May 21 2014 11:48 AM

Books-cooking is just a symptom

Eric Shinseki
Eric Shinseki
Photo by Jim Greenhill / Flickr

Barack Obama's spokesperson said Monday that the president would "soon" address the scandal in the U.S. Department of Veterans Affairs in a meaningful way. We hope those comments—and any ensuing action—are not limited to who did what at various VA offices around the country, where appointment records were allegedly falsified to hide the egregious time veterans have been waiting to get medical care. We hope his attention will be on why administrators felt the need to cook the books in the first place.

The most recent hubbub surrounding the VA emerged three weeks ago, when an investigation into books-cooking by the department's inspector general led the VA to place three administrators at the Phoenix office on leave. In the days that followed, similar allegations surfaced regarding VA systems in Fort Collins, San Antonio, Cheyenne and St. Louis.

That's at least five distinct VA healthcare systems around the country where there have been accusations of secret waiting lists, destroyed documents and threatened retaliation against potential whistleblowers. The Los Angeles Times published a good story on Sunday detailing how the long wait times—of six months or more—had affected a handful of elderly veterans.

The mess has fallen into the lap of Eric Shinseki, the secretary of veterans affairs, whose resignation has been called for by some Republicans in Congress, as well as the American Legion. We're certainly not opposed to seeing heads roll over this sort of thing, and if Shinseki and others have to go, they have to go. But what appears to be happening around the country is a symptom. The first order of business must be to identify and attack the root cause, which we can only assume is a dire need for more doctors in the VA system.

Let's be clear: Ineffecient care in the VA system has long been a problem. Obama himself vowed to fix it when he was a candidate for president. Last year, the VA made the decision to require that patients requesting care be seen within 14 days; the date of a patient's call would be logged and tracked so that administrators could be held accountable.

According to a May 14 story in The New York Times, "A major factor behind long waiting periods for care, outside experts and department officials agree, is that demand for primary care has risen sharply in recent years, fueled not only by younger veterans who served in Iraq and Afghanistan, but also a tide of Vietnam-era veterans, many with complex health problems relating to both their age and their military service."

A letter to the editor in the Los Angeles Times, written by Joey Liu of Newbury Park, put it another way: "As for the VA, it's a crime that Congress, which talks about cutting spending, dumps countless patients from endless wars on an underfunded healthcare system, and then acts shocked when the infinite demand for healthcare isn't met."

Liu added later: "Because it costs hundreds of thousands of dollars to get one of these [medical] degrees, many new doctors go into higher-paying specialties. As a result, burned-out primary-care MDs who get nothing but scathing criticism either go into limited concierge medicine or retire early, reducing access even more."

The New York Times reported that according to the Department of Veterans Affairs, "the number of primary care visits in the system rose by 50 percent over the past three years; the number of new nurses and other staff members increased a similar amount, but the number of full-time primary care doctors rose by only 9 percent."

These are the bigger-picture issues Obama needs to address, and he shouldn't let Congress off the hook while he's doing it. As Liu says, Congress can't be righteously indignant if it doesn't give the VA enough money to provide adequate care for the American service members whom Congress keeps sending into war.

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