Shinseki resigns from VA amid hospital delay scandal, says he'd become 'a distraction'
"We don't have time for distractions," Obama said. "We need to fix the problem."
The president was under mounting pressure this week from lawmakers on both sides of the aisle to let Shinseki go after the number of VA health-care facilities under investigation for manipulating patient wait-time data jumped from 26 to 42. The news underscored the nationwide scope of the crisis.
VA Deputy Director Sloan Gibson, a U.S. Military Academy graduate who joined the department just three months ago, will take the reins as acting VA secretary until a permanent replacement can be found. Gibson most recently served as chief executive of the USO.
"This is totally unacceptable," Obama said at a news conference afterward. "All veterans deserve the best. They have earned it. Last week I said that if we found misconduct, it would be punished, and I meant it."
The president stopped short of blaming Shinseki for the VA's woes, which predated the retired four-star general's tenure. He said he accepted Shinseki's resignation "with considerable regret."
Shinseki was frustrated that the manipulation of scheduling data and delays in medical care at VA facilities didn't get reported up the chain of command, Obama said.
"I think that's the thing that offended Secretary Shinseki the most during the course of this process," the president said. "I think he's deeply disappointed in the fact that bad news did not get to him. And that the structures weren't in place for him to identify this problem quickly and fix it."
While Obama asserted Friday that the scheduling problems at VA were "not something we were aware of" until recently, more than a decade's worth of reports from the VA's own inspector general and the Government Accountability Office identified the issue repeatedly in dozens of audits, as well as in testimony before Congress.
Even before the wars in Iraq and Afghanistan, the VA couldn't meet the agency's 30-day appointment standard, the GAO reported in 2001. The report said that "excessive waiting times for outpatient care have been a long-standing problem." Waiting times ranged from 33 days at one urology clinic to 282 days at an optometry clinic.
Since then, numerous other GAO reports and a total of 18 audits by the VA Office of Inspector General documented scheduling irregularities similar to those reported last month at the Phoenix VA Health Care System, where 40 veterans on a secret wait list allegedly died waiting for care.
The reports found VA schedulers kept "informal waiting lists" and routinely entered the wrong requested appointment dates into the system, making wait times appear shorter than patients actually experienced.
Auditors blamed inconsistent training and high turnover of VA's 50,000 schedulers, an outdated computer system, and a lack of staff dedicated to answering telephones. The VA pledged to fix the problem, but last year another GAO study reported that VA schedulers still were not reporting patients' desired appointment dates correctly.
The author of that study, Debra Draper, testified about her findings before Congress on March 6, 2013.
The VA's "ability to ensure and accurately monitor access to timely medical appointments is critical to ensuring quality health care to veterans, who may have medical conditions that worsen if access is delayed," she told lawmakers.
Tom Tarantino, policy director of Iraq and Afghanistan Veterans of America, said one reason Obama and Shinseki could claim they didn't know the full extent of problems at VA facilities lies in financial incentives for clinic heads to cover them up.
"The problem is that people at the VA think it's OK to lie to their headquarters and it's OK to lie to their patients so they can get their bonus money," Tarantino said. "They've been getting away with it for a very long time."
The new VA secretary's priorities should be cutting wait times for treatment, reducing the backlog of disability claims and helping stem the rising number of veteran suicides, Tarantino said.
"People are waiting too long to get the care they've earned," he said. "Once you get into the system, the care is actually quite good, but there are a lot of problems with access."
Tarantino said the new agency chief needs to be more dynamic.
"It needs to be someone who is able to communicate not just to vets, but to the American people what the VA is doing," Tarantino said. "Shinseki's biggest failure was that he was largely invisible. The secretary of veterans affairs for all intents and purposes needs to be the face of veterans' care in this country."