The VA Again. Still.

It gets worse and worse, or, to be strictly accurate, reporting about how bad it is continues to pile up. It appears that it was always this bad.

• ITEM: 27 May 14. Texas VA hospitals have systematically cooked the books to pad executive compensation; the facility is “run like an organized crime syndicate”; investigations have been phony and designed not to find the misconduct. VA officials in Texas and Washington have known about the fraud for years, and covered it up. The Daily Beast:

Emails and VA memos obtained exclusively by The Daily Beast provide what is among the most comprehensive accounts yet of how high-level VA hospital employees conspired to game the system. It shows not only how they manipulated hospital wait lists but why—to cover up the weeks and months veterans spent waiting for needed medical care. If those lag times had been revealed, it would have threatened the executives’ bonus pay.

What’s worse, the documents show the wrongdoing going unpunished for years, even after it was repeatedly reported to local and national VA authorities. That indicates a new troubling angle to the VA scandal: that the much touted investigations may be incapable of finding violations that are hiding in plain sight.

“For lack of a better term, you’ve got an organized crime syndicate,” a whistleblower who works in the Texas VA told The Daily Beast. “People up on top are suddenly afraid they may actually be prosecuted and they’re pressuring the little guys down below to cover it all up.”

The case of Dr. Joseph Spann, a recently retired doctor who reported malfeasance in the Texas VA system, where he worked for 17 years, raises the possibility that official investigations may only be hiding the problems they were charged to root out.

In 2011, the VA’s inspector general investigated the Central Texas health-care system in response to complaints it had received. The inspector general found that manipulated appointments were widespread and hid significant delays, but the report doesn’t seem to have led to a single VA official being disciplined or officially held responsible for gaming the system.

via Exclusive: Texas VA Run Like a ‘Crime Syndicate,’ Whistleblower Says – The Daily Beast.

ITEM: 28 May 14. Preliminary report from the IG is highly negative. Delaying medical care is systemic and pervasive in the VA system. The care of patients has been compromised. Still uncertain: if the corruption and misconduct rose to the level of crime. USA Today:

Delaying medical care to veterans and manipulating records to hide those delays is “systemic throughout” the Department of Veterans Affairs health system, the VA’s Office of Inspector General said in a preliminary report Wednesday.

“Our reviews at a growing number of VA medical facilities have thus far provided insight into the current extent of these inappropriate scheduling issues throughout the VA health care system and have confirmed that inappropriate scheduling practices” are widespread, the report said.

Investigators with the Inspector General’s Office also said their probe into charges of delays in health care at a VA hospital in Phoenix shows that the care of patients was compromised.

The probe found that 1,700 veterans who are patients at the Phoenix hospital are not on any official list awaiting appointments, even though they need to see doctors. Some 1,138 veterans in Phoenix had been waiting longer than six months just to get an appointment to see their primary doctors, investigators found.

“These veterans were and continue to be at risk of being forgotten or lost in the (Phoenix hospital’s) convoluted scheduling process. As a result, these veterans may never obtaina requested or required clinical appointment,” the report said.

The Inspector General’s Office said it is working with the Justice Department to determine if crimes occurred in how patients were handled.

The Inspector General’s Office said the problems it is finding are not new. It has issued 18 reports dating to 2005 documenting delays in treating veterans at some of the agency’s 150 hospitals and 820 clinics and detrimental health impact these delays have had on these patients.

The Inspector General appeared to draw a direct link between delays in health care and the bonuses of about $9,000 and salary increases that hospital officials receive as a result of their performance appraisal.

The Washington Times also had a report on the IG preliminary. It raised many of the same issues, but also others:

The report also found real wait times different drastically from what was reported by the Phoenix facility. Of 226 veterans, the data from Phoenix showed the average wait time to be just 24 days for their first primary care appointment. The inspector general, however, found the average wait time was 115 days.

Three top VA officials are expected to testify before the House Committee on Veterans Affairs Wednesday night after failing to appear before the committee last week. If they don’t show, the committee will subpoena them to testify on Friday.

Nice to know they’re taking it seriously over there in Shinsekistan. They also noted that misconduct is now under investigation in 42 facilities.

• ITEM: 28 May 14. Turns out, the VA hasn’t got the time to treat veterans with service connected disabilities, but what it has been doing since 2011, at a higher priority than the combat disabled, is providing sex-change support for sex-confused vets. Over 2,500 of them last year (that’s the count of tranny vets, not treatments).

The VA has supported counseling, cross-sex hormone therapy, evaluations for sex reassignment surgeries performed outside the department and post-reassignment surgical care since 2011, [Ndidi] Mojay said.

Mojay is one of the VA’s inexhaustible supply of PR dollies and spin doctors. If spin was a service-connected disability, they’d be well placed to treat it.

We guess that answers the musical question, “What has the VA been blowing all their money (budget +175% since 2009, patient load +38%) on lately?” On giving sex change treatments to sexually confused (“gender dysphoric”) veterans, who number over 2,500, at a higher priority than treating service-connected disabled veterans. But that’s just our cismale gendernormative cryptofascism coming out, they tell us.

Stuck on the endless secret-waitlist treadmill? Just tell them you feel like you need to be a pole dancer named Tiffany, and you’ll zip to the head of the line!

• ITEM: 29 May 14. A troubled vet was put on a delay treadmill in Kansas City, despite the fact that his treatment was court-ordered. Isaac Sims was shot by police Sunday in what appears to be suicide-by-cop.

Iraq War veteran Issac Sims was killed Sunday by Kansas City, Mo., police after a standoff at his family home. Sims suffered from post-traumatic stress disorder and been told he could not get care from the local Veterans Administration center for another 30 days.

Sims, 26, had gotten into an argument with his father Sunday and reportedly fired off a gun multiple times inside and outside the home. Police responded to reports of the shooting and subsequently called in the SWAT team. When Sims emerged from the house 5 hours later with a rifle, he was shot dead. Officers stated he pointed the gun at them.

Now, Sims’s own actions compelled the cops to shoot him, so the VA’s delay is a contributing factor, but not a cause, as we see it. YMMV. Still and all, VA’s endless delays are not fair to the veterans, or to the cops, who have to live with having done shot this guy. (If they’re vets, their care will be delayed, too! Welcome to the chain reaction of stress).

If only he wanted a set of female secondary sexual characteristics, they’d have hooked him up, apparently. His bad luck that wasn’t what he needed.

• ITEM: 30 May 2014 (today): Our best guess is that Shinseki will commit seppuku, job-wise, sometime after 6 PM EDT tonight. It doesn’t help much because he’s simply the bumbling figurehead; all of the people responsible for the maltreatment of vets are job-for-life civil service drones. Personnel is policy, and those particular personnel are burrowed in like ticks on a hound. The Secretary can be fired (and should be), but he’s not the proximate cause of the problem, and his firing does not move us a millimeter closer to a solution.

If he doesn’t go tonight, they’re saving his resignation as a counterweight for news of further abuses.

UPDATE: We were wrong. Shinseki went under the bus first thing this morning. And the President said in a press conference that he (Secretary Shinseki) had already started firing people. Bridget Johnson at PJMedia notes that ~120 legislators including some 38 (mostly election-vulnerable) Democrats had called for the General’s head, while the always anti-military and anti-veteran Socialist Bernie Sanders and key leaders of both parties (Boehner, Reid) still backed him to the last. Shinseki has been replaced, temporarily, by Deputy Secretary Sloan Gibson, who may or may not be part of the problem.

ITEM: 30 May 2014. Secretaries come and go, but the staggering incompetence of overpaid, underworked, unaccountable Civil Service drones just putters steadily along. Jeryl Bier notes at Real Clear Politics that VA’s IT boss, Stephen Warren, was boasting about VA’s great electronic scheduling system (which dates to the 1990s).

A report released this week by the inspector general for the Department of Veterans Affairs (VA) found that “inappropriate scheduling practices are systemic throughout VHA.” But as recently as September 2013, Stephen Warren, the executive in charge for information and technology for the VA, said that he could not “pass up an opportunity to brag about how” VistA, the scheduling software in use for more than two decades by the VA, “plays a role in providing the quality care Veterans receive at VA.”

Warren made the remarks in his keynote address at the 2nd annual summit of the Open Source Electronic Health Record Alliance (OSEHRA).

Warren’s remarks also reveal one of the reasons VA is so poor at health outcomes: of the VA’s quarter-million employees, a bare 70,000 are health care providers (docs and nurses): the rest are clerical overhead. Like Warren.