The Technocrat Stumbles: President Claims Ignorance, Blames Old Software for Deadly Wait Times
When scandal breaks, President Obama usually claims he first read about it in the news. But in this case the President claims he missed news reports and more than a dozen GAO and OIG reports highlighting wait times as a significant problem at the VA. He says he didn't hear about any of it.
President Obama stepped before the press corps today to announce word of Sec. Shinseki's resignation and to explain why his administration hadn't done more to address VA wait times before the current scandal erupted. But the excuses he offered--that he and Shinseki didn't know about the problem--were nonsense.
Midway through his briefing today President Obama offered this excuse, "This issue of scheduling is one that the reporting systems inside the VHA did not surface to the level where Rick [Shinseki] was aware of it we were able to see it. This is not something that we were hearing when I was traveling around the country, the particular issue of scheduling."
Either the President is being dishonest here or he is admitting to an astounding level of negligence. The "particular issue of scheduling" had been the subject of a 18 different reports. Here's a partial list from the VHA's interim report which came out this week:
- 2005 - "VHA did not follow established procedures when scheduling appointments, resulting in inaccurate wait times and lists"
- 2006 - "VA medical facilities did not have effective controls to ensure all newly-enrolled veterans in need of care, received it , and within VHA’s goal of 30 days of the desired date of care"
- 2007 - "OIG performed a follow-up audit, Audit of VHA’s Outpatient Wait Times, Sept 2007, again concluding the data in the scheduling system remained inaccurate"
- 2008 - "VA made only limited progress in addressing the long-standing and underlying causes of problems with outpatient scheduling, accuracy of reported waiting times, and completeness of electronic waiting lists"
- 2009 - "OIG reported long-standing problems with outpatient scheduling delays, accuracy of reported waiting times, and incomplete electronic waiting lists."
- 2011 - "We substantiated the allegation that renal cancer patients faced delays in treatment."
- 2012 - "staff indicated that appointments were routinely made incorrectly by using the next available appointment date instead of the patient's desired date. These practices led to inaccurate reporting of GI clinic wait times."
- 2012 - "A complainant alleged that a dialysis patient waited more than 4 months for permanent vascular access and that ambulatory monitoring for a cardiac patient was delayed 3 months. We substantiated that these and other patients experienced excessive wait times...appointment dates requested by patients for vascular and cardiac procedures were incorrectly recorded by scheduling staff."
- 2013 - "GAO testified on wait times, before the HVAC, Subcommittee on Oversight and Investigations, that VA needed improvements in the reliability of VHA’s reported medical appointment wait times, scheduling oversight and VHA initiatives to improve access to timely medical appointments."
Even if Obama and Sec. Shinseki somehow missed all of these reports, how did they miss news media stories about deaths related to wait times at the VA? How did they miss this one at the Army Times or this one at NBC News? And how did they possibly miss this blockbuster report on CNN from last November which suggested at least 9 and possibly as many as 23 vets had died because of long wait times?
The President and his VA Secretary should have been able to hear and see this problem. But there was an even bigger problem than the President's supposed ignorance. His response today was purely technocratic. He said, "in some of these facilities you've got computer systems for scheduling that date back to the 90s, situations in which one scheduler might have to look at 4 or 5 different screens to figure out where there's a slot and where there might be a doctor available."
What? Does Obama really think this is about updating the VA's software?
GAO and IG reports going back a decade make clear that staff, likely with knowledge of administrators, was intentionally gaming the system to reduce wait times on paper. That's precisely what was happening in Phoenix and according to Debra Draper, who investigated scheduling practices as part of the VA's OIG, gaming the system was a fairly common practice. Software is not the problem therefore upgrading software won't fix the problem. It's not clear the President gets this.
The real problem at the VA is a lack of accountability for the cheating and its sometimes deadly consequences. That lack of accountability is something the President is perpetuating even now as he blames software instead of people. Those who have been part of the corrupt system will hear him speak and assume they have nothing to worry about. After all, he's not coming after them, he's coming after the software.
There's a reason the same problems show up at the VA year after year. Administrators have been winking at these problems because they know oversight is unlikely to result in anyone ever paying a price for failure. Instead of dragging his feet on letting one person go, the President ought to be encouraging a VA-wide house-cleaning. Only when people believe they are personally accountable will the system change.