The news about the Department of Veterans Affairs (VA) health care system known as the Veterans Health Administration (VHA) is not good and it is getting worse.
Astonishing stories about VA’s failure to provide timely health care to veterans have now spread to twenty six VA Medical Centers (VAMC).
HORROR STORIES ABOUND
For weeks now, the steady drum beat from whistle blowers, families of deceased veterans, nonstop news reports, press releases from across the country, and testimony on Capitol Hill have flooded our collective consciousness. The sensation is not a good one.
Since the scandal broke at the Phoenix VA Medical Center (VAMC), the appearance of corruption, negligence, dereliction of duty, aloofness, arrogance, and reckless behavior displayed at a few VAMCs and VA Central Office in Washington, DC, has not only been growing but exploding across the VA health care system.
IT IS NOT THE END OF THE WORLD BUT YOU CAN SEE IT FROM HERE
From all accounts, the VA and the White House are trying to assess the problem but it is beginning to look like “business as usual.”
VA cannot and should not be allowed to investigate itself.
When reports of secret, off-line waiting lists and allegations of preventable deaths are this widespread, an independent, external inquiry is compulsory.
How can the American people and veterans realistically expect the Veterans Integrated Service Networks that manage VA medical facilities investigate each other?
If this persists, VA will be on a “fool’s errand” because no one except the pathetically naïve or “kool aid” drinkers will believe the results of VA investigating itself.
Despite what the White House talking heads spout to the contrary, this scandal is not waning but is actually in its embryonic stage.
Wishful thinking notwithstanding, the true scope of this disgrace is just beginning to unfold and the news will get much worse before it gets better.
HOW BROKEN IS THE VA — CAN IT BE FIXED?
At this juncture, any fair-minded person must reasonably conclude that VA is broken.
But is it broken beyond repair?
Will the path of least resistance win out and VA move to a comprehensive health care voucher system?
Or will we look for and find the root causes of the VA’s failures and move to reorganize, streamline, and find new persons that are competent and capable?
The VA is a Tale of Two Cities – it is the best of times and the worst of times.
The good news is there are legions of dedicated VA employees that go to work every day, sometimes under daunting circumstances, to take care of our nation’s veterans. It is not a job to them – it is a calling and sacred trust.
Yet VA has had a triple fold increase in its funding since 2001, and yet is facing its worst crisis in decades.
The VA is awash in tax-payer money and throwing more at VA will not solve this problem.
The truth is rigged record keeping yielded human suffering and possibly scores of deaths. To stay out of trouble with higher-ups or to capture a bonus, rampant cheating became commonplace and veterans experienced pain and suffering often times with their lives left hanging in the balance.
This VA failure of leadership is not centralized but has metastasized across the board and throughout much of the VHA chain of command.
Veterans deserve the best we have to give and but that notion is a mismatch with reality at VA today.
They gave full measure for us and the least we can do is ensure VA does not act as an imperious overseer anymore.
HOW BAD IS THE VA SCANDAL?
It is utterly shameless and indefensible. This scandal is so bad that even in the poisonous atmosphere on Capitol Hill there is bipartisan outrage.
This growing scandal is a most dreadful story with human tragedy and avarice as its twin centerpieces.
This dishonor at VA does not lend itself to obfuscation, misdirection, or dilatory tactics. Veterans and the American people will demand administrative competence at VA and not reactive stonewalling.
In fact, it took less time to fight and win World War II than it has to fix the Veterans Benefits Administration adjudication system and ensure the provision of high-quality and timely health care to veterans.
WHAT SHOULD IMMEDIATELY BE DONE?
Secretary Shinseki should resist any calls to disguise or white-wash this latest disgrace. This scandal is what it is.
The public is demanding accountability and nothing short of a public purge will quench the thirst of the outraged; nor should it. Secretary Shinseki should:
- Call a “war counsel” of VA leaders to determine who knew of, was involved in, or should have known about this debacle and then ask for resignations.
- Take decisive action and not hide behind the smokescreen of the lame excuse that there is an “ongoing investigation.”
- Eliminate political appointees who are not up to the job. They serve at the pleasure of the secretary and White House so heads should roll there too
- All former or current “waiting lists” must be captured immediately and clinically reviewed. All patients should be seen in private sector settings using the Fee Basis program or the VA Patient Centered Community Care contract managed by Triwest and HealthNet.
- Establishment of an independent investigation to identify problem areas, take decisive follow-up action, and start the long-term process of restoring confidence in the VA health care system.
The White House should redouble their efforts to identify a successor to Secretary Shinseki who can straight away take charge and restore confidence in VA.
WHY IS THIS SCANDAL CENTRAL TO RESOLVE?
Once again, the President became aware of this latest horror show at VA through the media. It is high time that this Administration recruit a VA team that knows what’s going on in its own department.
VA requires a team that will proactively pursue, identify, and fix problems in the delivery of health care and benefits. Importantly, the VA Secretary needs to know what is going on at VA and keep the Commander-in-Chief informed.
The lack of general knowledge and lack of focus on VA details exhibited by Secretary Shinseki at congressional hearings is nothing short of jaw dropping.
It is time for a Secretary that is fully engaged in VA.
HOW CAN PRESIDENT OBAMA FIX VA?
Secretary Shinseki has served his country well in uniform. If the President allows him to, he should steel himself and be prepared to take swift action to end the public hemorrhaging at VA. He, better than most, knows his days at VA are numbered so decisiveness is compulsory if he wants to “tee it up” for his successor whenever that change of command occurs.
If the White House is willing to listen and think about creative ways to begin the long process of restoring faith and confidence in VA and this Administration, the next Secretary of Veterans Affairs should be a person with immaculate credentials and an experienced leader who will immediately begin repairing the damage at VA.
The President should nominate someone who has been successful in turning around large governmental agencies.
That someone must have the strength and vigor to begin the arduous task of repairing the harm done to veterans and VA’s reputation.
Some crucial guidelines for shaping a succession might include the following:
- Why not appoint someone who has successfully turned VA around in the past?
- Why not select someone who has the instincts and capability to put “Veterans First” instead of a placeholder?
- How about someone who has exemplary leadership skills and knows how to get things done?
- Why not someone who thinks outside of the box and has successfully built a VA team?
- Why not someone who is experienced and capable of reorganizing and streamlining VA?
- How about someone who will meet with members on the Hill, give them the unvarnished truth, and build trust in/outside of VA as an unapologetic advocate for veterans?
I recently reread a 2009 study about the future of VA health care delivery system. The report challenged VA policy-makers to think creatively and ensure returning veterans from today’s foreign wars and those twenty years hence will have a robust VA health care system to care for them.
The Final Report of the Commission on the Future for America’s Veterans: Preparing for the Next Generation is a thought provoking study and a good read of “outside the box” thinking. It outlines how VA should function in the future; manage the health care system without political interference, and developing payment mechanisms that ensure VA’s long-term survival. This report takes a hard look at VHA and makes interesting recommendations.
The recommendations of this report may not solve VA’s current crisis of leadership but this kind of clear-eyed thinking would be a good place to start.
IS THERE A PROVEN LEADER WHO CAN FIX VA?
Where can the Administration find the person who could “hit the ground running” at VA and take immediate corrective action to Put Veterans First?
It may not be as hard as it sounds.
Several individuals spring to mind but none as much as one. The administration can immediately recruit a proven VA leader who is dedicated to getting it right for veterans; an honest broker who will not allow politics to cloud his judgment, and a man of principle who will fight for what he believes in.
I suggest the White House speak with the former VA Administrator Harry N. Walters. He has keen insights regarding VA and knows how to get things done without needless hand-wringing and equivocation. This is man of high character with a well-defined moral compass. He is proactive and does not suffer fools readily.
For those who know him and those who have not had the privilege, do not challenge Harry to a foot race, pull up challenge, or butt-kicking contest. Despite his experience of years, he is as tough as they come.
Following his army service, Harry enjoyed a successful career in business. In May 1981, President Reagan nominated Walters to be Assistant Secretary of the Army for Manpower and Reserve Affairs. Later he was nominated to be Administrator of the Veteran’s Administration and served from 1983 to 1986.
Harry was thought to be one of the best VA leaders because he was deeply committed to providing benefits and health “Second To None.” Harry was in fact, hard — yet fair, and turned VA around from a failing institution to one where employees were proud of their work and veterans starting receiving the full range of benefits they earned.
Who better than a former Reagan appointee to take the helm at VA?
Someone who was equally rough on Republicans and Democrats when they did not play nice in the sandbox?
Harry is not someone to be trifled with or micromanaged by “youngsters” in the White House. Is the Obama Administration smart enough to recruit a Harry Walters type leader and get out of the way and let him do the work of rebuilding VA? One can hope they would and only time will tell.
If not Harry, find another like him and get out of the way and let the new leadership turn the ship around.
Mr. Poteet is a former Army gunship pilot with two tours in the Republic of Vietnam; a registered lobbyist for the Veterans of Foreign Wars;Deputy Assistant Secretary for Congressional Affairs; Director of three VA Regional Offices; a VA Medical Center Director; and Executive Director of the President’s Task Force To Improve Health care Delivery For Our Nation’s Veterans. He resides in central Texas with his wife Miriam.
For earlier columns by Al Poteet on The Forum see the following: