Trust the Data? Not When It's the VA's
People may have died while on secret waiting lists for care at VA hospitals, which is why President Barack Obama was forced to address the allegations yesterday -- and why they may yet claim the job of Eric Shinseki, secretary of Veterans Affairs. Shinseki is an honorable public servant, and calls for his resignation are premature. It's the VA's data that can no longer be trusted.
Much of the VA's reputation as the nation's best health-care system depends on that data, which is voluminous and on the whole favorable. According to the VA's most recent performance report, 93 percent of existing patients got primary care or specialty appointments within 14 days in 2013, along with 95 percent of existing mental-health patients. Ninety-three percent of veterans got appropriate preventive care. Four-fifths of veterans discharged from a mental-health unit got follow-up care within seven days.
Pretty good numbers -- if true. Are they still reliable? What about the VA's data on patient satisfaction, such as the finding that 87 percent of patients score it 8 or higher on a scale of 1 to 10 for quality of care? Or that 91 percent say they were treated with "respect and dignity"? A thorough and wide-ranging audit may now be necessary to restore public confidence in this kind of data.
Here's more data: The agency's funding increased from $59 billion in 2003 to $136 billion last year, but the demands on it have also grown. The VA treated 5.6 million veterans in 2012, up from 4.4 million in 2003. And the number of so-called Priority 1 veterans -- those with the greatest level of disability -- was 1.3 million in 2012, more than double that of a decade earlier.
There can be little doubt that the VA needs more resources. That increase in patients has outstripped the increase in money. In fact, spending per Priority 1 veteran fell 8 percent from the time Obama took office to 2012. Compare that with the private health-care market, where the costof employer-sponsored insurance increased 18 percent over the same period.
The president said yesterday that the VA's misconduct, if proved, "will be punished." As it should be. But repairing the VA's reputation, and giving it the resources it needs to work well, will require more than that. The VA also needs to restore public faith in its numbers.
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