Editorial: Reforming the VA
For those of us who have been struck by the high rhetoric-to-fact ratio in the uproar over alleged misconduct at the Department of Veterans Affairs, Monday brought a needed infusion of hard data in the form of a department-wide audit.
Alas, the document confirmed preliminary findings by the department’s inspector general about bad service, and the covering-up thereof, at VA health centers around the country. More than 57,000 former troops have been waiting at least 90 days for their first VA medical appointments; 14 days is supposed to be the limit. About 13 percent of VA schedulers surveyed told the auditors they had been pressured to fudge records to make wait times seem shorter. Such practices are “sufficiently pervasive,” the audit noted, to warrant a complete overhaul of VA’s entire performance management system.
The audit landed on Capitol Hill at about the same time that Senate Veterans’ Affairs Committee Chairman Bernie Sanders, a Vermont independent who caucuses with Democrats, and Sen. John McCain, R-Ariz., were unveiling a bipartisan proposal to fix what ails the VA. In one respect, it’s a modest improvement over legislation that’s already passed the House with an overwhelming bipartisan majority. Unlike the House bill, which would purportedly instill “accountability” at the VA by allowing the secretary to fire or demote senior career officials pretty much at will, Sanders and McCain have agreed to provide an appeals process — albeit a far more truncated one than civil servants ordinarily enjoy, with a review board required to rule within three weeks. But it still is not enough protection against politicized scapegoating.
In addition, the Sanders-McCain proposal would allow vets who can’t get an appointment at the VA within 30 days to seek care elsewhere, at government expense; however, this promising effort to relieve the backlog would expire after only two years. There’s $500 million to help the VA fill its roughly 400 vacancies for doctors and other health-care providers — proving that, in a pinch, you can always get bipartisan agreement to spend more money without offsetting tax increases or spending cuts. And the bill authorizes the leasing of 26 new VA facilities in 18 states.
All of this may relieve short-term pressures on the VA system, but it does basically nothing to change that system itself: It remains a government-operated centralized bureaucracy, utterly lacking the capacity to adjust its supply of services to rapid changes in demand. As the new department audit clearly demonstrates, the root cause of scheduling chicanery is not the inherent corruption of VA staff but the fact that there are too many veterans pursuing too few physicians, which, the audit said, made the 14-day goal “simply not attainable.”
Leasing more buildings probably won’t help; indeed, a new Government Accountability Office report showed that the VA’s leasing program is already plagued by long delays in getting buildings operational and cost overruns.
“Privatization” is a dirty word to many VA supporters on the Hill and in the veterans’ lobby. But if the Sanders-McCain bill’s two-year experiment in letting vets seek care outside the system becomes law, and if it proves to be effective, Congress may well see the wisdom of this approach and want to continue and expand it.
The Washington Post