VA Scandal: The Stain on America's Soul

After major scandals shuddered the Department of Veterans Affairs, the Obama Administration pledged to improve health care for America's military men and women.  More than two years have passed and nothing has changed, except the media and politicians have developed amnesia.

The shame of dozens of retired military men and women dying while they waited for treatment should have awakened the government to the urgency of the situation.  Instead, the plodding VA bureaucracy has shuffled top administrators, but done little else to address the shoddy treatment.

For those with short memories, the Department of Veterans Affairs was jolted in 2014 when a congressional investigation uncovered malfeasance at the Phoenix VA Hospital.  It found at least 40 cases where the wait times "contributed to the deaths" of military people. 

The actual number of deaths remains in dispute.  Some outsiders believe the number may be closer to 83.  The outcry prompted the VA's chief watchdog to launch an investigation.  The probe found wait time problems at 51 of the 73 VA hospitals that were reviewed by investigators. 

After those findings were made public, there was a universal cry for change.  Instead of a sweeping housecleaning, the VA brushed the scandal under the rug. Even worse, soulless executives rewarded themselves with $3.3 million in bonuses in 2015 instead of lopping off the heads of the guilty.

An independent review of the Veterans Affairs' health care, released in September of 2015, found a "significant leadership crisis" at the agency and called for a complete overhaul of the system.  The report's collaborators included Rand Corp., McKinsey Company and the Institute of Medicine. 

Nowhere is the management crisis more evident than at the beleaguered Phoenix VA Hospital.  It is now operating under its seventh director in the past three years.  The last head of the giant VA department was Bob McDonald, an Obama appointee who was a retired consumer product executive.

Now President Trump has rattled the calcified culture at the department with the nomination of David Shulkin, a hospital chief executive with private sector experience in health care. Shulkin, unanimously approved by the Senate, becomes the first non-veteran to lead the VA in 86 years. 

Most of the previous VA department heads were plucked from the military.  However, they had no experience in running a behemoth medical organization.  Veterans Affairs is the largest integrated health care system in the U.S. with 1,233 facilities, including 168 medical centers.

Nearly nine million veterans were served last year, according to the department.  The VA not only offers health care, but also provides counseling, operates community living centers, distributes financial benefits and oversees 128 national cemeteries. 

The job requires a gargantuan workforce of 325,935, earning the VA the title of the largest non-military department in the massive federal government.  This sprawling bureaucracy, founded in 1930, has grown too unwieldy and unresponsive to serving veterans.  It must be streamlined.    

The new VA chief needs to carve up the department, creating a new stand-alone agency to deliver health care to veterans.  Under the current organizational structure, health care is just one cog in a bloated department.  It deserves its own chief executive, reporting directly to the president.   

Once the new agency is birthed, the top echelons of the organization need to be staffed with professionals with hospital and medical operational experience.  Too often in the past, the VA has hired veterans for jobs that should be occupied by those with health care credentials.

In Washington, the knee-jerk response to any crisis is to throw money at the problem instead of dealing with the underlying issues.  On cue, the Congress increased the department's budget for fiscal year 2017 to $182.3 billion.  That's a hike in discretionary spending of 4.9 percent from 2016.

Although money can buy new equipment for hospitals and fund increased hiring, it does not guarantee America's veterans will get better health care.  That's why one of the first steps of the new administrator should be to conduct a third-party assessment of the current performance.

The days of asking the VA to evaluate itself are over.  Civilian medical professionals need to do a thorough evaluation of the department's facilities, treatment and follow-up procedures, bench marked against the nation's best integrated medical facilities.   

As part of this process, new standards for care should be adopted.  Pay for employees and executives alike should be tied to meeting goals for timely, professional health care delivery.  If implemented correctly, this pay-for-performance package will shake-up the department's fossilized culture.    

America has turned its back on the brave men and women who served in the nation's armed forces for too long.  The country must never again accept any excuses for shabby treatment of veterans. America's veterans deserve nothing less than the best health care the country has to offer.