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VA scandal forces Congress to study systemic change

WASHINGTON — With calls rising for the resignation of the secretary of the Department of Veterans Affairs, Eric Shinseki, the House and Senate are confronting the broadening health scandal at the department in ways that will challenge both parties to rethink the future of the medical system for veterans.

House legislation would nudge the department toward privatization by allowing any veteran who has had to wait for care for 30 days to seek it through private medical providers, at the department’s expense. The Senate is preparing legislation that would fund as many as 27 new health care facilities within the VA system to address the backlog of care at a cost of billions of dollars.

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With shockingly long wait times at some facilities eliciting bipartisan condemnation, the next steps by Congress will hold significant ramifications for veterans’ health care — and government-run health care broadly.

“Certainly we ought to address the issue of personnel who made mistakes and falsified records, but that’s not going to solve the problems of veterans who’ve had to wait for so long,” Senator Charles E. Schumer, Democrat of New York, said. “We have to look at the underlying problems.”

The scandal was amplified Wednesday with the release of a report by the department’s inspector general that found wide-ranging and “systemic” abuses of its lists to mask the problems of long wait times for care. The investigation’s preliminary report found that 1,700 veterans at the agency’s medical facility in Phoenix were left off the official waiting list and that wait times were systematically understated.

Six Democratic senators, all campaigning for election this year, have called for Shinseki’s resignation: Mark Udall of Colorado, Kay Hagan of North Carolina, John Walsh of Montana, Jeanne Shaheen of New Hampshire, Al Franken of Minnesota, and Mark Warner of Virginia. Senator John McCain, Republican of Arizona, added his voice to the growing chorus. He and Walsh are the Senate’s only combat veterans.

“The systemic problems at the US Department of Veterans Affairs are so entrenched that they require new leadership to be fixed,” Udall said. “Secretary Shinseki must step down.”

In the House, Representative Jeff Miller, Republican of Florida and chairman of the House Veterans Affairs Committee, and Representative Howard “Buck” McKeon, Republican of California and chairman of the House Armed Services Committee, also said Shinseki should step down. For weeks, Miller had said a change at the top would only shift attention from the changes needed to address the underlying problems.

The “report makes it painfully clear that the VA does not always have our veterans’ backs,” said Paul Rieckhoff, chief executive and founder of the Iraq and Afghanistan Veterans of America.

How to fix the problem, however, is a broader political issue. House Speaker John A. Boehner of Ohio made that point Thursday morning when he again declined to call for Shinseki’s resignation.

“The question I ask myself is, ‘Is him resigning going to get us to the bottom of the problem? Is it going to help us find out what’s really going on?’ And the answer I keep getting is no,” Boehner said. “This is more than just about phony waiting lists. This is also about the quality of care we provide for our veterans.”

That leaves both parties with a fundamental question: Does Congress expand a government health program to deal with a net increase 1.5 million new veterans, their ranks swollen by the wars in Iraq and Afghanistan, or does it move toward a privatized health system?

Most veterans organizations are leery of more vouchers for private care, maintaining that the Department of Veterans Affairs has expertise unmatched outside the system in areas such as traumatic brain injury, amputee care, and other combat-related ailments.

Senator Bernard Sanders, independent of Vermont and chairman of the Senate Veterans Affairs Committee, said veterans returning from Iraq and Afghanistan are overwhelming facilities in the Southwest and South. And, he noted, the nation’s entire health care system is facing acute shortages of primary care physicians, so vouchers may not relieve the backlog.

Senate legislation written by Democrats in February that would have expanded the department’s health system with 27 new facilities fell to a filibuster over its cost.

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