Not that it's a shocker at this late date, but the inspector general at the Department of Veterans Affairs says there are, in fact, wait-list shenanigans at the Veterans Health Administration facility in Phoenix, Arizona. Why would officials do such a thing? To boost their job reviews so they get put at the front of the line for raises. No surprise, this is not an isolated problem at one facility.
Here's a money quote from the interim report, released today:
Our reviews at a growing number of VA medical facilities have thus far provided insight into the current extent of these inappropriate scheduling issues throughout the VA health care system and have confirmed that inappropriate scheduling practices are systemic throughout VHA. One challenge in these reviews is to determine whether these practices exist currently or were used in the past and subsequently corrected by VA managers.
To date, our work has substantiated serious conditions at the Phoenix HCS. We identified about 1,400 veterans who did not have a primary care a ppointment but were appropriately included on the Phoenix HCS' EWLs [electronic wait lists]. However, we identified an additional 1,700 veterans who were waiting for a primary care appointment but were not on the EWL. Until that happens, the reported wait time for these veterans has not started. Most importantly, these veterans were and continue to be at risk of being forgotten or lost in Phoenix HCS's convoluted scheduling process. As a result, these veterans may never obtain a requested or required clinical appointment. A direct consequence of not appropriately placing veterans on EWLs is that the Phoenix HCS leadership significantly understated the time new patients waited for their primary care appointment in their FY 2013 performance appraisal accomplishments, which is one of the factors considered for awards and salary increases.
If I'm reading that correctly, more patients were improperly excised from the wait list than were included, which represents something a tad larger than an institutional hiccup.
President Obama, according to White House press secretary Jay Carney, finds the report "extremely troubling."
As I've written before, the VA's woes aren't peculiar to itself—government-run, single-payer health systems tend to run into long, often lethal, and frequently concealed delays. And that's before you even get to the poor quality of care offered to the lucky patients who make it to the front of the line.