Sunday, May 18, 2014

Congress and Veterans


Dona: On Thursday, the Senate Veterans Affairs Committee held a hearing on the allegations that several VA centers have been keeping two lists of appointments -- one demonstrating the VA is providing medical appointments within 14 days of their being requested by the veteran and another list that shows how many weeks and months the veteran may actually be waiting.  C.I. reported on the hearing in Thursday's snapshot and Friday's, Ruth covered it in "Senator Richard Blumenthal says call in the F.B.I.," Kat covered it in "Shinseki needs to be fired," Ava covered it in "Shineski (Ava)" and Wally covered it in "More talk, no action (Wally)."  Kat, give us a few basics of the Committee itself.

Kat: Sure.  Senator Bernie Sanders is the Chair and Senator Richard Burr is the Ranking Member.  They heard from three panels.  Two were made up of Veterans Service Organizations -- VSOs -- and Inspector General staff.  The first was VA Secretary Eric Shinseki. 

Dona: As the Secretary, Shinseki has come under fire before and we've called for him to step down some time ago. I would argue that it's hard for anyone to cover Shinseki and not argue that he needs to step down because has has presided over so many fiascos.  But today, Katrina vanden Heuvel appeared on CBS' Face The Nation.  The daughter of a spy is most infamous for buying her way into The Nation magazine where her drooling is passed off as insight.  From the program:

KATRINA VANDEN HEUVEL:  I'm glad, Jackie, that you brought that up. Because I do think the V.A. has been the most effective, efficient health care system in this country over these last decades. And it was nickel and dimed under the Bush administration. They felt they needed to spend more on defense than on veterans' benefits.
If you're going to send brave men and women into war, you have to take care of them, and the multiple deployments. So, I think the president faces the important task of speaking to what is going to happen now, just showing what has been improved. The question is, what do you do with Congress? The Republican Congress has slashed benefits. Do you bring in someone like a Colin Powell? I personally think Shinseki should be left there to fight. But the president has said he may say goodbye. But if Colin Powell speaks more effectively and will have more (UNINTEL) and clout with this Republican Congress.

BOB SCHIEFFER: Well, I don't know what they need to do. But all I know is they need to do something. And what you say, I take your point. But that was then and this is now. This is a problem that no matter how it got to be where it is, has to be fixed.
And old Bob Gates, say what you want to about him. When you had a similar thing like this that came up in Walter Reed Hospital, he went out there and fired a bunch of people. And they got it straightened out. It's not perfect, but it's a whole lot better than it was.

KATRINA VANDEN HUEVEL: But firing Shinseki? I mean, the crisis of veterans' care has been with us for many years. And I think history is important to bring to bear in this and find a way to reform, but understanding that we have nickel and dimed the V.A. in these last years.

Dona (Con't): Ruth, you want to jump in?

Ruth: Ms. vanden Heuvel is not one to pass up an opportunity to show ignorance so why should this be any different?  The VA has been "nickeled and dimed . . . in these last years"?  Would she mean the last six years where the president has been Barack Obama?  She does not care about veterans.  She needs to shut her mouth, she really does.  She has become a joke in the same manner that Ann Coulter is.  I believe the term is "partisan whore."

Ava:  If Barack has inherited the problem -- and there's no indication in Katty van van's response that she's aware of any problem -- he would have owned it himself by the end of 2009.  She's much more interested in playing partisan nonsense than in helping veterans.

Dona: We should point out that vanden Heuvel is not a veteran and that The Nation magazine largely ignores veterans and veteran issues.

Wally:  We should also point out that she's a failure in every way possible.  Not only does she have a face that belongs on radio, she's a dumb idiot.  If Shineski is fired or retired, Katty van van has just argued Colin Powell needs to be the replacement?  WTF?  How stupid is this woman?  Colin Powell lied to the UN and now we've got Katty van van bringing him up as a replacement?

Dona: She really is useless and while I realize she bought her seat at the table -- she didn't earn it -- I'm reminded of the same sense of repulsion I had for years watching Paul Begela allegedly represent me on TV -- we can't have any attractive people on the left?  She seems to get booked solely to imply that those of us on the left are unattractive.  C.I.?

C.I.: The ugliest thing about her is her pretense that she cares about veterans issues.  She's much more likely to muse at her magazine's website over how much she spent on her daughter's birthday party than on veterans' issues.  She really should learn when to stay silent.  What the idiot doesn't know or won't share is the VA's suffered no real cuts.  Katty wants to blame Bully Boy Bush and "the Republican Congress." In January 2007, the Congress sworn in was one with Democratic majorities in both houses.  This would remain true until January 2011 when the House returned to Republican control but the Senate remained controlled by the Democrats.  Even more importantly, Katrina's never bothered to attend a Congressional hearing on veterans.  If she had, she's know Congressional funding has increased each year for veterans and that the VA, unlike other departments, is actively encouraged to request all the resources they believe they need and none of these requests have been turned down.  

Dona: And I was thinking about that last thing as well because it is something you have noted before in your reports.  On the same program, White House chief of staff Denis McDonough declared that Barack was "madder than hell" about the issue."  Any thoughts there?

Kat: Well Ruth pointed out in "Step down Shinseki" that McDonough didnt grasp the difference between service member and veteran.  I'm not really sure why we'd valued McDonough's remarks.  But if someone's "madder than hell" you'd assume they'd be trying to fix the problem and I haven't seen anything to indicate Barack's worried about this issue other than his trotting out White House spin which isn't going to do a thing to help veterans.

Dona: Did the hearing help veterans?

Kat: No.  I would say that we heard nothing from Shinseki or the VA that spoke to awareness or responsibility.  

Dona: Okay.  Ruth?

Ruth: I think the fact that the hearing is taking place in May goes to a lack of serious oversight by the Senate.  This issue emerged in April and the House Committee has addressed the topic in hearings.  But we have had little from the Senate until now.  I hope that the investigation being conducted by the VA's Inspector General finds no one died in Phoenix, Arizona as a result of these lists because if any deaths took place in Phoenix the Senate Veterans Affairs Committee looks pretty stupid and pretty inactive.  40 deaths are reported in April but the Senate cannot be bothered to hold hearings that month?  This scandal could be taking place around the country but the Senate cannot be bothered to hold hearings until now?

Dona: Ava?
Ava: Ruth's making an important point.  Where is the oversight?  When 40 veterans are said to have died from the actions of one VA medical center, why doesn't the Committee whip into action?  Don't give me 'ongoing investigation' because this is now a safety issue and the Committee has the obligation to do immediate hearings and oversight to ensure that no veteran's life is at risk.

Dona: I'm going to note this lengthy exchange from the hearing:

Ranking Member Richard Burr:  Mr. Secretary, were you aware that on October 25, 2013, the Office of Special Counsel requested that the VA conduct an investigation into the allegations of inappropriate scheduling at the Fort Collins Community Outpatient clinic?  And that since then, the media has reported about Mr. Freeman's e-mail of June 19, 2013 that explains how to game the system to avoid being on the bad boy list.  Were you aware of those?

Secretary Eric Shinseki:  Uh, Senator, I became aware of that-that, uh, that screen shot -- I believe that's what it was -- screen shot of an employee who was suggesting that there are ways to game.  I put that employee on administrative leave, uh, 

Ranking Member Richard Burr:  When was that?

Secretary Eric Shinseki:  That was last Friday.

Ranking Member Richard Burr:  Mr. Secretary, it's my understanding that on June 21, 2013, VA received a report from the Office of Medical Inspector  regarding chronic understaffing issues at the Jacksonville VA Medical Center and that report described multiple patient scheduling problems including scheduling two patients for the same appointment slot and scheduling patients for a clinic that does not have any assigned  providers -- often referred to as ghost clinics.  And that on September 17, 2013, the Office of Special Counsel submitted a letter to the President of the United States on which the VA was courtesy copied the findings of that June 21st Office of Medical Inspector on the Fort Jackson Medical Center including the practice of double-booking patients and the use of ghost clinics.  Do you remember reading that report and receiving that copied letter to the president?

Secretary Eric Shinseki:  Uh, I can't say that I remember it today here.

Ranking Member Richard Burr:  Okay.  There was a December 23, 2013 report by the Office of -- by the Office of Medical Inspector  regarding the Cheyenne Medical Center in Fort Collins Clinic that found that several medical support assistants reported that, and I quote, "Medical Center's business office training included teaching them to make the desired date the actual appointment and, if the Clinic needed to cancel appointments, they were instructed to change the desired date to within 14 days of the new appointment."  Did you read that report? 

Secretary Eric Shinseki:  That, uh, report has come to my-my attention here recently.

Ranking Member Richard Burr:  Okay, on February 25, 2014, your Chief of Staff, Mr. [Jose D.] Riojas, submitted a response to the Office of Special Counsel which included the December 23 , 2013 Office of the Medical Inspector report on Fort Collins.  And in that letter, Mr. Riojas states, and I quote, "However as OMI" Office of Medical Inspector "was not provided any specific veterans cases effected by these practices, it cannot substantiate that the failure to properly train staff resulted in danger to public health or safety."  Were you aware of what your Chief of Staff wrote?

Secretary Eric Shinseki: I was.

Ranking Member Richard Burr:  Okay.  Mr. Secretary, were you aware that the GAO report entitled "VA Health Care: Reliability of Reported Out Patient Medical Appointment Wait Times Scheduling Oversight Need Improvement" which was publicly released in January 2013 and then on December 11, 2012, to that same report, your former Chief of Staff, John Gingrich, sent a letter to the GAO which stated, and I quote, "VA generally agrees with the GAO's conclusions and concurs with GAO's recommendations to the Dept"?  Do you remember that letter?   That report and your Chief of Staff's response?

Secretary Eric Shinseki:  In-in general, I do remember that report.

Ranking Member Richard Burr:  Mr. Secretary, you knew that there were specific issues relating to scheduling and wait times as early as June 21, 2013 at Jackson, December 23, 2013 at Fort Collins, as well as numerous IG reports related to excessive wait times in January '012 in Temple, Texas, September '012 in Spokane, Washington, October 2012 in Cleveland, Ohio, September 2013 in Columbia, South Carolina.  December '012, a GAO report questions the validity and the reliability of the reported wait time performance measures.  Which brings us to today in Phoenix.  On May 1, you publicly stated that you had removed Ms. Hellman as the medical director.  And you  stated then that that was to ensure the integrity of the IG's current ongoing investigation.  On May 5th, Dr. Petzel conducted a conference call with all medical directors, all VISN directors and the chiefs of staff -- a rather large group -- to discuss the ongoing face-to-face audits of all VA centers and large community outpatient clinics.  I have been told by sources that were on that call that during that call, Dr. Petzel made the statement that the removal of Ms. Hellman was, I quote, "political and that she's done nothing wrong."  If you're asking us to wait until the investigation is over, doesn't the same apply to people who work for you?  And, Mr. Secretary, from all I've described to you and the current investigation, why should this Committee or any veteran believe that change is going to happen as a result of what we're going though? 

Secretary Eric Shinseki:  I-I was not aware of, uh, the phone call you referred to and I will look into it.  Uhm, I would just tell you that, uh, my removal of the director, uh, placing her on administrative leave was at the request of the IG.  He is the lead in this, uh-uh, comprehensive review.  Uhm, I don't get out ahead of him.  Uh, he requested it.  And I, uh, put Director Hellman and two other individuals on administrative leave.

Dona:  Wally, is Shinseki showing any sort of leadership?

Wally: I don't see how.  He is, from his testimony, unaware of very basic issues involved and this ignorance takes place when he shows up at a scheduled hearing.  He should have been prepared and on top of his game.  Instead he seems distant and not all that interested in the events.

Dona:  C.I., you wrote in your two snapshots about your initial impressions and then your feelings after speaking to veterans.  In the second snapshot, you say that the veterans were unimpressed with the hearing and you agree with them.  Can you speak to that?

C.I.: Yes, their impression was that Chair Bernie Sanders was not present as an advocate for veterans but as a defender of the VA.  I went into this at length in the second snapshot but Sanders made remarks, initially, that seemed strong but that were found lacking as the hearing went on.  He followed that up with an appearance on CNN which only fed into the impression further --

Dona: Because even the CNN host, Chris Cuomo, told Sanders on air that he was carrying the water for the VA.

C.I.: So that didn't help either.  There's a feeling that the April 30th hearing, on the topic of alternative medicine, should have been shelved and the focus put on this current issue.  Words like "pet causes" are being used to describe that hearing --

Dona: Because Sanders has made this issue -- alternative medicines -- a key issue as Chair of the Senate Veterans Affairs Committee.

C.I.: Right.  So there's this whole group of elements coming together to form a storm.  We're talking about this in terms of Shinseki and that's where the focus should be.  However, I think the way this unfolds will also determine how Bernie Sanders tenure as Chair is seen.   I think they need to get ahead of this, Sanders and his office, because they've lost a lot of support already, in the days since the hearing, as a result of this issue and what is seen as a lack of strong response to it.

Dona: Are you calling for his resignation?

C.I.: Senator Bernie Sanders?  No.  I'm stating veterans attending the hearing saw things which caused them dismay and Sanders can address that or leave it alone.  If he leaves it alone, his tenure as chair will be judged poorly.

Dona:  Okay, we're going to end there.  This is a rush transcript.  Our e-mail address is 

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