Tag: responsible
Shinseki Says VA Hospitals Will Extend Hours, Hold Personnel Accountable

Shinseki Says VA Hospitals Will Extend Hours, Hold Personnel Accountable

By Richard Simon and Molly Hennessy-Fiske, Tribune Washington Bureau

WASHINGTON — Veterans Affairs Secretary Eric K. Shinseki called in leaders of veterans groups Thursday and pledged to keep VA hospitals open nights and weekends if necessary to set up speedy appointments for veterans whose long waits for medical care triggered a departmental crisis.

As bipartisan pressure mounted in Congress for his resignation, Shinseki said he would announce as soon as Friday new steps to hold VA employees accountable, including personnel changes and the option for veterans to seek private-sector care, according to participants at the hourlong meeting.

“I got the idea that there might be some heads that will roll,” said Garry Augustine, executive director of the Disabled American Veterans’ Washington office. “I think they realize the urgency.”

Shinseki’s fate could be determined by the preliminary findings of an audit he ordered of the VA health-care system, which he is expected to deliver to the White House, perhaps Friday.

A report from the VA’s Office of Inspector General on Wednesday found systemic problems throughout the hospital network in scheduling veterans for medical care, including manipulating records to hide long waits for appointments.

Veterans at the Phoenix VA Health Care System, which the report focused on, waited an average of 115 days for appointments.

The report also disclosed that the investigation had expanded to 42 sites, up from the 26 previously stated.

In Texas, meanwhile, Republican Sen. John Cornyn said he sent a letter to President Barack Obama calling for the FBI to lead the investigation into allegations that VA employees falsified records to cover up long waits.

At the White House, spokesman Jay Carney stopped short of declaring Obama’s full confidence in Shinseki, a retired four-star Army general, saying that the president has “made clear that he believes there ought to be accountability once we establish all the facts.”

The firestorm surrounding Shinseki heated up, with calls for his resignation from members of both parties, including at least 11 Democratic senators, a number of whom face tough re-election campaigns.

Derek Bennett, chief of staff of the Iraq and Afghanistan Veterans of America, one of the veterans groups that met with the VA chief Thursday, said Shinseki “did not seem to me to be shaken by the recent drumbeat from both sides of the aisle for his resignation.”

But Bennett said the meeting “did nothing to restore confidence” in the secretary to fix the problems.

“We do not doubt the secretary’s sincerity in wanting to fix the problem, but we still have serious questions about whether the secretary has the tools, resources and the confidence of VA staff and veterans to create real reform,” he said.

Augustine said Shinseki was upfront. “He started out the meeting by saying, ‘Look, I’m a general. I had to look at crises all the time, and maybe I’m not as dramatic as some would like, but that’s just who I am. But I can assure you that this is very upsetting, and I’m going to get to the bottom of it.’”

Cornyn, who met in Houston with about a dozen local veterans and leaders of veteran groups Thursday, said he wanted the FBI to investigate allegations by Texas VA employees that managers received bonuses after concealing wait times for appointments.

“When you hear the leadership at the VA are receiving bonuses only for cooking the books, to me that speaks of corruption,” Cornyn said.

Rep. Jeff Miller, R-Fla., chairman of the House Veterans Affairs Committee, said in a letter to Attorney General Eric H. Holder Jr.: “I believe it is now time for the Department of Justice to assess the criminality of these facts to ensure this blatant manipulation of patient wait times … does not go unpunished.”

Although the VA inspector general has said his office is working with the Justice Department, Cornyn said “the breadth and complexity of these problems very likely exceeds the capabilities of any IG office.”

Reginald White, a retired longtime Houston VA cardiology supervisor, told the gathering how high-level VA managers had profited by artificially reducing wait times to improve their annual evaluations and receive bonuses, even as veterans suffered without care.

“A lot of individuals will do what they have to do to inflate that and make it look good to get that bonus,” White said.

Dr. Joseph Spann, who recently retired from the VA in Austin, Texas, after 17 years, this week discussed his recent letter to VA investigators accusing a doctor manager at a facility in nearby Temple, Texas, of directing doctors to manipulate patient appointments to hide treatment delays.

“I saw patients waiting for cancer evaluations, for staging for (CT scans) or MRIs, even ultrasounds. They would have to wait for several weeks, more weeks than I felt comfortable with,” Spann said. “If someone told you that you had cancer, would you want to wait several weeks for treatment?”

Spann said VA officials cleared the doctor involved and dismissed the problem as a training issue.

He disagreed, insisting that, as a Texas VA clerk has claimed, supervisors routinely broke the rules and instructed staff to adjust patient appointment dates.

Spann is now assisting IG investigators.

In Washington, Carney was peppered with questions at Thursday’s briefing about the VA scandal and said the president expected to see “action taken immediately.”

“The president’s focused first and foremost on the need to address the problems that have impeded the quality and speed of care and benefits that our veterans have been receiving,” he said. “He is also committed to making sure that people are held accountable if it is established that there was misconduct or mismanagement. But we can take action on the former while we await assessments on the latter.”

Also Thursday, Sen. Mark R. Warner, D-Va., said: “The controversy over Gen. Shinseki’s leadership has taken attention away from the real issue: the need for swift, decisive action to reform the VA, change its culture and ensure that we provide quality, timely services for our veterans.”

Although numerous Republicans have called for Shinseki to step down, House Speaker John A. Boehner, R-Ohio, said Thursday: “The question I ask myself is, is him resigning going to get us to the bottom of the problem? Is it going to help us find out what’s really going on? And the answer I keep getting is no.”

Photo via Wikimedia Commons

Obama’s Paradox Problem

WASHINGTON — Call it the Party-of-Government Paradox: If the nation’s capital looks dysfunctional, it will come back to hurt President Obama and the Democrats, even if the Republicans are primarily responsible for the dysfunction.

Then there is the Bipartisanship Paradox: No matter how far the president bends over backward to appeal to or appease the Republicans — no matter how nice, conciliatory, friendly or reasonable he tries to be — voters will judge him according to the results. And the evidence since 2009 is that accommodation won’t get Obama much anyway.

This creates the Election Paradox: Up to a point, Republicans in Congress can afford to let their own ratings fall well below the president’s, as long as they drag him further into negative territory. If the president’s ratings are poor next year, Democrats won’t be able to defeat enough Republicans to take back the House and hold the Senate. The GOP can win if the mood is terribly negative toward Washington because voters see Obama as the man in charge.

Everything the Republicans are doing makes sense in light of the three paradoxes, even though, by the numbers, they have been the big losers from the summer’s debt ceiling fiasco and their broader refusal to cooperate with Obama.

A Pew Research Center survey released last week showed Obama with a 49 percent disapproval rating, but Congress with a 70 percent unfavorable rating. So Obama is still “ahead.” The Democrats are also better regarded than the Republicans — or, perhaps more accurately, less poorly regarded. “Only” 50 percent of respondents had an unfavorable view of the Democratic Party; 59 percent had an unfavorable view of the Republican Party.

But the trend on the president’s numbers has been downward, and the Republicans seem willing to pay a high price to keep them moving that way. Remember: The core GOP argument is that government can’t do much good and generally makes everyone’s life worse. Democrats are the ones who insist that government can solve problems and improve people’s lives. If government isn’t doing that — if it is discredited and made to look foolish — guess whose side of the debate is weakened?

Obama’s central task is to break out of the three paradoxes, not just to get re-elected but also to get anything done. Having tried conciliation, his only alternative is to build pressure on the Republicans. He needs to get them to act, or, failing that, to make clear who is responsible for Washington’s paralysis.

That’s why his coming speech on jobs has to describe a program that’s broad and imaginative enough to capture the public’s attention. The middle-of-the-road voters his advisers want to win back look first for chief executives to be strong, decisive, and principled, not at how many millimeters they are from the political center.

Despite reports that the White House is split over how much Obama should ask Congress to do, the president has signaled that he understands the stakes. “My attitude is that my job is to present the best plans possible,” Obama said in an interview Tuesday with talk-show host Tom Joyner. “Congress needs to act. If Congress does not act, then I’m going to be going on the road and talking to folks, and this next election very well may end up being a referendum on whose vision of America is better.”

Obama hates to bring up the nasty fact that we have political parties, but very soon, he will have to point out that it is Republicans in Congress who are blocking his program. They will either have to start worrying about its low ratings, or begin to pay a real price for obstruction.

The model, of course, is Harry Truman. In a lovely book on the 1948 election, The Last Campaign, Zachary Karabell explains the problems that Truman’s attacks on the “do-nothing” Republican Congress created for his GOP opponent, Thomas E. Dewey.

“Dewey couldn’t distance himself too much from Congress or he would lose the support of his own party and perhaps jeopardize Republican chances in the congressional elections,” Karabell wrote. “Yet he needed to create some space between himself and the Congress in order to avoid being dragged down in their wake. It was a precarious position.” Indeed it was.

Truman, it’s true, didn’t get to this strategy until the election year. But the unemployment rate in 1948 averaged below 4 percent. Obama doesn’t have the luxury of waiting.

E.J. Dionne’s email address is ejdionne(at)washpost.com.

(c) 2011, Washington Post Writers Group