WASHINGTON (AP) -- President Barack Obama, already under pressure to replace the Cabinet official overseeing Veterans Affairs, now must contend with a scathing new report that found systemic problems in the medical system for military veterans.
The issue of how the U.S. provides medical care to about 6.5 million veterans each year has the potential to become a headache for Democrats ahead of the November midterm elections, when Republicans hope to gain full control of Congress. Reports that Veterans Affairs employees have been "cooking the books" have exploded since an Arizona clinic director went public with allegations that management at a veterans hospital in Phoenix had instructed staff to keep a secret waiting list to hide delayed care and that as many as 40 patients may have died while waiting for appointments.
Allegations arose that as many as 40 patients may have died at the hospital while awaiting care. The interim report, released Wednesday, found no evidence so far that any of those deaths were caused by delays. It did confirm allegations of excessive waiting time for care in Arizona, with an average 115-day wait for a first appointment for those on the waiting list and that about 1,700 veterans in need of care were "at risk of being lost or forgotten" after being kept off the official waiting list at the troubled Arizona veterans hospital.
The report increases pressure on VA Secretary Eric Shinseki to resign and has become a major issue in Washington, with bipartisan outrage over the treatment of Veterans.
Three Senate Democrats facing tough re-election contests -- Colorado's Mark Udall, Montana's John Walsh and North Carolina's Kay Hagan -- called for Shinseki to leave.
"While our work is not complete, we have substantiated that significant delays in access to care negatively impacted the quality of care at this medical facility," Richard J. Griffin, the department's acting inspector general, wrote in the 35-page report. It found that "inappropriate scheduling practices are systemic throughout" VA health facilities nationwide, including 151 hospitals and more than 800 clinics
Shinseki called the IG's findings "reprehensible to me, to this department and to veterans."
The IG's report said problems identified by investigators were not new. The IG's office has issued 18 reports to George W. Bush and Obama administrations as well as Congress since 2005.
A probe of operations at the Phoenix VA Health Care System found that about 1,700 veterans in need of care were "at risk of being lost or forgotten" after being kept off an official waiting list. The investigation, initially focused on the Phoenix hospital, found systemic problems in the VA's sprawling nationwide system, which provides medical care to about 6.5 million veterans annually.
Dr. Samuel Foote, a former clinic director for the VA in Phoenix who was the first to bring the allegations to light, said the findings were no surprise.
"I knew about all of this all along," Foote told The Associated Press. "The only thing I can say is you can't celebrate the fact that vets were being denied care."
Still, Foote said it is good that the VA finally appears to be addressing long-standing problems.
"Everybody has been gaming the system for a long time," he said. "Phoenix just took it to another level. ... The magnitude of the problem nationwide is just so huge, so it's hard for most people to get a grasp on it."
Shinseki called the Inspector General's findings "reprehensible to me, to this department and to veterans." He said he was directing the Phoenix VA to immediately address each of the 1,700 veterans waiting for appointments. The hospital system's director has already been placed on leave amid the probe.
Lawmakers say the agency's 14-day target for seeing patients seeking appointments is unrealistic, while the Inspector General's report found it encourages employees to "game" the appointment system in order to collect performance bonuses.
The report described a process in which schedulers assigned appointments based on the next available slot, but marked it down as the patient's desired date.
"This results in a false 0-day wait time," the report said.
Griffin said investigators' next steps include determining whether names of veterans awaiting care were purposely omitted from electronic waiting lists and at whose direction and whether any deaths were related to delays in care.
Investigators at some of the 42 facilities "have identified instances of manipulation of VA data that distort the legitimacy of reported waiting times," he said.
U.S. Justice Department officials have already been brought into cases where there is evidence of a criminal or civil violation, Griffin said.