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Shinseki resigns, criticizing ‘systemic’ failures of VA health care system

May 30, 2014 at 6:10 PM EDT
Eric Shinseki ended his five-year tenure as secretary of Veterans Affairs after more than 100 members of Congress demanded he step down. How will the VA clean up its problem-plagued health system? Jeffrey Brown talks to retired Army Brig. Gen. Stephen Xenakis, M.D., Joseph Violante of Disabled American Veterans and Paul Rieckhoff of Iraq and Afghanistan Veterans of America.
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TRANSCRIPT

JUDY WOODRUFF: The storm surrounding the embattled Veterans Administration reached a crescendo today. Heeding a steady drumbeat of criticism and calls for his ouster, Eric Shinseki, the 71-year-old retired Army general, who had been the president’s first and only secretary of the VA, offered his resignation this morning at the White House.

Our Jeffrey Brown has the story.

PRESIDENT BARACK OBAMA: A few minutes ago, Secretary Shinseki offered me his own resignation. With considerable regret, I accepted.

JEFFREY BROWN: The announcement came just after Shinseki left his private meeting in the Oval Office, ending his five-year stint in the Veterans Affairs post.

President Obama said the secretary decided he could not effectively deal with the scandal in the VA health care system amid growing cries for his ouster.

PRESIDENT BARACK OBAMA: He does not want to be a distraction because his priority is to fix the problem and make sure our vets are getting the care that they need. That was Ric’s judgment on behalf of his fellow veterans. And I agree. We don’t have time for distractions. We need to fix the problem.

JEFFREY BROWN: More than 100 members of Congress, of both parties, had demanded the secretary step down or be fired. In accepting his resignation, the president heaped praise on the retired four-star general.

PRESIDENT BARACK OBAMA: So Ric’s commitment to our veterans is unquestioned. His service to our country is exemplary.

I am grateful for his service, as are many veterans across the country. He has worked hard to investigate and identify the problems with access to care. But, as he told me this morning, the VA needs new leadership to address them.

JEFFREY BROWN: The storm over Shinseki intensified Wednesday after his own inspector general released a scathing report on the VA Medical Center in Phoenix, Arizona. It found veterans there were waiting an average 115 days to be seen, and 1,700 veterans were kept off any official waiting list.

Even more damning, the review said VA staffers in Phoenix cooked the books to make delays appear closer to the goal of 14 days. Today, Shinseki gave the president an internal audit that found similar problems are widespread in the VA health care system.

ERIC SHINSEKI, Secretary of Veterans Affairs: Given the facts I now know, I apologize, as the senior leader of the Department of Veterans Affairs.

JEFFREY BROWN: Before going to the White House, Shinseki offered his own public mea culpa, addressing the National Coalition for Homeless Veterans.

ERIC SHINSEKI: I said when this situation began weeks to months ago that I thought the problem was limited and isolated, because I believed that. I no longer believe it. It is systemic.

I was too trusting of some, and I accepted as accurate reports that I now known to have been misleading with regard to patient wait times.

JEFFREY BROWN: He announced the removal of senior VA leaders in Phoenix, and he suspended bonuses for meeting wait time targets. It’s been alleged that policy proved an incentive to falsify data.

REP. JOHN BOEHNER, Speaker of the House: Business as usual cannot continue.

JEFFREY BROWN: In Congress, reaction to the resignation poured in from both sides of the aisle.

New York Democrat Steve Israel was one of many who said it was the right move.

REP. STEVE ISRAEL, D, N.Y.: It is unfortunate that Secretary Shinseki had to resign, although I support that decision, but this doesn’t put a period at the end of a sentence. We owe it to our veterans to get to the root of this problem.

JEFFREY BROWN: Republicans, led by House Speaker John Boehner, voiced similar sentiments, but in tougher terms.

REP. JOHN BOEHNER: And until the president outlines a vision and an effective plan for addressing the broad dysfunction at the VA, today’s announcement really changes nothing. One personnel change cannot be used as an excuse to paper over a systemic problem.

JEFFREY BROWN: Major veterans groups also supported the resignation, and called for a closer look at the overall VA system.

One of the largest, the Veterans of Foreign Wars, said in a statement: “We support Shinseki’s decision to resign because the outside calls for his resignation were overshadowing the crisis in health care issues veterans face.”

The president today said he will leave it to the Justice Department whether the scandal warrants a criminal investigation, as many in Congress are demanding.

In the meantime, he’s appointed Sloan Gibson, the VA’s number two, as acting secretary.

And we explore the problem, the resignation and what’s next with Paul Rieckhoff, an Iraq war veteran and founder and executive director of Iraq and Afghanistan Veterans of America. Joseph Violante is a Vietnam War veteran. He’s now national legislative director of Disabled American Veterans. And Dr. Stephen Xenakis a retired Army brigadier general who had a 28-year career as an Army psychiatrist. He’s the founder of the Center for Translational Medicine, a nonprofit organization providing mental health care services to veterans.

Welcome to all of you.

Paul Rieckhoff, let me start with you. Your reaction to the resignation of Eric Shinseki? Was it the right thing to do? Is it best for the VA?

PAUL RIECKHOFF, Iraq and Afghanistan Veterans of America: It was, and it needed to happen.

Our members across the country had lost confidence in Secretary Shinseki. The country had lost confidence in Secretary Shinseki, and many of the VA employees had as well. So, this was a dam that burst. And I think it’s important to note it wasn’t just building over the last few weeks. This has been building for years.

I.G. reports have been coming back, coming out going back to 2007 noting the wait times. There have been congressional testimonies. Groups like ours have maybe trying to raise these issues for year after year. And there continued to be delays, stonewalling. And I think that’s really part of what got to the bottom of this. Veterans had had it, enough was enough.

And we do note that there are much bigger institutional, bureaucratic changes that must take place. This is not going to solve everything, but a change in tone and a change at the top is definitely necessary.

JEFFREY BROWN: All right, well, we will get to those larger issues.

But, Joseph Violante, your group had not called for the resignation, right? Did you want him to stay on?

JOSEPH VIOLANTE, Disabled American Veterans: That’s correct.

We supported Secretary Shinseki, in the sense that he had brought a lot of change to the VA. We had confidence in his ability to bring change to this once it came to light. So we didn’t ask for his resignation for those reasons.

JEFFREY BROWN: And what do you think happened? Why did he decide to do it?

JOSEPH VIOLANTE: It’s a good question, and I think probably because he was becoming a political lightning rod for criticism and he may have felt that this was bad for the VA.

JEFFREY BROWN: Now, Stephen Xenakis, of course, the question is, how much does his resignation start to fix the problem, or what’s the connection between the resignation and the larger problem?

BRIG. GEN. STEPHEN XENAKIS (RET.), U.S. Army: It could destabilize the program.

JEFFREY BROWN: Destabilize?

BRIG. GEN. STEPHEN XENAKIS: In other words, what I mean is that it could sort of, for a while, because there’s not going to be clear leadership here, and people are going to be spending so much time figuring out who should be the successor and what — and discussing the problems, that it could delay there being fixes that he may have already had in place and recognized that — recognized that he needed to make.

JEFFREY BROWN: Right.

Let me start — let me start with you, Stephen Xenakis. What is the problem? Let’s go around here. How would you define it?

BRIG. GEN. STEPHEN XENAKIS: Well, started years ago. The VA didn’t prepare for what was going to be now 2.5 million men and women who served in Iraq and Afghanistan, the fact that the population of soldiers and the veterans from the Vietnam War were aging and were going to be hitting a point in time that they were going to need a lot more medical care.

And they didn’t map out what was going to be the load, the burden, demand for services that were going to be required. They also were an organization that didn’t welcome change and didn’t allow themselves, didn’t have flexibility in figuring out what they needed to do to meet the mission.

JEFFREY BROWN: Well, Joseph Violante, Eric Shinseki seemed to go much further and certainly the I.G.’s report talking about a systemic, total unacceptable lack of integrity.

JOSEPH VIOLANTE: Yes.

And I would just like to say one thing about this problem, because it started well before these wars. Back in 2001, President Bush established a task force to look at the delivery of health care for veterans. This was prior to the attack on our nation. Two years later, in May of 2003, the war in Afghanistan was still young. We were just going into Iraq.

This task force found that, at that time, there were 236,000 veterans on a wait list waiting six months or more for care. They also found it was a mismatch between funding and demand and, if that mismatch wasn’t addressed, the situation would impact access.

Here we are 11 years later, and that’s the problem. So, we have not addressed those problems then. When that report came out, Congress and the administration shelved it, even though the veterans organizations wanted those recommendations to be looked at.

JEFFREY BROWN: Well, but those problems — Paul Rieckhoff, come in on this. Those problems have been there, you’re all saying, for a long time, but this is all — this goes further. This is about falsifying reports, and a real lack of integrity was the word used.

PAUL RIECKHOFF: Right. Right. It’s a total system failure.

And it started with the revelations in Phoenix over four weeks ago. And the secretary was slow to respond and the president was slow to respond. Now the I.G. is investigating over 40 different facilities. So it’s a system-wide failure. People are cooking the books. And we want to see criminal investigations.

I mean, if veterans died waiting for care, then people need to go to jail. It’s really got to be boiled down into human terms here. We have got Iraq and Afghanistan veterans, most in their late 20s, who have served overseas multiple tours, are coming home and seeking help. They’re bravely stepping forward and going to get help, and the VA is failing them.

So, this is a bureaucrat problem. But it’s also been kicked down the road after president after president and year after year. It’s time for the president to step up and make this a presidential authority. He has also got to integrate the other government agencies around the VA and communicate to the American people that the VA can’t do it alone.

Community-based nonprofits, health care groups, veterans groups are also overwhelmed trying to fill the gap, because right now only about 55 percent of Iraq and Afghanistan veterans are even using the system. So if we all come forward, the system is going to be stretched that much more. And that’s what we expect to happen in the years to come.

JEFFREY BROWN: Is it — Joseph Violante, is it a funding problem; is it a funding a congressional oversight problem?

JOSEPH VIOLANTE: It’s both.

We have asked, in the independent study, which was co-authored by DAV, AMVETS, Paralyzed Veterans of America, and VWF, for $7.8 billion more than Congress has provided for medical care alone over the last 10 years. In construction, that’s $9 billion over the last 10 years that VA’s been shortchanged. So, yes, it is. And there needs to be oversight to ensure that VA is spending this money properly. If they aren’t using it properly to care for veterans, then Congress needs to step in.

JEFFREY BROWN: Do you think it’s a funding issue, Stephen Xenakis?

BRIG. GEN. STEPHEN XENAKIS: I don’t think it’s primarily.

I think it’s an issue of the culture. You talked about integrity. And I think it’s people understanding, from the front-line doctors and nurses, to the management, of what their responsibility is to the veterans and what they need to do in terms of accomplishing their objectives.

I think it’s organizational. I think it’s how they’re set up, who has what authority to run, execute programs and develop programs, and I think there’s problems with the support systems. The information systems are old and clumsy and clunky, and so I think it’s those problems. I would first look at fixing those, bring in the right leadership, and then, because there has been pretty good funding up to now, then think about what the funding needs are going to be.

JEFFREY BROWN: Paul Rieckhoff, what — what — speaking of leadership, I mean, what do you — who do you — not exactly who, but what kind of person should the president look to now?

PAUL RIECKHOFF: Well, we need someone who’s aggressive, someone who can be a veterans advocate, not a veterans adversary, someone who can tear through bureaucracy, someone with energy and motivation to really rebrand the VA.

This is our opportunity to really change the way the public, our veterans, all of America thinks about the VA, but it’s got to be someone who has experience as a turnaround artist.

JEFFREY BROWN: Well, but is it…

PAUL RIECKHOFF: I would argue…

JEFFREY BROWN: Is it — I’m sorry — I just want to ask, should it be someone inside who knows the system or outside who can come in and totally change the system?

PAUL RIECKHOFF: Well, I think it’s clearly got to be somebody from the outside.

I mean, the calcified bureaucracy internally is part of what Secretary Shinseki wrestled with throughout his term. And, again, we just need a system that works. It shouldn’t be that complicated to have a disability claim, for example, go through a process. But our veterans, they are routinely waiting six months, sometimes years, because until recently it was a paper-based system.

This is a system that has to be dragged forward into the 21st century. It has to be a system that emphasizes technology, responsiveness and, most of all, I think especially right now, transparency. So there has got to be someone who can do a thorough housecleaning and restore that confidence at every level.

JEFFREY BROWN: Joseph Violante, inside, outside, what’s the best way forward?

JOSEPH VIOLANTE: I don’t know that it makes a difference, but it has to be someone who is willing to come in and look at the entire structure, listen to the veterans that have been working with the VA for all these years, and determine what needs to be done and having the authority from the president to do it.

JEFFREY BROWN: And very briefly, Stephen Xenakis, you’re the one who talked about the culture, so is it the leadership or just…

BRIG. GEN. STEPHEN XENAKIS: It’s a leadership — I think you have to bring a turnaround artist, a person who knows how to change organizations.

I think he’s got to be from the health care field and understand how complex that is. And he’s got to be bold. But I think he’s got to come from the outside and be able to put a fresh eye on it.

JEFFREY BROWN: All right. Stephen Xenakis, Joseph Violante, Paul Rieckhoff, thank you all, three, very much.

JOSEPH VIOLANTE: Thanks.

BRIG. GEN. STEPHEN XENAKIS: Thank you.

PAUL RIECKHOFF: Thank you.