Surgeon Michael Mann

Former VA Surgeon Says Agency Refuses Care For High-Risk Patients

Surgeon Michael Mann

A former VA surgeon in cardiology says hospital administrators manipulate mortality rates by denying high-risk patients access to lifesaving surgical procedures.

Dr. Michael Mann, a professor of surgery and director of cardiothoracic research at the University of California San Francisco, is calling out VA for manipulating its mortality rates.

The National Surgical Quality Improvement Program (NSQIP) is the system VA invented to measure rates. Those measurements are tied to… wait for it… wait for it… to justify bonuses and promotions for local level administrators.

The better the rating, the better the bonus.

To get a better rating, health administrators deny high-risk patients access to certain procedures where the veteran has a lower likelihood of surviving.

Now, Dr. Mann is no second-rate surgeon.

As noted, he is a cardiothoracic surgeon and professor of medicine. He was trained at Stanford and went on to work within VA for many years only to ultimately be fired in 2011 for blowing the whistle about poor administrative decisions within the agency.

This year, Dr. Mann wrote the book “Mission Betrayed” addressing manipulations in the VA system.

For some context, Dr. Mann is not the only physician or surgeon working on the heart to be blasted by VA after questioning authority. You may recall Dr. Lisa Nee, an interventional cardiologist turned VA whistleblower who was forced out of the agency in 2011 at Hines VA Hospital.

RELATED: Deadly Hines VA Cover-up Exposed

Dr. Mann tracked the move to quantify VA using NSQIP back to 1985. At the time, poor conditions and outcomes at VA nationwide forced Congress to pass Public Law 99-166 where the agency would compare its surgical mortality statistics to the “prevailing national standard.”

RELATED: OSC Says VA Inadequately Addresses Deficiencies In Cardiovascular Care

The fly in the ointment is that no other health care system is like VA, and no national standard comparable to allow such a comparison other than for VA to compare its own hospitals to themselves.

By that measure, I am both the fastest and strongest man on the planet, so long as I only compare me to the other men in my house right this second.

According to Dr. Mann’s TheDCF interview:

“The VA did an amazing job of measuring its own surgical outcomes, something that had never been done before in such an immense system, but there was no prevailing national standard to be compared to,” he said. “We still don’t really have it for all of surgery, and so the VA instead just compared its own individual institutions within its system and developed something called NSQIP, the National Surgical Quality Improvement Program, and all it really did was rank the hospitals in the VA based on surgical mortality, so one hospital had the lowest mortality and the other end of the spectrum there were hospitals with the highest.”

As Mann notes, mortality rates at VA facilities suddenly began dropping through the floor by close to 50 percent from the mid-to-late 1990s to the mid-to-late 2000s.

“The only way you could’ve rationalized that drop was by saying, “Well, the worst institutions were somehow learning from the best institutions,” Mann said. “But that’s not what happened. Numbers dropped everywhere across the board. There were unprecedented drops of mortality and morbidity. That’s never been seen in any system designed to improve outcomes. There’s no scientific explanation for that.”

Dr. Mann believes the manipulation was less of a conspiracy and more a matter of smart bean counters knowing how to make the numbers look good for VA Central Office.

As a result, veterans are forced to go without needed health care services, and practitioners trained within the agency’s health care system come away with a confirmation that the VA is second-rate:

“[T]he idea that the VA is a second-rate system for second-class patients is the very first impression medical students get in their training in the United States. And I don’t think that impression ever changes.”

In response to TheDCF interview, VA Press Secretary Curt Cashour said, “These are serious allegations. If the doctor can provide evidence, we will look into them.”

This is a bit of doublespeak since VA has access to all the data necessary to initiate an investigation through IG to substantiate the allegations – – which are quite serious indeed.


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  1. VA is committed to serving Veterans and providing them with the best possible health care.[IMPOSSIBLE] You are getting very very sleepy

  2. OFF TOPIC – – – Keep up with the VA’s Current Press Releases and Propaganda, visit . . .


  3. Voting out everyone. Too sick for my taste. All this info is insane and yes xemployee for jails told me as she works at VA now was disgusted they treat vets worse than prisoners. Someone needs to gather all information give to prime time and have them question all politicians. This is gross.

  4. Doublespeak is a nice way to put it Ben.

    Being a disinterested ass-covering, lying weasel is another.

    Would an IG investigation find anything? Or would they report they couldn’t find enough evidence to substantiate the charges?

    I’ve said it before…if we had Congressional oversight committees worth a shit, there would be little need for Whistle Blowers to go to the press or write books. There would be far fewer scandals to cover up, and far fewer payouts to both veterans or their families and to Whistle Blowers.

    Not only are we second class patients, we are second or third class constituents.

    1. Remember: Stairmasters can be weaponized catapults when presented with bad outcome morning news. 🙂

  5. As we have all learned that AFGE Union Members collect their Veterans Administration Salaries while doing Union work. It is important to note all the publicity stunt rallies that VA employees are performing across the country right now, at each and every VA Health Care Facility, while being paid by the VA.

    Their rallies calling for hiring 49,000 additional employees.

    This of course this raises the question of what good would it do to hire 49,000 new union members when the Veterans Administration Health Care System is not even scheduling half of the available appointments now? That is while the AFGE union members are being paid by the VA to pull these publicity stunt rallies.

    1. “VA only filling half of its medical appointments while veterans wait for weeks”
      by Eric Hannel, Washington Times, Sep 17, 2017

      “Rally to support VA on Wednesday”, September 18, 2017, “”

      Of Course the pay is coming out of the VA Health Care Budget and not the Public relations budget.

  6. Veteran Legal Check-Up – Employment, Housing, Domestic Legal Issues – – – Ultra light website, answer simple questions, no asking of name or any other information about you. Get simple indicators if you may have a legal matter, and the website lists contacts to help you with your possible legal matter.

    1. Here’s the URL for the website mentioned above;


      1. Thank you for your professional service of tightening up the time to receive pertinent information about segments of the Court of Law.

        Nam, there is so much information online, in the cloud, on backs of large capacity hard drives, cabinets, and ever where else who only knows. The VA system is too damn hard to understand for the average Veteran, and the factor of information overload.

        Here is the other issue. There are no really good Spousal Programs. My wife is kind of burnt out between hearing me complaining about the VA (more like ranting and raving all over).

        VA offers nothing specific for my wife to gain coping tools. And, at the same time, watching me battle as I try my best to build legal arguments against the VA.

        Nam, I’m so fucking pissed off that I can feel my body temperature change. The VA has a way that it can (and many times will), entrap its beneficiaries in the web of twisted thinking.

        And, whom ever is tinkling the stream of lies into POTUS’s head, this person’s credibility is in question. I can surely see how many good and well attended Veterans, are totally turned of from the VA and say fuck it. But, some of these Veterans will always have a sour taste in their mouth from dealing with the VA.

        The VA was built to eat your time, and to make you frustrated. Time is used as an item of discouragement, so that Veterans can always get hit with feelings of frustration. Who wants to do VA paperwork where you always get ticked off. Plus, you’re always concerned about making mistakes, leaving something out, or you just outright forgot about something that you previously studied for at length.

        Hey look, there hasn’t been one referral or recommendation given to me about any VSO’s or other organizations, which was trusted to help me, even after all the information that I posted here on Ben’s about the incidents of my being treated by the VA.

        Nam, its like you have dig down deep, to find and grab another packet of bursting enthusiasm and confidence to continue. And, not knowing what’s on the other side, until you make the moves. – – – Nutter’s Ranting Observation and Opinion.

        September 18, 2017, Monday, 8:21pm

      2. That’s why I try to take one day at a time on this planet, otherwise, if I think too much about it, all at once, I will become even more batshit crazy.

  7. This is “off topic”, yet needs to be seen by veterans. Especially those living up in the Oregon area!

    From: “The Liberty Hound”
    Dated; September 17, 2017 (6:30 min.)

    “What Kind of Animal Attacks a Disabled Veteran”

    Jesse Waters interviews Tim Pool about violence in Portland! Antifa attacks a “wheelchair bound disabled veteran!”

  8. From: VA service quality pilot program team lead
    To: Sec. VA
    Subject: Success of quality assurance pilot project

    Mr. Sec.,

    I am pleased to report the new quality assurance program implemented at VISN-20 as a pilot program has improved quality patient outcomes by 87% during the course of this study. This is fully validated board data input into the system by the patients themselves.

    As you know under the new bonus program our employees are now rated on a daily basis of quality by the patients themselves on a large bulletin board set near the exit. Patients are allowed to write on the board a quality number of one to ten. Moreover we allow “choice” by allowing any vet to return unsupervised and cross out the number they originally wrote and post a new score as they see fit. This will be done on a daily basis and the average of the score will be used on a daily bonus basis. For every day a facility scores an average of 9 or above each employee will receive a bonus of $100.

    Employees where strictly forbidden from crossing out the numbers themselves and putting new ones up on the board hidden from close scrutiny.

    We are happy to report that the acerage quality score on a daily basis soared to record levels! More importantly we can demonstrate maximum veteran utilization of the “choice” program by tabulated the sheer numbers of crossed out scores. Veteran participation in this aspect of the program was nearly 100% according to study data so tabulated.

    Employees are rewarded for their quality efforts with a daily bonus and this seems to be enough incentive for them to do what they need to do to get it. We therefor recommend rolling out the new “quality choice” program nationwide.

    Team Quality Leader
    Dr. Ben Dover Phd.

  9. 4th of July, 2007, Major heart attack (widow maker), taken to local hospital, revived 3 times, transported to area heart center, by ambulance, no airlift available. Two stents paced in main artery to the heart, 90% and 99% blockages. Waiting overnight for my heart to stabilize, and then another stent was to be placed in the main artery going away from the heart, 89% blockage. While waiting overnight, the hospital called the VA, the VA told the hospital to stabilize, and transport to either Hines or, Milwaukee.
    3 heart caths at Milwaukee, yet the 3rd stent was never placed. When asked why not, the cardiologists stated the blockage percent is a matter of personal opinion, and in his opinion, the blockage was only 82%, and they do not stent until it is 86%.

    Thank you VA for nothing. For years I felt like I was walking around with a hair trigger 45acp pointed to the back of my head. Now? I just don’t give a shit anymore, pull the damn trigger. Asshole criminal agency, and their deadly bonus programs to deny Veterans their proper health care, and the other criminal agency, the VAOIG, that protects them at all costs. You think the VA gives a shit about any Veteran? I sure as hell don’t think they do, what they do care about is their fucking POCKET BOOKS. Fuck you AFGE, fuck you very much.

  10. Suggestion for Ben. Why not submit this article to the New Richmond, WI newspaper – letters – asking where Trump Appointee Jacob Leinenkugel is on this issue. Stick him in the ribs in front of his homies.

    1. THAT is a great idea. Jacob Leinenkugel name was all but forgotten, just like those that turned-down taking the helm of V.A. Titanic Secretary of Poop Decks.
      I’m thinking the piggy VSO’s received a fat beer donation to their lodges/bars, tax deductible, of course….otherwise, have not heard Jacob helping with any of these daily issues at the VA.

  11. Crime after crime when are they going to be arrested and put in federal prison. This is disgusting and once again veterans are paying the price , so higher management could receive a Bonus.

    Hell I did not do anything and the VA punished me. The VA could let veterans DIE by the hundreds and no one is doing anything.

    The Investigating bodies that are to protect the veterans have let us down, for a Buck !

    Dirty, Dirty shame. Guess we are like the dogs they are doing experiment’s on for their Heart. They say the dogs are like the veterans, except the dogs get surgery and the veterans are let to Die.

  12. Let me fill in between the lines of Va response;

    “If the doctor (who has decades of experience investigating and validating empirical medical data from medical research and in fact earned a Phd from a preemminent ivy league school demonstrating mastery of this AND was hired by VA because he is so very good at collating factual evidence in an impartial manner that he is now called “doctor”) can provide evidence, we will look into them.”

    Just an added little factoid for emphasis…

  13. I agree with “Ranger11bv”!
    “And what is going to be done about it…

    Until our “neutered” DOJ grows some balls, will we see accountability within the Veterans Administration! So far, the DOJ has stated they “…aren’t pursuing [any] charges…” against anyone in government for breaking the laws! What does that tell y’all about HOW useless our top law enforcement agency is!!!!!!!
    Yea, right. The “blindfolded lady justice” IS really living up to her reputation – NOT!!!!!! That “blindfold” slipped off when Hillary Clinton was exonerated from ALL the crimes she, and her family, was involved in!

    Congress, both houses, will only give “lip service”! Oh, they’ll put on a “Dog and Pony Show”, which will allow that $25/year VA Public Relations Firm” to spin the truth to their advantage! Will it help veterans? HELL NO!

    The Secretary of VA, Dr. “SHITHEAD SHULKIN” will NOT do anything about it! He’s an “Obutthead Holdover”! He’s only interested/wanting to line his pockets with taxpayers monies! And, he’s doing one hell-of-a-job doing just that! I wonder what his “990” tax forms will look like! Does he have any “off-shore accounts”? BETCHA HE DOES!

    I wonder what he’s doing with all that money coming in from that “5 star” “Pershing Hall Hotel” in Paris France? I’ll bet he’s living high on the hog stealing from the taxpayers! (Just like Mueller and that Special Council [FAKE] investigation against President Trump!)

    EVERYTHING that reprobate has done does NOTHING for veterans! He needs to be tried for obstruction of justice!
    Gitmo needs to be replenished with prisoners!

    Rant over, FOR NOW!

  14. Dr. Garth Nicolson – Weaponized Mycoplasmas

    Cancer, AIDS, Weaponized Mycoplasmas & Gulf War Illness. Prof. Garth Nicolson’s hypothesis is straightforward: “The emergence of new illnesses and an increase in the incidence rate of previously described signs & symptoms are due to our toxic environment & the purposeful development & testing of Weapons of Mass Destruction.” Dr. Nicolson heads the Institute for Molecular Medicine. He spoke at the 9th Common Cause Medical Research Foundation Conference, Sudbury, Ontario, Canada

    1. From personal experience, I know the Nicolson’s (Garth and Nancy) are dedicated, passionate professionals who may be trusted. They were discredited by the US Government in the 90’s for being on the leading edge of Gulf War Illness.

      Turns out they were right all along. Particularly with regards to Mycoplasmas.

      Their research has helped thousands of veterans who served in the Gulf in ’91, and has saved more than a few lives. Including mine.

  15. VA Health Care has evolved into nothing more than an extension of DOD research and is solely concerned with managing us Guinea Pigs.

    1. Biological Warfare: Experiments on the American People
      Dr. Garth Nicolson, Institute for Molecular Medicine


    2. Biological Warfare – Experiments on the American People

      Mycoplasma Experiments were conducted in Texas prisons without consent, by C. Brown

      The evidence came out because the guards and their families were getting sick, too, and the problems were similar to Gulf War Illness. Huntsville, TX (three prisons) had a huge incidence of diseases, and the only thing in common with the illnesses were that someone in the family of the sick person worked in the prison. “Walls Unit”, death row, the prisoners were dying before they were executed. Congressional testimony

  16. “Dr. Michael Mann, a professor of surgery and director of cardiothoracic research at the University of California San Francisco, is calling out VA for manipulating its mortality rates.”

    Just exactly what do you think the Disruptive Behavior Committee is used for lolz! When you need a “customer” to go away you tag him as disruptive then he is not treated. Then he goes away. Want proof that VA knowingly does this? Ben, I can tell you how but wont do it for you because I have already given at the front gate.

    FOIA VISN-20 Portland Oregon. It is that VISN that is (or was) the host to the folks put in charge of … are gonna love this….. predicting disruptive behavior in veteran patient populations. No shit. The VA actually has a crew to create a profile justifying preemptive justice, and the HQ is VISN-20, Portland Oregon. I can tell you with certainty of one report generated from within VA and presented as a Powerpoint presentation meant only for VA eyes that was seen by me and attest this is accurate. Within that report an internal VA study was mentioned that claimed over 50% of patients flagged by DBC as disruptive that normally would be expected to return for care, do not.”

    This blew my mind and in fact I cited this reference in the first appeal of my own bogus Catagory One Violent And Disruptive Patient Recod Flag (PRF). Of course I also referred to their style of justice as “kangaroo court” justice forbidden by the Supreme Court in a child services case in which the government had also set up “kangaroo courts” for children that also bypassed their constitutional rights. Then I referred to all of them as “The Whole HeeHaw gang, although to his day I am unsure if any kangaroos actually made any appearances on that show…. I think the reference lacked the created punch I had hoped because they did not even respond to the appeal.

    Now, if fully validated as true, take both this article’s claims and my claim. Knowing full well that half the patients refuse to surrender to police custody, the VA still elects to flag patients with PRF. Since each VISN determines via kangaroo court what constitutes a disruption for any given day by any given VA employee the temptation to terminate patients who drag down their ability to get a bonus is understanable if not evil. After all, We The People GIVE THEM THE TOOLS, do we not? Do you expect folks not to use them?

    Is this a betrayal of the Constitution? Nope. It’s a bastardization of it.

  17. More manipulated data: VA Releases Suicide Data by State for 2014: “”
    And rather than attempt to manipulate the ‘data’ on Veterans who want a more peaceful death & live in a Veterans Home in California they must leave it as giving the drugs under California’s End of Life Option Act that aids the dying has been Forbidden. “Allowing doctors at Veterans Homes to help end patients’ lives would endanger about $68 million in annual federal funding, according to CalVet spokeswoman June Iljana. That’s the reason we had to go this route, to preserve our ability to provide care” “” & “”

  18. so answer me this. If what is being said about the VA and I am not doubting any of the stories her, why is the VA not pursuit in a criminal fashion. Any civilian hospital would be shut down in short order. I would like to think that the testimony of a medical man such as the VA surgeon would warrant an investigation. I have my own stories, but have given up dealing with it. I use my own medical insurance to deal with medical problems.

    1. Peter,
      Our “neutered” DOJ has become “politicized”, just like the FBI and other law enforcement agencies, to such a degree they are ‘refusing’ to do their jobs!
      Look at what has transpired for decades. Only those in lesser job titles are prosecuted for breaking the law! Or, only those who are willing to “take the fall” are prosecuted: example; Martha Stewart!
      The “blindfolded lady justice” IS no longer able to hold people accountable! Because “her” blindfold was stripped off years ago! Holding anyone in any government agency is almost nonexistent nowadays!

    2. President Reagan created the VA as a cabinet level agency against ALL advice and wisdom. He himself was largely elected because of his opposition to all of the cabinet level positions that Carter created. He blasted growth in government as a bad thing and vowed to correct it – then he grew the government by creating an entire cabinet level agency.

      Against the advice of veterans who served in congress this agency level post did something that ONLY the charisma of Reagan could do. Against fierce opposition he managed to pass all of this legislation without a provision that allowed for “judicial review”. In other words the other balancing legs of our government set up to keep the ship on course were bypassed the moment the agency was created sans judicial review. Nice right? And he did this why? Because corruption was so rampant he felt that taking direct control of it by folding it into the Executive Branch was a solution. Veterans rights would get in the way of his plans.

      Without judicial review that was fought so hard for this gave the cabinet level agency unprecedented freedom to operate without oversight. At the same time the elevated agency offers all of the protections really that the
      president himself enjoys exclusive of The People. A president cannot be prosecuted successfully AT ALL FOR ANY CRIME without exhaustive impeachment processes reserved exclusively for that purpose and it is fucking hard to pull off. Much harder to pull off than Monica Lewinski’s bra. Even then nothing stops a president from pardoning himself of any crime. “Mr. President” is not king but he is untouchable so we kick him out every eight years at a minimum because no human can endure this power indefinately without it corrupting them.

      However, since VA was made untouchable by being made a cabinet level agency the answer to your question is simple; they are not subject to the Constitution because they are an aberation from it. The President assumes the role of chief lawmaker in the land and by elevating VA to a cabinet level it was raised to a level of power that really can only be desribed as “above the law”. The problem is that VA is like herpes. Unlike a president, it just won’t go away.

    3. The Congress and everybody else does not care about veterans or what happens to them after they’re used up. It’s sad that a lot of the abuse of Veterans are committed by other veterans

    4. @Peter Kreutzfeldt – – – This article may help to explain why hardly suits against the VA.

      “” – – – Nutter’s Library

    5. kaiser permanente has been doing the same thing for decades. Giving supervisors & management (doctors & nurses) bonuses to not give care. The VA took lessons from kaiser and its partner in crime SEIU of denial of medicine. Anyone that was a skilled and trained employee was fired via its other partner in crimes, the CA state WC system.. Being a federal contractor, we pay for these horrors to the tune of billions every year while they use the money to spread more of its horrors in the medical community. Medicare loves kaiser too because it saves from paying out on medicare and medicaid patients. kaiser’s holy grail is to save everyone money BY NO giving the medical care necessary to live.

  19. World class health care…..VA making great strides in the art of BULLSHIT …..We don’t give a shit = I care…..Just as always just reverse their whirled/words…Just another spin job.
    And don’t forget they are there just for U, Aren’t you feeling special yet, If not you need a antidepressant YUM YUM

    1. The VA only gave me Flintstones Antidepressants Tablets (FAT). I learned quickly to stay clear of taking a Wilma or Betty, as they made me antsy and the Bam Bam’s made me violent. I much prefer Scooby Snacks.

    2. Copy that! The VA may justifiably be the bottom feeders of the medical field, but they have Orwellian ‘Newspeak’ honed to a fine science!

  20. “[The National Surgical Quality Improvement Program (NSQIP) is the system VA invented to measure rates. Those measurements are tied to… wait for it… wait for it… to justify bonuses and promotions for local level administrators.
    The better the rating, the better the bonus.]”

    This is not to be confused with “National Surgical Quagmire Improvement Program” (NSQIP), also invented by the VA, where fresh from grass and mud hut VA surgeons can practice on nonhuman test subjects with no repercussions for “bad outcomes”.

    1. I echo your word “NOTHING”. Prisoners get better health care, education and job security (once out) than veterans.

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