In the two years since reports about long wait times at the Phoenix VA Health Care System leading to patients’ deaths, federal investigators ultimately found 20 instances where people may have died from deficient care or delayed access to care.
Now, it is the Southern Arizona VA Health Care System, in Tucson, that has attracted unwanted scrutiny. The system, which employs over 2,500 health care professionals and support staff, bills itself as “a national model of clinical and organizational excellence,” in part based on its promise to deliver “efficient” care to its patients.
Yet in a report issued in February, the inspector general for the Department of Veterans Affairs found the organizational efficiency of the Southern Arizona facility sorely lacking. Auditors found that in late 2014, the hospital arranged to lease some 360 pieces of urology equipment, only to let the machinery sit, idle and unused, for over four months – at a cost to taxpayers of $217,000.
“[Southern Arizona] delayed using the urology equipment because of inadequate acquisition planning and coordination with its support services,” the inspectors found. “The lack of coordination occurred, in part, because [Southern Arizona] had not established policies and procedures to ensure support services staff review leased equipment requests during acquisition planning.”
Officials at Southern Arizona said they “concur with the findings” of the inspector general’s office. “We acknowledge that there was a delay in introducing the equipment into the procedural environment,” hospital executives said in a written response included in the final report. “The person who ordered the equipment retired suddenly, and therefore the normal coordination did not occur in a timely fashion.”
The toll of this wasteful spending extended beyond financial impact. As the auditors noted, Southern Arizona also “missed the opportunity to provide veterans services using endoscopic urology equipment with improved visualization.”
That diminution in the care afforded our veterans, while difficult to quantify or gauge, is magnified in the wake of the earlier problems recorded at the Phoenix VA health system – and feeds into a broad perception that our brave women and women in uniform are not being treated appropriately when they leave the armed forces. An Associated Press report last fall found close to 900,000 veterans had health care requests pending at that time.
“It's certainly money that could have been used to get veterans appointments faster, said Carlos Fuentes, senior legislative associate at the Veterans of Foreign Wars of the United States, about the $217,000 wasted by the Southern Arizona facility. “You have veterans waiting on care, so this could have been put to better use.”
A review of Southern Arizona’s website found the facility advertising for various open positions where the salaries involved provide some idea of what else could have been purchased with that sum. For example, until April 5, the institution was conducting a search for a physician who could serve as its chief of staff, someone whose duties would include "ensuring high quality and cost effective care." That individual’s annual salary was identified as $150,000 to $300,000 – right in the range of the cost associated with the unused urology equipment.
Likewise, Southern Arizona last week closed out its search for a pharmacist; given the minimum starting salary of $105,515, the money spent on the idle urology equipment could instead have purchased the services of two pharmacists for a year’s time. And ongoing right now is the institution’s search for a registered nurse, whose minimum starting salary – $56,292 – could almost pay for the services of four registered nurses for a year’s time.
“In a private marketplace, your boss would immediately say to you, ‘Look at this: You wasted $200,000 by not even knowing you had equipment over here in a closet," said Sen. Rand Paul, R-Ky., whose office flagged the inspector general’s findings as part of an ongoing project that Paul calls The Waste Report. “But government doesn't have the profit motive; so they work very slowly.”
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