Obama pledges to fix health system as report cites lapses in veterans’ care

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CHARLOTTE, N.C. — Pres­i­dent Barack Obama on Tues­day prom­ised sev­eral thou­sand mil­i­tary vet­er­ans that he would ful­fill his “sa­cred trust” to those re­turn­ing from Amer­ica’s wars by over­haul­ing a dys­func­tional health care sys­tem, even as a new re­port doc­u­mented “un­ac­cept­able and trou­bling lapses” in med­i­cal treat­ment.

Ad­dress­ing the Amer­i­can Le­gion’s na­tional con­ven­tion three months af­ter a scan­dal rocked the Depart­ment of Veter­ans Af­fairs and forced the res­ig­na­tion of the agency’s leader, Mr. Obama said he had “made real prog­ress” in im­prov­ing ser­vices and get­ting pa­tients off wait­ing lists. But he added that he was “very clear-eyed about the prob­lems that still are there,” and about the need to “re­gain the trust” of vet­er­ans.

“What we’ve come to learn is that the mis­con­duct we’ve seen at too many fa­cil­i­ties — with long wait times and vet­er­ans de­nied care and folks cook­ing the books — is out­ra­geous and in­ex­cus­able,” Mr. Obama said to po­lite, though not en­thu­si­as­tic, ap­plause. “We are go­ing to get to the bot­tom of these prob­lems. We’re go­ing to fix what is wrong. We are go­ing to do right by you and do right by your fam­i­lies. And that is a solid pledge and com­mit­ment I’m mak­ing to you here.”

Mr. Obama’s speech came less than an hour be­fore the Depart­ment of Veter­ans Af­fairs in­spec­tor gen­eral re­leased a re­port on long de­lays and fal­si­fied wait­ing lists at the vet­er­ans med­i­cal cen­ter in Phoe­nix, where whis­tle-blow­ers this spring al­leged that 40 vet­er­ans had died be­cause of de­lays in care. The re­port found no di­rect con­nec­tion be­tween de­lays and pa­tient deaths. “While the case re­views in this re­port doc­u­ment poor qual­ity of care, we are un­able to con­clu­sively as­sert that the ab­sence of timely qual­ity care caused the deaths of these vet­er­ans,” it said.

But the re­port con­cluded that the Phoe­nix cen­ter was plagued by long waits and cover-ups. One vet­eran waited nine weeks for a bi­opsy to con­firm lung can­cer, ac­cord­ing to the re­port. Another waited 10 months for a doc­tor to check spread­ing splotches for mel­a­noma. Wait­ing times for classes on an­ger man­age­ment and cop­ing ran two months. In­di­vid­ual psy­cho­ther­apy re­quired waits of “sev­eral” months. A sui­cidal vet­eran, fresh out of a psy­chi­at­ric hos­pi­tal, waited 12 weeks for a fol­low-up visit with a men­tal health nurse.

In an at­tempt to ap­pear to meet the agency’s goal of sched­ul­ing ap­point­ments within 14 days, the re­port said, work­ers ma­nip­u­lated more than 3,500 ap­point­ments, ei­ther by can­cel­ing and re­sched­ul­ing them, or by keep­ing pa­per records in desk draw­ers for weeks be­fore en­ter­ing them in com­put­ers.

The Phoe­nix med­i­cal cen­ter di­rec­tor, Sharon Hel­man, and two other of­fi­cials there have been placed on paid leave pend­ing the in­ves­ti­ga­tion. The in­spec­tor gen­eral’s of­fice is also ex­am­in­ing 93 other vet­er­ans med­i­cal fa­cil­i­ties, and “while most are still on­go­ing, these in­ves­ti­ga­tions con­firmed wait time ma­nip­u­la­tions were prev­a­lent,” the re­port said.

After the ini­tial al­le­ga­tions, Eric Shinseki re­signed as sec­re­tary of vet­er­ans af­fairs, and Mr. Obama re­placed him with Robert A. McDon­ald, a for­mer chief ex­ec­u­tive of Procter & Gam­ble. Con­gress passed and the pres­i­dent signed a $16 bil­lion bill to fix the vet­er­ans health care sys­tem by hir­ing more pro­vid­ers to shorten wait­ing times, mak­ing it eas­ier to fire of­fi­cials for poor per­for­mance and al­low­ing vet­er­ans to use other health care pro­vid­ers if they can­not ob­tain prompt at­ten­tion.

Ac­com­pa­nied by Mr. McDon­ald, the pres­i­dent used his visit to the Amer­i­can Le­gion con­ven­tion to an­nounce sev­eral ad­di­tional steps, us­ing his ex­ec­u­tive au­thor­ity, to make it eas­ier for vet­er­ans to re­ceive men­tal health care and to lower their hous­ing costs. Among other things, mem­bers of the mil­i­tary leav­ing ser­vice will be au­to­mat­i­cally en­rolled in the de­part­ment’s tran­si­tion pro­gram, rather than hav­ing to seek it out them­selves or re­quir­ing re­fer­rals.

The de­part­ment will test ex­panded peer sup­port for men­tal health, con­duct stud­ies on early de­tec­tion of post-trau­matic stress and sui­cidal thoughts, and ex­tend sui­cide pre­ven­tion and men­tal health train­ing for health care pro­vid­ers, chap­lains and oth­ers who work with vet­er­ans.

The Obama ad­min­is­tra­tion will also team up with banks to make it eas­ier for ac­tive-duty ser­vice mem­bers to re­duce mort­gage in­ter­est rates.

The vol­a­tile pol­i­tics of the Veter­ans Af­fairs scan­dal was ev­i­dent as the pres­i­dent landed in Char­lotte, where he was met on the tar­mac by Sen. Kay Hagan, a Dem­o­crat locked in a tight race for re-elec­tion this fall in a state that Mr. Obama won in 2008 but lost four years later. Days ear­lier, Ms. Hagan said the Obama ad­min­is­tra­tion had “not yet done enough to earn the last­ing trust of our vet­er­ans.” On the tar­mac, she moved to shake Mr. Obama’s hand; he kissed her on the cheek.

Crit­ics said not enough has been done to es­tab­lish ac­count­abil­ity for the fail­ures, and some said the new re­port pa­pered over the im­pact of the mis­con­duct by dis­count­ing its re­la­tion­ship to pa­tient deaths. Dr. Sam Foote, a re­tired VA phy­si­cian who was among the first to raise alarms, noted that one pa­tient cited by the re­port died of heart fail­ure af­ter wait­ing four months for a pace­maker. “How can you say that’s not linked to de­lays?” he said

United States - North America - United States government - Barack Obama - North Carolina - Charlotte - Eric Shinseki - Peter Baker - Kay Hagan - Jeffery Miller - U.S. Department of Veterans Affairs - Bob McDonald


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