is good and the problem is primarily about access. But as each new week brings another case that seems to show the same pattern of duplicity inside the VA, some are growing impatient.
“Our members are outraged and are demanding true accountability and systemic reform for what appears to be increasingly widespread problems,” said Derek Bennett, chief of staff for Iraq and Afghanistan Veterans of America (IAVA). “We cannot fix the problems until all the facts are on the table,” Bennett said but added that, “scapegoating and politicization of this issue will not reform the Department of Veterans Affairs nor best serve our veterans.”
To encourage getting the facts on the table, the IAVA has started its own initiative to gather stories from veterans and VA employees. “We have partnered with the Project on Government Oversight on vaoversight.org to provide a safe place for whistleblowers to come forward for this very reason,” Bennett said.
Despite the volume of incidents that have already been publicly revealed and theinspector general’s admission last week that he had more evidence pointing to new mismanagement, the VA has not announced any broad reforms or disciplinary actions. In the only major leadership shakeup since the VA became embroiled in the secret wait list charges, Secretary Shinseki announced the resignation last week of Dr. Robert Petzel, his undersecretary for health. But as many were quick to point out, and in what the IAVA called a “cynicial twist,” Petzel was already scheduled to retire this year after a 40-year career.
For Rep. Miller, the time is overdue for change within the VA. “We simply can’t afford to wait for the results of another IG investigation or VA’s internal review when veterans may be at risk,” Miller said. Immediate actions can be taken now, Miller added, even before formal investigations draw their conclusions. “Sec. Shinseki needs to take emergency steps,” he said, “to ensure veterans who may have fallen victim to these schemes get the medical treatment they need.”
On Sunday, the White House, which has remained relatively quiet on the VA’s latest troubles, weighed in with an interview by President Obama’s chief of staff, Denis McDonough.
“The president is madder than hell, and I’ve got the scars to prove it, given the briefings that I’ve given the president,” McDonough told CBS’ Face the Nation. “Madder than hell” was the first echo of Secretary Shinseki, amplifying a phrase he used in his testimony last week to describe his own feelings. The second echo of Shinseki came when McDonough said the president had sent staff to look into the VA investigation and “find out if this is a series of isolated cases or whether this is a systemic issue.”
The VA’s own investigation is ongoing and will continue to attract attention as more revelations, like the claims about the Albuquerque VA, keep coming out. It remains to be seen how leaders who are “madder than hell” will react to the evidence they find and what, if anything, they will order done about the situation.
http://www.thedailybeast.com/articles/2014/05/18/exclusive-v-a-scandal-hits-new-hospital.html
Vets Using Phoenix VA are Angry, Sick and Scared
by Jennifer Hlad
The veterans who use the Phoenix Veterans Affairs Health System are angry, sick and scared.
They say they call and call, but get no answer.
They say they are ignored, disrespected and turned away by employees with no medical training.
They say they wait months for an appointment with a primary care doctor, then wait several more months to see a specialist.
More than 200 veterans and family members packed into American Legion Post 41 to share horror stories of delays, misdiagnoses and poor treatment with the national commander of the American Legion and the interim director of the Phoenix VA. Steve Young took over after whistleblowers revealed secret waiting lists used to cover up backlogs and extensive wait times. One of the whistleblowers, Dr. Samuel Foote, said there are at least 13,000 patients without primary care doctors, and even more who can’t get timely specialty appointments or follow-ups.
He said 40 veterans died while waiting for appointments in Phoenix VA clinics, and VA wrongdoings have surfaced in at least 10 states.
The Legion’s Daniel Dellinger told the crowd that the VA has “a pattern of unresponsiveness that has infected the entire system.”
People in the room waited their turn, then spoke of broken promises, fear and frustration. Some choked back tears; others spoke harshly of misplaced loyalty, angered that they had proudly served in the military yet weren’t being served by the VA in return.
Turned away
Dennis Morris’ arm was swollen, and he wasn’t feeling well, so he and his wife, Lynn, went to the Phoenix VA’s emergency room. They spent the whole night there, she said, and were sent home with a bag of ice.
The next day, his arm was worse — even more swollen and turning black. They went back to the ER and he was released with another bag of ice, she said.
On the third day, she insisted her husband go to the civilian hospital near their home in Sun City. Dennis was diagnosed with cellulitis and two strains of pneumonia, and he spent several days in the hospital. She said she had to write to Sen. John McCain, R-Ariz., to get the VA to cover the medical bills.
Three years later, when her husband turned 65, she told him there was no longer any reason for him to go to the VA. She signed him up for Medicare, she said, but he still liked the VA.
Late last summer, Dennis, then 66, started feeling bad and began calling the VA to get an appointment with his primary care doctor. After about eight weeks and no appointment, the couple went to the ER at the VA. Dennis was seen immediately, she said, and the doctors did blood tests and took a chest X-ray. They discovered he was extremely anemic and admitted him for six or eight hours to administer iron directly into his blood.
But he didn’t get better. Early the next week he got a call from the VA saying he might have pneumonia. They sent him to a VA clinic closer to home for a second X-ray. He was given antibiotics, but he still felt bad.
Finally, Lynn decided to take her husband back to the civilian hospital. Within 12 hours, he was diagnosed with Stage IV lung cancer, she said. He died 21 days later.
“I’m convinced they never looked at the X-rays,” she said of the VA.
She acknowledges that it might have been too late to save her husband even if the doctors had found the cancer when they went to the VA emergency room in August. But, she said, the couple would have had time to make plans. Instead, he was nearly unconscious by the time he came home from the hospital 15 days after the diagnosis, and he died less than a week later.
“He just totally disintegrated,” she said. “I was not prepared to lose Dennis in five days.”
‘He stayed loyal to the military’
Navy veteran Dennis Richardson had struggled with post-traumatic stress and survivor syndrome since he returned from Vietnam, his brother Darrell said.
“But he stayed loyal to the military,” he said, and was proud to get his care at the VA.
Dennis Richardson split his time between Wisconsin and Arizona. When he was diagnosed with liver cancer by a civilian doctor in Wisconsin in late July 2012, he decided to get his treatment from the VA in Arizona.
He hand-carried his medical records and diagnosis to Phoenix, but when he tried to get an appointment with his primary care doctor at the VA so he could be referred to oncology, he was told he would have to wait seven months, his brother said.
“They wouldn’t even look at his records,” Darrell Richardson said. Family members tried calling to get him an appointment, but had no luck.
Richardson waited about three months, until he could no longer stand the pain. At the end of September 2012, he went to the VA emergency room and doctors started him on chemotherapy, but it was too late, his brother said. Dennis Richardson stopped chemo after a few weeks, saying he was simply too sick to handle it. He died Nov. 8, 2012, at the age of 65.
Darrell Richardson said he later found out that the Houston VA has one of the best liver cancer treatment programs in the country. If his brother had gotten a transfer to that program when he first arrived in Phoenix, he said, maybe he could have lived longer.
‘You have to be almost dead’
Carolyn Stoor struggled to hold back tears as she recounted the two times she said she almost lost her husband, Ken, in the past year.
“You have to be almost dead for them to do something” at the Phoenix VA clinics, she said.
Ken Stoor served in the Army from 1965 to 1969, and suffers from medical issues including diabetes, heart problems, PTSD and pre-cancerous tumors in his bladder, she said. He has been going to a VA clinic in Phoenix for about three years, even though it is about 65 miles away from their home in Superior, Ariz.
Ken Stoor kept his arm around her shoulders at the meeting, as she talked about how they have struggled to get him help.
In October, she took him to his primary care doctor with low blood pressure and a high fever. The doctor told her to take him home and “pump him full of fluids.”
She said she had already done that, so she took him to a civilian hospital, where doctors diagnosed him with a severe infection.
“They said, ‘We don’t know if he’s going to make it,'” Carolyn said, now crying.
After that, she requested a different primary care doctor for her husband.
“I actually told that last primary doctor what a rotten job she did: ‘Thank you very much but you almost killed him,'” she said. “I should have moved him out of the whole clinic,” she said, but they both really like the physician’s assistant he sees for his heart.
In April, Ken was having severe chest pains and Carolyn took him to the VA. He and six others were waiting for a test when the machine went down, she said.
They left to go to the civilian hospital, where doctors told her Ken was having a heart attack and might not survive.
“I just said, ‘I’m not letting him die on me,'” she said. “I’m not going to lose him over something stupid” like a broken machine.
Forgotten on the 4th floor
Robert Sertich served in the Air Force from 1947 to 1961. He went to the VA hospital in 2011 after being diagnosed with sepsis. His daughter, Kim Sertich, said doctors told her that he might be there for a few weeks.
He was 81, with underlying health issues, but she said he was coherent and could move around when she left him the first night.
By the second night, he was no longer coherent. She said she walked in to find him sitting in the dark, with his oxygen tube pinched under the wheels of his chair.
Doctors had requested an MRI to find the source of the infection, and he was put on a breathing machine in the intensive-care unit for a few days. He never got the test, she said.
When he started having trouble swallowing, the doctors put in a feeding tube.
One night, Robert pulled out the tube in his sleep. Kim gave permission for his hands to be loosely secured when he slept, so he couldn’t pull it out. Then he was moved to a different floor, Kim said, and the problems began adding up.
The MRI was never done, she said, and though a test of his swollen arm had been ordered on the third floor, the staff on the fourth floor never did it. They also refused to secure his hands, she said, and when he pulled the tube out, they wouldn’t put it back in.
Kim tried to feed her father, she said, but he could barely swallow. After a few days, Kim insisted they put the feeding tube back in. She paid for someone to watch her father 24 hours a day so he wouldn’t pull it out.
Her father’s blood tests were improving and he was getting more coherent, Kim said, but his arm continued to swell. When doctors realized it was a blood clot and began giving him blood thinners, “that was pretty much the end,” she said.
Robert Sertich died Nov. 14, 2011, after 33 days in the VA hospital. A week later, the hospital sent a condolence letter for “Richard Sertich.”
They keep coming back
Despite having serious problems with their care, many veterans return to the VA again and again for myriad reasons.
Stoor said her husband continues to go to the VA, where he has appointments and therapy a few times a week and gets many of his medications.
“It’s kind of scary, every time you go,” she said. “But if you don’t go, then you don’t get your benefit.”
Richardson said his brother always “stayed loyal to the military,” he said, and was proud to get his care at the VA, even with a cancer diagnosis, access to the Mayo Clinic and a seven-month wait for a referral.
Lynn Morris said she never really liked the VA, but her husband, Dennis, insisted on going there.
“The waiting room was horrendous,” she said, “and the attitude of the people working there was even worse.”
Still, he had served in the Army and liked his doctors at the VA, she said.
When he turned 65, his wife signed him up for Medicare, she said, but he still went to the VA.
She didn’t understand.
The emergency room was full of people with their heads between their legs because they were in such intense pain, she said. Foote said the average wait time there was frequently 12 to 16 hours.
“I thought it was a horrible mess from Day 1,” she said.
Robert Sertich lived nearly 90 miles from Phoenix, in Payson, Ariz., but going to the VA was “like this badge of honor,” his daughter Kim said.
The hospital floors were filthy, she said, and there were several days when the bathrooms for visitors and the hot water for patient showers didn’t work.
Young, the interim director of the Phoenix VA system, told the crowd he didn’t have answers for the veterans and families. But he stayed at the meeting for hours and took notes.
“I’m just here to listen and understand,” he said. “I don’t have the perfect solution yet.”
Background Articles and Videos
United States Department of Veterans Affairs
The United States Department of Veterans Affairs (VA) is a government-run military veteran benefit system withCabinet-level status. It is the United States government’s second largest department, after the United States Department of Defense.[1] With a total 2009 budget of about $87.6 billion, VA employs nearly 280,000 people at hundreds of Veterans Affairs medical facilities, clinics, and benefits offices and is responsible for administering programs of veterans’ benefits for veterans, their families, and survivors. In 2012, the proposed budget for Veterans Affairs was $132 billion. [2] The VA 2014 Budget request for 2014 is $152.7 billion. This includes $66.5 billion in discretionary resources and $86.1 billion in mandatory funding. The discretionary budget request represents an increase of $2.7 billion, or 4.3 percent, over the 2013 enacted level.[3]
It is administered by the United States Secretary of Veterans Affairs.
Contents
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History
The Continental Congress of 1776 encouraged enlistments during the American Revolutionary War by providing pensions for soldiers who were disabled. Direct medical and hospital care given to veterans in the early days of the republic was provided by the individual states and communities. In 1811, the first domiciliary and medical facility for veterans was authorized by the federal government, but not opened until 1834. In the 19th century, the nation’s veterans assistance program was expanded to include benefits and pensions not only for veterans, but also their widows and dependents.
VA Medical Center in Manhattan, New York City
After the Civil War, many state veterans’ homes were established. Since domiciliary care was available at all state veterans homes, incidental medical and hospital treatment was provided for all injuries and diseases, whether or not of service origin. Indigent and disabled veterans of the Civil War, Indian Wars, Spanish-American War, and Mexican Border period as well as discharged regular members of the Armed Forces were cared for at these homes.
Congress established a new system of veterans benefits when the United States entered World War I in 1917. Included were programs for disability compensation, insurance for servicepersons and veterans, and vocational rehabilitation for the disabled. By the 1920s, the various benefits were administered by three different federal agencies: the Veterans Bureau, the Bureau of Pensions of the Interior Department, and the National Home for Disabled Volunteer Soldiers.
The establishment of the Veterans Administration came in 1930 when Congress authorized the president to “consolidate and coordinate Government activities affecting war veterans”. The three component agencies became bureaus within the Veterans Administration. Brigadier General Frank T. Hines, who directed the Veterans Bureau for seven years, was named as the first Administrator of Veterans Affairs, a job he held until 1945.
The close of World War II resulted in not only a vast increase in the veteran population, but also a large number of new benefits enacted by Congress for veterans of the war. In addition, during the late 1940s, the VA had to contend with aging World War I veterans. During that time, “the clientele of the VA increased almost five fold with an addition of nearly 15,000,000 World War II veterans and approximately 4,000,000 World War I veterans”.[4] Prior to World War II, in response to scandals at the Veterans Bureau, programs that cared for veterans were centralized in Washington, D.C. This centralization caused delays and bottlenecks as the agency tried to serve the World War II veterans. As a result, the VA went through a decentralization process, giving more authority to the field offices.[5]
The World War II GI Bill, signed into law on June 22, 1944, is said[by whom?] to have had more impact on the American way of life than any law since the Homestead Act nearly a century before.
The VA health care system has grown from 54 hospitals in 1930 to include 171 medical centers; more than 700 outpatient, community, and outreach clinics; 126 nursing home care units; and 35 domiciliaries. VA health care facilities provide a broad spectrum of medical, surgical, and rehabilitative care. The responsibilities and benefits programs of the Veterans Administration grew enormously during the following six decades.
Further educational assistance acts were passed for the benefit of veterans of the Korean War, the Vietnam Era, the introduction of an “all-volunteer force” in the 1970s (following the end of conscription in the United States in 1973), the Persian Gulf War, and those who served following the attacks of September 11, 2001.
The Department of Veterans Affairs Act of 1988 (Pub.L. 100-527) changed the former Veterans Administration, an independent government agency established in 1930, primarily to see to the needs of World War I veterans, into a Cabinet-level Department of Veterans Affairs. It was signed into law by President Ronald Reagan on October 25, 1988, but actually came into effect under the term of his successor, George H. W. Bush, on March 15, 1989.
The Department of Veterans Affairs was created due to nearly one third of the population being eligible for veterans benefits. Its proponents argued that due to the large number of Americans affected by the VA, it needed an administrator who had direct access to the president.[6]
In their major reform period of 1995–2000, the Veterans Health Administration (VHA) implemented universal primary care, closed 55% of their acute care hospital beds, increased patients treated by 24%, had a 48% increase in ambulatory care visits, and decreased staffing by 12%. By 2000, the VHA had 10,000 fewer employees than in 1995 and a 104% increase in patients treated since 1995, and had managed to maintain the same cost per patient-day, while all other facilities’ costs had risen over 30% to 40% during the same period.
VA Medical Center in Palo Alto, California
Functions
The Department of Veterans Affairs is headed by the Secretary of Veterans Affairs, appointed by the President with the advice and consent of the Senate. The current Secretary of Veterans Affairs is Retired Army General Eric Shinseki.
Its primary function is to support Veterans in their time after service by providing benefits and support. A current initiative in the Department is to prevent and end Veterans’ homelessness.[7] The VA works with the United States Interagency Council on Homelessness to address these issues. Shinseki sits on the Council and is committed to ending Veteran’s homelessness by 2015 as laid out in Opening Doors: Federal Strategic Plan to Prevent and End Homelessness, released in 2010.[8]
The Department has three main subdivisions, known as Administrations, each headed by an Undersecretary:
- Veterans Health Administration (VHA): responsible for providing health care in all its forms, as well as for biomedical research (under the Office of Research and Development), Community Based Outpatient Clinics (CBOCs), and Regional Medical Centers
- Veterans Benefits Administration (VBA): responsible for initial veteran registration, eligibility determination, and five key lines of business (benefits and entitlements): Home Loan Guarantee, Insurance, Vocational Rehabilitation and Employment, Education (GI Bill), and Compensation & Pension
- National Cemetery Administration: responsible for providing burial and memorial benefits, as well as for maintenance of VA cemeteries
Benefits
The benefits provided include disability compensation, pension, education, home loans, life insurance, vocational, rehabilitation, survivors’ benefits, medical benefits, and burial benefits.[9] The VA currently breaks down benefits in a benefits booklet.[10] Benefits and topics include; VA Health Care Benefits, Veterans with Service-Connected Disabilities, VA Pensions, Education and Training, Home Loan Guaranty, VA Life Insurance, Burial and Memorial Benefits, Reserve and National Guard, Special Groups of Veterans, Transition Assistance, Dependents and Survivors Health Care, Dependents and Survivors Benefits, Appeals of VA Claims Decisions, Military Medals and Records, and Other Federal Benefits.
Costs for care
As is common in any time of war, recently there has been an increased demand for nursing home beds, injury rehabilitation, and mental health care. VA categorizes veterans into eight priority groups and several additional subgroups, based on factors such as service-connected disabilities, and one’s income and assets (adjusted to local cost of living).
Veterans with a 50% or higher service-connected disability as determined by a VA regional office “rating board” (e.g., losing a limb in battle, PTSD, etc.) are provided comprehensive care and medication at no charge. Veterans with lesser qualifying factors who exceed a pre-defined income threshold have to make co-payments for care for non-service-connected ailments and pay $9 per 30-day supply for each prescription medication. VA dental and nursing home care benefits are more restricted.
VA Medical Center in Long Beach, California
Reservists and National Guard personnel who served stateside in peacetime settings or have no service-related disabilities generally do not qualify for VA health benefits.[11]
VA’s budget has been pushed to the limit in recent years by the War on Terrorism.[12] In December 2004, it was widely reported that VA’s funding crisis had become so severe that it could no longer provide disability ratings to veterans in a timely fashion.[13] This is a problem because until veterans are fully transitioned from the active-duty TRICARE healthcare system to VA, they are on their own with regard to many healthcare costs.
The VA’s backlog of pending disability claims under review (a process known as “adjudication”) peaked at 421,000 in 2001, and bottomed out at 254,000 in 2003, but crept back up to 340,000 in 2005.[14]
No copayment is required for VA services for veterans with military-related medical conditions. VA-recognized service-connected disabilities include problems that started or were aggravated due to military service. Veteran service organizations such as the American Legion, Veterans of Foreign Wars, and Disabled American Veterans, as well as state-operated Veterans Affairs offices and County Veteran Service Officers (CVSO), have been known to assist veterans in the process of getting care from the VA.
In his budget proposal for fiscal year 2009, President George W. Bush requested $38.7 billion—or 86.5% of the total Veterans Affairs budget—for veteran medical care alone.
In the 2011 Costs of War report from Brown University, researchers projected that the cost of caring for veterans of the War on Terror would peak 30–40 years after the end of combat operations. They also predicted that medical and disability costs would ultimately total between $600 billion and $1 trillion for the hundreds of thousands treated by the Department of Veterans Affairs.[15]
The New GI Bill
The new GI Bill authored by Sen. Jim Webb (D-VA) doubled GI Bill college benefits while providing a 13-week extension to federal unemployment benefits. The new GI Bill doubled the value of the benefit to roughly $90,000 up from $40,000. In-state public universities essentially are covered to provide full scholarships for veterans under the new education package. For those veterans who served at least three years a monthly housing stipend was also added to the law.
Upon passage of the new GI Bill President George W. Bush stated “Our nation has no greater responsibility than to support our men and women in uniform—especially because we’re at war… This bill shows the American people that even in an election year, Republicans and Democrats can come together to support our troops and their families”, which highlighted that the new GI Bill had been overwhelmingly supported by both parties in the U.S. Congress.[16]
Congress and President Barack Obama extended the new GI Bill in August of 2009 at the cost of roughly $70 billion over the next decade. Upon passing the GI Bill extension President Obama stated his support of the fighting forces of the United States by saying “Over the last eight years, they have endured tour after tour of duty in dangerous and distant places… They’ve experienced grueling combat, from the streets of Fallujah to the harsh terrain of Helmand province. They’ve adapted to complex insurgencies, protected local populations and trained foreign security forces.”
The Pentagon worked closely with Congressional lawmakers to ensure military families were protected in the expansion of the law. In doing so, military officials worked non-stop to add a provision to extend the GI Bill to the surviving spouse and children of servicemembers killed while in combat.
This provision was highly favored by the Pentagon which authorized the Department of Defense (DoD) to allow individuals who, on or after August 1, 2009, have served at least 6 years in the Armed Forces and who agree to serve at least another 4 years in the U.S. Armed Forces to transfer unused entitlement to their surviving spouse. Servicemembers reaching 10 year anniversaries could choose to transfer the benefit to any dependent(s) (spouse, children).[17]
National Cemetery Administration
In 1973, the Veterans Administration assumed another major responsibility when the National Cemetery System (NCS) (except for Arlington National Cemetery) was transferred to the Veterans Administration from the Department of the Army.
The VA was charged with the operation of the NCS, including the marking of graves of all persons in national and State cemeteries (and the graves of veterans in private cemeteries, upon request) as well and administering the State Cemetery Grants Program. The VA’s National Cemetery Administration maintains 131 national cemeteries in 39 states (and Puerto Rico) as well as 33 soldier’s lots and monument sites.
The Department of the Army maintains two national cemeteries, the Arlington National Cemetery and the U.S. Soldiers’ & Airmen’s Home National Cemetery. Many states have established state veterans cemeteries. The American Battle Monuments Commission maintains 24 overseas military cemeteries that serve as resting places for almost 125,000 American war dead; on Tablets of the Missing that memorialize more than 94,000 U.S. servicemen and women; and through 25 memorials, monuments and markers.
Fourteen national cemeteries are maintained by the National Park Service.
Related legislation
- 1944: Mustering-out Payment Act PL 78-225
- 1944: Servicemen’s Readjustment Act PL 78-346
- 1944: Veterans’ Preference Act PL 78-359
- 1952: Veterans’ Readjustment Assistance Act PL 82-550
- 1974: Vietnam Veterans’ Readjustment Assistance Act
- 1988: Department of Veterans Affairs Act PL 100-527
- 2006: Veterans Benefits, Health Care, and Information Technology Act of 2006 PL 109-461
See also
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- DD Form 214
- List of veterans’ organizations
- Old soldiers’ home
- United States Department of Veterans Affairs Police
- Department of Veterans Affairs Under Secretary’s Award in Health Services Research
- Veterans Health Information Systems and Technology Architecture (VistA)
- Benefits for US Veterans with PTSD
- EBenefits
Notes and references
- Jump up^ [1] USA.GOV
- Jump up^ [2] VA Press Release 2011
- Jump up^ [3] VA.gov
- Jump up^ Kammerer, Gladys 1948. “The Veterans Administration in Transition”. Public Administration Review Vol. 8, No. 2, pp 104.
- Jump up^ Kammerer, Gladys 1948. “The Veterans Administration in Transition”. Public Administration Review Vol. 8, No. 2, pp. 103–109.
- Jump up^ http://www.va.gov/opa/publications/archives/docs/history_in_brief.pdf
- Jump up^ [4]
- Jump up^ Opening Doors | United States Interagency Council on Homelessness (USICH). Usich.gov (2010-06-22). Retrieved on 2013-07-23.
- Jump up^ Benefits: Links, US Department of Veterans Affairs, Retrieved May 26, 2007
- Jump up^ [5] Federal Benefits for Veterans, Dependents and Survivors
- Jump up^ Detailed list of VA eligibility criteria
- Jump up^ Dennis Camire, “New fees, limits face ailing veterans,” Albany Times Union, 10 February 2003, A1.
- Jump up^ Cheryl L. Reed, “VA chief orders inspector to probe disability rating system,”Chicago Sun-Times, 11 December 2004, A3.
- Jump up^ Cory Reiss, “VA fighting losing battle against backlog of veterans’ claims”,Sarasota Herald-Tribune, 27 May 2005, A7.
- Jump up^ “Caring for US Veterans”. Costs of War. Brown University. Retrieved 19 July 2011.
- Jump up^ [6] President Bush Signs GI Bill
- Jump up^ [7] Post-911 GI Bill Transferability Fact Sheet
Further reading
In 1998, the Institute of Medicine began a series of studies to respond to requests from the U.S. Department of Veterans Affairs and Congress for an examination of the health effects of potentially harmful agents to which Gulf War veterans might have been exposed.
- Jan. 1, 2000: Gulf War and Health: Volume 1. Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines
- Feb. 18, 2003: Gulf War and Health Volume 2: Insecticides and Solvents
- Aug. 20, 2004: Gulf War and Health: Updated Literature Review of Sarin
- Dec. 20, 2004: Gulf War and Health: Volume 3. Fuels, Combustion Products, and Propellants
- Sep. 12, 2006: Gulf War and Health: Volume 4. Health Effects of Serving in the Gulf War
- Oct. 16, 2006: Gulf War and Health: Volume 5. Infectious Disease
- Nov. 15, 2007: Gulf War and Health: Volume 6. Physiologic, Psychologic, and Psychosocial Effects of Deployment-Related Stress
- Jul. 30, 2008: Epidemiologic Studies of Veterans Exposed to Depleted Uranium: Feasibility and Design Issues
- Jul. 30, 2008: Gulf War and Health: Updated Literature Review of Depleted Uranium
- Dec. 4, 2008: Gulf War and Health: Volume 7. Long-term Consequences of Traumatic Brain Injury
External links
 |
Wikimedia Commons has media related to United States Department of Veterans Affairs. |
- Official website
- Department of Veterans Affairs in the Federal Register
- Official blog
- VA History in Brief
- A Brief History of the VA from the Office of Facilities Management
- VA HyperFAQ directory of top VA web pages.
- Veterans Benefits Administration: An Organizational History, 1776-1994 by Knight & Worden, 1995.
- A Nation Repays Its Debt: The National Soldiers’ Home and Cemetery in Dayton, Ohio, a National Park Service Teaching with Historic Places (TwHP) lesson plan
- PBS NOW | Fighting the Army
- Investing In Veterans by Eric Shinseki
- United States Department of Veterans Affairs collected news and commentary at The Washington Post
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