The VA's Growing Scandals
| Published May 12, 2014 |

By Earl Perkins
Thursday Review associate editor

Former House Speaker Newt Gingrich, several members of Congress and American Legion leaders, have called for Veterans Affairs Secretary Eric Shinseki to resign following fallout from the VA embarrassment which included numerous preventable deaths and a persistent backlog of patients.

Daniel Dellinger, national commander of the nation’s largest veterans’ organization, has demanded Shinseki resign, and he also seeks removal of Robert Petzel, VA under-secretary for health, and Allison Hickey, under-secretary of benefits. US Senator Jerry Moran (R-Kansas), a member of the Senate Veterans' Affairs Committee has demanded accountability from Shinseki, calling for the secretary's resignation if he's unwilling to enforce needed changes to the VA system and culture.

Rep. Mike Coffman (R-Colorado) chairman of the House Veterans Affairs oversight and investigations subcommittee, is blaming Shinseki for chronic mismanagement and systemic failures, including cost overruns in construction projects and patient safety problems.

"Secretary Shinseki has failed to provide any leadership for this organization and instead he has allowed himself to be led by a circle of incompetent and corrupt bureaucrats who have long forgotten that they are there for the sole purpose of serving those who have sacrificed so much on behalf of this nation," said Coffman, a US Marine Corps veteran.

"If he had these same responsibilities as an Army officer, he would have been relieved a long time ago for his lack of leadership,” Coffman said of Shinseki, a retired four-star Army general. “If he fails to resign, then the president, as the commander-in-chief, has a duty to fire him for gross incompetence."

Rep. Jackie Walorski (R-Indiana) also a member of the veterans’ committee, is calling for the removal of Shinseki, Petzel and Hickey.

“Nowhere else in this country would this kind of lack of accountability and transparency be allowed,” Walorski told the Washington Examiner. “The American people deserve better and veterans for sure deserve better. How much more do we need to see? Enough is enough. There has to be a line here.”

Despite this growing chorus of disapproval, a Veterans Affairs spokesman quickly responded with a press release that stated Shinseki has no plans on vacating his office.

“Secretary Shinseki has dedicated his life to his fellow veterans, and nobody is more committed to completing the work that lies ahead," said VA spokesman Drew Brookie. "As the secretary says, providing veterans the quality care and benefits they have earned through their service is our only mission at VA."

Dellinger showed little regard for Shinseki and his public relations spin doctors, focusing on preventable deaths nationwide, internal agency cover-ups and a refusal to hold those responsible accountable, instead rewarding bad administrators with performance bonuses and positive reviews. Dellinger says Shinseki has shown "poor oversight and failed leadership” in the post he's held since 2009. “The existing leadership has exhibited a pattern of bureaucratic incompetence and failed leadership.”

VA hospital administrators have allegedly been using scheduling tricks to hide dangerous backlogs in patient care, according to numerous news outlets. The Examiner reported recently that more than 1.5 million medical orders were purged to hide the fact that patients were not receiving needed medical care or tests.

Last February, a Washington Examiner investigation claimed 40,000 medical appointments were purged in Los Angeles beginning in 2009, along with another 13,000 in Dallas in 2012, which made it appear that backlogs of appointments were shrinking. A common practice was for facilities to keep two sets of logs, which hid actual waiting times, thus keeping the hospitals within VA deadlines.

In April, Rep. Jeff Miller (R-Florida), chairman of the House Veterans' Affairs Committee, revealed a committee staff investigation discovered two separate sets of appointment lists at the Phoenix VA hospital, almost certainly leading to 40 patient deaths due to care delays.

An Arizona Republic report last week claims administrators destroyed records to cover up bogus wait lists, despite Miller's April 9 order demanding that all documents be preserved pending a probe by the agency's inspector general.

Miller is withholding judgment on Shinseki's status until the VA inspector general's investigation is completed.

"Right now, President Barack Obama and Secretary Shinseki are faced with a stark choice: take immediate action to help us end the culture of complacency that is engulfing the Veterans Health Administration and compromising patient safety, or explain to the American people and America’s veterans why we should tolerate the status quo,” Miller said in a written statement.

Numerous life-threatening conditions have evidently been commonly allowed at VA facilities nationwide, according to the Government Accountability Office. The GAO and inspector general are investigating VA procedures that allowed the 1.5 million medical order cancellations noted by the Examiner. The agencies' primary focus is studying delays in delivering potentially life-saving medical tests, unsanitary conditions, poor maintenance and bad management leading to dozens of patient deaths.

VA officials acknowledged in April that 23 gastrointestinal cancer patients died after waits for potentially life-saving diagnostic tests, such as colonoscopies. Agency officials have not disclosed how many patients died of other conditions due to inadequate care.

People in general wonder how these things happen in this day and age. You must consider that cabinet-level positions are the ultimate plum job in the political process, usually a favor for delivering favors, money or votes. These are extremely willful people willing to do whatever it takes to retain power, which means those who don't do as they're told just disappear from public service.

Those at the highest level of government don't step down until those who appointed them begin losing power, money and influence. People nationwide have been crying that someone should have done something long ago. What? If you tell someone, you could lose your job, never receive another promotion or get billed as not a team player (aka: rat). Families, futures and retirements swing in the balance, so make your choices carefully.

But I digress. Getting back to Dellinger, he was particularly enraged that generous bonuses were extended to top officials at medical facilities where patients died.

Michael Moreland, former head of the Pittsburgh area regional office, received a $63,000 bonus although six patients apparently died from Legionnaire's disease because of improper maintenance, according to a Pittsburgh Post-Gazette investigation last July.

Terry Wolf, director of the Pittsburgh VA hospital, received a perfect performance review. This despite the fact Pittsburgh Veterans Affairs officials recently changed the status of a deceased Delmont veteran's Legionnaire's outbreak case from "probably not hospital acquired" to "probably hospital acquired", according to a man's daughter and her legal counsel.

Following the Post-Gazette probe released Feb. 6, VA officials admitted to family in a disclosure meeting that Frank "Sonny" Calcagno, 85, most likely contracted the disease at the Pittsburgh VA, not Forbes Regional Hospital where he died Nov. 23, 2011.

Meanwhile, James Clark, Atlanta VA medical center director, received a $65,000 bonus, although four preventable deaths occurred on his watch, and the inspector general blamed three of those on widespread mismanagement, according to Dellinger. Dellinger and other Legion leaders, like many other veterans' groups, had avoided calling for Shinseki's resignation, but sought more VA accountability while giving the secretary stronger authority to discipline poor-performing managers.

However, recent revelations concerning the Phoenix deaths and cover-ups, along with similar stories from Fort Collins, Colorado, caused the Legion to change its attitude toward Shinseki.

“These disturbing reports are part of what appear to be a pattern of scandals that has infected the entire system,” Dellinger said at a recent press conference.

“Patient deaths are tragic, and preventable patient deaths are unacceptable,” he said. “But the failure to disclose safety information, or worse, to cover up mistakes, is unforgivable, as is fostering a culture of nondisclosure. VA leadership has demonstrated its incompetence through preventable deaths of veterans, long wait times for medical care, a benefits claims backlog numbering in excess of 596,000, and the awarding of bonuses to senior executives who have overseen such operations.”

It has been nearly 80 years since the American Legion last demanded the resignation of a cabinet-level official. But Dellinger is very frustrated about the preventable deaths, and he's even more upset about Shinseki's inability to eliminate the backlog of disability claims filed by veterans.

The Examiner reported more than a year ago that vets with service-related disabilities and medical conditions often waited an average of nine months before receiving a resolution of their claims. It was also not uncommon at many offices to stretch to more than a year.

At that time, more than 1 million vets had disability claims or appeals pending with VA. More than half of almost 560,000 disability claims now pending are older than 125 days, which violates VA guidelines thus flagging them as backlogged. Initial ratings on claims are averaging eight months at this time. There are also 275,000 claims on appeal, which could take years before reaching resolution. Hickey, as undersecretary for benefits, is responsible for all VA disability claims.

The Legion's decision to seek leadership changes makes it much easier for Congress and veteran's groups to call for Shinseki's removal, according to Pete Hegseth, chief executive officer of Concerned Veterans for America. Last year CVA became the first major veterans’ group to call for Shinseki’s resignation.

“This is an infected system that doesn’t have oversight, doesn’t have accountability, and today the Legion stepped up to say, ‘We need to hold it accountable at the very top,’ ” Hegseth said. “We agree that that’s just the first step because whoever comes in next has to have the tools necessary to force real accountability."

CVA and other groups are backing Miller's bill that would give Shinseki the power to fire or demote poor-performing top managers.  Hegseth's reaction to the Legion's call for removing Shinseki was admirable.

“It’s a very welcome step, a courageous step. A group like that, that big, that much access, they are risking a lot when they step out this courageously,” Hegseth said.

But the Legion’s decision drew opposition from Veterans of Foreign Wars, the nation’s largest combat veterans’ organization. The VFW is very upset with VA for what happened at Phoenix and other veterans' hospitals nationwide, but they are not advocating that Shinseki, Petzel and Hickey be stripped of their duties.

Petzel announced last year that he plans to retire, and Shinseki recently placed three top Phoenix VA leaders on administrative leave. However, Shinseki's tenure at VA has shown some bright spots and a dogged determination to help vets in several different ways. He stood his ground in front of Congress, defending a decision adding three illnesses to 12 others presumed to be caused by Agent Orange herbicide exposure during the Vietnam War.

Testifying before the Senate Veterans' Affairs Committee in the fall of 2010, Shinseki said he decided to give presumptive condition status to ischemic heart disease (IHD), B-cell leukemia and Parkinson's disease because scientific evidence from nine medical studies "more than satisfies the positive association standard of the 1991 Agent Orange Act." This action had been fought for and supported by The American Legion.

"These decisions were not made lightly, but based on our duty to faithfully execute the purpose of the Agent Orange Act," Shinseki said. "Our actions will be viewed as an example of our seriousness and commitment to America's veterans."

Lest it seem like everyone has been piling on Shinseki, the retired 4-star general had a long and distinguished career in the Army and private sector. His parents were of Japanese ancestry, and he was born in 1942 in what was then the Territory of Hawaii.

He grew up on a sugar plantation on Kauai, and following high school graduation he attended the United States Military Academy at West Point, graduating with a Bachelor of Science degree in 1965. He earned a Master of Arts degree in English literature from Duke University, and received further education at US Army Armor School, General Staff College and the National War College. Later, the Vietnam War combat veteran commanded NATO peacekeeping forces in Bosnia-Herzegovina (1997-98) and served as Army chief of staff (1999-2003), before becoming secretary of veteran's affairs in 2009.

On the job at VA, he helped move 31,000 chronically homeless veterans off the streets and into permanent housing in 2010, enrolling them in health treatment, substance abuse programs and job training. This program cut the homeless veteran population to 65,000, giving Shinseki the possibility of eliminating veteran homelessness by 2015, said Vincent Kane, director of the VA's homeless programs. "The end of 2015," Kane stressed.

The newest generation of veterans poses additional challenges, with 50,000 wounded returning from Iraq and Afghanistan. Common war wounds are compounded by the most-severely injured, roughly 15,000 who would have perished on the battlefield previously. They now are saved because of advanced and speedy medical intervention, with many being double or triple amputees or severely burned patients who will require intensive and lifelong care.

This generation is also more diverse, with the number of female vets doubling from 6 percent in 2000 to 14.5 percent by 2035, requiring advanced services concerning women's health and sexual trauma issues.

More than 2.5 million young Americans served in the past decade of wars, but projected budget cuts over the next decade should shrink the military ranks by about 88,000 additional personnel.

"Look, let's not kid anybody—this system is gonna be overwhelmed. It's already overwhelmed," Marsha Four, a Vietnam war combat nurse and veterans advocate, said recently. "As we draw down over the next five years we're gonna be adding another 100,000 per year, and to effectively deal with health care, benefits and other challenges—that’s not gonna be easy. This is inherently part of the cost of war, and it'll be a big ticket item."

By 2010, the VA was acknowledging that war is traumatizing, and that many soldiers need help when they return home. Increasing numbers of veterans are being diagnosed with post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI), and tens of thousands of others either go undiagnosed or just cope with mild symptoms.

The VA's suicide hotline was recently jammed with 17,000 calls a month, and the VA estimates that 18 veterans kill themselves daily. The VA's decision to provide free treatment to each veteran with PTSD symptoms was the proper one, but prompted a flood of demands for mental health services with minimal additional funding from the federal government. The VA was immediately inundated by a massive influx of veterans, and 20,000 newly-hired mental health clinicians was not enough.

Thousands of veterans sought mental-health counseling, but discovered long waiting lines for very short appointments, and some VA counselors were unschooled in military culture and insensitive to specific combat veteran concerns.

Even the falsified vet records couldn't save the VA this time, and the climate worsened as the US 9th Circuit Court of Appeals ruled that "unchecked incompetence" at VA was unconstitutionally denying veterans access to timely mental health care.


Related Thursday Review articles:

The VA's Phony Waiting Lists; Earl H. Perkins; Thursday Review; April 29, 2014.