The doctor who helped expose the VA health care scandal will tell Congress on Wednesday that patients did indeed die because they were stuck on secret waiting lists, and will accuse the department’s inspector general of trying to cover up the problem.
Dr. Sam Foote, who worked on some of the cases himself, says in testimony prepared for a House Veterans’ Affairs Committee hearing that the inspector general repeatedly downplayed facts and minimized the consequences for patients who ended up on the waiting lists, and who eventually died.
VA officials have acknowledged major problems at health facilities throughout the country, including cooked books and patients who had appointments delayed or canceled to help supervisors earn bonuses by appearing to be meeting their numerical goals.
The inspector general, in a report issue last month, corroborated the reports of poor care and cooked books, but said none of the 40 patients Dr. Foote said died at the Phoenix VA could “conclusively” be linked to delays in getting care.
“At its best, this report is a whitewash. At its worst, it is a feeble attempt at a cover-up,” Dr. Foote says in his prepared testimony.
In one example, a patient came to the VA in late summer 2013 with severe heart problems. A doctor later recommended he get an implantable device to treat an irregular heartbeat within about a month. The patient never received the device and died in early 2014. Dr. Foote said he didn’t understand how anyone could conclude that the patient’s death wasn’t directly linked to the delay in getting a device.
The IG report has come under fire from several lawmakers who say that after the inspector general shared a draft with the VA, the IG inserted language watering down its findings.
The initial draft included the conclusion that “the death of a veteran on a wait list does not demonstrate causality,” Richard Griffin, the acting inspector general, says in his own testimony prepared for Wednesday’s hearing. That sentence was changed in the final report to say the IG was “unable to conclusively assert that the absence of timely care caused the deaths of these veterans.”
“This change was made by the OIG strictly on our own initiative; neither the language nor the concept was suggested by anyone at VA,” Mr. Griffin said.
He also said that the IG denied requests from the VA to change data in the report.
“VA requested we remove five cases. We did not remove the cases,” he said. “In all instances, the OIG, not VA, dictated the findings and recommendations that appear in our final report.”
In his prepared remarks, VA Secretary Bob McDonald apologized to veterans who waited too long for care, and said the department is looking now at the “appropriateness” of notifying those whose family members’ cases were reviewed by the report.
He also detailed many previously launched proposals to fix the health-care system, including hiring 53 more full-time staff at the Phoenix facility, getting veterans off wait lists, and increasing accountability throughout the system.
The reports of poor care in Phoenix kicked off a broader investigation into care throughout the VA health system. Then-VA Secretary Eric K. Shinseki resigned under intense pressure, paving the way for Mr. McDonald to take over, and Congress passed a law allowing veterans who end up waiting too long for appointments to seek care from private doctors, at government expense.
Mr. McDonald is trying to get that program up and running.
Meanwhile, the investigations continue.
Dr. Foote, in his testimony, asked for an independent review outside of the IG, saying its report on Phoenix was as transparent as “a lead-lined four-foot-thick concrete wall.”
Dr. Katherine Mitchell, another whistleblower who serves as the medical director of the Iraq and Afghanistan Post-Deployment Center in Phoenix, said that she thinks that some key details are missing from the report, though she said she doesn’t believe they were omitted on purpose.
“After reading the case studies in the OIG report, as a clinician I was unable to reach the same conclusions as the OIG investigation team,” she said. “Although I agreed with OIG’s observations in many patient cases, I believe the OIG case review overlooked actual and potential causal relationships between health care delays and veteran deaths.”