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Hon. Jeff Miller

The Honorable Jeff Miller, Chairman, House Committee on Veterans' Affairs

Welcome to today’s Full Committee oversight hearing, “An Examination of Bureaucratic Barriers to Care for Veterans.”

As we all well know, during a Committee oversight hearing in early April, we came forward with the results of a Committee investigation that had uncovered evidence suggesting that dozens of veterans died while waiting for care at the Phoenix Department of Veterans Affairs (VA) health care system. Just over two months later, we know now that in addition to twenty-three veteran deaths that the Department linked to delays in care earlier this spring, at least thirty-five more veterans died while awaiting VA care in the Phoenix, Arizona, area.

What’s more, a VA audit released earlier this week found that over fifty-seven thousand veterans have been waiting ninety days or more for their first VA medical appointment and sixty-four thousand veterans who have enrolled in the VA healthcare system over the last decade never received the appointment they requested. That is one-hundred and twenty-one thousand veterans who have not been provided the care they have earned.

That number exceeds the population of several mid-sized U.S. cities like Athens, Georgia, or Abilene, Texas, or Santa Clara, Texas, or Evansville, Indiana. And, I fear that there is more yet to come.

Yesterday I spoke to a group of VA providers from across the country at an event for the National Association of VA Physicians and Dentists (NAVAPD). Speaking about the current crisis engulfing the Department, NAVAPD has stated that VA’s, “procedures and processes are inconsistent, inconsistently applied, and often prevent efficient use of personnel...” This statement echoes the serious calls for alarm we have heard from many others in recent weeks.  

During a recent Committee hearing, Dr. Daigh [DAY], VA’s Assistant Inspector General for Healthcare Inspections, testified that VA suffers from, “…a lack of focus on health care delivery as priority one,” as a result of, “…several organizational issues that impede the efficient and effective operation of [the VA health care system] and place patients at risk of unexpected outcomes.”

In an article published last week in the New England Journal of Medicine, a former VA Under Secretary for Health – Dr. Kenneth Kizer - and a current staff physician at a major VA medical center wrote that the systemic data manipulation and lack of integrity VA is experiencing are but, “…symptoms of a deeper pathology,” because, “[q]uite simply, VA has lost sight of its primary mission of providing timely access to consistently high-quality care.”All of these remarks go to prove what we already know. The VA health care system and the bureaucratic behemoth that accompanies is complex and its problems are even more complex.

I believe that the majority of VA’s workforce – in particular, the doctors and nurses who provide our veterans with the care they need – endeavor to provide high-quality health care. Unfortunately, VA leadership has failed those employees almost as much as it has failed our veterans and correcting those failures is going to take a lot more than the band-aid fixes the Department has proposed thus far – it is going to take wholesale systematic reform of the entire Department, starting with holding senior staff accountable.

VA hasn’t gotten where it is today due to just bloated and ineffective middle management; or lack of training and professional development for administrative staff; or inefficient or nonexistent productivity and staffing standards; or cumbersome and outdated IT infrastructures. The Department got where it is today due to a perfect storm of settling for the status quo. VA cannot continue business as usual.  The status quo is unacceptable.  It is time for real change – again, beginning with accountability up to the highest levels of VA bureaucracy. I hear repeatedly from the VA about its delivery of high-quality, patient- centered care…but this Committee will not rest until we hear that same assessment from every veteran seeking care. It is time for VA to tell us the bad news, not just the good.