Friendly Fire: Death, Delay, and Dismay at the VA by Sen. Tom Coburn, M.D.
From the introduction:
Too many men and women who bravely fought for our freedom are losing their lives, not at the hands of terrorists or enemy combatants, but from friendly fire in the form of medical malpractice and neglect by the Department of Veterans Affairs (VA).
Split-second medical decisions in a war zone or in an emergency room can mean the difference between life and death. Yet at the VA, the urgency of the battlefield is lost in the lethargy of the bureaucracy. Veterans wait months just to see a doctor and the Department has systemically covered up delays and deaths they have caused. For decades, the Department has struggled to deliver timely care to veterans.
The reason veterans care has suffered for so long is Congress has failed to hold the VA accountable. Despite years of warnings from government investigators about efforts to cook the books, it took the unnecessary deaths of veterans denied care from Atlanta to Phoenix to prompt Congress to finally take action. On June 11, 2014, the Senate recently approved a bipartisan bill to
allow veterans who cannot receive a timely doctor’s appointment to go to another doctor outside of the VA.1046But the problems at the VA are far deeper than just scheduling. After all, just getting to see a doctor does not guarantee appropriate treatment. Veterans in Boston receive top-notch care, while those treated in Phoenix suffer from subpar treatment. Over the past decade, more than 1,000 veterans may have died as a result of VA malfeasance,1 and the VA has paid out nearly $1
billion to veterans and their families for its medical malpractice.2The waiting list cover-ups and uneven care are reflective of a much larger culture within the VA, where administrators manipulate both data and employees to give an appearance that all is well.
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I am digesting the full report but I’m not sure enabling veterans to see doctors outside the VA is the same thing as holding the VA “accountable.”
From the early reports in this growing tragedy, there appear to be any number of “dark places” where data failed to be collected, where data was altered, or where the VA simply refused to collect data that might have driven better oversight.
I don’t think the VA is unique in any of these practices so mapping what is known, what could have been known and dark places in the VA data flow, could be informative both for the VA and other agencies as well.
I first saw this at Full Text Reports, Beyond the Waiting Lists, New Senate Report Reveals a Culture of Crime, Cover-Up and Coercion within the VA.