President Barack Obama and Veterans Affairs Secretary Robert McDonald on Tuesday acknowledged the agency's past failures and vowed to better serve veterans with new programs and more access to care.
Speaking before The American Legion convention in Charlotte, North Carolina, Obama also pledged that the wait-list scandal that prompted recent legislation enabling more veterans to seek care outside the agency wouldn't be the start of dismantling the government-run system.
"I'll continue to resist any effort to exploit the recent problems at the VA to turn veterans' health care into a voucher system," he said.
The expanded use of private and community medical centers is intended to be a temporary measure, until the VA can fix its appointment scheduling system and ensure it has hired more people and created more facilities to serve the veteran community.
Some lawmakers have suggested that veterans be given a special ID or voucher and allowed to go to any hospital for treatment. That move is widely opposed by the Legion and other veterans groups, as well as the administration.
"We don't need vouchers," Obama said. "You need VA health care that you have earned and that you can depend on. We need to make the system work."
The VA for years has struggled to tame its disability claims backlog and faced allegations of wasteful spending and preventable deaths at several hospitals. The agency took its biggest public-relations hit in May when whistleblowers claimed 40 veterans on a secret wait list at the VA Medical Center in Phoenix, Arizona, died before getting an appointment.
The agency's inspector general, in a report also released on Tuesday, says it found no evidence that veterans on the list – or similar ones at other hospitals – died due to delays in care.
"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," a summary of the 143-page document states. Even so, "Inappropriate scheduling practices are a nationwide systemic problem," it states.
The revelations triggered congressional hearings, investigations and ultimately the resignation of former VA Secretary Eric Shinseki. They also led to legislation, signed by Obama earlier this month, enabling more vets to go to private and community health care providers if they live more than 40 miles from a VA facility or cannot otherwise get a timely VA appointment.
The same $16.3 billion bill included funds to hire new medical staff and expand VA health care through new leases at hospitals across the country – both measures intended to improve the agency's ability to provide health care within its own system.
Obama also used the Legion appearance to announce 19 new executive actions to benefit the military and veterans' communities in getting mental health care, as well as programs to make the transition from active-duty and VA health care for smoother, and improve job opportunities for veterans.
But neither speaker shied away from acknowledging the problems the VA has wrestled with, and been hammered on, for months.
At a number of agency medical centers, leadership fell down on the job, failing to address veterans' needs and even glossing over or covering up those failures, they said.
"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 [to hide the facts] -- is outrageous and inexcusable," Obama said.
"Cooking the books" is a reference to schedulers manipulating appointment wait times to hide the fact that the hospital was not meeting the standard of care on appointments. In some cases executives drew annual bonuses based, in part, on meeting that standard, opening these up to prosecution if confirmed.
A number of investigations are underway, including some being done jointly between the VA and the Federal Bureau of Investigation. If any deaths are directly linked to delayed care because of appointment manipulation, there could be criminal charges.
"We are going to get to the bottom of these problems. We're going to fix what is wrong," Obama said. "We're going to do right by you, and we are going to do right by your families. And that is a solemn pledge and commitment that I'm making to you here."
McDonald told the Legion that "the truth of the matter is that we've failed in a number of ways." "Right now, it's up to the department to reaffirm its worth and regain veterans' trust," he said. "Over the past months, we've been forced to take a hard look at ourselves through their eyes, and through their experiences — good, bad, and indifferent."
To be "truly veteran-focused" means continually measuring performance, 24-hours a day, seven days a week, he said. "And that's what we intend to do."
Since the wait-times scandal broke, according to McDonald, the VA has gotten more than 266,000 veterans off of wait lists and into care. The number of veterans waiting for appointments has gone down by 57 percent since May 15, when CNN first reported the wait-times story out of Phoenix.
In that time the VA has made nearly 912,000 referrals for care in the private sector, he said.
Meanwhile, VA facilities are adding more clinic hours, recruiting to fill physician vacancies, deploying mobile medical units, and using temporary staffing to provide more in-house care to veterans more quickly, he said.
-- Bryant Jordan can be reached at firstname.lastname@example.org