Ken Hare In Depth: Start VA fix with firings, lots of them, but don't end there

MONTGOMERY, AL (WSFA) - One of the ironies of the ongoing Veterans Affairs Administration scandal is that many veterans still seem to have a warm place in their hearts for the people who care for them at VA facilities, even at those facilities where the veterans have been made pawns by bureaucrats more interested in meeting quotas and earning bonuses than in serving those who served their nation so well.

Sadly, the VA's own probe into allegations of improprieties shows the Montgomery and Tuskegee VA facilities are among the worst offenders in keeping veterans waiting for health care, and possibly in falsifying records to hide the system's failures.

The public should demand that those VA employees who falsified records to hide the long waits for health care be fired, as well as those who pushed them to falsify records, and any administrators who may have turned a blind eye to the falsifications.

But that should be just the beginning of fixing what is in many ways a broken system.

This is a personal issue with me, but not because I receive VA services -- my own years as an Air National Guardsman did not include enough active duty to qualify. But I have so many family members and friends who do rely on the VA for health care that I cannot help but take the recent disclosures personally.

My father, a World War II Navy veteran, was in and out of VA hospitals late in his life as he dealt with sinking health issues. He always praised the care he received, and built strong relationships with many of the people who provided that care. I always will have a warm place in my heart for those who cared for him so well, primarily at the VA hospital in Augusta, GA.

To this day, my father-in-law, also a WWII Navy vet, praises the care he receives at the Montgomery VA facility. I've heard similar stories from uncles and other relatives and friends who served in World War II and Vietnam.

But those are older veterans who have been in the system for some time. The ongoing VA scandal has touched some of those older vets, but it seems that newer veterans just seeking care are the ones most affected.

The scandal first emerged in Phoenix, AZ., through the efforts of whistleblowers and  the news media, not from the inspector general program that taxpayers spend millions on to be a watchdog. The Phoenix VA faces allegations that dozens of veterans may have died while waiting for medical care.

A subsequent VA study found that nationally more than 57,000 veterans were forced to wait 90 days or longer for medical appointments. Another 64,000 still may not have seen a VA doctor.

The 14-day goal for patient appointments has become a joke at some facilities, and falsifying records to show the goal was being met became far too common.

The federal audit showed that Central Alabama VA centers have an average wait time of 75 days for new patients, which makes it the seventh worst in the nation. New patients needing specialty care have an  average wait time in Montgomery and Tuskegee of 65 days.

As the federal investigation goes forward, the public should insist, through their representatives in Congress, that strong actions are taken against anyone involved in covering up the VA's failures. But they also should insist that Congress and the Obama administration address the underlying systemic issues as well.

Some points:

-- Congressional watchdogs need to ensure that not just those schedulers who falsified records are fired. Any administrator who encouraged them to do so should be fired as well.

(And a note specifically to  Central Alabama Veterans Health Care System Director James Talton, who Rep. Martha Roby said misled her into believing that some employees at fault in the scandal were dismissed: Firing means firing, not relieving of duties or transferring or any other action short of being given the boot. For heaven's sake, isn't it clear by now that trying to talk around the issues the VA faces is a major part of the problem?)

-- Any scheduler or supervisor who instigated or condoned falsifying records that resulted in their receiving bonuses should be the focus of a criminal probe. To falsify records may be a crime in and of itself, but to do so to receive a bonus sounds a lot like fraud, and should be treated as such.

--  Firings should not be limited to those who actively falsified or encouraged falsification of records. Those administrators who failed at their responsibilities to prevent such abuses should be fired or at least demoted, depending upon how culpable they are. And that includes top directors as well as those down the line. 

-- The entire bonus system in the VA (and probably other federal agencies as well) needs to be reassessed and overhauled, and maybe even ended.

The U.S. House has passed a bill to end VA bonuses, but only through 2016.

Even while the backlog of VA applications grew, millions in bonuses were paid to processors. Across the VA, annual bonuses have cost taxpayers $350 million or more in recent years. The system needs to be reformed so that bonuses do not encourage processors to concentrate on easy applications for services while ignoring the complicated ones. Bonuses should be sharply curtailed, and those relatively few bonuses that are given should go only to those who dramatically excel in their duties.

-- The falsification of records issues raises serious questions about the VA's inspector general's office and why it did not discover and move to prevent these problems earlier. The office does appear to be on top of the issues now, but attention still needs to be focused on why this problem grew to the point it did, especially in Phoenix.

-- Congress should look closely at whether funding is part of the problem with delays in providing services. I suspect it is, and that funding needs to increase. But I also suspect that it isn't just a matter of spending more, but also a matter of spending old and new money in more efficient ways. (See above regarding $350 million or more in annual bonuses.)

-- Based on what I have heard personally in the past, but also what I have read lately, I believe that most veterans (but certainly not all) prefer to receive medical treatment in a VA facility. But if that treatment is not available in a VA hospital or clinic, perhaps it can be more efficiently provided by the VA subsidizing more care in a non-VA setting, especially for veterans who do not live near a VA facility. Congress is moving to allow more of that to deal with the backlog, but perhaps it needs to be a greater part of a long-term solution.

In one way, the falsification issues may be a good thing, because they have focused public attention on what has been a long-term problem with the backlog of veterans seeking services. But passing outrage won't be enough to solve the access issues that have plagued the VA for years.

That will take a commitment from this Congress and president, and from future lawmakers and presidents, to ensure that this nation's veterans receive the medical care that they have earned and deserve.

Ken Hare was a longtime Alabama newspaper editorial writer and editorial page editor who now writes a regular column for WSFA's web site. Email him at

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