‘Significant Delays in Access to Care’ Confirmed by VA Inspector General

Not that it’s a shocker at this
late date, but the inspector general at the Department of Veterans
Affairs says there are, in fact, wait-list shenanigans at the
Veterans Health Administration facility in Phoenix, Arizona. Why
would officials do such a thing? To boost their job reviews so they
get put at the front of the line for raises. No surprise, this is
not an isolated problem at one facility.

Here’s a money quote from the interim report,
released today:

Our reviews at a growing number  of VA medical facilities
have thus far provided insight into the current extent of these
inappropriate scheduling issues throughout the VA health care
system and have confirmed that inappropriate scheduling practices
are systemic throughout VHA. One  challenge in these reviews
is to determine whether these practices exist currently or were
used in the past and subsequently corrected by VA
managers. 

To date, our work has substantiated serious conditions at the
Phoenix HCS. We identified about 1,400 veterans who did not have a
primary care a ppointment but were appropriately included on the
Phoenix HCS’ EWLs [electronic wait lists]. However, we identified
an additional 1,700 veterans who were waiting for a primary care
appointment but were not on the EWL. Until that happens, the
reported wait time for these veterans has not started. Most
importantly, these veterans were and continue to be at risk of
being forgotten or lost in Phoenix HCS’s convoluted scheduling
process. As a result, these veterans may never obtain a requested
or required clinical appointment.  A direct consequence of not
appropriately placing veterans on EWLs is that the Phoenix HCS
leadership significantly understated the time new patients waited
for their primary care appointment in their FY 2013 performance
appraisal accomplishments, which is one of the factors considered
for awards and salary increases.

If I’m reading that correctly, more patients were improperly
excised from the wait list than were included, which represents
something a tad larger than an institutional hiccup.

President Obama, according to White House press secretary Jay
Carney, finds the report “extremely troubling.”

As I’ve
written before, the VA’s woes aren’t peculiar to
itself—government-run, single-payer health systems tend to run into
long, often lethal, and frequently concealed delays. And that’s
before you even get to the
poor quality of care offered to the lucky patients who make it
to the front of the line.