Warnings have been sounded for more than a decade that veterans were dying because of long waits for health care that were covered up by bogus record- keeping at Department of Veterans Affairs hospitals.
They came in nearly two dozen reports from the agency’s inspector general and the Government Accountability Office.
They even came in a memorandum sent by a top VA official in 2010 to all medical network directors within the Veterans Health Administration.
Yet somehow this “bad news” escaped Veterans Affairs Secretary Eric Shinseki. At least that's what President Obama said Friday as he accepted the resignation of the retired four-star general, who took command of the nation's largest civilian agency in 2009.
“I think he is deeply disappointed in the fact that bad news did not get to him and that the structures weren’t in place for him to identify this problem quickly and fix it,” Obama said in announcing Shinseki’s departure.
Obama added that information about falsification of waiting lists "did not surface to the level where Rick was aware of it or we were able to see it.”
The announcement came days after the release of a damning interim report from the IG documenting widespread falsification of patient wait data at the Phoenix VA hospital.
The immediate cause of Shinseki's downfall is the revelation last month of a whistleblower's allegations that secret waiting lists were kept at the Phoenix facility to hide long delays in providing care.
Rep. Jeff Miller, R-Fla., chairman of the House Veterans' Affairs Committee, disclosed the allegations at an April 9 hearing, ordered that documents be preserved and directed the inspector general to investigate. Miller said as many as 40 veterans died waiting for care.
The interim IG report released this week “confirmed that inappropriate scheduling practices are systemic throughout VHA.”
Aside from verifying the phony wait lists in Phoenix, the inspector general has expanded its investigation to 42 VA medical facilities nationwide.
An internal audit ordered by Shinseki and released Friday also found evidence of “systemic lack of integrity within some Veterans Health Administration facilities.”
Both the IG investigation and internal audit are continuing.
Yet despite the president’s lament, the bad news Shinseki missed is old news.
The inspector general has published 18 reports since 2005 documenting flaws in scheduling of medical appointments and manipulation of reported wait times to meet agency goals.
Several of those reports directly linked the delays to patient deaths.
In September 2013, the IG found six patients at the VA hospital in Columbia, S.C., died after improper delays in receiving colonoscopies.
That triggered a nationwide review by VA officials, who in April 2014 admitted 23 patients died of gastrointestinal cancers after long delays in receiving diagnostic tests at veterans' health facilities.
VA officials have not said how many preventable deaths tied to other medical conditions occurred.
Secret waiting lists like those used in Phoenix were described in a GAO report published in December 2012.
That report cited similar findings in prior investigations by both GAO and the IG that had gone uncorrected.
Keeping two sets of appointment books also was one of many scams used to hide backlogs described in an April 2010 memo sent to health care network directors by William Schoenhard, then VA deputy under secretary for health.
The Schoenhard memo ordered an immediate review at all facilities “to identify and eliminate all inappropriate practices.”
Shinseki said he had not seen the Schoenhard memo when asked about it during a Senate hearing May 15. When asked directly during the hearing whether VA was “cooking the books” to hide long waits for care, Shinseki dismissed the burgeoning scandal as “a number of isolated cases.”
Obama’s transition team was warned in 2008 that the IG had repeatedly found reported patient wait times at VA facilities were unreliable.
One of those audits showed about 28,000 veterans waited more than a month for medical appointments, almost 10 times what VA officials claimed.
The Examiner and other media have reported for months about internal policies at VA aimed at hiding long backlogs of medical appointments. Agency officials have routinely ignored requests for comment or dismissed the allegations as overblown.
Rep. Jackie Walorski, R-Ind., a member of the House veterans’ committee, said there clearly is widespread corruption at VA and a deliberate cover-up of delays in delivering care.
The investigations need to continue, those involved should be fired and criminal charges should be brought against those who broke the law, she said.
“I think criminal convictions will come out of this,” Walorski said. “Somebody in that organization put a deliberate plan together of deceit and corruption and people died.”
Walorski added she is skeptical that Shinseki did not know about the falsification of wait times when it was so widely documented in official investigations, media reports and congressional hearings.
“Of course he should have known,” she said. “I don’t know how you don’t know.”
Rep. Tim Huelskamp, R-Kansas, also a member of the veterans’ committee, said neither Shinseki nor Obama can credibly claim they were unaware of improper practices at the agency.
“Somehow they act surprised,” Huelskamp said. “It’s classic. The length at which this president somehow is never responsible for anything is shocking and amazing, and, in this case, veterans died as a result. I don’t think this one is going to sell with the American people.”
Pete Hegseth, chief executive officer of the group Concerned Veterans for America, which called for Shinseki’s resignation last year, said Shinseki’s detached management style makes it possible he was not aware of the extent of the problems in his own agency.
“I’ve heard from a lot of people at the VA who feel like he’s been living in a bubble world for a long time, that he’s spent a little bit too long reading his own department’s talking points,” Hegseth said.