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ICYMI - Jason Chaffetz: Shinseki Must Go - Obama Administration Must Hold Itself Accountable
With great fanfare, President Obama in April 2009 gave the VA a mission: modernize health care delivery to veterans by integrating electronic health records between the Department of Defense and the VA. Five years later, with cost estimates in the billions, the mission has been aborted. Secretary of Defense Chuck Hagel candidly explained the decision in formal testimony before Congress, saying: “I didn’t think we knew what the hell we were doing.”
As consequences of the Obama Administration’s failure are magnified, the calls for accountability are justified. Secretary Shinseki presides over an agency in chaos, in which whistleblowers are coming out of the woodwork to report problems with the delivery of care, allegations of cooking the books and claims of retaliatory action against those who spoke up or refused to go along.
Today the VA is no closer to electronic record integration than they were the day Secretary Shinseki was sworn in. The much-heralded integrated Electronic Health Record (iEHR) project, slated for full implementation by 2017 after a scheduled preliminary rollout in 2014, has been scrapped in favor of maintaining two separate systems indefinitely.
As is the pattern of the Obama administration, no one at either agency has ever been held accountable for failing to implement the President’s policy. Instead, the agencies have sought to be rewarded for their incompetence with large infusions of money to “improve” the failed systems they refuse to integrate.
The iEHR project, which President Obama himself promised would “cut through red tape and reduce the number of administrative mistakes” would have ostensibly created a seamless system for transitioning electronic medical records. President Obama promised that, “When a member of the armed forces separates from the military, he or she will no longer have to walk paperwork from a DoD duty station to a local VA health center; their electronic records will transition along with them and remain with them forever.”
Just two years later, both the DoD and VA not only continued to use their separate systems, but began asking Congress to appropriate billions of dollars to each agency to improve the two redundant record systems iEHR was intended to replace.
According to a 2011 GAO report, DoD had obligated approximately $2 billion over the 13-year life of its own health record system (Armed Forces Health Longitudinal Technology Application - AHLTA) and requested $302 million in fiscal 2011 year funds for a new system.
Meanwhile, that same GAO report showed the VA spent a combined total of nearly $600 million during a six-year period as part of its health record system modernization (Veterans Health Information Systems and Technology Architecture (VistA). VA estimated in 2008 an $11 billion total cost to complete the modernization by 2018.
President Obama in his first year made promises to veterans with the expectation that his staff would carry them out. They didn’t. And so far, the only people who have paid a consequence for that failure are America’s veterans.
The promises to cut red tape at the VA, provide a seamless transition from active duty military to veteran status, provide a single permanent electronic health record and reduce wait times have gone unfulfilled. The results speak for themselves.
Once again, I find myself asking – just what does it take to get fired in this administration? If no one is ever held accountable, there is little incentive to perform.
For his part, President Obama can hardly plead ignorance. The red tape, long transition times and inadequate communication between DOD and VA are the same problems he told us five years ago would be resolved through the implementation of the iEHR project.
Having abandoned that project more than a year ago, the administration has unveiled nothing to take its place. To put it simply, the quality of care to America’s veterans has not been a priority. The new plan of action appears to be limited to throwing more money at the same system that created the problems in the first place.
The futility of efficiently operating a government-run health system notwithstanding, Secretary Shinseki has had plenty of time to prove he can at least implement the President’s agenda. Given the nation’s experience thus far with healthcare.gov, there is no guarantee the iEHR project would have accomplished its stated objective. Nevertheless, when the President makes a commitment to America’s veterans, his staff should take that commitment seriously.
The systemic problems at the VA call for new solutions and new leadership. Federal agencies need to be put on notice that incompetence will neither be rewarded nor tolerated. It’s time to replace Secretary Shinseki and move forward with real reforms and proven solutions.
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