The Biden VA’s “Independent” Echo Chamber on Community Care
By
| February 24, 2025
The Department of Veterans Affairs (VA) Executive Roundtable, or Red Team report on the supposed “Urgent Need to Address Community Care Spending,” sold itself as an independent and authoritative report, but instead it was a conduit for the VA and the Biden Administration to publish its own views through third parties, wasting taxpayer dollars and government time in the process.
According to over nine hours of meeting videos and 158 pages of documents obtained by Americans for Prosperity Foundation through a Freedom of Information Act request, the Red Team exclusively consulted VA executives and employees for its two-day meeting and subsequent follow-ups.
Further, most materials the Red Team reviewed and referenced were produced by the VA, VA-affiliated scholars, or its employees, creating an echo chamber that served to reinforce the VA’s existing narratives rather than challenge them. At no point did the Red Team meaningfully engage with opposing viewpoints. Instead, they dismissed any contrary perspectives as merely politically motivated attacks.
The VA Red Team Was Never Independent
Despite former Biden Administration Undersecretary Shereef Elnahal’s assertion in the Red Team Report cover letter that “[t]he Executive Roundtable conducted its own analysis, and issued its recommendations to VHA independently,” the records tell a different story.
The VA’s Executive Red Team was anything but independent. The Chair of the Red Team and another participant were former Under Secretaries for Health at the Veterans Health Administration.
As we explained in our last post, the VA drafted the Red Team report, not the Red Team members.
VHA Chief of Staff Ryung Suh told a VA colleague that the Red Team’s “report/minutes from the January Meeting were not really on point, so we started from scratch on the draft report to give the [Red Team] members:”
Truly independent reviewers would have authored their own report and included insights from external stakeholders, policy experts, and even critics of the VA’s policies. The lack of such engagement underscores the VA’s effort to control the narrative rather than seek genuine reform.
The Red Team’s Purpose was to Validate Existing VA Biases Against Community Care
Red Team members spoke openly about how they knew the Red Team report would be politically useful for the VA. One report participant, former VHA Undersecretary for Health Jonathan Perlin, explained to other Red Team members how their report would be a “set of important tools” for the VA and urged them to consider how they can make it most helpful for the agency:
We’re giving VHA a set of important tools. I think we should be prepared to think about how when VA gets the incoming they are going to take, we help them in a way that’s most productive and anticipate the questions that we as members of the Red Team, [Dr. Kizer] in particular, will get. Not all favorable.
So, it’s no surprise that emails show former Biden Administration VA Secretary Denis McDonough made rolling out the report a priority in March 2024. However, when asked by Senator Cassidy on May 1, 2024, about its contents he claimed he had not read it.
Why would he make it a priority to get the report released if he didn’t read it? Because the VA knew the report that the agency drafted itself was going to support its institutional positions on community care.
The VA’s Metrics Crisis
The Red Team discussed the VA’s data and metrics issues. Dr. Kenneth Kizer, a former VA Undersecretary for Health, put it bluntly: “The problem with a lot of the VA-specific metrics is they are VA-specific and nobody has any confidence or trust in them outside of the VA. And many within the VA don’t.”
This statement is particularly relevant given the VA’s history of manipulating wait-time data. Our previous reporting revealed how the VA systematically used inaccurate wait-time numbers to deny veterans access to community care.
The Office of Inspector General (OIG) reported in 2022 that a VA-published study on wait times used misleading and inaccurate data. The study, published in JAMA Network Open in 2019 and authored by then-current and former VA leaders, including then Undersecretary Elnahal who set up the Red Team, falsely claimed that VA facilities had shorter wait times than the private sector for primary care, cardiology, and dermatology.
The OIG’s investigation found that the VA used a flawed methodology, measuring wait times from the “create date” rather than the actual date a veteran requested an appointment. This manipulation artificially shortened reported wait times. The OIG noted that they were informed in interviews that “then acting principal deputy undersecretary for health acknowledged the study was flawed.” Moreover, the OIG could not even validate the precise methodology or underlying data, further calling into question the reliability of the VA’s claims.
Conclusion
The VA’s efforts during the Biden Administration to manipulate public perception—whether through the fabrication of an “independent” Red Team or through misleading data on wait times—underscore the urgent need for greater oversight and accountability. Veterans deserve transparency and genuine reform, not bureaucratic cover-ups and manipulated data.
Former VA Secretary Denis McDonough told the Red Team on its first day:
The other indicator of success is the fact that individual veterans are recommending to their buddies to come [to the VA]. Rather than what is oftentimes the case is…men and women are complaining that there’s not access, or…they’ve had a bad experience.
These anecdotes from our veterans are what the misleading or manipulated data is covering up.
The Red Team was an attempt to support and justify the VA’s failures. This sort of bureaucratic self-promotion is a waste of taxpayer dollars and government time and resources.
The VA has a long road ahead to restore trust. That process must begin with an honest reckoning about the failures that continue to plague the system and a commitment to genuine, independent oversight—not rubber-stamp reviews orchestrated by insiders. Until then, veterans and taxpayers alike should remain deeply skeptical of the VA’s claims.
Watch the VA Red Team Meeting Videos
- Department of Veterans Affairs Executive Red Team on Community Care – Day 1 Meeting Part 1
- Department of Veterans Affairs Executive Red Team on Community Care – Day 1 Meeting Part 2
- Department of Veterans Affairs Executive Red Team on Community Care – Day 2 Meeting Part 1
- Department of Veterans Affairs Executive Red Team on Community Care – Day 2 Meeting Part 2
- Department of Veterans Affairs Executive Red Team on Community Care – Report Review Meeting
- Department of Veterans Affairs Executive Red Team on Community Care – Report Meeting with Dr. Deb
