The Conversation

VA Supporters Should Stop Citing Dubious VA Wait Time Data

It wouldn't make much sense to cite Enron's annual reports after word broke that the books were being cooked. Similarly, it doesn't make much sense to cite VA wait times when the veracity of that data is (and has been) highly suspect.

A few days ago, Timothy Noah writing for MSNBC argued that, despite the ongoing VA scandal, VA wait times aren't much worse than those in the private sector:

News stories about the Phoenix VA and some other bad actors indicate the wait can be many months, but an internal VA estimate—one based on “hard” time stamps and therefore less vulnerable to manipulation than the records allegedly falsified — puts the average wait at about 21 days.

Noah's claim is now being cited by Vox as part of the counterargument to the idea of privatizing the VA:

The available evidence suggests veterans do wait longer for care than patients in the private sector. An internal agency estimate, cited by Timothy Noah, puts the VA's average wait time for non-urgent care at 21 days. A 2014 survey, meanwhile, found the average wait time in the private sector to be 18.5 days.

I asked Noah to clarify the source of this wait time data and he replied that he was seeking a hard copy from the VA. With some help from a friend, I was able to get my hands on this May 2012 research slideshow which has a chart (page 4) showing the mean VA wait time for new patients in July 2010 was about 21 days. I don't know if this is the same data Noah is relying on but it does seem to match his claim and also does mention time stamps.

The problem of course is that this data is not reliable. In fact two slides later we read, "Reliability of Wait Time Measures is Unknown." In fact, the GAO looked into VA wait times and concluded, "Outpatient medical appointment wait times reported by the Veterans Health Administration (VHA), within the Department of Veterans Affairs (VA), are unreliable." As part of its investigation, the GAO identified 3 types of scheduling errors which would, "potentially result in the reporting of more favorable wait times for those medical appointments."

In March 2013, Debra Draper, GAO's health care director, testified before a subcommittee of the Committee on Veterans Affairs about the problems with VA scheduling data. She offered a summary of the findings of the 2012 report that showed some VA clinics were misusing the scheduling system to make wait times appear shorter than they actually were. Draper testified, "The bottom line is it is unclear how long veterans are waiting to receive care in VA’s medical facilities because the reported data are unreliable."

All of this is similar to the findings of the IG's interim report released today. It found that, at the Phoenix VA, the officially reported wait time for an appointment was 24 days. However, using a sample of cases, investigators found the actual wait time for an appointment was 115 days. The interim report made clear this was not an isolated case, "we are finding that inappropriate scheduling practices are a systemic problem nationwide."

We have ample evidence going back at least two years that reported VA wait times are not reliable and, more specifically, have been intentionally underreported across the nation. Under the circumstances, it makes little sense for the VA's defenders to cite wait time as proof things really aren't so bad.

Addendum: I should have noted this but starting on page 11 of today's IG interim report is a chronology of oversight on patient wait times going back to 2005. Doubts about VA's reported wait times have been around for almost a decade.


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