A visibly frustrated House Veterans Affairs panel pushed, scolded and pleaded with three Department of Veterans Affairs officials on Wednesday to say what they know about the VA Medical Center in Phoenix, Arizona, where up to 40 veterans reportedly died waiting to get a doctor's appointment.
The rare nighttime hearing into VA's failure to comply with a House Veterans Affairs Committee subpoena of documents related to the Phoenix facility also happened to fall on the same day the VA's Inspector General confirmed some of the allegations about Phoenix. The hearing ended shortly before midnight.
The report confirmed 1,700 veterans were left waiting for a primary care appointment without being entered on the authorized electronic waiting list used to track unmet demand.
"The OIG clearly found that inappropriate scheduling practices are systematic throughout VA," said Rep. Jeff Miller, R-Fla., chairman of the House Veterans Affairs Committee. "The ... findings make it all the more urgent for VA to come clean and fully comply with our subpoena. Veterans health is at stake and I will not stand for a department cover-up."
The IG report has also added fuel to demands by a growing number of lawmakers for VA Secretary Eric Shinseki to step down. He says he will not resign and so far President Obama continues to support the VA chief.
On the Hill Wednesday night, the committee took testimony from VA Under Secretary for Health-Clinical Operations Dr. Thomas Lynch, Assistant Secretary for Congressional Affairs Joan Mooney and VA Congressional Relations Officer Michael Huff.
Lawmakers have previously read reports and heard testimony that VA hospital officials have gamed the appointment system in order to pull down thousands in performance bonuses. But Congress and the VA appear to have taken the issue seriously only since last month when CNN reported on the Phoenix hospital and the possible deaths associated with the secret wait list.
During a rare nighttime hearing -- attended by VA officials under threat of being brought in on Friday under subpoena -- lawmakers hit the VA for failing to respond to demands for information.
Miller said the VA has been slow to comply with a committee subpoena for documents related to Phoenix, and what it has provided has been incomplete. This includes three communications that the VA is withholding citing attorney-client privilege, though the department has yet to back that up by producing the privilege log or any other explanation that the committee can review to determine if it is valid.
But with the IG report in hand on Wednesday, lawmakers were eager to vent their frustration as well as ask questions of the VA officials.
When Mooney responded to Miller's argument that the VA has stonewalled committee requests for information by saying VA had responded to more than 100,000 requests since 2009, Miller quickly interrupted her.
"Ma'am! Ma'am! Ma'am! Ma'am! Veterans died! Get us the answers. Please!" Miller said sharply.
It was Lynch who took most of the criticism, however, largely because of what he did not bother to ask during two visits to the VA hospital in Phoenix.
Several lawmakers asked him specifically who kept and then destroyed the unofficial lists of veterans waiting for an appointment. Lynch said he did not know and that it was not something he inquired about. He also did not raise the issue with the hospital's acting director when he met with him, Lynch said.
"I was there to understand the process," Lynch said. "I knew the inspector general was there to assess intent and who did what. I was there to understand the system."
"You can't understand the system if you don't know who did it and what their motivation was," said Rep. Dan Benishek, R-Mich., who is also a doctor.
Another doctor on the panel, Rep. Phil Roe, R-Tenn., said he understands how a workload can become overwhelming, but not trying to hide it and then getting a financial bonus for doing so.
"I don't understand as a veteran and a doctor how you can look at yourself in the mirror [when you] shave in the morning and not throw up," he said.
Lynch did say that the VA's policy that newly enrolled vets see a primary care doctor within 14 days was probably unrealistic. Before VA Secretary Eric Shinseki established the 14-day period, the standard was 30 days.
Lynch also offered that the VA's determination to keep as much primary care in-house as possible may also have been a mistake, rather than provide more "fee for service" so that vets can get care from private practices.
Because of the current controversy, the VA is now expanding its fee for service option.
"I believe we did it because primary care is seen as a core mission," he said. "In retrospect, I think that was not a wise move."
-- Bryant Jordan can be reached at firstname.lastname@example.org.