Boastful on the occasion of Memorial Day, President Donald Trump and his Veterans Affairs secretary are claiming full credit for health care improvements that were underway before they took office.
Trump said he passed a private-sector health care program, Veterans Choice, after failed attempts by past presidents for the last "45 years." That's not true. The Choice program, which allows veterans to see doctors outside the government-run VA system at taxpayer expense, was first passed in 2014 under President Barack Obama.
Trump's VA secretary, Robert Wilkie, also is distorting the facts. Faulting previous "bad leadership" at VA, Wilkie suggested it was his own efforts that improved waiting times at VA medical centers and brought new offerings of same-day mental health service. The problem: The study cited by Wilkie on wait times covers the period from 2014 to 2017, before Wilkie took the helm as VA secretary. Same-day mental health services at VA were started during the Obama administration under Wilkie's predecessor, David Shulkin.
TRUMP: "We passed VA Choice and VA Accountability to give our veterans the care that they deserve and they have been trying to pass these things for 45 years." — Montoursville, Pennsylvania, rally on May 20.
THE FACTS: Wrong. Trump is not the first president in 45 years to get Congress to pass Veterans Choice; Obama did it in the wake of a scandal at VA's medical center in Phoenix, where some veterans died while waiting months for appointments. The program currently allows veterans to see doctors outside the VA system if they must wait more than 30 days for an appointment or drive more than 40 miles (65 kilometers) to a VA facility.
Trump did expand eligibility for the program. Now, starting June 6, veterans are to have that option for a private doctor if their VA wait is only 20 days (28 for specialty care) or their drive is only 30 minutes.
Still, VA's top health official, Dr. Richard Stone, described the new program's start to "almost be a non-event" in testimony to Congress. That's in part because wait times in the private sector are typically longer than at VA. In 2018, 34 percent of all VA appointments were with outside physicians, down from 36 percent in 2017.
Also key to the Choice program's success is an overhaul of VA's electronic medical records to allow seamless sharing of them with private physicians, a process expected to take up to 10 years. Wilkie has said full implementation of the expanded Choice program is "years" away.
WILKIE: "The first thing I did was change out the leadership at VA. ... (The president) also allowed me to change out leadership in the VA centers. If someone wasn't walking the post, getting to know the people who work for her or him, or getting to know those veterans, they had to leave. And, as a result, the Journal of the American Medical Association this year said that our waiting times are now as good or better than any in the private sector." — interview Thursday with Fox News.
THE FACTS: It's true that a study by the medical association came out in January that found wait times at VA medical centers on average were better than the private sector. But the improvement wasn't a "result" of anything that Wilkie did: The study involved a period largely covering the Obama administration — and before Wilkie became acting VA secretary in late March 2018.
In fact, in a VA press release in January announcing the study's results, Wilkie credits the department's "concerted" effort to improve access to care "since 2014."
The study covered four specialties, primary care, dermatology, cardiology and orthopedics.
It found that in 2014, the average wait time at VA medical centers was 22.5 days, compared with 18.7 days in the private sector, which was not statistically different. By 2017, the wait time at VA improved to 17.7 days, while increasing to 29.8 days for private doctors. Wait times at VA medical centers were shorter in all specialties except orthopedics.
According to the study, the number of patients seen yearly in VA increased slightly between 2014 and 2017, to about 5.1 million. VA patient satisfaction also rose, according to patient surveys cited in the study.
WILKIE: The VA "had suffered from bad leadership. And that's a bipartisan comment. And the second thing I had to do was make sure that as we approach our veteran population that we make sure that they are at the center, their needs are at the center of what we do ... I think we've had it backwards at VA for many years. ... One of the things that we're doing at VA is that we have same-day mental health service. ... It is huge." — interview with Fox News.
THE FACTS: Same-day mental health service started at VA before Trump took office in January 2017, let alone Wilkie.
VA's effort to provide same-day primary and mental-health care when medically necessary at every VA medical center was publicized in April 2016 under the Obama administration. At the time, Shulkin was helping lead the effort as VA's top health official. By late 2016, the department's blog announced that the goal of same-day mental health services would be achieved by year's end.
A Dec. 23, 2016, article in the Harvard Business Review cites new same-day services at all VA hospitals as evidence of notable progress at the department. Shulkin, who was then named by Trump to be his VA secretary, told Congress in late January 2017 the services already were fully in place.
Trump selected Wilkie to be his VA secretary after firing Shulkin in March 2018 because of ethics charges and internal rebellion at the department over the role of private care for veterans. Trump's initial replacement choice, White House doctor Ronny Jackson, withdrew after allegations of workplace misconduct surfaced. While Wilkie has been credited by both parties in Congress for bringing stability to the department, the VA improvements he attributes to himself this past week are misplaced.