U.S. President Barack Obama delivers a statement after meeting with Veterans Affairs Secretary Eric Shinseki at the White House in Washington, DC, May 21, 2014. Veterans have had to wait months to see a doctor at some hospitals, and allegations have arisen that administrators at a VA hospital in Phoenix, Arizona, covered up the delays there.
May 21, 2014 11:38 PM EDT

President Obama finally took to the White House podium Wednesday to denounce the VA wait-list delays that allegedly have led to dozens of veterans’ deaths around the country. “When I hear allegations of misconduct — any misconduct, whether it’s allegations of VA staff covering up long wait times or cooking the books — I will not stand for it,” he declared. “Not as Commander-in-Chief, but also not as an American.”

It was interesting that Department of Veterans Affairs Secretary Eric Shinseki was visible by his absence. Sure, the VA chief has an important job to do in his office right across Lafayette Square from the White House. But right now, Shinseki faces no more important task than fixing what ails the VA — and salvaging his own reputation to boot. His absence betrays an increasingly lukewarm attitude from the President and his team to the wounded Vietnam-era soldier who has run the agency for more than five years.

“People have died while waiting for basic services for their service-connected issues,” says ex-sergeant Rob Kumpf, who retired from the Army earlier this year after five years of service, including tours in Iraq and Afghanistan. “This is criminal neglect, and the fact that the government continues to fail our armed forces and our veterans is disheartening at best.”

Plainly, the White House is stalling for time. The problem existed well before Obama took over, and formal reports have detailed them for nearly a decade. The Administration has endorsed investigations into the problems in the hope that they’re not serious enough to imperil Shinseki’s continued service. But you can tell there are a lot of crossed fingers at 1600 Pennsylvania Avenue. The key to Shinseki’s fate is how systemic the “gaming” of scheduled appointments was; the more systemic it turns out to be, the higher the chance Shinseki will be sent packing. The VA inspector general said Tuesday that 26 VA facilities now are under investigation, more than double last week’s number.

“President Obama’s remarks didn’t introduce many actions we didn’t already know about, but it did put Shinseki on the clock,” says Alex Horton, who spent 15 months in Iraq during the 2006-07 surge as an infantryman before going to work for the VA for three years until 2013 as an online communications specialist. “Shinseki must take actions now to reform the VA’s scheduling system so it can resist manipulation.” He also must call in the Justice Department, Horton believes, to investigate possible criminal wrongdoing. “And the most important thing: he must swiftly repair the broken trust between the VA and veterans.”

Yet it’s interesting to get away from cable TV postmortems and Internet screeds to determine more of what — accountability, doctors, money, eager employees, jail time, respect? — is needed to fix the VA. Perspective is an important element in understanding any problem. “Over the past two weeks, the American Legion has received over 500 calls, emails, and online contacts from veterans struggling with the healthcare system nationwide,” Daniel Dellinger, the Legion’s national commander, told the Senate Veterans Affairs Committee on Thursday. Over that same period, the VA saw a total of about 3.2 million patients. That works out to a complaint rate of 0.015%. Including a wider date range drops that share even lower.

Carl Blake of the Paralyzed Veterans of America suggested the Senate panel go undercover. “If the committee wants to get the truth about the quality of VA health care, spend a day walking around in a major VA medical facility,” he said. “We can guarantee that you will likely hear complaints about how long it took to be seen, but rare is the complaint about the actual quality of care … It is no secret that wait times for appointments for specialty care in the private sector tend to be extremely long.” The public, he says, has gotten a distorted view of the quality of VA care at various field hearings where a handful of those with poor experiences have taken center stage.

“If one veteran is not receiving the care he or she needs, it is one too many,” Ryan Gallucci of the Veterans of Foreign Wars told the panel. That’s a worthy goal for any healthcare organization, but one impossible to achieve when that organization is treating 230,000 patients a day.

There have been success stories. “I have to say that until Senator Obama became President and Secretary Shinseki became the secretary, I couldn’t get adequate care,” says Alex Lemons, who was a Marine from 2002-09 and served as a scout sniper among other billets during three combat tours in Iraq. “PTSD claims under President Bush were as successful as expeditions to Everest. I got my claim within one year of Shinseki taking office,” he says. “Sadly, my claim had actually been sitting in the wrong pile, on the wrong floor of the VA in Portland, Oregon. I had to call someone there, track it down, they found it and then took it, literally, up to the next floor and I saw the acceptance letter about two weeks after that.”

Acting VA inspector general Richard Griffin told Senators his probe has found potentially 17 veterans who died while waiting for care in Phoenix, but said there was no evidence that the waiting caused those deaths. The original whistleblower, a recently-retired VA doctor, elaborated Wednesday. “In terms of the allegation that I originally made,” Sam Foote told CNN, “that was up to 40 people may have died while waiting for care at the Phoenix VA. We never made the comment that they all died because of the wait, just that they were dying while waiting for care.”

An unscientific poll released by VoteVets.org Wednesday among its members found that 60% of 3,300 veterans want Shinseki to stay on the job. Only 17% want him to leave; the rest are undecided. “The American Legion has called on Shinseki to resign,” VoteVets co-founder Jon Soltz wrote. “As of yet, I don’t believe they asked their members if they agreed. So, we decided to. Of those on our list who also are members of the American Legion, only 17% backed the Legion’s call for Shinseki to resign. Sixty-four percent said he should not resign, with 19% saying they weren’t yet sure.”

“The problem is the inability to fire terrible VA employees, not the faulty chain of command,” says William Treseder, who spent 10 years as a Marine before leaving as a sergeant in 2011 after tours in Afghanistan and Iraq. Congress is pushing to give Shinseki more authority to cashier ineffective VA workers; Shinseki, whose agency fired 3,000 of its 300,000 workers last year, says he doesn’t need such power. “If Secretary Shinseki can’t overcome these problems in six years at the head,” Treseder adds, “I’m not sure what we expect the President to do in the next week” — which is when Obama expects to receive “preliminary results” from the IG’s nationwide survey of access to VA care.

Like most Washington battles, the fight for the VA’s future boils down to money. Some believe the tripling of the VA budget since 9/11 is sufficient. “They have gotten more money, number one. And number two is there is no shift in priorities,” David McGinnis, a retired Army brigadier general and Obama supporter, said on the PBS NewsHour Wednesday. “The internal attitude is, ‘If you want me to do more, give me more money,’ instead of taking a look at, this is the new world order. We got Vietnam veterans now realizing, ‘Hey, we need the VA.’ We went 30 years without realizing that, or longer. Also, you have this whole new group of veterans coming in. And we haven’t adjusted the priorities inside VA to spend the money appropriately.”

Others believe there is no way to change the VA without boosting its budget. Despite the surplus of congressional outrage directed toward the VA in recent weeks, there’s been a congressional deficit when it comes to giving the VA the money it and its advocates say it needs — even as its budget has grown from $50 billion in 2001 to $150 billion today.

  • Joseph Violante of the Disabled American Veterans told the panel last week that the VA’s own capital investment plan requires between $5.6 billion and $6.9 billion annually over the next 10 years to keep pace with demand, but the Administration has sought no more than $1.5 billion yearly.
  • Congress is also short-changing the VA. Blake, of the Paralyzed Veterans of America, noted that veterans groups for years have told Congress more money is needed to fix the agency. “In recent years, our recommendations have been largely ignored by Congress,” he told the Senate committee. “The House just recently approved an appropriations bill for VA that we believe is nearly $2 billion short for VA health care in 2015.”

Typical Washington, if you believe those two. Apparently there’s enough blame, but not enough money, to go around.

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