inside story is next. on al jazeera. new records coming out of the operations of the department of vetted remembers affairs has identified one way the v.a. dropped backlogs. by lying about them. secretary eric was in the hot seat it reese the inside story. ♪ hello, i'm ray

swarez. it is an administrative perfect storm. the vietnam veterans are hitting their years of highest need in healthcare, just as the client rolls are coming up with hundreds of thousands of people that fought in the latest wars. it's long been known inside and outside, the vast veterans healthcare system, that wait times for care can be long, backlogs were enormous, and it was promised over and over again, in congressional hearings that the department of vet reps affairs understood it's problems. and would take care of them. and they did. or said they did. by minute niplating dates reported between the time a vet asked for treatment and when he got it. now congress is looking at dysfunction in the

enormous healthcare system, and summoned the cabinet secretary in charge, retired genre rick to testify. of secret waiting lists at veteran hospitals. >> many adverse incident like this makes me as -- makes me mad as hell, i could use stronger language, but in deference to the committee i won't. but at the same time it saddens me. >> the former four star army general has been under pressure for weeks. >> i asked the secretary to submit his resignation, and i asked president obama to accept that resignation. a healthcare system in phoenix may have gamed the reporting and that may have caused more than 40 deaths.

he says he has worked tirelessly. to cut bureaucracy and backlogs. >> we have enrolled 2 million more. >> we didn't simply go after the backlog just to end what was then five years ago, a set of claims. but some disagree. saying it's common to wait weeks for an appointment. one of those is mark craneny whose unit was supposed to agent orange. >> there was promises there's out and out. pros from the military that they would care for us. >> it was probably at least four months before i got to see the v.a. eye

doctor. >> by the time he got the surgery, it was too late. >> in san antonio texas, one scheduling clerk came forward to al jazeera america, and said he was odderred to hide patient wait times. >> there are a number of clerks that would substantial the schedules that i have claimed in the coaching of us changing those dates. to make it look like the v.a. lad a shorter wait time. asking for a cover sup in effect right now, and if it is part of a larger culture problem. >> this is not new news. >> that this is not news.

that these concerns did not aride yesterday, or in phoenix. but in fact there have been reports by the inspector general, by the general accounting office on numerous occasions. about problems have to do with scheduling and with waiting lists. >> but he insisted that as a under workerrer vietnam veteran today, he would not stand for gaming if it's true. i want to know how you are going to get your medical directors to tell you whether it's through this survey or in the future, when they have a problem, and will work with you to address it, rather than pursuing these secret lists and playing games. >> senator, if there's anything that gets me angrier than just hearing allegations is to hear you tell me that we have

folks that can't be truthful because they think the system doesn't allow it. trust is an important aspect of everything we do here, and has been in my previous life as well. and in order to do that, we have to be transparent, and we have to hold people accountable. >> he also said only president barack obama could convince him to give up his host, helping all wounded veterans. >> i intend to continue this mission until i have satisfied either that goal or until i abide by the commander in chief that my time is been served. one of his close toast oversee a review of veterans affairs policies. the result of the audit by the inspector general is expected in the coming weeks.

the secretary as we mentioned is a retired four star general, and former chief of staff. he is rejected calls to resign, and pledged in interviews to get to the bottom of the problems at the v.a. what is it that is -- that's this edition of inside story. now responsible for the care of millions of men and women, who are joined by lewis. is senior fellow at the center for american progress, and rich charred allen smith, a veteran of the were in afghanistan, and former v.a. staff member. you saw him open the questioning by saying this is not new news, hasn't the department of

veterans affairs promised to roll up these problems when they have erupted in the past. >> we have testified on several different occasions we have brought it up in the past, and when the phoenix scandal hit that's when the american legion finally decided to speak out. it was because of a break down in the leadership. to defend secretary just a year ago, through a time magazine article. the american he john stepped up and said no, we think he doing some good things we want to give him more of an opportunity to fix these problems and then when the scandals broke out, we finally had to reassess, and our leadership, got together, they voted, and our members decided that it was really time for new leadership. according to your own investigation, several

other centers as well. >> true. not just phoenix, and the other centers now in addition to our investigation now that phoenix is broke, and they have spoke out, it is encouraged others to come forward. >> lawrence core not only did you serve in uniform, but you are a former assistant secretary of defense. you know about big systems. when we went to war, we thought those wars would be short, the administration calls them a cake walk. and general said it is going to be a long war, you need a lot of troops they said he doesn't know what he is talking about, and sidelined him, so the general has been playing catch up ball, because

since we didn't plan for the long wars nor did we plan for what we call mental problems or ptsd, the numbers were much greater than they thought. and then as the run up comes up, the two came together, and i think if you look at it, he has residued the number of claims. he has reduced the waiting times. we need an i.g. inspector general investigation to find out if these were individuals who are acting on orders or were basically worried about their own careers. before they say you should go. for example, we didn't ask the secretary of defense to resign when that walter reed scandal came out. richard smith, tell us what it was like. you are one of those new generations looking for help for a variety of

problems. was it easy to use the system? >> yeah, it was for me. and they testified to this on the hill, no one is criticizing the quality of care delivered by the department of vet reps affairs, what we have here is access to that case. >> so once you get in you are okay? >> yeah, and it depends on where you are. i took a friend to a v.a. emergency room, and we walked in and he was seen right away when i was in denver, colorado, and birmingham alabama it is easy to see someone, here in washington, d.c. it has taken longer. i think what is important is when the general came in 2009, there was an immediate culture shift. at v.a. he is the guy that wants to know what is wrong. for decades was mismanaged and the number one priority was making things look good. not making them good.

that are either unwilling to change, or just don't know any other way of doing business, that don't get that this is -- making things look good is the kind of thing that will get you in trouble. what about that, that this is a really regional and limited problem that's limited to certain centers where care is given, but overall satisfaction is high with the product once you get through the door. >> i think the american he john agrees with that. these are systemic problems that are peppered throughout the united states. if you ask the average veteran, and we ask veterans what do you think about your care, by and large, 95% of the veterans we hall love their v.a. care, they love their care team, they love their doctors. it isn't the v.a. care. there are some issues and some sporadic pockets around the country, for

instance, the colonoscopies dirty equipment with dental care. there are problems that are isolated. our chief complaint is with the administration of this healthcare. it is witness the health care itself, it is with trying to get care. it is with the wait times, we also have some problems with the construction, of the hospitals we have problems with the electronic records that was abandoned between d.o.d. and va, so there are a lot of break downs that we have issued with. >> we are going to take a short break, and when we come back, we will talk about whether that's a legitimate answer. this new flood of veterans and what it would take to get the v.a. where it needs to be, to handle both the vets of the past, and the newest former service people, this is inside story.

urn necessary deaths long waits for treatment, false fied records to cover up mismanagement, serious charges have been brought against the veterans at ministration. we are looking inside the centralling health system for americas veterans and lewis chelsea, you heard larry just a moment ago talk about the unfunded and unintended size of the patient pool now.

is that a legitimate answer for why it's been so tough to ramp up to where the system needs to be. >> absolutely not, and the american he john is not saying that the v.a. does haven't a tough job. and there aren't a lot to serve, we have never said that. our complaint is that the v.a. has consistently sat before congress and said hey, we have everything under control. we have this -- and veterans are getting an appointment within 14 days and everything is good. and the congress keeps coming back and saying are you slur, because we will give you more resources if that's what you are looking for, and they say no, we are good. but the truth is they are hiding a wait list, so the question now becomes if may open that hidden wait list, and dutch everybody into the system, will the v.a. then be overrun, will they then say we don't have enough resources. >> it is arguable they are overrun now? the last three years primary care rose by 50%,

and the number of doctors on staff rose by 9%. isn't that a gap that can't be closed? >> it sounds like a gap that can't be closed until you hear from the v.a. and they say we are handling it just fine, so it sounded like they are managing their assets in a way as to compensate for the increased secretary said 2 million more, but then he later said that 1.4 came in for services after they registered. so he has another 1.5 million veterans that need to be seen. we believe that they are being taken care of, we come to find out that they are not. richard, is this more than a bureaucratic inconvenience? is something that young fellas like yourself are depending on to be there, and then finding it's not all it was cracked up to be? >> i think so. but i think again, it is

key to remember that look, the v.a. was mismanaged for decades. and that's hard to describe to somebody who hasn't experienced that. but we are talking epic levels of mismanagement that you can't turn around in six years. yeah, there is some accountability that needs to happen. that says yes we are handling this. if there's a spill a dug churr that says yes we have it under control, what is he going to do and go and say yes we have it under control. >> i am asking about when you are transitioning out of uniform, is part of the mind set for demobilizing vets coming off of multiple tours, multiple tours in iraq, that yes, i know, because i have been promised than waiting for me. >> absolutely. and when i got out of the army, and went to huntsville that is correct was my only health insurance was v.a. care, and thankfully the folked at outcare patient

clinic in huntsville took great kade of me there. as a manager, now in a very different kettle of fish, they go in understanding the life they are entering but also being told on the other hand, here are -- here is what you can expect for the rest of your life. >> well, i think the point that's been made here, by the he john is that people were not being honest with general. he was telling of them to cut down the waiting period, all right, now people who did not want to admit they weren't following that, or couldn't follow that, were gaming the season by pretending people did. is that's a problem we need to find out about.

but you flow as a manager, if you say we are going to reduce the backlog by x or y%, people out in the field say we better do that or we won't get promoted and they aren't as honest as hay should be, and that's what we are finding out now. that's why i think the general said i'm mad as hell. because he is used to the army where people don't do that, and he couldn't believe that people may do that. and we will find out how bad. they gamed the season, and they should be held accountable for it. but you can't say because you have people within

the system, you have hundreds of thousands of employees you have to blame the person on the top. can you know if someone below you is lying to you. >> i certainly hope so, and i would hope i would know if the job isn't getting done. if the job is not getting done, i would have to root it back to find out where it wasn't getting done. and when i was receiving answers telling me it was -- that's what leadership is all about. who here will be held accountability. then when you find out they are lying it is your fault. everything that happens or fails to happen in a military unit is i am sure both of my colleagues here know is the result of the commander and the first sergeant what flows up to a man like eric is not guys in casts or holding mris it is data. and if the data looks good, how are you supposed to know that it is not? >> yeah, but you don't blame the chief of the

staff of the army. look at the sexual assault problem, we are looking at the commanders in the units, and yes, you should look at those people, but not the top person. it is very easy to do that, i agree there has to be accountable to the people in phoenix, or wherever it is, if they are telling them, that things are going well, the wait time several layers in between that should be checking on. >> i hear what you are saying but for years on end, since 2010 at a men mum, he has heard there have been mel mows that have been sent to him and the president explains exactly what is going on, and yet nothing happened. and when he was asked today, saying he didn't remember seeing it. is he not inyou remember toking the secretary, and after four years is it his responsibility to know that this is -- of course it is.

hold that thought, i know you want to jump in. we will talk about whether this latest crisis has the potential to break up the monopoly. this has been a politically fraught conversation in the past, what about the future? this is inside story.

inside story.ack to we aren't cooing our conversation on the u.s. department of veterans affairs. as of 2012, there were 22 million veterans in the united states, 8 1/2 million are enrolled in the v.a. healthcare system. you often hear about the size of the bureaucracy, these numbers tell part of the story. there are 56 regional offices for benefit administration. 152 veterans administration hospitals, 300 veterans centers, 817 community based outpatient clinics.

richard at len smith, you wanted to jump in before the break. >> yeah, i just want to say, we all agree, that if people are in the system, that's wrong. but i think we would also all agree, that access to care and quality care is a lot better than it was in 2007, before general took over. and i think it is important that we don't throw the baby out with the bath water. the general has done an amazing job at modernizing the v.a. and second, i want to point out that the he john support add spending bill, that republicans in congress spiked. and that bill contain as lot of funding for new medical center constructions and other things that would improve access to care. so if we are talking about holding people accountable, let's hold the folks in congress accountable. >> one issue that has come up from time to time, there have been veterans that have said look, i can't travel to the nearest center, it is very inconvenient, or

people have pointed out that providing things like colonoscopies may be cheaper if you just did it in a port billion clinic where you live in an already standing hospital, wrath err than traveling to a v.a. facility, but that's often been stopped. people say no we already have the paragraph, already have the systems in place, could we see some rationalization of the way we use these resources and still deliver the care? >> i believe we should. given the way we communicate, and the internet now, yes, you can do it. and one problem they have, they haven't been able to hire enough doctors because the v.a. doesn't pay as well as people in private practice. so i think we out to do that, and then you have to have the d.o. department of defense and the veterans administration together too, that would also help. >> i agree with that. and as far as remote care, the f.i. has been

instrumental in instituting rueful care initiatives. they have the sea box, these are things that the american he john has constantly lobbied for. so keeping the v.a. in place saves money. >> quick yes or no, do you think general's job is in danger is he going to stay until the end of the administration? >> i hope he does. >> i know you hope he does, is he? >> yes. >> he is gone. >> really. >> i think he is gone. i think he had a shot, today's performance before congress, i don't think he had the answers that congress was looking for. i think that he and secretary came unprepared. i was -- embarrassed for him. because he didn't have the answers that congress was looking for, and very simple questions like is this a performance review, that will earn them money, he said he

didn't know. i think the administration has had it. >> thank you for being with us, the program may be over, but the conferring continues we want to hear what you think about the issues raised on this or err day's show, you can log on to our facebook page, you can send us your thoughts on twitter, our handle is a.j. inside story a.m. you can reach me directly at ray swarez news, see you for the next inside story, in washington, i'm ray swarez. real reporting that brings you the world. >> this is a pretty dangerous trip. >> security in beirut is tight. >> more reporters. >> they don't have the resources to take the fight to al shabaab. >> more bureaus, more stories. >> this is where the typhoon came ashore. giving you a real global

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