Beyond McDonald's Idiotic Comment, Our System Is Still Failing Our Veterans
Quite a few people are calling for the resignation of Secretary of Veterans Affairs Bob McDonald over this remark: During a Christian Science Monitor press event on Monday, McDonald responded ongoing attacks about how VA leaders measure patient wait times, saying the focus on specific numbers overshadows what should be the larger goal. "What data do you get from Cleveland Clinic or Kaiser Permanente to compare with our data?" he asked. "To me, personally, the days to an appointment are really not what we should be measuring. What we should be measuring a veterans' satisfaction. "What really counts is how does the veteran feel about their encounter with the VA. When you go to Disney, do they measure the number of hours you wait in line? What's important is what your satisfaction is with the experience. What I would like to move to eventually is that kind of measure." Yes, that's quite stupid, on many levels –among them, Disney does measure the wait times for its rides and focuses on minimizing them to ensure happy customers. But don't fire McDonald over this. Fire him over this report from April: Supervisors instructed employees to falsify patient wait times at Veterans Affairs' medical facilities in at least seven states, according to a USA TODAY analysis of more than 70 investigation reports released in recent weeks. Overall, those reports -- released after multiple inquiries and a Freedom of Information Act request -- reveal for the first time specifics of widespread scheduling manipulation. Employees at 40 VA medical facilities in 19 states and Puerto Rico regularly "zeroed out" veteran wait times, the analysis shows. In some cases, investigators found manipulation had been going on for as long as a decade. In others, it had been just a few years. In many cases, facility leaders told investigators they clamped down the scheduling improprieties after the Phoenix scandal, but in others, investigators found they had continued unabated. The manipulation masked growing demand as new waves of veterans returned from wars in Iraq and Afghanistan and as Vietnam veterans aged and needed more health care. When McDonald took the job, he declared, "I won't tolerate those who stifle initiative, who seek to punish people who raise legitimate concerns, or those who lack integrity in word or deed. Trust is essential in everything we do." Or fire him over this obvious face-saving way of adjusting the wait-time measurement: Released Monday, the Government Accountability Office's review of appointment wait times for patients new to VA health care found that veterans wait three to eight weeks for medical appointments. Others could not see a primary care doctor at all because VA staff did not handle the appointments correctly, the report GAO report says. On Monday, VA Secretary Bob McDonald said 97 percent of VA appointments are completed within 30 days, with the average wait time from three to six days. The GAO and VA measure wait times differently, which is why there's a discrepancy: VA starts counting from the day a scheduler returns a veteran's call or request for an appointment, according to GAO health care issues director Debra Draper. Draper said VA should count from the day a veteran calls to request an appointment. The difference is crucial, Draper said, to understanding whether appointment wait times are in fact decreasing. Subtract the VA wait-time estimate from the GAO wait-time estimate, and you conclude that some veterans are still waiting weeks just to get a response to their appointment request. I think most Americans would agree that's a system that fails to serve its patients. Or fire McDonald for failed implementation of the post-Shinseki reforms: Congress and the VA came up with a fix: Veterans Choice, a $10 billion program that was supposed to give veterans a card that would let them see a non-VA doctor if they were more than 40 miles away from a VA facility or they were going to have to wait longer than 30 days for a VA provider to see them. There was a problem, though. Congress gave the VA only 90 days to set up the system. Facing that extremely tight time frame, the VA turned to two private companies to administer the program and help veterans get an appointment with a doctor and then work with the VA to pay that doctor. Although the idea sounds simple enough, the fix hasn't worked out as planned. Wait times have gotten worse -- not better. Compared with this time last year, there are 70,000 more appointments that took vets at least a month to be seen. The VA says there has been a massive increase in demand for care, but it's apparent the problem has more to do with the way Veterans Choice was set up. The program is confusing and complicated. Vets don't understand it, doctors don't understand it, and even VA administrators admit they can't always figure it out. On that last program, you can throw a little blame Congress' way for the rushed time frame, although for obvious reasons they wanted the VA to fix this problem immediately. (Why is this so hard? The VA has a budget of $163 billion. Why can't we just give veterans the equivalent of a credit card that can be used at any accredited medical facility?) Wait, there's more! Construction costs for a new VA hospital in Aurora, Colorado went $1.1 billion over the cost estimate. Wait, there's still more! In his speech, [House Veterans Affairs Committee Chairman Jeff] Miller railed against a lack of accountability at the VA and an agency culture that has allowed officials to spend millions of dollars on artwork and conferences with little repercussion for the gross mismanagement of the Aurora facility. "The (House veterans) committee recently found that the Palo Alto (Calif.) VA health care system has spent at least $6.3 million on art -- on art and consulting services," he said. "These projects include an art installation on the side of a parking garage that displays quotes by Abraham Lincoln and Eleanor Roosevelt in -- wait for it -- in Morse code that cost $285,000. It actually lights up." A stupid comment is a stupid comment; but McDonald was sent to fix problems and has failed to do so. Expect groups like Concerned Veterans for America to raise hell over this. Least Surprising Headline Ever: Terry McAuliffe Under Investigation Everybody saw this coming: The FBI is investigating Gov. Terry McAuliffe over donations to his 2013 gubernatorial campaign. According to CNN, the governor is the subject of an ongoing investigation by the FBI and prosecutors from the public integrity unit of the Justice Department. Remember, this is the guy who wanted to offer access to exclusive dinners and meetings with him in exchange for donations to his political action committee -- three months after he took office, and even though he's limited to one term. A Virginia state official took one look at his proposal for an electric car company and concluded, "I can't get my head around this being anything other than a visa-for-sale scheme with potential national security implications that we have no way to confirm or discount." CNN reported that the probe has focused, in part, on McAuliffe's campaign donations, including $120,000 from Wang Wenliang, a Chinese businessman, through his U.S. businesses. West Legend Corp., a New Jersey-based building materials supplier, is an affiliate of Wang's Chinese business, Rilin Enterprises. West Legend donated a total of $120,000 to McAuliffe in 2013, in campaign contributions of $10,000 on March 27 and $60,000 on Sept. 9, plus a $50,000 contribution to his inaugural fund on Nov. 21, according to the Virginia Public Access Project, a nonpartisan tracker of money in state politics. CNN reported that investigators also have looked at McAuliffe's tenure as a board member of the Clinton Global Initiative, an initiative of the Clinton Foundation. The Clinton Foundation, a charitable organization, has come under scrutiny from news organizations, and criticism from the Clintons' opponents, for its acceptance of millions in donations from foreign governments. CBS has reported that in 2013 Wang's Rilin Enterprises pledged $2 million to the Clinton Foundation and that Wang is a delegate to the Chinese parliament. Wait, I think that lead got buried so deep we need archeologists. Chinese government officials are writing $2 million checks to the Clinton Foundation? Does this not set off sirens to anyone? If Lazy Government Workers Get Your Goat, Then You Need to Hear This . . . Over at Hot Air, Jazz Shaw finds genuine good news: "In Pittsburgh, Pennsylvania, the local government is handling at least one challenge by adding more workers to the payroll, but for once it may be a program which conservatives can get behind. They're taking care of an invasive species problem as well as some routine maintenance needs with goats." It's a national trend! More governments are turning to goat grazing as they look for an environmentally friendly -- and more cost-effective -- way to nip noxious weeds in the bud. Nationwide, eradicating weeds costs taxpayers and private landowners $34 billion a year, a 2000 study found. Infestations of invasive plants reduce the amount of productive farmland, bring down property values, inhibit public utility operations, and harm the health of ecosystems, according to the U.S. Fish and Wildlife Service. In the last 20 years, city, county and state governments have leased goats in more than a dozen states. Through the trials, effective eradication programs have emerged along rivers in Iowa and a highway in Maryland. But although goats may be a greener option and may attract popular public interest, they don't always prove their worth. Some local programs, such as one in Salem, Oregon, have ended up costing more than mowing, controlled burns and herbicides. Shaw writes, "Goats are immune to corruption, they never sue you for infringing on their rights, and they rarely take a sick day." He's right, they're not ba-a-a-a-ad. ADDENDA: It's official. For three days in Louisville, Kentucky, 80,450 gun owners, hunters, and Second Amendment advocates -- less than 3,000 away from the all-time record in 2013 -- gathered in a location with open carry and no one got shot.  | 
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