opinion

VA continues to resist reform at all costs

The French army at Verdun in 1916 wasn’t this deeply entrenched.

In two separate developments last month, the Veterans Administration demonstrated yet again that its concrete-encased bureaucracy is willing and able to resist reform at all costs.

Early in July, Department of Veterans Affairs inspectors produced a 35-page analysis of the private-care alternative Congress created in 2014 to help alleviate the enormous backlog of veterans seeking health care through the VA.

Inspectors found the program, designed as a release valve for the crush of VA patients, was itself awash in delays and incompetence. Research of patients seeking care through nine VA facilities, including those in Phoenix, Tucson and Prescott, found tens of thousands of authorized doctor visits were never scheduled or carried out.

As reported by The Republic’s Dennis Wagner, one private contractor took an average of 146 days to return 50 unfilled-appointment authorizations for oncology patients. In another case cited in the report, 94 of 150 rheumatology appointments booked by one private provider involved waits greater than 30 days.

Has nothing changed with the VA? Government-supplied care? Private care? It all appears the same. No one, it seems, can provide prompt, quality health care to American veterans.

At first blush, anyway.

There are a number of explanations for this latest failure of care, and few reflect negatively on the private health-care system that represents the only real hope for sick veterans.

The VA bureaucracy has resisted reform from the beginning. The Patient-Centered Community Care program, known as PC3, suffered at its onset from the usual government-program plague of delays and cost overruns, but it suffered infinitely more from the bureaucracy’s determination to kill it.

Patient participation in the original 2014 reform, the $10 billion “Choice Card” program giving vets in rural areas a private-care option, was grossly limited by VA rules restricting eligibility.

VA SCANDAL: ONE YEAR LATER

The agency hated the program, and last week won a stare-down with Congress over its funding. On Thursday, Congress approved moving $3.3 billion from the Choice Card program into other VA programs.

As for PC3, its administration has been a mess. Private contractors hired by the VA appear to have become just as incompetent as the bureaucracy itself. The report noted the prevalence of “blind scheduling” — setting up doctor’s appointments without bothering to consult with the patients. An enormous swath of those appointments went unfilled. What a surprise.

Private insurers involved in PC3, such as TriWest Healthcare Alliance Corp., enjoy excellent reputations for service in their contracts with other military agencies. Yet, somehow, they become instantly incompetent when linked up with the VA?

Perhaps some of the foibles noted in the report originated with the VA? You think, maybe? From the report: “VHA staff need to improve their timeliness in submitting authorizations to the PC3 contractors.”

Meanwhile, VA whistleblowers had their first chance to hear from the new VA chief watchdog at a Senate hearing last week. They were not much impressed.

The new VA Inspector General, Linda Halliday, told senators that whistleblowers often “are not in a position to know all the facts, or they overemphasize the(ir) viewpoint.”

That does not bode well for rooting out corruption and incompetence.

“I was incredibly disappointed to the point of being horrified," said Dr. Katherine Mitchell, one of the key whistleblowers at the Phoenix VA hospital.

The more the VA changes and “reforms,” the more its deep-seated desire to remain exactly the same becomes clear.

It is going to be a long, hard struggle to refashion this agency into something more responsive to the veterans it serves.