Finally, A Real Scandal in the Obama Administration: The Veterans Affair Wait List
VA HOSPITAL IN MANHATTAN, NY
THE IRS SCRUTINY OF TAX-EXEMPT APPLICATIONS, BENGHAZI, SOLYNDRA, waging war against Libya are all false scandals the Conservatives ballyhood; none has ever risen to the level of what is an honest scandal unless it is in the way the Conservatives waged its propaganda war against President Obama. But, finally we have a real one inside the Obama administration, yet ironically, President Obama seems to be escaping the wrath of those whose reason for being in political office is to bring him down; the forging of Veteran Affairs records to hide the fact that many veterans at certain VA facilities waited months or years to be seen, possibly leading to the deaths of some of them!
The issue is this. The VA has had for decades policies, procedures, and standards in place for how veteran's applications for healthcare should be processed and the timeliness that should be observed during this processing. Standards were set as well as ways to measure performance. According to a Washington Times report from Freedom of Information Act information, all through the Bush administration, after the beginning of the Afghan and Iraq wars, various Inspectors' General reports identified a systemic failure of the VA to meet these processing goals, meaning veterans waited extraordinary amounts of time to be seen.
This information was passed on to the Obama transition team in 2008; consequently the VA was forewarned. One can say that this piece of information was just one bullet point among thousands that were probably presented during the transition, but boy, what a point for it drives straight at the mission of the VA.
In response, the twice-wounded General Eric Shinseki, now the VA Secretary, instituted a 14-day response time as one of his first orders when he assumed his position; a worthy goal. This was a great start, but there was apparently no follow-up.
THE RESPONSE TO AN ORDER IN A CIVILIAN BUREAUCRACY is not the same as an order in a military one. I have belonged to both, being a retired Army officer and a retired Air Force civil servant; albeit the civil service duty was still for a military organization. My wife, however, did retire from a real civilian agency, the Department of Agriculture. But even with the AF, the civilian workforce did not respond the same way to directives from the top as the military officers did who sat at the next desk.
I have no idea of how naive Gen Shinseki may or may not have been regarding what it takes to head up a totally civilian agency, even one set up to serve the military, but directives mean nothing if they aren't followed up by quality control; especially in the terrible budgetary environment the VA found itself in as he took over.
It was clear in 2012, after a Government Accountability Office report, that nothing had improved in the wait-time arena since the dismal reports from the Bush administration. That should have been a wake-up call to Shinseki, but apparently it was not. By this time, money should not have been a problem, or so one would think, because even though Bush finally started increasing the VA's budget, Obama really did after he took office, fulfilling one of his campaign promises (see Chart 1). But appearances can be deceiving for if you are to believe the news reports in 2014, one of the reasons for the long waiting lists is lack of resources to process the veterans applications and see the veterans themselves.
VA FUNDING SINCE WW II
The Troubled History of the VA
I CAN'T SPEAK TO THE VA'S REPUTATION BEFORE VIETNAM, but I can afterwards, since it was often front page news; and, except for a bright spot during the Clinton administration, it sucked ... big time. Even though Nixon ramped up spending for the VA, and things did get better, it only lasted a short while. I was on the second to the last plane out of Vietnam in March 1972; by 1977, funding was already being cut leaving hundreds of thousands of physically and mentally (who were basically ignored) Vietnam vets stranded. President Carter and then President Reagan didn't stop cutting VA funding until 1988. By that time, the VA had become the laughingstock of the nation and a national embarrassment. President H. W. Bush stopped the slide and President Clinton took the VA under his wing and by the time his two terms were finished, the VA had done a complete 180-degree turnaround and became a very respected, well run organization.
President Bush let the VA fall back into disrepute. It wasn't really due to not increasing funding, one look at Chart 1 shows a dramatic growth. Instead, it was due to 1) lack of attention and 2) to his defense department's, like with his war, PPPP, piss poor prior planning. DoD, for whom I worked at the time, didn't plan on the kinds and quantities of casualties that would come out of Afghanistan and Iraq, even though just a brief look at history would have given them a very good clue (I remember making the same comments then as Bush marched the United States into the Iraq War and away from the War on Terror); much different and very much more expensive than that found in WW II. Given that Obama is still behind the eight ball with a $125 billion budget, clearly Bush's $70 - 90 billion budget was not nearly enough.
THE VA SCANDAL ISN'T JUST ABOUT LONG WAIT LINES to see a doctor, that is bad enough given it has existed through almost the entire terms of two Presidents from polar opposite Parties, it is about the falsifying of records to cover up the "secret" lists used to convince Secretary Shinseki his 15-day goal was being met. Was something like this probably going on during the Bush administration as well, but wasn't documented, there is no doubt in my mind; but that is neither here nor there. What is the scandal is 1) that it is going on, 2) why civil servants found it necessary to hide the truth, and 3) why civil servants found it necessary to hide the truth (not redundant, a different question using the same words.
The fact this condition and practice has been going on since 2005 or 2006 is well documented and well known to first the Bush administration and his VA leadership and then to the Obama administration and its VA leadership. It is not that the VA Secretary under Bush did or did not try to do anything about it, those facts have not reached my eyeballs yet. The only paltry fact that has is the current VA Secretary's initial order to process applications and see veterans in a 15 - 30-day window, or something like that; then ... nothing. That directive obviously didn't work and the VA and Obama administration knew it in 2012. The fact is, whatever was done by either administration clearly failed and not aggressively acting to solve the problem is a scandal.
It is the culture in any bureaucracy, be it private or public, for each employee to CTA (cover their ass). If goals are set and cannot be met, regardless if the reason is one of impossibility to laziness, then attempts at each level will be made to hide the fact. That is human nature. What gets in the way of this process are the few ethical individuals at each bureaucratic level who will tell the truth and do the right thing, regardless of the consequences, as well as a proactive quality control system to ferret out "truth hiding". Again, private or public, there are consequences from above for not meeting goals that need to be reported up the chain; consequences such as reduced or forgone bonuses to disciplinary action. Clearly, if you are missing your goals on a regular basis, such as the 15-day service requirement, then there is a great incentive to hide the fact.
From my perch in the Air Force Cost Analysis Agency, I watched this happen frequently as the private contractors we hired to design and build our equipment twisted and turned, trying to put the best face on a failing program: I don't know how many times we caught major corporations lying about their progress. Well, the VA is no different, except they apparently didn't have an agency with the responsibility to keep them honest (and with all of the budget cuts, neither does the Air Force anymore, at least an effective one). So cheat and lie they did, and when they saw they could get away with it, even though they were caught and it was reported up the chain to Presidents Bush and Obama (or their stand-ins), they did it some more and it appears it has spread through-out the Veterans Affairs system. That is a scandal.
Finally, there is the question of why the waiting lines increased so much; there could be many reasons. It could be 1) lack of funding to hire the resources needed to service the veterans, 2) if sufficient funds are provided by Congress, then misallocation of the appropriations received by the VA leading to long lines, 3) mismanagement of resources up and down the chain, and 4) mismanagement in delivery of services regardless of funding levels. Clearly, for much of the VA's history, they have been underfunded by Congress and, except for the Clinton era, in ill-repute in terms of health care delivery, although the quality of the doctors themselves have often been highly regarded, it was just there was never enough of them.
I can't speak to how well the VA has historically or currently allocated the funding it did receive although I am sure there are many reports about it. There are, however, many more reports, both official and unofficial, that speak to 1) mismanagement at many levels of the bureaucracy and 2) chronic and sometimes acute shortages of equipment and personnel over the decades. This is just begging for the kind of situation we find ourselves in today ... and that is a scandal.
"BONUS ARMY" MARCH ON D.C. IN 1932
The Mistreated Veteran
WHAT IS EXTREMELY DEPRESSING TO ME, and probably most veterans is that we know that throughout our 250-year history the American soldier has been a throw-away resource. Until after WW II, Congress would not fund a standing Army which cost millions of wasted lives because America was never prepared for any of the major wars it undertook, not a one. So, every time a new war popped up, and there were many, fresh faces were conscripted, given brief training with improper equipment (because Congress wouldn't equip its Army either) and send them off to die trying to hold the line until more, better trained soldiers could arrive, ones that had the advantage of America's war machine spinning up.
Also, in order to get its recruits, the propaganda machine of Patriotism as put into high gear making it look like it was a heroic thing to do to go off and serve your country and that when you are done, the country will have your back. American soldiers were proud to march off for whatever the cause was; sometimes it was righteous like the Revolution, the Civil War, WW I, WW II, Vietnam, and Afghanistan. While other times it was for clearly the wrong reasons such as the Indian Wars, the Spanish-American Wars, the Mexican-American Wars, and Iraq. But in all instances, two things were certain, 1) before and during the war, there was nothing better than the American soldier and 2) not too long after the war, America didn't want to be bothered by human detritus of war, today called the Wounded Warrior and were simply cast aside to work it out on their own.
Iraq and Afghanistan, at least as it applies to the American People, appear to be an exception. Maybe it is because of the memory of 9/11, the fact that Afghanistan is still going on, the threat of terrorism is still very real, or social conservatives still raise their patriotic voices very loudly and haven't moved on to other things. I don't know what combination of those or other factors have still kept the American veteran still on the American People's (if not government's) agenda, but I am grateful for it, at least for as long as it lasts.
© 2014 Scott Belford