An NPR investigation found that despite $2.5 billion in special funding, VA added no more doctors and other clinicians than without the extra money.
Veterans Choice and Accountability Act added $16 billion to the VA budget in 2014 with the goal of fixing the wait time problem that led to a scandal where many veterans died without much-needed healthcare.
$10 billion was supposed to go to help veterans get non-VA healthcare. $2.5 billion was supposed to go to hiring more doctors, nurses and other clinicians.
NPR’s recent investigation into effects of the expensive but needed fix found the following:
- VA has about the same number of new hires as it projected to have without the added funding;
- The new hires were not sent to VA hospitals with the longest wait times;
- The medical centers that received new hires were not likely to see improved wait times.
Doctor Hiring Funding Shell Game
The reason for the hiring failure is reportedly budget shuffling that occurred after the funding was distributed. This is no surprise to anyone who noticed VA reallocating other funding to pay for cures like the Hepatitis C vaccine.
According to NPR, VA used the funds to hire the same clinicians it would have hired without the funding. Instead of doubling down on hiring clinicians, VA then reallocated less restricted funds in the same amount to fund other projects.
David Shulkin, the soon to be Secretary of Veterans Affairs, supported his decisions as to how the funds were allocated while he led the Veterans Health Administration.
Shulkin told NPR in December:
“When you’re given a budget you face a number of new stresses on those resources. You have increases in pharmaceuticals, you have your wage increase, you have your leasing cost increases, you have IT increases. So without the Choice money, we would not have been able to have maintained the type of hiring that we were doing and expanded the type of hiring we were doing.”
Phil Carter, of the Center for New American Security, says this kind of budget strategy is common for self-interested bureaucracies in Washington:
“It makes complete sense for a self-interested bureaucracy to hire with that money first. I think VA hired staff with this money will all intention of improving access and quality. I think the VA leadership found it harder to do that.”
Carter went on to state he did not believe the shell game with funds intended to increase the number of clinicians was done with malice, “But I don’t see malice here, just the basic inefficacy of American bureaucracy.”
Do you agree?
It will be interesting to see if any Senators ask Shulkin about this apparent shell game today (February 1) during his confirmation hearing starting at 2:30 PM EST.
For those of you hoping Shulkin will be pressed on this issues, do not hold your breath. He has wide support from Democrats, veteran organizations, and some Republicans including Senator Johnny Isakson.
Sen. Isakson reportedly promoted keeping former Secretary Bob McDonald after the 2016 election. While that seemed like an impossible request in light of the animosity between President Donald Trump and McDonald, keeping Shulkin was the next best thing to some.
Following a meeting with Shulkin, Sen. Isakson provided the following comments:
“As the undersecretary for health at the VA, Dr. Shulkin is no stranger to the work that needs to be done to bring accountability to the department. Dr. Shulkin’s overwhelming approval by the Senate in 2015 demonstrates the kind of broad, bipartisan support that I expect to see this time for his confirmation as secretary of the VA. I believe Dr. Shulkin to be a passionate veterans advocate who will work to transform the VA and ensure our veterans get the timely, quality care and support they deserve. I look forward to chairing his confirmation hearing.”
Personally, I bet Trump was unable to find a suitable substitute for McDonald who was also willing to take the job.
Each administration brings in someone new who is always taking a year just to get caught up with the cronies and scandals must less developing policies to address them.
By picking Shulkin, a person who should be familiar with the wait list scandal, the success or failure of reforms over the next few years will deservedly hang around Shulkin’s neck.
Instead of giving him a Scarlet A, we would give him a Scarlet F – – for FAIL.
While I will not hold my breath, I will remain hopeful Shulkin succeeds.