Last Thursday, the Secretary of the Department of Veterans Affairs (VA), Eric Shinseki, testified before the Senate Veterans Affairs Committee to address the recent scandals within the VA health care system.
This hearing was highly anticipated by the public. As CNN and other news stations have lamented, Shinseki is an elusive fellow to interview about – well, anything.
So how was the hearing? Did Shinseki convince us that he shouldn’t resign, as the American Legion and others have called for him to do? (This is the first time in 30 years that the American Legion has called for the VA Secretary to resign).
To be perfectly honest, prior to the hearing I had no solidified opinion regarding whether Shinseki should resign.
Obviously (as I have a working brain and conscience), I think it’s figuratively (and in some cases, literally) criminal how our veterans are being treated. At the same time, I acknowledge that someone at the absolute top like Shinseki isn’t responsible for everything. How is he supposed to prevent fudging the numbers at an individual health care center? Or a single Regional Office from having a particularly high error rate in resolving disability claims?
And while Shinseki might dodge CNN interviews or give general answers to burning questions, that might not be his choice.
Now I’m inclined to side with the American Legion. Even though Shinseki testified (absolutely stone-faced) that he is “mad as hell” about the VA’s shenanigans, I didn’t get the sense from his testimony that change will come with him at the helm. Instead, we’ll get reports and memos.
Here why the testimony convinced me of this:
First, on a basic level, Shinseki’s common answer to important questions was “I was not aware of that.” And at his level, he should have been aware. For example:
Johnny Isakson (R-Ga.) asked whether Shinseki was aware of an April 26, 2010, memo by William Schoenhard, former deputy undersecretary for health for operations and management, sent to all 21 VA service regions titled “Inappropriate Scheduling Practices.”
“Paragraph two begins, “It has come to my attention that in order to improve scores on assorted access measures, certain facilities have adopted the use of inappropriate scheduling practices, sometimes referred to as gaming strategies.”
A listing of inappropriate scheduling practices was attached to the memo, which noted that the extensive list was “not a full description of all current possibilities of inappropriate scheduling practices that need to be addressed.”
This memo was sent to all 21 VA service regions. By the deputy undersecretary. Four years ago. Confirming, in writing, inappropriate scheduling practices (ie, “fudging the numbers”). Now Mr. Secretary, I know you’re busy, but no one clued you in?
Shinseki also responded that he “didn’t know” or was “unaware” of other instances or facts with a significant impact on the VA and/or our veterans. As the Secretary, it’s his high-paid (with taxpayer dollars) job to know.
Second, Shinseki was evasive when it came to concrete plans for change. When asked whether there would be a change in the management team given systematic failure over a period of years, he gave a non-answer referencing the pending Inspector General (IG) report. He also dodged the question of how veterans can believe that positive change in the VA health care will occur. Nor did he give a straight answer on whether employees who engaged in wrongdoing at individual facilities would be disciplined or terminated (as opposed to being “reassigned” or given administrative leave).
In general, Shinseki’s testimony was soft, leaving no one to believe that change is going to come. Even though Shinseki has ordered an IG investigation, national review of the Veterans Health Administration, and has asked President Obama for assistance in reviewing the allegations, the issue is that this doesn’t do anything, at least not yet. As Senator Jerry Moran, one of the senators calling for Shinseki’s resignation, said after the testimony, “the last thing we need is another report.”
I couldn’t agree more. We don’t need another report with “recommendations.” We need some pink slips and some serious overhaul of a broken system.
But once we clean house, where do we begin? And if Shinseki is shown the door, what can we expect of his replacement? Even if Shinseki should resign, he’s only one piece of a very, very big problem.
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Access the hearing before the Senate Veterans Committee here.
The problem is VA wide, for example it took me 18 months to get the SDVOSB
VetBiz designation,and now after two years we are due for re-designation and they failed to provide us with any notification plus when we call to notify them that we are still doing the same business, no change in our company we get less that.
We are a small company of 70-75 employees, many of them are Veterans and our deadline is the end of June 2014, we have submitted all of the required paperwork and now begin the wait.
so the problem is not just VA Hospitals it is anything you try to do with the VA.
James D. Hill, SGM US Army (Ret)
General Shinsheki inherited the VA mess. Underfunded for many years, without good leadership it foundered. I worked there and volunteered there. My wife struggled to help veterans as a Nurse Practitioner. As she and I were veterans, we were not a part of the management inner circle – cartel. Since 2009, the General has significantly reduced veteran homelessness, has reduced the claims backlog even though he expanded the Agent Orange presumptive disease links that added to it. They did fire or force to retire several directors.
The VA education assistance program was expanded and improved. The Veterans Cemetery Administration is ranked among the top in the way a government agency should be run. Most important, the veterans now have the highest ratings of their VA care in the 30 years I have worked with them since my Army retirement.
Now what good would it do to have a successful secretary resign? What jis needed is for Congress to finally pass some bills that are needed to give him the authority to rid the VA of corrupt directors and administrators in the Veterans Health Administration. Congress has always kept the VA budget close to their chests to help them bring the pork barrel to their areas.
Here in Las Vegas, we have a beautiful, large VAMC and four clinics that are state of the art. The problem is, it is still being run by non-medical SES and GS–15/16 without much management training. The Bonus system drives the phony statistics and waiting lists and the VA central office puts out goals that are unattainable with current medical staffing levels.
The secret here is to get rid of about 25% of the administrative overhead, replace them with volunteers (many of us out here) and hire more primary care doctors and nurse practitioners. Where the problem lies as well is that the VA will not pay for local care they cannot provide but put veterans on waiting lists to other VAMCs that will. This does not come out of their local budget.
THe VA IG never does much to make waves as the word is to keep the VA out of the headlines. They did a good job when veteran claims were backlogged and in the headlines, now they are working the health and wait issues.
Unlike the military, VA executives generally do what they want to. often disregarding things like directives from central office they do not like or threaten their bonus chances.
Go back to the 1980s and the GAO. It was so bad, the Justice Dept got involved and 46 executives went to prison. This kind of shake up is needed in the VHA, often known as the Medical Mafia. If you want to find out what is wrong, interview both veterans and direct health care providers such as primary care doctors.
I have the best primary care Doc I have ever had but he is restrained in that the specialties that are needed go on long wait lists. What is wrong with this picture? Doctors and Nurses in positions of being chiefs get there through seniority or just an open position. No management training required. Many founder and take the easy way out. Mental health, not even in the news these days is the worst. Lazy psychiatrists rely on pills (they all own pharma stock) and have not learned to use new alternative therapies. Those that do know them are not in power and are stifled as the VA doesn’t want to pay for them. They say they claim liability which is just more B.S.
Local VAs must have power taken from them. Follow VACO directives to the letter. If the VACO is monitored to insure the policies are sound, all it takes is an IG unannounced inspection policy to keep things running right.
Many have risen to the top in the VA as they can lie, cheat and steal to make their bosses look good and receive bonuses. A case in point, a GS-15 recently retired went from a clerk to an administrative officer in mental health to an administrative officer to the Chief of Staff without college, or any credentials above Navy basic Corpsman training. Nothing much else. In many ways, she actually ran kthe local VA. Moving funds around, ruining good working programs, she was the in crowd.
What you and others do not realize that the VA looks at the Secretary as an outsider. To be tolerated until the next political change. He does not have the power right now to make the deep changes that are needed.
Give him a chance to bring better healthcare to the rural veterans that now have to travel 100-150 miles to a VAMC. Give him the power to fire or force retire those in leadership that cook the books. I am sure I have left out some pertinent facts. What I furnished came from my memory when I read your email. I could go into the many EEO violations, failure to hire veterans, forcing the good guys to retire and more. You are dealing with organized crime here.
Even with all this, the VA has dedicated healthcare providers who still provide veterans the healthcare they deserve. They fight daily to do this but the system has far too many who block them. The VA excels in some areas. Diabetic care is perhaps the best around. The health records system should be adopted across the country. With current funding, the VA could hire many such as marriage and family counselors. Occupational and recreational therapists who can keep the veterans healthy and active. In mental health here, they only do education and pills. There is so much more available. They do what they want to. Give the General a bit more power and he will fix the system.
Your argument stating that the secretary should resign is based on asn assumption that he should have known. This tells me that you know little about how this largest of all healthcare agencies is organized. The process is to keep those in the decision making areas unaware of the crime happening throughout the system. That is how a former VAMC director gets a $12, 567 bonus when his new VAMC is over budget, over time, and under staffed.
There are websites such as VAMALPRACTICE that have covered the many things wrong with the VA. I doubt that many in Congress have bothered to look around. They surely haven’t provided the legislation to stop the crimes as yet. There are a few exceptions. Too few. To base your argument on what you saw in an interview on TV without investigation – seems a bit too simplistic. The general knows the Army IG system that works fairly well. If the VA IG is doing well, the VA should be doing well. It isn’t. Perhaps the GAO along with justice needs to really get involved. The General can do little without written reports and the power to take corrective actions..
CSM (R) Lou Rothenstein, USA