The system needs management overhaul to better serve our veterans.
CAL: In a rare instance of common ground, senators from both parties agreed last week that the Department of Veterans Affairs has done a poor job assisting our military veterans with their health needs. And that is what prompted President Obama on Wednesday to come to the White House briefing room. Predictably, he said the inspector general is investigating and he doesn't want to jump to conclusions, but the problems at the VA — as he acknowledged — have been known for decades. Forty veterans died while waiting to get into the system in Phoenix, and VA hospitals in at least 10 states have been accused of falsifying documents to cover up their incompetence.
BOB: The president is right. A full investigation is warranted, and conclusions should wait until it is completed. There is no excuse for falsifying documents, if that occurred, but it doesn't change the fact, as the president noted Wednesday, that the 154 VA medical centers have been overwhelmed with 2.8 million veterans returning from the Iraqi and Afghan wars over the past decade. Many suffer from post-traumatic stress disorder, requiring long treatment.
CAL: That's a good point, but it ought not be an excuse for propping up a broken system. Neither should this be a political issue. The problems with the VA have stretched across Republican and Democratic administrations. The Obama administration has spent more money on the VA, but money alone won't fix the problem of poor treatment and long waits.
BOB: Money does matter. The Obama administration asked for $153 billion for the VA in 2014, 50% more than in 2009. But your point is well taken. Problems with the VA have gone back decades, yet it's still a broken system.
CAL: In August 2009, President Obama delivered a speech to the Veterans of Foreign Wars, ironically, in Phoenix. In that speech the president said, "Whether you've left the service in 2009 or 1949, we will fulfill our responsibility to deliver the benefits and care that you earned. And that's why I've pledged to build nothing less than a 21st century VA. ... We're keeping our promise to fulfill another top priority at the VA — cutting the red tape and inefficiencies that cause backlogs and delays in the claims process." Noble, but empty, words.
BOB: Change isn't that easy. The VA is a huge bureaucracy employing over 300,000 people. It will require many years to meet Obama's goals.
CAL: That's true, but there needs to be a plan. There are predictable calls for VA Secretary Eric Shinseki, a Vietnam War veteran, to step down, but he isn't the main problem. What is needed is an approach reminiscent of the "systems thinking" created by W. Edwards Deming, who helped rebuild Japan after World War II. Deming believed in "working smarter," not harder. By adopting his principles of management, organizations can improve the quality of their services while cutting costs. This is achieved by thinking of the VA as a system instead of individual parts, reducing waste, staff attrition and litigation while building customer loyalty. The key is to practice continual improvement.
BOB: That sounds doable. Also, in the time-honored Washington tradition, heads are beginning to roll. Robert Petzel, VA undersecretary for health, has resigned. Others are sure to follow.
CAL: They should; we've known about the VA problems for a long time. In 2010, Phil Leveque, a physician, wrote a column for the Salem, Ore., newspaper. In it, he said: "As a physician for PTSD veteran victims, I have seen some of these voluminous medical files. It appears that extreme paperwork is the main function of the caregivers rather than care itself. There have been many reports that these caregivers are told, 'Don't make a diagnosis of PTSD: Call it Adjustment Disorder, pre-existing' before the veteran entered the service."
BOB: He has a valid point. But PTSD often requires lifelong treatment, and the VA is not prepared yet to deal with the number of cases that have swamped it over the last decade. Some in Congress have suggested that PTSD cases be referred to non-VA hospitals to ease the VA backlog. That would be fine if those hospitals were in a position to treat PTSD effectively, which the VA is uniquely qualified to do.
CAL: That approach might work, especially in hospitals that want to fill available beds. But the system is so dysfunctional, it probably is beyond repair, at least by those now running it. Too many seem more interested in protecting their interests than the health and future of our veterans. The disgust must not come only from the politicians, who have a way of grandstanding without getting much done. The public must rise up and demand significant change. We owe it to those who have given so much for their countrymen.
BOB: I agree, but we need to keep one thing in mind. The load on the VA is going to keep getting heavier. Battlefield medical care is getting better and better, resulting in thousands of wounded soldiers — who most likely would have died in previous wars — being saved and sent home. These are the most critical cases requiring long-term care from the VA.
Cal Thomas is a conservative columnist. Bob Beckel is a liberal Democratic strategist. But as longtime friends, they can often find common ground on issues that lawmakers in Washington cannot.