VA chief's satisfaction measure draws GOP howls

WASHINGTON -- Veterans Affairs Secretary Robert McDonald, under pressure to be more transparent about how the federal department measures wait times for veteran care, on Monday said the government should be more like Disneyland.

Disney doesn't track how long visitors wait in line for attractions at its theme parks to decide if they liked their experience, he said, arguing that the VA should not be held to that standard for medical appointments for veterans.

"When you go to Disney, do they measure the number of hours you wait in line? Or what's important?" McDonald told reporters at a breakfast sponsored by the Christian Science Monitor.

"What's important is, what's your satisfaction with the experience?"

Disney was one example he cited of how private-sector companies look more closely at whether their customers are satisfied overall than at the time they have to wait for service.

"What I'd like to move to eventually, is that kind of measure," McDonald said.

Disney, it turns out, does collect and analyze extensive waiting time data, which it considers core to its overall customer experience. The company has a system that manages the information.

McDonald's comments were quickly denounced by top Republicans on Capitol Hill, including House Speaker Paul Ryan, R-Wis., as insensitive to veterans, whose long waits at VA hospitals -- and the agency's attempt to cover them up -- exploded into a scandal two years ago.

Ryan called McDonald's comments "flippant" and said they show "just how seriously the Obama administration's VA is taking life or death problems" at the agency.

"This is not make-believe, Mr. Secretary. Veterans have died waiting in those lines," Ryan said on Twitter.

"There is nothing amusing about VA's performance over the past few years, and comparing VA wait times to those of an amusement park is just plain wrong," said Rep. Jeff Miller, R-Fla., chairman of the House veterans panel.

Sen. John McCain, R-Ariz., chairman of the Senate Armed Services Committee and a longtime veterans' advocate, called McDonald's comment "outrageous and completely inappropriate," especially since McDonald himself is an Army veteran.

"Our veterans aren't in line for a theme park ride -- they are in desperate need of timely access to quality medical treatment," McCain said.

Whistle-blowers and the VA Office of Inspector General revealed that Veterans Affairs employees in Phoenix and at other hospitals across the country were putting appointment dates in the system earlier than the real ones, which were later on the calendar and exceeded the reasonable time a veteran should wait to see a doctor. The scandal cost Veterans Affairs Secretary Eric Shinseki his job.

In the scandal's aftermath, VA has said that wait times for care have shortened in many places, thanks to more resources and a focus on outsourcing care to private doctors. But a recent report by the Government Accountability Office criticized the metric the agency uses to calculate how long a veteran waits for an appointment or procedure. That measure is called the "preferred date," but does not count the wait from the time a patient first calls or sends an email to schedule an appointment.

But McDonald said the wait from the day the appointment is created, which varies widely among VA hospitals, "is not what we should be measuring."

"We don't think it's valid," he said Monday. "We have a very large health care system. I don't want to create more measures that are irrelevant."

He said the date the appointment is made "is not the ultimate measure of satisfaction."

"You would have a veteran who waits two days and one who waits eight days" for a medical appointment, McDonald said, but the one who waited longer might feel better about the care he received.

Information for this article was contributed by Lisa Rein of The Washington Post and by Matthew Daly of The Associated Press.

A Section on 05/24/2016

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