WASHINGTON (AP) - Boastful on the occasion of Memorial Day, President Donald Trump and his Veterans Affairs secretary are claiming full credit for health care improvements that were underway before they took office.
Trump said he passed a private-sector health care program, Veterans Choice, after failed attempts by past presidents for the last “45 years.” That’s not true. The Choice program, which allows veterans to see doctors outside the government-run VA system at taxpayer expense, was first passed in 2014 under President Barack Obama.
Trump’s VA secretary, Robert Wilkie, also is distorting the facts. Faulting previous “bad leadership” at VA, Wilkie suggested it was his own efforts that improved waiting times at VA medical centers and brought new offerings of same-day mental health service. The problem: The study cited by Wilkie on wait times covers the period from 2014 to 2017, before Wilkie took the helm as VA secretary. Same-day mental health services at VA were started during the Obama administration.
The half-truths and exaggerations came in a week when selective accounting was a norm in Trump’s rhetoric, extending into his trip to Japan , where he inflated the drop in the U.S. unemployment rate for women.
A look at the claims, about the Russia investigation, the border, drug prices and more:
TRUMP: “We passed VA Choice and VA Accountability to give our veterans the care that they deserve and they have been trying to pass these things for 45 years.” - Montoursville, Pennsylvania, rally on May 20.
THE FACTS: Wrong. Trump is not the first president in 45 years to get Congress to pass Veterans Choice; Obama did it in the wake of a scandal at VA’s medical center in Phoenix, where some veterans died while waiting months for appointments. The program currently allows veterans to see doctors outside the VA system if they must wait more than 30 days for an appointment or drive more than 40 miles (65 kilometers) to a VA facility.
Trump did expand eligibility for the program. Now, starting June 6, veterans are to have that option for a private doctor if their VA wait is only 20 days (28 for specialty care) or their drive is only 30 minutes.
Still, VA’s top health official, Dr. Richard Stone, described the new program’s start to “almost be a non-event” in testimony to Congress. That’s in part because wait times in the private sector are typically longer than at VA. In 2018, 34 percent of all VA appointments were with outside physicians, down from 36 percent in 2017.
Also key to the Choice program’s success is an overhaul of VA’s electronic medical records to allow seamless sharing of them with private physicians, a process expected to take up to 10 years. Wilkie has said full implementation of the expanded Choice program is “years” away.
WILKIE: “The first thing I did was change out the leadership at VA. … (The president) also allowed me to change out leadership in the VA centers. If someone wasn’t walking the post, getting to know the people who work for her or him, or getting to know those veterans, they had to leave. And, as a result, the Journal of the American Medical Association this year said that our waiting times are now as good or better than any in the private sector.” - interview Thursday with Fox News.
THE FACTS: It’s true that a study by the medical association came out in January that found wait times at VA medical centers on average were better than the private sector. But the improvement wasn’t a “result” of anything that Wilkie did: The study involved a period largely covering the Obama administration - and before Wilkie became acting VA secretary in late March 2018.
In fact, in a VA press release in January announcing the study’s results, Wilkie credits the department’s “concerted” effort to improve access to care “since 2014.”
The study covered four specialties, primary care, dermatology, cardiology and orthopedics.
It found that in 2014, the average wait time at VA medical centers was 22.5 days, compared with 18.7 days in the private sector, which was not statistically different. By 2017, the wait time at VA improved to 17.7 days, while increasing to 29.8 days for private doctors. Wait times at VA medical centers were shorter in all specialties except orthopedics.
According to the study, the number of patients seen yearly in VA increased slightly between 2014 and 2017, to about 5.1 million. VA patient satisfaction also rose, according to patient surveys cited in the study.
WILKIE: The VA “had suffered from bad leadership. And that’s a bipartisan comment. And the second thing I had to do was make sure that as we approach our veteran population that we make sure that they are at the center, their needs are at the center of what we do … I think we’ve had it backwards at VA for many years. … One of the things that we’re doing at VA is that we have same-day mental health service. … It is huge.” - interview with Fox News.
THE FACTS: Same-day mental health service started at VA before Trump took office in January 2017, let alone Wilkie.
VA’s effort to provide same-day primary and mental-health care when medically necessary at every VA medical center was publicized in April 2016 under the Obama administration. At the time, David Shulkin was helping lead the effort as VA’s top health official. By late 2016, the department’s blog announced that the goal of same-day mental health services would be achieved by year’s end.
A Dec. 23, 2016, article in the Harvard Business Review cites new same-day services at all VA hospitals as evidence of notable progress at the department. Shulkin, who was then named by Trump to be his VA secretary, told Congress in late January 2017 the services already were fully in place.
Trump selected Wilkie to be his VA secretary after firing Shulkin in March 2018 because of ethics charges and internal rebellion at the department over the role of private care for veterans. Trump’s initial replacement choice, White House doctor Ronny Jackson, withdrew after allegations of workplace misconduct surfaced. While Wilkie has been credited by both parties in Congress for bringing stability to the department, the VA improvements he attributes to himself this past week are misplaced.
TRUMP, on the unemployment rate: “With women, we have the best numbers we’ve had in now 71 years. That’s going to be, very soon, a historic number, meaning the best ever.” - remarks Saturday with Japanese business leaders in Tokyo.
THE FACTS: The unemployment rate for women is not the best in 71 years.
According to the Labor Department, the women’s unemployment rate fell last month to 3.1%. That’s just the lowest since October 1953, or 66 years ago, when it also was 3.1%. The lowest on record was 2.4% in May 1953.
TRUMP: “My Administration is achieving things that have never been done before, including unleashing perhaps the Greatest Economy in our Country’s history.” - tweet Wednesday.
TRUMP: “Most successful economy, perhaps, in our country’s history.” - remarks to reporters Wednesday.
THE FACTS: The economy is solid but it’s not one of the best in our country’s history, no matter how many times he asserts it. Trump is also claiming full credit for an economic expansion that began under Obama in mid-2009.
The economy expanded at an annual rate of 3.2 percent in the first quarter of this year. That growth was the highest in just four years for the first quarter.
In the late 1990s, growth topped 4 percent for four straight years, a level it has not yet reached on an annual basis under Trump. Growth even reached 7.2 percent in 1984.
While the economy has shown strength, it grew 2.9% in 2018 - the same pace it reached in 2015 - and simply hasn’t hit historically high growth rates.
TRUMP claims “the best unemployment numbers in history.” - Pennsylvania rally on May 20.
THE FACTS: The 3.6% unemployment rate in the latest report is not the best in history. It’s the lowest since 1969, when it was 3.5%. The U.S. also had lower rates than now in the early 1950s. And during three years of World War II, the annual rate was under 2%.
TRUMP: “I don’t do cover-ups.” - Rose Garden remarks Wednesday to reporters.
THE FACTS: Federal prosecutors may not agree with that assertion, which he made in response to House Speaker Nancy Pelosi’s accusation that the president was engaged in a cover-up. Trump spoke after breaking off an infrastructure meeting when Pelosi and Sen. Chuck Schumer, D-N.Y., came to the White House for it.
Prosecutors’ court filings in December said Trump directed his former personal lawyer, Michael Cohen, to make payments to buy the silence of porn actress Stormy Daniels and former Playboy model Karen McDougal during the 2016 presidential campaign. Both women alleged they had extramarital affairs with Trump, which the White House denies.
In particular, the Justice Department says the hush money payments were unreported campaign contributions meant to influence the outcome of the election. That assertion makes the payments subject to campaign finance laws, which restrict how much people can donate to a campaign and bar corporations from making direct contributions.
Trump has said the payments were “a simple private transaction,” not a campaign contribution.
Separately, the Mueller report found that Trump dictated his son Trump Jr.’s misleading statement about a June 2016 meeting at Trump Tower to cloak its purpose.
Cohen, who pleaded guilty last year to campaign finance crimes in connection with those payments, had previously implicated Trump. The department’s filings backed up Cohen’s claims.
The Mueller report said Trump learned in summer of 2017 that the news media planned to report on the meeting at Trump Tower between senior campaign officials and Russians offering derogatory information about Hillary Clinton, the Democratic presidential nominee.
Trump directed aides not to disclose the emails setting up the meeting. Before the emails became public, the president also edited a press statement for Donald Trump Jr. by deleting a line that acknowledged that the meeting was “with an individual who (Trump Jr.) was told might have information helpful to the campaign” and instead said only that the meeting was about adoptions.
That episode was among 10 identified by the Mueller investigation of possible obstruction of justice by Trump. Special counsel Robert Mueller said in his report that he could not conclusively determine that Trump had committed a crime or that he hadn’t.
TRUMP: “The greatest Hoax in American History.” - tweet Wednesday.
THE FACTS: A two-year investigation that produced guilty pleas, convictions and criminal charges against Russian intelligence officers and others with ties to the Kremlin, as well as Trump associates, is not a hoax.
Mueller charged 34 people, including the president’s former campaign chairman, Paul Manafort, his first national security adviser, Michael Flynn, and three Russian companies. Twenty-five Russians were indicted on charges related to election interference, accused either of hacking Democratic email accounts during the campaign or of orchestrating a social media campaign that spread disinformation on the internet.
Five Trump aides pleaded guilty and agreed to cooperate with Mueller, and a sixth, longtime confidant Roger Stone, is awaiting trial on charges he lied to Congress and engaged in witness tampering.
Mueller’s report concluded that Russian interference in the 2016 presidential election was “sweeping and systematic.” Ultimately, Mueller did not find a criminal conspiracy between Russia and the Trump campaign. But the special counsel didn’t render judgment on whether Trump obstructed justice, saying his investigators found evidence on both sides.
TRUMP ON BIDEN
TRUMP, on Democratic presidential contender Joe Biden: “He’s not from Pennsylvania. I guess he was born here but he left you, folks. … He left you for another state and he didn’t take care of you because he didn’t take care of your jobs. He let other countries come in and rip off America.” - Pennsylvania rally on May 20.
THE FACTS: It’s true that Pennsylvania-born Biden left the state without taking care of jobs for the people he left behind. He was a boy, 10 or 11, when his family moved to Delaware in 1953.
TRUMP on his trade dispute with China: “I’ll be honest, we are getting hundreds of millions of dollars brought into our country. We’ve never gotten 10 cents. We are getting hundreds of billions of dollars coming into our country.” - remarks to reporters Thursday.
THE FACTS: This is not true. The tariffs he’s raised on imports from China are primarily if not entirely a tax on U.S. consumers and businesses, not a source of significant revenue coming into the country.
A study in March by economists from the Federal Reserve Bank of New York, Columbia University and Princeton University, before the latest escalation, found that the public and U.S. companies were paying $3 billion a month in higher taxes from the trade dispute with China, suffering $1.4 billion a month in lost efficiency and absorbing the entire impact.
It’s also false that the U.S. never collected a dime in tariffs before he took action. Tariffs on goods from China are not remotely new. They are simply higher in some cases than they were before. Tariffs go back to the beginning of the U.S. and were once a leading source of revenue for the government. Not in modern times. They equate to less than 1% of federal spending.
TRUMP, on a border wall: “We have, we will soon have hundreds of miles under construction and will have way over 400 miles completed by the end of next year.” - remarks to reporters Thursday.
TRUMP: “The wall is being built as we speak. We’ll have almost 500 miles of wall by the end of next year.” - Pennsylvania rally on May 20.
THE FACTS: It’s unclear how Trump arrives at 400 to 500 miles (800 km), but he would have to prevail in legal challenges to his declaration of a national emergency or get Congress to cough up more money to get anywhere close. Those are big assumptions.
So far, the administration has awarded contracts for 244 miles (390 km) of wall construction, but more than half comes from Defense Department money available under Trump’s Feb. 15 emergency declaration. On Friday, a federal judge in California blocked Trump from building key sections of the wall with that money; a separate challenge is before a judge in New York.
Nearly all of what Trump has awarded so far is for replacement barriers and fencing, not new miles of wall. Even if Trump prevails in court, all but 14 miles (22 km) of those awarded contracts replace existing barriers.
The White House says it has identified up to $8.1 billion in potential money under the national emergency, mostly from the Defense Department.
Customs and Border Protection officials say the administration wants Congress to finance 206 miles (330 km) next year. The chances of the Democratic-controlled House backing that are between slim and none.
TRUMP: “Our country is full. We don’t want people coming up here. Our country is full. We want Mexico to stop. We want all of them to stop. Our country is packed to the gills. We don’t want them coming up.” - Pennsylvania rally on May 20.
THE FACTS: Trump’s declaration that the U.S. is too “full” to accept migrants due to an overwhelmed southern border is his latest flip-flop. It turns out the U.S. is only “full” in terms of the people Trump doesn’t want.
Just last month, the president had made clear that more migrants are needed due to an improving economy.
“We have companies pouring in. The problem is we need workers,” he told Fox Business Network on April 28.
“We need people to come in,” Trump said at a Wisconsin rally on April 27.
Immigrants as a whole make up a greater percentage of the total U.S. population than they did back in 1970, having grown from less than 5 percent of the population to more than 13 percent now. In 2030, it’s projected that immigrants will become the primary driver for U.S. population growth, overtaking U.S. births.
TRUMP: “Drug prices are coming down, first time in 51 years, because of my administration.” - remarks Wednesday to reporters.
THE FACTS: Trump continues to ignore an increase in drug prices.
The Labor Department’s Consumer Price Index for prescription drug prices shows an increase of 0.3% in April compared with the same month last year. The index tracks a set of medications, both brand names and generics, and Trump has frequently made his boast since the updated numbers showing higher costs came out.
Other independent studies point to increasing prices for brand-name drugs as well and more overall spending on medications.
An analysis of brand-name drug prices by The Associated Press showed 2,712 price increases in the first half of January, compared with 3,327 increases during the same period last year. However, the size of this year’s increases was not as pronounced.
Both this year and last, the number of price cuts was minuscule. The information for the analysis was provided by the health data firm Elsevier.
An analysis by Altarum, a nonprofit research and consulting firm, found that in 2018, spending on prescription drugs was one of the main factors behind a 4.5% increase in U.S. health spending. Spending on prescription drugs grew much faster than in 2017, according to the study.
Associated Press writers Christopher Rugaber in Washington and Elliot Spagat in San Diego contributed to this report.
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