Nel's New Day

May 30, 2014

Search for Blame in VA Debacle

Filed under: Uncategorized — trp2011 @ 7:54 PM

The conservative media has brought a strong message to their listeners that the problems in the Department of Veterans Affairs (VA) are unique. Yet Omar Bradley chaired a presidential commission almost sixty years ago that lambasted the VA for its “backward-looking” management style and urged “more positive leadership.”  A 1993 Blue Ribbon Panel declared that wait times were “unacceptable” and a backlog “created additional and unacceptable delays” for veterans. Former Sen. Robert Dole (R-KS) and former Secretary of Health and Human Services headed a 2007 panel concluding that the department’s problems ran so deep that “merely patching the system, as has been done in the past” wasn’t enough.

Eric Shinseki, who resigned today as Secretary of the VA, made one serious mistake: he believed that the people in the VA are honorable. Shinseki came up through the ranks in a culture that prized honesty. As Robert H. Scales, a retired Army major general and West Point classmate of Shinseki, said, “If you screw up you have dead soldiers, and you can’t hide them.” That policy has changed.

The VA reported that 93 percent of these veterans got their appointments in a timely fashion, and Shinseki believed the reports. He demanded that all veterans be seen within 14 days of requesting medical aid, but the demand could not be achieved. A shortage of qualified health staff was combined with a new demand for accountability and 20-year-old rewards for the accomplishment of goals.  Rep. Jeff Miller (R-FL), chairman of the House Veterans Affairs Committee, said whistle-blowers at several veterans hospitals told his staff members that they would be threatened if they failed to alter data to make patient-access numbers look good for their supervisors.

The VA has 1,465 unfilled mental health job openings on its career site. Seventeen of the 22 veterans who kill themselves every day have not tried to get care at the VA. The agency didn’t recognize PTSD as a disorder for eight years after the mental health profession did so in 1980. Veterans weren’t compensated for exposure to the Vietnam herbicide Agent Orange for decades. The VA also fought against acknowledging the Gulf War Syndrome.

In his blog, The Sterling Road, a veteran wrote about Shinseki’s major problem: “Guilty of The Crime of Being VA Secretary In An Election Year”:

“What does matter is what this firing means for veterans.

“Ultimately it means one of the most qualified, dedicated and accomplished men in government – a man who, if he weren’t the current secretary, would probably be the guy everyone else would be screaming to take over – has just gotten shoved out the door.

“Why?

“For the crime of being VA Secretary following two wars and two million returning veterans filling up VA treatment centers that weren’t equipped to handle the influx.

“For the crime of not being a psychic and predicting that various VA clinics would go rogue and keep separate sets of books in order to meet patient care guidelines and receive bonuses.

“But ultimately for the crime of being a mild-mannered and measured administrator at a time when a convergence of angry veterans, VSO’s and the media demanded someone who screams and shouts and conveys a sense of outrage – regardless of whether it would actually improve anything at the VA.

“Because just like in pro sports, if a team has a losing year – it’s easier to fire a single coach than get rid of dozens of players.

“So what does his firing accomplish?

“Three things:

1.  It gives certain politicians running in the 2014 midterms an opportunity to claim a “victory” for calling for his resignation and an easy chance to knock any opponents who didn’t call for his dismissal.

2.  It sets up a certain political circus over the confirmation of the next VA Secretary, with potential presidential candidates and senators up for re-election lining up get their 15 minutes of fame by grilling whatever poor sap is unfortunate enough get tabbed for the job.

3. It makes whoever replaces Shinseki less likely to be able to deal with the scandals. Whoever gets picked to be the new VA Secretary will be spending the first few months just getting used to the job, getting to know those who’ll be working under them and understanding how to navigate the vipers’ pit of bureaucracy that current VA has become. Then when the next secretary finally has all the information and experience they need to deal with the problems – well, a new VA Secretary will be taking over with the next president.

“Because if you think the next VA secretary is going to come into the department blind and fix this mess in the next two years you have no concept of the complexity of the problem.”

The same veteran summarized the 25-year history of VA secretaries:

Eric Derwinski (1989-1992): The George H.W. Bush appointee was replaced a few months before the 1992 election after complaints from veterans groups about Derwinski’s suggestion that VA clinics should be opened to non-veterans.

Jesse Brown (1993-1997): Former executive director of the Disabled American Veterans (DAV), the Clinton appointee expanded the services offered to female and homeless veterans. He also opened services to vets ill from chemical exposure in Vietnam and Iraq.

Togo D. West Jr. (1998-2000): As Army Secretary, Clinton’s second appointee to this position created stricter regulations on sexual harassment. Conservatives alleged that he gave favorable burial plots at Arlington National Cemetery to major Democratic donors.

Anthony Principi (2001-2005): The Senate unanimously confirmed George W. Bush’s nominee. Veterans criticized the VA secretary for suspending health care enrollments for some veterans and shutting down old and underused VA hospitals.

Jim Nicholson (2005-2007): Under the watch of George W. Bush’s second appointee, VA computer files with personal data, including Social Security numbers for over 25 veterans, went missing.

James Peake (2007-2009): The third George W. Bush appointee suffered criticism from the Vietnam Veterans of America because hundreds of veterans’ claim records were shredded and Peake refused to view veterans’ high rate of suicides as having any different reasons from those in the general population. The VVA responded, “Secretary Peake is completely out of touch with what has happened to the men and women who serve our nation. They are looking for help from the very organization that devalues their service.”

During his term as Secretary of the VA, Shinseki expanded treatments for victims of past wars and reduced the number of homeless veterans by one third, despite underfunding for the department. Instead of providing enough money to cover costs, the process allows the budget to be at the whim of Congress. President Obama expanded treatment for post-traumatic stress and diseases stemming from Agent Orange exposure—an action that veterans and their advocates had sought for decades. Agent Orange cases consumed 37 percent of the VA’s claims-processing resources between October 2010 and March 2012. Yet last February 41 GOP senators used the filibuster to kill a bill to expand funding for the VA.

Sen. Jeff Sessions (R-AL) said, “This bill proposes to spend more than we agreed to spend. This bill creates new veterans’ programs and it’s not paid for — it’s all borrowed money. We’re not going to use some bogus gimmick to justify busting the budget.”

Many VA locations suffer from soaring demands for veterans’ care that outpaces doctor availability and high turnover in medical staff. In the past three years, primary-care appointments have increased by 50 percent while the department’s staff of primary care doctors has grown by only 9 percent. Each primary-care doctor, who should be responsible for 1,200 patients, has to treat over 2,000 veterans. The VA also has lower pay scales for doctors who generally earn from $98,000 to $195,000 compared to a median compensation of $221,000 for private-sector primary care physicians in 2012.

Widespread use of paper lists to hide veterans waiting for appointments were common in 2005, according to a VA inspector general’s report. Two years after the report, another audit found that the VA had not acted on the recommendations. The VA agreed to tackle the issue with a work force, but there is no indication that this occurred. The problem of cooked books continued throughout George W. Bush’s term. In 2010, William Schoenhard, VA deputy undersecretary for health for operations and management, finally gave VA network directors instructions for detecting and stopping gaming strategies. He said they “will not be tolerated.”

“Business as usual cannot continue,” House Speaker John Boehner (R-OH) said in response to Shinseki’s resignation. With the GOP, however, business does continue as usual—lack of VA funding, greater veterans’ health needs by causing more wars, refusal to provide for a safety net of food and housing that includes veterans, and deporting veterans’ family members because of no immigration reform. There is no proof that the wait time at the VA has killed anyone. At the same time, however, GOP-led states, half of those in the nation, kill hundreds of thousands of people through refusing federal aid in health care.

The Republican National Committee and many GOP candidates, including senate candidate Monica Wehby from Oregon, use the VA situation to raise funds. Conservative Ben Carson referred to the VA situation as “a gift from God.” GOP politicians such as Wehby want better VA administration but no help in providing health care for anyone else.  They will use the VA problems with health care as a reason to avoid health care for all, despite the fact that the veterans’ care has failed because underfunding.

I agree with Mr. Boehner that “business as usual cannot continue,” but he will make sure that it does. His only business is to discredit President Obama and the other Democrats through de- or under-funding government programs to prove that they will fail. Boeher’s business as usual will continue as GOP members of Congress continue to point fingers and refuse to solve problems.

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