Caring for Those Who Serve: Key Facts About the Veterans Affairs’ Health System in the Wake of the Waitlist Allegations
In the wake of recent revelations of veterans’ long wait times for medical appointments and allegations of secret waiting lists, many have called for Veterans Affairs Secretary Eric Shinseki to resign. These are very serious claims and are rightfully receiving widespread attention and calls to reform the Veterans Affairs’, or VA’s, health care system. Our veterans deserve the best possible care. Secretary Shinseki should do everything he can to swiftly and publicly get to the root of these problems. But calling for his resignation is counterproductive.
A decorated, disabled Vietnam veteran who served in the Army for 38 years, Secretary Shinseki has fought an uphill battle to reform the VA bureaucracy and make sure our veterans receive the health care and benefits they deserve. Although much remains to be done, under Shinseki, the VA has made improvements that both veterans and the American people can stand behind.
The Department of Veterans Affairs Veterans Health Administration, or VHA, is the largest health system in the United States, serving 6.5 million veterans and dependents in 2013.
- The Veterans Health Administration consistently delivers high-quality care, outperforming the private sector on several metrics, including management of chronic conditions, cancer screening, and several aspects of hospital care.
- The VHA cared for veterans with more than 91,720,000 outpatient visits and more than 900,000 inpatient admissions in 2013.
- Veterans are overall very satisfied with the health care they receive through the VA: More than half would rate it a “9” or “10” on a scale from 0 to 10.
- The VHA is also the largest telehealth system in the United States, providing care to more than 600,000 patients remotely, reaching many in rural areas who would otherwise face difficulty accessing care.
The VA has recognized the toll the wars in Iraq and Afghanistan have taken on the mental health of our veterans and has dramatically expanded its mental health care services.
- In 2013, the VA added more than 1,600 mental health practitioners.
- Since 2009, spending for mental health care has increased by 54 percent, from $4.4 billion to $6.8 billion in 2014.
- The VA’s mental health care is as good, or better than, mental health care through the private sector.
- The VA also relaxed the documentation requirements for veterans who are have suffered from post-traumatic stress disorder, or PTSD, allowing millions of veterans of the Iraq and Afghanistan wars, as well as earlier conflicts, to access mental health care and to receive disability compensation.
Disability compensation claims backlog
Secretary Shinseki has also spearheaded the effort to eliminate the disability claims inventory and backlog and has made steady progress. In April 2009, Shinseki required the VA to identify and prioritize all claims older than 125 days. This was the first time the claims backlog had been specifically defined.
- Over the past two years, the claims inventory has dropped 35 percent, from nearly 900,000 to 577,000.
- The number of backlogged claims—more than 125 days old—has declined by more than half, from more than 600,000 to less than 300,000, in 14 months.
Simultaneously, the VA is overhauling their claims processing system, moving from paper to electronic records. The VA is also catching up from an increased number of claims from Iraq and Afghanistan veterans, aging Vietnam veterans, and those newly eligible to claim disabilities resulting from Agent Orange exposure or Gulf War Syndrome.
Access to health care
In 2012, the VA set a goal of ensuring veterans’ access to primary, specialty, and mental health appointments within 14 days. Unfortunately, some providers and facilities, including the Phoenix VA hospital, seem to have been gaming the appointments to make it appear as if they were meeting this 14-day target. This is a very serious issue, and our veterans deserve better than a shadow waiting list and long delays for health care.
- Secretary Shinseki has called for a full Inspector General report investigating the Phoenix VA and all other locations where these secret waiting lists were reported, as well as “face-to-face” audits of all VA facilities. Meanwhile, he immediately ordered the director and associate director of the Phoenix VA to be put on administrative leave and promised that those responsible will be held accountable.
- VA Inspector General Richard Griffin has so far reviewed the cases of 17 of the approximately 40 veterans who died while waiting for appointments at the Phoenix VA. He has concluded that their deaths were not related to their waiting time.
- The VA had already been taking actions to improve wait times and accuracy, including evaluations of provider capacity, better clinic management, improved scheduler training, and compliance visits to all VA facilities to audit scheduling practices.
However, more can and should be done, including greater transparency about the VA’s efforts to solve these problems and a review of VA medical provider staffing to see whether sufficient providers exist to meet the 14-day standard.
Ultimately, Secretary Shinseki is a diligent soldier and public servant who has tackled the tough job of reforming the VA’s outdated bureaucracy. As Secretary of Veterans Affairs, Shinseki has steadily improved the health care, education, and disability systems on which our veterans rely.
Obviously, there is more work to be done. This Memorial Day, in addition to remembering the men and women who died in service to our country, we must also meet our solemn obligation to provide all of our veterans with the best possible care and support.
Lawrence J. Korb is a Senior Fellow at the Center for American Progress. Katherine Blakeley is a Research Assistant with the National Security and International Policy team at the Center.
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