VA crisis slowly changing health-care system for veterans

The Department of Veterans Affairs' crisis in health care came to a head in April 2014 at a meeting of the House Committee on Veterans' Affairs.

Chairman Jeff Miller, R-Fla., told his panel, "It appears as though there could be as many as 40 veterans whose deaths could be related to delays in care" within the Phoenix VA Health Care System.

The Arizona Republic reported the news the next day, along with allegations by a key whistle-blower. The Republic had been investigating the matter since late 2013, when longtime VA physician Sam Foote told the newspaper that administrators were deliberately under-reporting the time veterans had to wait for medical care. Foote, who retired shortly thereafter, also took the matter to the Office of Inspector General and Congress.

The news, including Foote's allegations, traveled fast. Other whistle-blowers and angry veterans came forward in Phoenix and other cities with similar allegations and more, eventually prompting a flurry of media coverage and dozens of separate investigations.

The VA Office of Inspector General eventually confirmed that wait times had been falsified and that some veterans had died while awaiting care. When it came to light that executives had received bonuses based on bogus wait-time data, those payments were rescinded.

Fallout from the VA's intense public scrutiny is ongoing. So far:

• VA Secretary Eric Shinseki resigned. Dr. Robert Petzel, undersecretary for health and second in command at the VA, and Susan Bowers, the VA regional director for Arizona, New Mexico and west Texas, were forced into early retirements. Sharon Helman, Phoenix VA's top official, was fired and the action upheld by an administrative judge in December. Two other top Phoenix executives are under suspension pending disciplinary action.

• Investigations eventually were launched at more than 90 of the nation's other VA medical facilities as a direct result of the disclosures in Phoenix, uncovering system-wide manipulation of wait times.

• Congress approved and President Barack Obama signed into law bipartisan VA reform legislation, including $16.3 billion to expedite care. The Veterans Access, Choice and Accountability Act empowers the VA secretary to more easily fire and replace executives for misconduct, negligence and incompetence. Congressional critics recently noted, however, that minimal disciplinary action has yet been taken.

• Some money appropriated under the VA act will expand the Phoenix-area's network of VA facilities and satellite clinics and hire more doctors, nurses and support workers.

• The VA reached out to veterans sidetracked by the scheduling mess to get them appointments. Those unable to get VA appointments are being sent outside the system to private care. Veterans continue to complain of long waits, however, and Arizona Sen. John McCain said in a statement Tuesday that fewer than 1 percent of veterans who have received Choice Cards have been able to access medical care outside the VA.

• After removing key members from a Gulf War illness research advisory committee, including Phoenix resident and Chairman James H. Binns, the VA replaced them with medical experts with extensive knowledge of the affliction. The committee's work potentially could affect roughly 250,000 veterans suffering complications from the illness.

• Retaliation against whistle-blowers has been publicly repudiated by the VA, and new rules are in place that the VA says are designed to protect those who report problems, inefficiencies or corruption.