A government watchdog uncovered further evidence of delays in care at the Department of Veterans Affairs the same day Hillary Clinton’s campaign doubled down on comments blaming Republicans for exaggerating the VA’s problems.
After Clinton took fire for suggesting last week that the VA wait-time scandal has “not been as widespread as it has been made out to be,” her campaign spokesman called it a “systemic problem” and an “outrage.”
The spokesman’s contradictory words came within hours of the release of a VA inspector general review that detailed a familiar failure in veterans’ healthcare.
A veteran in his 70s who was having difficulty swallowing died after his doctors failed to schedule an appointment for him, according to an inspector general report made public Wednesday.
The veteran “experienced poor access to care” at a California VA outpatient clinic when a physician ignored his condition for nearly a year before ordering a neurology test that did not take place for another six months.
When the veteran finally did get to see the VA’s neurologist, the doctor requested surgery to place a feeding tube in the veteran’s throat.
“The neurologist classified the request as ‘routine’ despite documentation that the patient could not eat,” the inspector general found. The surgery was then scheduled for three weeks after the neurology appointment, but the veteran died waiting for his feeding tube.
The watchdog noted it was unable to “substantiate that the patient died as a result of the failure” because no autopsy was performed and no records were made after the veteran in question died in his home.
But the review uncovered a six-week minimum waiting period for neurology patients at the Los Angeles clinic in a finding that mirrored problems at VA facilities around the country.
The agency has weathered criticism of its low-quality healthcare, poorly-run facilities, lengthy wait times and enormous backlog of veterans who have yet to receive their promised benefits.
As of last week, the VA has fired just three employees for their participation in a sweeping scheme to cover up delays in care at hospitals across the country that was recognized internally since at least 2008.
Clinton brushed off the scandal during an interview Friday in which she accused Republicans of inflating the VA’s problems in order to justify closing it.
“I don’t understand why we have such a problem, because there have been a number of surveys of veterans and, overall, veterans who do get treated are satisfied with their treatment,” Clinton told MSNBC’s Rachel Maddow last week.
“Now, nobody would believe that from the coverage that you see and the constant berating of the VA that comes from the Republicans,” she said.
Her comments instantly drew fire from lawmakers and veterans groups who questioned how the Democratic front-runner could minimize problems that contributed to the deaths of dozens of veterans, including 40 patients at one hospital alone.
Brian Fallon, Clinton’s campaign spokesman, attempted to clear the air Wednesday by touting Clinton’s intention to reform the VA.
“At this point, Republicans are trying to exploit the scandal to try to score partisan points and push an ideological agenda to privatize the VA,” Fallon said, according to The Wall Street Journal. “Hillary Clinton has said repeatedly that the systemic problem of excessive wait times at the VA is an outrage, but she refuses to believe the VA is beyond fixing.”
Fallon claimed Republicans have pushed for “ending [the VA] altogether,” a proposal supported by virtually no Republicans.
Ben Carson, a GOP presidential contender, did suggest rolling the VA into the Department of Defense earlier this year, but his plan was quickly and widely condemned by veterans groups. The vast majority of Republicans have never raised the possibility of shuttering the VA.
Instead, many reform plans include expanding veterans’ access to care in the private sector if they live prohibitively far from a VA facility or are unable to schedule an appointment in a timely fashion within the troubled VA system.
But Clinton’s comments suggested Republicans had created the VA’s problems by withholding funding.
“They try to create a downward spiral,” she said of the GOP. “Don’t fund [the VA] to the extent that it needs to be funded because we want it to fail so that we can argue for privatization,” she said. “They still want to privatize Medicare. They still want to do away with Social Security.”
Under President Obama, the VA’s budget proposals have jumped from $93.7 billion in 2009 to $168.8 billion for 2016. Earlier this month, congressional Democrats blocked a bill to fund the VA as part of a political strategy to corner Republicans on budget negotiations.
Funding aside, the VA’s problems have persisted despite national outrage over the scandal that was publicly exposed in a watchdog report last summer. A few months earlier, a whistleblower had alerted the media to the existence of a secret waiting list to cover up delays at the VA hospital in Phoenix.
The agency’s inspector general continues to uncover problems at the Phoenix facility.
Earlier this month, the watchdog published a report that found “clinically significant delays” in the hospital’s urology department that occurred after a sudden staffing shortage arose.
Between April 2013-August 2014, the urology department canceled more than 4,000 appointments, according to the review which detailed problems lasting until at least April of this year.
The report cited an email in which one VA official described an interaction with the wife of a veteran with prostate cancer who had driven her husband six hours to the Phoenix hospital, only to discover that his appointment had been canceled without notice.
“At receiving the news the veterans [sic] wife spent the remainder of her time holding back tears” as the VA official informed her that her husband could not be seen by a doctor for another month.
The inspector general described seven cases in which delayed or mismanaged care preceded a veteran’s death, including an instance in which a veterans’ daughter called the VA hospital to report concerns about her father’s symptoms, which were worsening. No doctor ever contacted the daughter, nor did anyone at the VA ever suggest her father come in for an appointment. He died less than two weeks later.
VA officials blamed the most recent rash of problems at the Phoenix facility on the urology department’s staffing shortage.
However, the inspector general has repeatedly highlighted treatment lapses in that department, describing delays in an August 2014 report and a significant gap in agency records in a January 2015 report.
The Phoenix VA hospital is far from the only facility to experience persistent problems.
Clinton’s claim that VA dysfunction is “not as widespread” as her opponents say raises questions about her familiarity with the issue.
This month alone, the inspector general has identified problems at VA facilities in Alaska, Illinois, California, Michigan, New Jersey, Arkansas and Arizona.
Congress and whistleblowers have revealed even more VA weaknesses in recent weeks.
For example, lawmakers learned in July that nearly one-third of veterans who applied for VA healthcare benefits died before the agency ever got around to reviewing their applications.
That same month, VA officials threatened to close hospitals around the country unless Congress allowed them to take funds out of an agency program that gives veterans the option to seek treatment from their own doctor in the private sector.
Democrats and Republicans agreed the seemingly sudden budget shortfall — the largest in the agency’s history — was further evidence of the “lack of accountability” within the VA.
Internal documents later indicated the VA had considered a plan to ration expensive drugs for veterans even after pleading with lawmakers to approve the transfer of funds out of the veterans’ choice program to pay for those drugs.
The VA, which employs 340,000 people, has struggled to protect whistleblowers from retaliation when they attempt to report wrongdoing.
In hundreds of cases, VA whistleblowers have been unfairly punished or fired after they brought internal problems to the attention of Congress, the media or the inspector general.
The corrupt environment has also allowed some VA officials to game the system for their personal benefit.
Most recently, agency executives have come under fire for manipulating an agency program designed to relocate employees in order to give themselves salary raises.
Some officials created less-demanding job openings for themselves in other cities, then took advantage of the relocation program to bill the VA for their moving expenses.
A pair of senior VA staff that were cited in an inspector general report about the scheme failed to appear before the House Veterans Affairs Committee last week after the VA refused to allow the testimony of five employees who were invited to the hearing.
The committee then voted unanimously to subpoena the officials, who are set to appear before the panel Monday.
