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Veterans Affairs Secretary Eric Shinseki faces calls for his ouster amid allegations that some veterans have died after being unable to get medical care. / Chip Somodevilla Getty Images

WASHINGTON -- President Obama on Wednesday called his encounters with wounded American troops "the most searing moments of my presidency."

Responding to allegations that Department of Veterans Affairs workers at 26 hospitals and clinics lied or falsified documents to hide how slowly patients were seeing doctors, Obama minced no words in expressing his outrage.

"When I hear allegations of misconduct -- any misconduct -- whether it's allegations of VA staff covering up long wait times or cooking the books, I will not stand for it," he said. "Not as commander-in-chief, but also not as an American."

Yet the strains on the VA's health care system are certain to become even more severe.

Nearly 9 million veterans rely on the VA for medical and mental health care, and their needs are increasing. Last year, VA medical personnel handled 85 million outpatient visits. The number has grown each year.

Medical complications for aging veterans from World War II, Korea and Vietnam combined with an array of health problems for more than a million -- and counting -- veterans of the two most recent wars translate into unprecedented strain, according to VA statistics.

"The demands on the VA are going to grow," Obama warned. "So we're going to have to redouble our efforts to get it right."

Obama made the comments after summoning embattled VA Secretary Eric Shinseki to the White House to discuss the crisis.

The president acknowledged that he does not know how widespread the problems with health care delays or falsifying scheduling records are at the VA's 150 hospitals and 820 outpatient clinics.

"I don't yet know if there are a lot of other facilities that have been cooking the books," Obama said. "I want to know the full scope of the problem."

The House of Representatives passed legislation late Wednesday designed to make it easier for Shinseki to fire or demote senior executives at the VA, cutting through some of the red tape that now exists.

Obama's comments marked the first time he has publicly addressed the issue at length since the furor erupted in April with allegations, first reported by The Arizona Republic and CNN, that secret waiting lists had been created at the VA in Phoenix to hide delays in care and that as many as 40 veterans have died while awaiting a doctor.

The allegations came from a retired doctor who worked at the hospital. Since then, whistle-blowers at other hospitals or clinics have stepped forward to report similar problems at other VA facilities around the nation.

"I will not tolerate it, period," Obama said, adding that if the delays are the result of a shortage in doctors, the need should be quickly remedied so veterans can get care rapidly.

"I want to know what's working. I want to know what's not working. And I want specific recommendations on how the VA can up its game," Obama said.

He said he expects preliminary results on his demands next week.

Reaction to the president's comments came rapidly. Rep. Jeff Miller, R-Fla., chairman of the House Committee on Veterans' Affairs, described Obama's remarks Wednesday as "too little too late." "This outrage that he is trying to express should have been immediate and swift," Miller says.

Strong credentials

Shinseki took charge of the federal government's second-largest bureaucracy five years ago cloaked in the kind of virtue and integrity most politicians would bleed for -- a war hero-risen-to-Army chief with a reputation for speaking truth to power on the eve of a controversial new war in Iraq.

As the 71-year-old VA secretary was sworn in last week before a Senate committee investigating a growing scandal around delays in providing medical care, in some cases causing harm to veterans, he seemed to remind those present of his sterling reputation.

"I've been taking oaths most of my life, Mr, Chairman," said the twice-wounded Vietnam War veteran. "You have my best answers based on what I know, as truthful a presentation as I can make."

Yet the cloak of integrity has been fraying badly in recent weeks.

A small but growing chorus of critics -- including several Republican congressmen and the American Legion, the nation's largest veteran service group with 2.4 million members -- have called on Shinseki to resign. They were joined recently by two Democratic congressmen, David Scott and John Barrow, both of Georgia.

American Legion National Cmdr. Daniel Dellinger said Wednesday he regretted that Obama had not fired Shinseki after meeting with him.

"I think he (Shinseki) is out of touch," said Paul Rieckhoff, founder and executive director of Iraq and Afghanistan Veterans of America, referring to evidence that delays in care have been plaguing the VA for years without definitive corrective action. "It doesn't seem that he has a grasp of the enormity of these problems."

But supporters said that Shinseki's success in reducing veteran homelessness, cutting the backlog in pending compensation claims, encouraging veterans to enroll in VA health care and processing GI Bill education claims are factors in his favor.

"He's an administrator of great talent. He has tremendous integrity. He's been a gun-carrying veteran in the field and I think the longer he's there, the more likely he is gradually moving this World War II artifact (the VA) in the right direction," said retired Gen. Barry McCaffrey, who served with Shinseki.

Obama on Wednesday offered measured endorsement of his VA chief, noting that the retired general has put his "heart and soul" into his work. But Obama said that pending investigations are crucial.

"I have said to Ric and I said it to him today, 'I want to see the result of what these reports are, and there is going to be accountability,' " Obama said. "I am going to expect even before the reports are done that we are seeing significant improvement in terms of how the admissions process takes place in all our VA health care facilities."

During recent testimony before Senate Committee on Veterans' Affairs, then-Veterans Health Administration chief Robert Petzel - who resigned Friday - said that a face-to-face audit of all 150 VA hospitals and all the major clinics would be completed at the end of last week. He added that the rest of the VA's 820 clinics would be reviewed this week.

Last Friday, VA acting inspector general Richard Griffin told the committee his office was already looking at 10 facilities. On Tuesday, the IG said that number had more than doubled to 26.

Griffin said that his investigators have so far not linked any deaths directly to a delay in healthcare.But John Daigh, VA assistant inspector general, testified there was evidence veterans had suffered "harm" because of delays in the medical treatment.

The GAO and the agency's inspector general have published reports going back several years warning of delays in care and efforts by hospital personnel to cover them up. William Schoenhard, a former VA deputy under secretary for health operations and management, drafted a memorandum in 2010 outlining dozens of ways schedulers hide proof that patients wait to get medical care.

"In order to improve scores on assorted access measures, certain facilities have adopted...scheduling practices sometimes referred to as 'gaming strategies,' " Schoenbaum wrote four years ago. "These practices will not be tolerated."

W. Scott Gould, Shinseki's former deputy secretary who left last year, said this current controversy may be the hardest fight of Shinseki's long career in public service."

"This is obviously very tough," Gould said. "It's also harder because it's happening later (in his tenure at VA). Everyone has sort of a life cycle in these positions. And the longer you're there, the more you own it. So there's no question this has got to be hard for him and for the team that's there."



Copyright 2014 USATODAY.com

Read the original story: What lies ahead for the VA

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