'Not much has changed' at Phoenix VA, doctor testifies at Senate panel's hearing Arizona's GOP Sens. John McCain and Jeff Flake used the Gilbert hearing to promote a universal Choice Card so all veterans could seek private care.

Dennis Wagner | The Republic | azcentral.com

Show Caption Hide Caption Senate Commitee on Veterans' Affairs Field hearing Senate Commitee on Veterans' Affairs Field hearing.

Choice Cards were authorized last year in the $16.3 billion VA reform measure

McCain's proposed legislation would allow access to private medical care for all veterans

VA official: Congress would have to provide more funding if McCain's proposal is adopted

Arizona Republican Sens. John McCain and Jeff Flake used a Senate Committee on Veterans’ Affairs field hearing Monday to promote a “universal Choice Card” that would allow all military veterans to get subsidized health care outside the VA system.

The hearing at Gilbert Town Hall reviewed a nearly two-year saga of mismanagement and delayed medical care in the Department of Veterans Affairs, with testimony from embittered patients and a Phoenix whistleblower who helped expose the nationwide problem.

McCain, Flake and Sen. Dan Sullivan, R-Ala., who presided over the session, repeatedly expressed frustration with the VA’s failure to reduce wait times, as well as a perceived lack of accountability nearly two years since the crisis erupted.

David Shulkin, under secretary for health, said the VA has dramatically increased staff and reformed its scheduling system, but he admitted that “our overall wait times are probably not going to go down” because more veterans are enrolling for care.

McCain said that problem reflects “an urgent call to make the Choice Cards universal.”

The Choice Cards, authorized last year in a $16.3 billion VA reform measure, allow veterans who face appointment delays over 30 days, or who live more than 40 miles from a Veterans Affairs facility, to obtain private medical care at the government's expense.

McCain and some other members of Congress are proposing to eliminate restrictions so all veterans may use the cards. It is unclear what impact that would have on the massive Veterans Health Administration, or what the cost would be to taxpayers.

McCain said after the hearing that his proposed Choice Card legislation would essentially work like Medicare, and he believes the overall cost of veterans' care to taxpayers would decline because private medical treatment is cheaper.

Shulkin said data to confirm or refute McCain’s claim is difficult to obtain because costs of private and VA care are not “apples to apples.” He said the department supports removing some restrictions, but added that if a universal Choice Card is approved, Congress will have to provide more funding.

Dan Caldwell, a spokesman with the conservative advocacy group Concerned Veterans for America, said there is no definitive research comparing costs for VA and private health care. If McCain’s proposal is adopted, Caldwell said, it is unclear how many veterans might abandon the VA, or how much it may cost taxpayers.

CVA last year proposed an alternate plan that would transform the VA into a non-profit corporation and create a choice option while reducing some benefits for future veterans and those not already enrolled in the system.

The Veterans Health Administration operates 150 hospitals nationwide, and more than 800 clinics, serving about 9 million enrolled veterans.

Much of Monday’s hearing focused on issues of accountability, with senators complaining that VA Secretary Robert McDonald has not used the authority he was given to fire administrators found to be incompetent and unethical.

In Phoenix, McCain noted, Associate Director Lance Robinson and Administrative Services Chief Brad Curry have been on paid leave since they were recommended for removal 20 months ago based on allegations of misconduct.

Shulkin responded that those personnel actions have been in abeyance because the U.S. Attorney’s Office would not allow the VA to interview the two administrators during a criminal probe. But the department will no longer delay its decision, he added.

Dr. Darren Deering, chief of staff at the Phoenix VA Medical Center, was scheduled to testify Monday, but his appearance was canceled after members of the Senate committee learned an internal VA probe found Deering culpable for whistleblower reprisal. The Office of Administrative Review report said Deering retaliated against Dr. Katherine Mitchell, who also was on the witness list.

Mitchell testified Monday that “not much has changed” at the Carl T. Hayden VA Medical Center since she and others exposed falsified wait times and corrupt management practices in early 2014. She said triage nursing practices in the Emergency Department remain dangerous and are so “grossly inadequate” that she would not seek treatment there.

“Since the VA scandal erupted, there’s been no significant change in the dysfunctional culture,” Mitchell added.

According to an investigation conducted in November 2014, Deering retaliated against Mitchell by approving her removal as Emergency Department supervisor, and by failing to prevent insubordination among nurses.

A second investigative report shows Robinson, the associate director, was found to have retaliated against another VA whistleblower in a separate case.

Shulkin acknowledged problems with accountability and wait times, but said, “I can assure you, extraordinary efforts are what we’re going to do to get this fixed.”

The session was scheduled to review reform efforts in the Phoenix VA Health Care System since a nationwide scandal erupted there 20 months ago, and to discuss efforts to boost medical care for veterans by providing private treatment options.