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Franken, Peterson, Walz: Shinseki should resign

WASHINGTON — Citing an inspector general report about falsified wait times at a Veterans Affairs clinic in Phoenix, Democrats Sen. Al Franken and Reps. Collin Peterson and Tim Walz separately called on Secretary Eric Shinseki to resign on Wednesday.

“The Inspector General’s report is so troubling that I have come to the conclusion that the Department of Veterans Affairs needs new leadership. I believe it would be in the best interest of veterans for Secretary Shinseki to step down,” Franken said in a statement. “The VA needs to be delivering quality care to our veterans on a timely basis. Clearly there is a systemic problem that this leadership has not been addressing.”

“I am now ready to call for the resignation of VA Secretary Shinseki,” Peterson said in a separate statement. “I have been waiting for information and guidance from members of the House Veterans Affairs Committee, and after talking to members of the committee and seeing the Inspector General’s report, I have come to the conclusion that there needs to be accountability and new leadership and the best step forward is for the Secretary to offer his resignation so we can start fixing the problems where they exist. We have to do better by our veterans.”

“Secretary Shinseki is one of the most honorable and loyal men I have ever met,” Walz said in his statement. “He’s dedicated his entire life to the betterment of our nation and caring for our brave men and women in uniform. It’s a shame that he and other veterans were let down by certain people working under him at the VA, but ultimately the buck stops with the Secretary. That is why today, I believe it would be best if Secretary Shinseki stepped down. We need to fix the systemic problems outlined in the IG report and restore veterans’ faith in the system.”

The inspector general confirmed that officials at the VA clinic in Phoenix reported incorrect wait times to mask the fact 1,700 veterans were delayed in receiving care. The report indicated the problem could impact the VA system across the United States.

Many congressional Democrats, most of whom had been silent on Shinseki’s fate, moved quickly to condemn him after the report came out. Besides Franken, Sens. Mark Udall of Colorado, John Walsh of Montana, Jeanne Shaheen of New Hampshire and Kay Hagan of North Carolina all called on Shinseki to resign Wednesday. All five are on the ballot this November.

Just a week ago, Walz said it was too soon to say if Shinseki should lose his job. But that was before the inspector general report. All told, Politico reports the number of Democrats calling for Shinseki’s resignation doubled after the report came out, and that number continued to rise into Wednesday evening.

Minnesota Republican Reps. John Kline and Michele Bachmann and Democratic Rep. Rick Nolan had previously said Shinseki should resign.

(Updated at 9:45 with Walz comments.)

Devin Henry can be reached at dhenry@minnpost.com.

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Comments (30)

  1. Submitted by Paul Brandon on 05/28/2014 - 08:47 pm.

    Fine

    The next thing is for all of the members of Congress who voted for budget cuts that reduced the VA’s resources to also resign.

    • Submitted by mark wallek on 05/29/2014 - 01:06 am.

      Agreed

      that would be so wonderful, but lacking honor they simply would not resign. What they will do, in growing numbers as we’re seeing now, is belly up to the bar, call for a resignation, and have a nice shot of smart politics. It’s been decades this reneging on the fundamental promise of “what you need when you need it” has been going on. Shame on these pols for continuing the empty lip flapping.

  2. Submitted by Dennis Tester on 05/28/2014 - 09:19 pm.

    Not good enough

    The attorney general needs to bring criminal charges against the VA bureaucrats who falsified government documents. Knowingly falsifying federal government documents is a felony.

    The entire Veterans Administration should be defunded and shut down. And any congress people who knew about the fraud and voted to give them even more money to perpetuate it should be punished.

  3. Submitted by Steve Titterud on 05/29/2014 - 06:41 am.

    If you think this is a short term problem, with a short term fix

    …think again. The idea that what we really need to do now is make someone’s head to roll in the VA is ridiculous. Maybe we should consider whether we can afford these massively expensive foreign military adventures.

    Here’s an idea to save money: don’t go to war !!

    “45% of veterans of the Iraq and Afghanistan wars are seeking disability benefits.” and

    “…as of 2006 — when intense fighting was taking place in the Iraq War — 16 service members were being wounded for every one killed. This is by far the highest ratio in U.S. history — in Vietnam an average of 2.6 soldiers were wounded for every one killed; in World War II the ratio was two to one.”

    http://journalistsresource.org/studies/government/security-military/cost-long-term-medical-disability-benefits-afghanistan-iraq-veterans-research-roundup

    “…the cost of caring for war veterans …. peaks in 30 to 40 years or more after a conflict.”
    http://qcpages.qc.edu/~redwards/Papers/1_CostsofWar_7-12-11.pdf

    “Obligations for Future Spending: The costs of war don’t end when the fighting stops. Specifically, the U.S. has incurred obligations by fighting the wars. For example, the U.S. is obligated to pay the future medical and disability costs of veterans. As in past wars, medical and disability costs will peak in about 30 to 40 years, totaling an estimated $754 billion.”
    http://costsofwar.org/article/economic-cost-summary

    • Submitted by Dennis Tester on 05/29/2014 - 08:52 am.

      It’s not about the money

      And it’s not about Iraq and Afghanistan.

      From Investor’s Business Daily:

      The VA’s budget has been exploding, even as the number of veterans steadily declines. From 2000 to 2013, outlays nearly tripled, while the population of veterans declined by 4.3 million.

      Medical care spending — which consumes about 40% of the VA’s budget — has climbed 193% over those years, while the number of patients served by the VA each year went up just 68%, according to data from the VA.

      From 2008 to 2012 alone, per-patient spending at the VA climbed 27%. To put that in perspective, per capita health spending nationwide rose just 13% during those years.

      And per-enrollee spending for Medicare went up only 10%, government data show.

      Some will argue that the increase in health spending was the direct result of all those wounded warriors coming back from Iraq and Afghanistan.

      But these vets aren’t driving VA costs higher.

      A Congressional Budget Office report found that they cost $4,800, on average, in 2010 compared with $8,800 for other veterans who used the system.

      It also found that while these Iraq and Afghan vets account for 7% of those treated, they were responsible for only 4% of its health costs.

      Recent Vets Cheaper

      Iraq and Afghan vets, the report found, “are typically younger and healthier than the average VHA patient and as a result are less expensive to treat.”

      Investor’s Business Daily: http://news.investors.com/052014-701560-va-budget-exploded-amid-chronic-treatment-delays.htm#ixzz3371RUNDc

      • Submitted by Tom Lynch on 05/29/2014 - 04:54 pm.

        Investor’s Business Daily?

        Really? You’re quoting Investor’s Business Daily? That’s like quoting something you heard on Boss Rushbo’s show.

        • Submitted by Tom Anderson on 05/29/2014 - 08:05 pm.

          Feel free to reference a better source

          Are our legislators right or wrong to ask for the resignation or not? Should the President demand the resignation? (Relax, there will be some other government job for the man to do.)

  4. Submitted by Rosalind Kohls on 05/29/2014 - 04:36 pm.

    bonuses

    The veterans’ wait times were altered so the big wheels at the VA could get bonuses for “good management.” Funding from Congress had very little to do with this scandal. Shinseki is not the only one who should be fired.

    • Submitted by RB Holbrook on 05/29/2014 - 05:11 pm.

      Why?

      Accepting your point ,I have to ask why it was necessary to alter records? Surely, if the funding and staffing had been adequate the performance requirements could have been met without alterations?

    • Submitted by Steve Titterud on 05/29/2014 - 08:59 pm.

      100+ days for an initial appointment ?

      This certainly sounds like a resource problem to me.

      It’s the wait times that jump out to me, not the chicanery of massaging the data.

      The manipulation of system data to create false appearances to get bonuses is probably criminal, and if so, should be prosecuted, or at least used to bring the careers of the perps to an end. But that’s a side issue, to my mind, whereas the central issue seems to be resources, as in funding.

  5. Submitted by Neal Gendler on 05/29/2014 - 09:30 pm.

    Observations

    Some observations about people’s responses:

    1. I am astonished to be agreeing with John Boehner about anything, but he is correct when he says he can’t see any way Shinseki’s resignation will help any veteran be healthier. There is, however, a concept (known abroad, anyway) as “ministerial responsibility,” which has led many cabinet-level officials to resign over a failure well below them. As a manner of honor, this usually is most effective before people start demanding resignation.

    2. Shinseki was forced to resign once before — as Army chief of staff, he correctly estimated the number of troops that would be needed in Iraq (or was it Afghanistan? They begin to blur), which was double what the defense secretary thought would be needed. Shinseki turned out to be correct.

    3. Falsifying records is a crime, and those who did so should be prosecuted. But the underlying problem apparently is insufficient staffing or physical facilities, which lies at the foot of the same Congress now in a (predictable) frenzy to blame the secretary and score political points.

    4. The reason the ratio of wounded survivors to combat dead has shot so high is simply because modern medicine, prompt and effective treatment in the field, and — particularly — rapid evacuation of wounded to field or base hospitals has saved lives. Thanks in great part to the helicopter, many soldiers whose wounds would have been fatal in World War 2 now can be saved.

    5. Defund and close the Department of Veterans Affairs? This almost doesn’t deserve a response, but here it is: These people were injured, many very severely and permanently, on what we could call the company’s time and in the company’s service, and the company (i.e., us) is obligated to do what it can to make them whole. This means lifelong medical care for many. Some of this care is specialized. Get rid of it and see how close military recruitment can fall to zero

    • Submitted by Dennis Tester on 05/30/2014 - 07:44 am.

      Nonsense

      1. Boehner knows that as soon as Shinseki is gone, this story is pushed off the front page. His position is a strictly political in that he’s more interested in seeing Obama squirm than in solving the problem. If Shinseki had any honor (or had been in the Navy instead of the Army), he would have resigned by now.

      2. Shinseki was wrong about the number of troops. He said we needed over 200,000. But Petraeus’ surge solution was accomplished with no additional troops. Shinseki was given the VA job by Obama to help him save face.

      3. There are currently 1700 VA facilities across the country. With the veteran population decreasing, are you suggesting we actually build more VA hospitals? From 2000 to 2013, outlays nearly tripled, while the population of veterans declined by 4.3 million.

      4. No argument here, but it’s irrelevant to the issue.

      5. There is no care required by any injured veteran that is so specialized that a civilian hospital and staff hasn’t treated something similar. In fact, the VA has admitted that the temporary solution at least is to use civilian facilities because that’s what they’re doing now to reduce the backlog of appointments … sending them to civilian hospitals and doctors.

      Shut down the VA, redirect all their money to a DOD medical account. issue medical IDs to all eligible veterans to be shown at any medical facility of their choosing, billable to the DOD. Anything else is admitting that we veterans don’t deserve to be treated as well as civilians. Which is what I would expect from those who never served.

  6. Submitted by Peder DeFor on 05/30/2014 - 08:38 am.

    Knee Jerk Funding Talking Point

    The VA’s problem is NOT a lack of funding. Funding for the VA has been boosted to record levels over the past five years? Do you know who is making this claim? President Obama. That’s who. I know that he’s not the most reliable person but this claim has been checked out.
    http://www.azcentral.com/story/news/politics/fact-check/2014/05/23/az-fact-check-obama-va-funding-increases/9464699/
    From the article:
    Funding was as follows:
    2009:$97.7 billion;
    2010:$127.2 billion;
    2011: $125.5 billion;
    2012: $126.8 billion;
    2013: $139.1 billion;
    2014: $153.8 billion;
    2015: $163.9 billion.

    Look, I get that this is the easy response, but let’s make an effort here. If you want to convince people that single payer is the right way to go, you’ll have to make something like the VA work and work on budget.
    I don’t know that firing Shinseki will make much difference. It seems like the problems are pretty wide and deep. If the VA is going to change its culture, it will need to do more than change one guy at the top. If it was a private organization, I’d suggest that various hospitals look at what staff needs to be fired and replaced but that doesn’t seem to be an option here.

    • Submitted by RB Holbrook on 05/30/2014 - 10:30 am.

      Maybe so

      The figures quoted are the budget for all of the Department of Veterans Affairs, not just the Department’s health care spending. Although health care is a big part of what the Department does (does that consume most of the funding?), it is by no means the only thing. The Department is also the one that administers the GI Bill, home loan programs, veterans’ cemeteries, etc.

      The figures you quote are devoid of context. Yes, there has been an increase in funding, but from what level? Did prior budgets provide an adequate level, or is the Department making up for years of underfunding? What is the reason for the years of increase? Bureaucrats asking for and receiving money “just because,” or has the need for services increased? Remember that the US has committed a lot of humanity to fighting two long wars. The overextension of the military has consequences, one of them being a lot more injured and disabled veterans, as well as many who are entitled to the post-enlistment services they were promised.

      VA hospitals and clinics are chronically understaffed, especially in the area of primary care physicians. True, there is a nationwide under-supply of primary care doctors, but the problem is worse at the VA, possibly because of the relatively low salaries that VA physicians get. The whole scandal cannot be blamed on the inherent evils of government.

      • Submitted by Dennis Tester on 05/30/2014 - 11:11 am.

        The reason for the extra money

        is because liberals never solve problems. They just increase the budget or the size of the bueaucracy. By saying he increased the size of the budget, Obama and the democrats in congress can say they “addressed the problem,” when in fact the problem isn’t a lack of money it’s unreasonable wait times.

        The solution is to give the veterans a choice of facilities to go to, including civilian facilities. This would improve the chances the veteran would be able to get an appointment in a reasonable amount of time as well as the added benefit of giving him the choice of where to go.

        And that wouldn’t cost any more money. Imagine that.

        • Submitted by RB Holbrook on 05/30/2014 - 11:30 am.

          Of course!

          It’s all the fault of the liberals! Why did I not see that before? Increased demand for services could not possibly be a factor. It has nothing to do with wars in Afghanistan and Iraq (although, insofar as some Democrats favored those wars, it is a reason). It has nothing to do with the population of Vietnam-era veterans aging, and posing ever more complex health issues. It’s just those danged liberals!

          It’s all traceable back to the suicide of Vince Foster, if not Benghazi or Agenda 21. Wake up, America!

        • Submitted by Steve Titterud on 05/30/2014 - 12:14 pm.

          The civilian resource, if genuinely available to all vets, is…

          …a powerful buffer against a physician resource shortage and all these unreasonable wait times.

          In other words, when the need is great, the use of this alternate resource pathway can keep the veterans’ needs satisfied, and when the need declines, the alternatives can simply match that decline in real time.

          I say “is” rather than “would be” because apparently, this option is in fact available now and is exercised by many. There are comments here on MinnPost giving personal knowledge of exactly these kinds of redirects to alternative sources of care.

          So in light of this, it leaves you to wonder: why hasn’t this been used to mitigate the problem while an effort is made to increase the physician resources ?? Are the vets themselves simply not using it (an education issue), or has some required administrative action failed (administrative failure), is separate and specific funding for these alternatives required (funding issue, maybe an administrative issue) or….??

      • Submitted by Peder DeFor on 05/30/2014 - 11:34 am.

        Funding

        From what I can tell, the VA funding has followed closely to the requests made in the Obama budget. If it hasn’t been adequate, take it up with his administration. Also, it looks like the VA isn’t using its whole budget each year, so that suggests that funding isn’t the primary problem. http://www.foxnews.com/politics/2014/05/27/va-expects-to-have-more-medical-care-funding-than-it-can-spend-for-fifth-year/
        (Note: link goes to a Fox news article, so feel free to disregard it if contrary reporting will hurt your arguments.)

        I’ve heard the ‘not enough doctors/nurses/staff’ argument in other health care discussions but I’d never thought about it with the VA. Makes sense though. You’d think that fixing this problem would have been some sort of centerpiece of a large legislative attempt to make healthcare more affordable, but I guess not.
        I’ll repeat what I said, if you want to convince me that single payer is a good idea, then you need to be able to run something like the VA. If the problem was a lack of supply, then Shineski and others should have been clamoring for a fix. That didn’t happen. It seems like it was business as usual. You say that it’s possible for a system to be well run by the government? I don’t think it’s unreasonable to want to see some evidence.

    • Submitted by Steve Titterud on 05/30/2014 - 11:11 am.

      Speaking of “Knee Jerk”, your figures are misleading.

      First off, you’ve quoted the overall budget figures for the VA, which DO NOT represent the health care spending. Of that $163 billion for 2015, $95 billion is in so-called “mandatory” spending, which does not include the veterans’ medical programs budget. Only $68 billion is in so-called “discretionary” spending, 87% of which is for the medical programs, finally amounting so some $59 billion for health care expenditures. This also increases, year over year, but much smaller than your figures imply.

      So it is very easy to see that the figures you quote, while representing the overall VA budget for all categories of spending, does a serious misrepresentation of health care spending by the VA. Yet you use those figures as if they characterized the VA health care spending.

      It’s not 100% clear that the root of the problem is funding – it may or may not be. The delays seem to be caused by a shortage of physicians, which might be a funding problem, or maybe not.

      The VA has a physician resource problem which cries out for re-allocation of funding, and perhaps with creative and efficient effort this could be accomplished without new funding. So perhaps this is not entirely a matter of insufficient funding.

      “Most experts agree that soaring demand for veterans’ care has outpaced the availability of doctors in many locations, and that high turnover is a major problem. In the past three years, primary-care appointments have leapt 50 percent while the department’s staff of primary care doctors has grown by only 9 percent…”

      “Those primary care doctors are supposed to be responsible for about 1,200 patients each, but many now treat upward of 2,000…”

      http://www.nytimes.com/2014/05/30/us/doctor-shortages-cited-in-va-hospital-waits.html?_r=0

      A roster of 2,000 patients – many of whom will have complex conditions and require complex and continuing treatments, is certainly in excess of what is reasonable.

      Of some 270,000 employees of the VA, apparently only about 14,000 are physicians.

      SURELY some of the administrative overhead could be sacrificed to increase the number of doctors. If the administrators have time on their hands to massage and manipulate the numbers to qualify themselves for bonuses, I’d say they could be replaced with people who have a better work ethic, better professional ethics, and whose services are more needed.

      • Submitted by Peder DeFor on 05/30/2014 - 11:49 am.

        Misleading

        Ok, show me figures that show some fall of in the funds used towards health care spending then. Show me that GI Bill requests have gone through the roof or housing help, or something like that. I suppose it’s *possible* that some other part of the VA mission has become far more important than health care spending and has crowded it out. If you can’t show me that, then frankly, I’m not the one that’s being ‘misleading’.
        And speaking of ‘misleading’, if you could explain how lack of funds caused systemic falsifying of records, I’d appreciate that too.
        The funds given to the VA have been bumped up by quite a bit over the past five years. If lack of funds was an obstacle towards giving good care, shouldn’t they have, I don’t know, used their increase in funds towards solving that problem? If they needed to increase salaries, they had some money they could use to do that, no?
        If my salary increases by more than 50% over five years and I somehow go broke, they problem wasn’t that I didn’t have a high enough salary.

        • Submitted by RB Holbrook on 05/30/2014 - 01:32 pm.

          Increase salaries?

          Salary levels for government employees are not at the discretion of the agency that employs them. They are set by Congress, and good luck persuading that current crowd to pay government employees more.

          The low pay for VA doctors is just symptomatic of the larger problem. For decades, government service has been belittled and denigrated. We are told by those whose opinions matter that the private sector is the only place that provides “real”jobs. Government service is for losers, or maybe for those who want an easy way to bulk up a resume. The only measure of our worth is how much we net, not how much good we do. So the doctors at the VA work for less pay for a few years and then decamp to something that pays them enough to pay down their school loans. The administrative personnel who have any ambition are conditioned either to avoid the place altogether, or stay just long enough to give them an edge in the private sector. The pithy anecdotes about incompetent bureaucrats becomes a self-fulfilling prophecy because we are told that we should expect no more from mere government employees (maybe they’ll do a heckuva job).

          We get the civil service that we deserve.

          • Submitted by Peder DeFor on 05/30/2014 - 04:21 pm.

            All the Republicans Fault

            If those meanies in the GOP hadn’t suggested that civil servants weren’t always the best, then everything would work out all right. Incidentally, that means that we can’t have a useful single payer system until the GOP changes on this. That’s quite a roadblock.

            Is everyone else reading this too? Have you noticed the complete refusal to answer the questions asked and the issues raised? Some wildly awful behavior has happened. It must be because they didn’t have enough money! Why yes, they did have enough money. Then it must be because they’ve been run down by those awful nasty Republicans.
            I’m a little curious how far we go before finding out that this is all the fault of global warming.

            • Submitted by RB Holbrook on 05/30/2014 - 05:04 pm.

              Jumping to conclusions

              Nowhere did I say that it is all the fault of Republicans. I thought of it as a cultural issue that makes Americans less inclined to view government work as a “real” job. It goes beyond the current outrage. Of course, I do recall something about “protesting too much” that may be relevant here.

              The “issue raised” is that there was a pattern of misconduct in Veterans’ Hospitals. The misconduct was falsifying records to make it look like there was compliance with a goal. The failure or inability to comply is the result of systematic neglect and inadequate staffing.

              What is your explanation? Is it the inherent incompetence of anyone who works for the government? Lord knows, the Republicans have been SO supportive of those they wanted so badly to send to war.* After all, it was with the best of intentions that they voted down a legislative package to improve veterans’ benefits. No, it must be the liberals. If it weren’t for them–what? Privatize veterans’ medical care? Because it’s worked so well for the rest of us, hasn’t it? Privatizing government services always leads to such brilliant outcomes–just look at our prisons-for-profit.

              Or maybe it’s because of Benghazi, or gay marriage. One never knows.

              *Yes, some Democrats supported the wars. That talking point gives new depths to the word “tiresome.”

              • Submitted by Peder DeFor on 05/31/2014 - 01:20 pm.

                Conclusions

                Sorry RB, there is so much Republican bashing here that I thought your comments on the attitudes towards civil servants was another dig at the GOP. Maybe people of all ideologies see them as less valuable than private workers. Apologies.

                I’ve been looking around to try and find a similar type of scandal at a private hospital to see what caused it and what was done. I haven’t found any, though no doubt there is a big problem with the VA problems swamping my Google-fu. I did find what seemed to be similar problems with the single payer systems in Britain but I didn’t read deeply so maybe those scandals are different.
                There are at least two problems here that come from the left. Last week the House voted in an overwhelming, bi-partisan manner to make it easier to fire or demote civil servants who are responsible for the scandal here. The Senate, led by Harry Reid and the Dems, have failed to vote on it. Maybe they’ll do so, but right now it looks like they’d rather protect the incompetents and downright bad employees.
                The other problem is more meta, and it has to do with the over-sized protections that are given to civil servants in the first place. You noted that any pay increases would have to come through Congress. From what I understand, they would also need to work with the American Federation of Gov’t Employees. The VA has virtually no agility in dealing with problems because of the union framework in place. They also have out-sized protections that make it harder to change the culture of the VA. Not to mention that due to union work, things like this happen: http://www.nationalreview.com/article/379051/while-vets-wait-va-employees-do-union-work-jillian-kay-melchior
                “the U.S. Department of Veterans Affairs paid at least $11.4 million to 174 nurses, mental-health specialists, therapists, and other health-care professionals who, instead of caring for veterans, worked full-time doing union business.”
                Shameful.

            • Submitted by Steve Titterud on 05/31/2014 - 11:11 am.

              “Why yes, they did have enough money.”

              It may not be about the amount of money, but rather the way it’s being spent.

              There’s a resource shortage in physicians. What else could explain 100+ day wait times for initial appointments other than a resource shortfall ?? Mere incompetence in the VA bureaucracy ?

              If 14,000 physicians is not enough to deliver quality, timely care, then maybe we need 20,000 or 25,000. I don’t know the exact number, but it would seem clear we need more physicians.

              Is the money to support an increase like this already allocated to the VA, already in the system ? I suspect that sufficient funds may be currently spent elsewhere in the VA on fruitless concerns of an entrenched bureaucracy that do not serve the interests or needs of veterans. But we don’t know this for a fact. It’s a pretty good suspicion, but not a fact.

              The scandal of falsified data compels top-line coverage in the news, and that needs to be fixed, but the more important issue for the veterans is reducing those ridiculous wait times.

              This is a resource issue. Let’s find out whether current money can be moved from one part of the VA budget to address the resource shortfall. I don’t doubt that in a $160+ billion budget, a few or several billion of waste or featherbedding could be readily found. Launch a cash reward program for identifying waste within the VA itself, and the employees will give us an earful of candidates.

              How about a program like some rural jurisdictions have used – pay for a medical student’s education as a loan, then forgive the loan if you serve for 5 years ? Something like this could work for the VA to produce an “extra” few thousand physicians per year for a while until the need is met.

              It is easy to reduce this to just another p*ssing contest between DFL and GOP, liberal and conservative, but this is a route certain to getting nothing done.

              This may not be about the money.

              • Submitted by Peder DeFor on 06/01/2014 - 01:17 pm.

                Training

                Heh, I was talking with my wife yesterday and we thought up a similar program. I guess we’re on the same page as far as that goes.

                • Submitted by Steve Titterud on 06/01/2014 - 02:09 pm.

                  Here’s another where we can all get on the same page.

                  How about a “clawback” of ALL bonuses paid out over the last 5 years or 10 years based upon fraudulent manipulation of system data ?

                  The VA’s internal audit has suggested, typically, a namby-pamby measure of not paying THIS YEAR’S bonuses, a half-measure that doesn’t really cut it.

                  Astonishingly, that internal audit recommends steps, measures, and modifications of processes, but nowhere, so far as I can see, does it recommend hiring more doctors, even though that was cited by VA staff as the #1 cause of delays !!
                  http://www.cnn.com/interactive/2014/05/politics/document-va-audit/?iid=article_sidebar

                  • Submitted by Peder DeFor on 06/01/2014 - 10:40 pm.

                    Bonuses

                    I can get behind that too. I bet that there is a belief that they got away with the shoddy stuff for so long that they can get away with it for longer. My fear is that with Shineski gone, the focus will waiver and they’ll be proven right.
                    And since I’m ‘betting’, how much you want to bet that if you follow the trail long enough, you’ll find some entrenched group that is trying to keep the supply of new doctors low?

  7. Submitted by John Appelen on 05/30/2014 - 11:12 pm.

    Metrics Matter

    Top level managers tend to rely heavily on metrics when turning the knobs on a large organization. I mean what else can they do…

    So yes the misreporting was a huge problem. If you are in charge of the VHA and the reports continue to show excellent care, acceptable wait times, reasonable costs, etc. Why would you lobby hard for more resources or make big changes? What would you use as proof that change was required?

    This is a key problem with single payer/ single provider systems. The customers aren’t free to go elsewhere when they are dissatisfied. So the problem stays hidden…

    • Submitted by Peder DeFor on 05/31/2014 - 01:26 pm.

      Excellent Point

      If a hospital in the Twin Cities failed in the manner of the VA, we could quickly compare it to other hospitals and know that something else was wrong. Both in official statistics and (maybe more importantly) in everyday conversation.
      “Oh, you had to wait three months to get in? It only took us three days. I wonder what’s wrong with your hospital?”

      If there’s only one game in town, it’s much easier to rig it.

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