The current scandal in the Department of Veterans Affairs is a failure of the VA’s leadership to run the agency in the veterans’ best interest and a failure of Congress to provide needed resources.
As is generally known, VA managers, especially at the Phoenix hospital, manipulated waiting lists and kept secret records to enhance their own performance metrics and conceal extraordinarily long waiting times for patient appointments. But that might not have happened if the agency had the leadership to make such actions unacceptable and the funds to hire medical staff to meet the needs of the influx of veterans from Iraq and Afghanistan, as well as the aging population of Vietnam-era veterans.
Fortunately two senators, Bernie Sanders, an independent, and John McCain, a Republican, have jointly proposed a bill that begins to correct the problems. Their legislation will authorize veterans subject to long waiting times for appointments or who live more than 40 miles from a VA medical center to get care from private doctors at VA expense. It will also authorize the department to lease 26 major medical facilities in 18 states and Puerto Rico in order to shrink the backlog. Finally, it will provide $500 million to recruit and retain doctors to provide the needed care.
Those measures, if enacted (by no means a certainty), will help provide the VA with the resources it needs. However, they do not address the failure of leadership that underlies the agency’s problems. Eric Shinseki, the former VA chief on whose watch the scandal occurred, was an outstanding military officer, a veteran of two combat tours in Vietnam, who capped his career as the Army’s chief of staff. But what did he know about running a vast health-care system? Sloan Gibson, Shinseki’s former deputy and now acting secretary, is also a former military officer. He spent most of his career as chairman and CFO of AmSouth Bancorporation followed by a stint as president of the United Services Organizations. One might also ask about him, what expertise does he have in managing a health-care system?
The Obama administration seems finally to have recognized that perhaps an experienced health-care administrator, with the necessary knowledge and leadership skills, would be the best person to head the VA. It recently reached out to Dr. Delos Cosgrove, the chief executive of the Cleveland Clinic, to assess his interest in becoming secretary. Cosgrove withdrew after preliminary discussions because of his commitment to the clinic. Experts said it would have taken him months to master the bureaucracy of the VA, which is clearly in need of a top-to-bottom management shake-up.
Still, recruiting someone outside the department is the right course of action in the long term, despite the steep learning curve. There must be other health-care system administrators whom the administration could persuade to undertake leadership and reformation of the VA. Obama should also remember that the Army, Navy and Air Force operate their own medical departments with an extensive staff of medical professionals and a system of health-care facilities. That includes the Medical Service Corps, commissioned officers who are health-care administrators, health-care comptrollers, health-care informatics officers, patient administrators and health service human resource managers. Senior officers in the Medical Service Corps would seem to be a rich pool of talent from which to draw the next secretary.
Reforming the VA bureaucracy is a long-term project. In finding someone to lead the department, the Obama administration owes our veterans no less than the widest search possible.•