“To care for him who shall have born the battle, and for his widow, and his orphan.”
— Abraham Lincoln
As a veteran, I am angry.
With the revelations in the media of deaths caused by alleged fraudulent behavior on the part of VA bureaucrats, the emotions have risen to a fever pitch around that behavior and what it has done to those who have served and suffered for the nation. I have watched the unfolding news with a range of emotions, but I wanted to get beyond the emotions and to give some serious thought to the situation as well. I want to share a few of those thoughts here.
Feet to the Fire
First, I have had real mixed emotions. Like the rest of the veteran community, I’ve experienced anger and frustration over this situation. If there is a smidgen of anything positive in this whole situation, it is that both political parties are equally upset about what is happening. I will not speculate about their motives, as they have shown us lately that their thinking rarely, if ever, leaves the realm of political expediency and their own re-election concerns. But, the fact of the matter is that they are the only ones who have the power to affect the changes that are clearly needed in the Veterans Affairs medical care area.
Though these politicians may see veterans as a means to their own ends, we may have a chance of getting laws changed that could bring about the necessary changes in the VA culture at this time. We will have to wait and see on that. The worry is that their attention spans are not very long. We veterans, and those that support us, will have to keep the fire to their feet so that they do not pass over this problem or lose it in the fog of other re-election worries on their part.
The firing of General Eric Shinseki — a good soldier and twice-wounded Vietnam veteran — is sad, though it probably had to happen. My concern is that it should not be seen as the end of the story. In my estimation, the real problem is in the current culture of the VA (and probably many other government agencies). The news reporting alleges that VA bureaucrats, many who are civilian government employees, have cooked the books, changed computer programs, and other suspicious behavior to make it appear that the numbers of patients being seen and cared for were greater than the reality and to imply that wait times were shorter than the reality. It is also alleged in the media that they did so in order to receive performance bonuses in their paychecks each year.
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If this is so, this is not only immoral, but criminal behavior and, therefore, there are legitimate reasons to be angry at them, at the leadership in the VA, and at our government, from Congress to the President. If these allegations are true, we veterans want to see charges, arrests, and prosecutions, and we want to see them sooner, not later. But we also want to see a clear change in the bureaucratic culture that made this all possible.
Unique Needs for a Unique Culture
Some are arguing that more money needs to be allocated to the VA to address these problems. But the VA reportedly has a budget excess. Politicians are too facile with money — our money. They seem to think on the one hand, that if they appropriate more money they will shut us up, and on the other, that it will look like they really did something. The problem is not money here. The problem is a culture of fraud, lies and cover-ups. That’s what Congress and the President need to address, and now is not too soon.
What really has me concerned though is that I am beginning to hear some voices, from both sides of the political aisle, suggesting that maybe the VA should be scrapped and veterans put into the private sector medical system with everybody else. I am against this and here are my reasons. The fact of the matter is that we veterans are a special class. We are because of what we have done for the nation that no others have. We are the less than 1% who took on all the risks, made the sacrifices, and suffered wounds, both physical and psychological, so that the 99% of the rest of the country could continue to go about their daily lives without having to worry about those who want to take it all away from them. And that 99% rarely, if ever, gave us a thought.
The Founding Fathers understood that government has only a few, very necessary responsibilities, among these are the defense of the nation and of the liberties it enjoys. That is what we did. We served, we sacrificed, and we endured the pains of war, to protect and defend the Constitution of the United States of America. In doing so we were protecting and defending “We The People.” And the fact remains, we were the few — the very few — who took up that responsibility. The nation, in order to call itself a just nation, owes its veterans, this less than 1% of the nation, for their sacrifices. It is as simple as that. Closing the VA would be an injustice towards those who have sacrificed so much.
As a Vietnam veteran I have vivid memories of the treatment we received on our return. If the emotions of that time would have been given their full force, we would have been tossed aside either as unwanted trash, or worse, without a thought, care, or concern. If the VA were to be shut down, we would be, I fear, tossed aside, or lost in the shuffle worse than some may think we are now. The VA understands the medical issues, and the military culture, and can respond to it with much more insight and care than civilian private/public health institutions. If we were to be put into the new medical catch-all of the Affordable Care Act, it would concern me greatly.
Veteran medical issues, especially those related to wartime experiences and injuries, are unique and demand a sensitivity that the civilian culture does not have, or understand. I’m talking here of the “brotherhood” of those who have endured the horrors of wartime combat together. Without an intimate understanding of that, the course of the medical care will not be complete or as effective, in my opinion. I fear that if the VA were abolished, veterans and their unique issues, would be lost in the shuffle. Veterans need the VA system to meet their unique needs and culture. But they need a VA that is better administered, and better organized. Congress would help this situation a great deal by passing laws that would make it easier to fire people for lack of effectiveness, as well as for fraudulent behavior. The VA’s focus needs to be on the veterans it serves, not on the unions or the machinations of bureaucrats, who are mostly civilian in culture and who are often driven by motivations that have nothing to do with the veterans they serve.
Looking Beyond Emotions
I get my medical care through the VA. My experiences at the Seattle VA have been nothing but positive. Many of my veteran friends have been cared for and treated there with respect, care and positive effect, in both minor and major medical situations. I’m sure that others might have complaints, even serious ones. When I needed a colonoscopy last year, appointments were booked solid at the VA Hospital. My doctor told me, without hesitation, to go to an outside doctor I had seen before to get the procedure done. I did just that and it was covered completely by the VA. Why isn’t this being done for veterans routinely at other VA facilities?
Many VA hospitals around the country are being investigated for some of the fraudulent behavior practices that have been reported first at Phoenix. If there are VA hospitals around the nation who are doing good jobs in various areas, then what they are doing ought to be focused on and potentially adopted, or adapted to the other VA institutions. Another area to look at is what outside relationships the local VA facilities have with civilian public or private medical institutions in their areas.
For example, the Seattle VA hospital has strong ties with the University of Washington medical school and system. Does that kind of relationship in a local area have any practical and positive effects on the health care being offered at an individual VA hospital? These kinds of questions need to be asked and looked into by the President, the Congress, and the VA, with the goal of reforming the current bureaucratic culture in some of the VA hospitals, or the system in general. They need to do this for the veterans. They need to do this in order to improve their care and the delivery systems that are supposed to provide that care. They need to start with getting rid of the long wait times for necessary health care.
“It is a shame that the VA is in the condition that it is at the moment, but it would be an indescribable shame to get rid of it altogether.”
It is clear that things need to be done to improve the Veterans Administration hospitals and clinics and their ability to serve this important and valued population. More money is not the solution. Rather, Congress needs to pass laws that will make it easier to fire those who are either not helping, or those who are actually hurting the VA’s responsibilities toward veterans by engaging in fraudulent behavior. If the unions are a problem, they needs to be addressed. It is not about them; it is about the veterans they are supposed to be serving. The President needs to do more than make speeches about this issue. Words are easy and too easily manipulated. We need actions. We need real attention and action to be paid to solving this issue, always keeping the veterans at the center of our concerns and our solutions.
Angry? Yes, like all other veterans, I am angry about this. But I want to get beyond the emotions and into real, respectful, thoughtful, practical and effective efforts to improve the VA and its care of our veterans. I do not want to see it shut down. That would be a disaster for veterans far greater than what has been revealed in these recent reports. I want to see it changed and improved. We veterans, and those who support us, need to be vigilant in our efforts to keep the President and the Congress on this issue. It is a shame that the VA is in the condition that it is at the moment, but it would be an indescribable shame to get rid of it altogether.
1) Abraham Lincoln’s Inaugural Address, 1865. Holograph manuscript (Image courtesy Manuscript Division, Library of Congress).
2) Secretary of Defense Chuck Hagel, second from right, and Veterans Affairs Secretary Eric Shinseki, third from right, sit down for a Congressional roundtable discussion hosted by Senate Appropriations Committee Chairwoman Barbara Mikulski to discuss the VA claims backlog in Washington, D.C., May 22, 2013 (DoD Photo by Glenn Fawcett, OSD/PA, CC BY 2.0).