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VA culture, not Shinseki, was real problem

 Eric Shinseki   (AP Photo/Cliff Owen File)

Eric Shinseki (AP Photo/Cliff Owen, File)

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Updated: July 2, 2014 6:28AM

Veteran Affairs chief Eric Shinseki has fallen on his sword over the scandal about the excruciatingly long wait times for veteran medical care and the secret lists manipulated to hide the sometimes deadly delays in providing treatment to veterans of war.

His resignation solves an immediate political problem for President Barack Obama. Democrats in Congress facing tough re-election fights in November were braying for Shinseki’s head as it became clear the VA deception was not confined to a few hospitals but infected, in Obama’s words, “many across the country” and showed “a need for a change in culture” not only at hospitals but “perhaps the VA as a whole.”

The retired four-star Army general, a wounded veteran who did two combat tours in Vietnam, is such an admired figure that his resignation raised immediate questions about whether he was being scapegoated for political purposes. And there’s always concern that a quick resignation can take the spotlight off a scandal, giving rise to the appearance that something has been done only to see the same problem surface years later. In fact, the VA’s long wait lists are old news. They’ve been exposed time and time again. In his first presidential campaign, Obama repeatedly pledged to fix them.

Despite his sterling reputation, Shinseki likely faces tough questions. He says he was disappointed that “bad news,” meaning the persistence of long waits for treatment, didn’t get to him. But did he look hard enough? Or did he too readily accept the glowing reports VA administrators sent up to earn raises and bonuses?

Here is the heart of the problem, the self-protection and cover-your-behind culture inherent in any vast bureaucracy. Throw in the too often toxic influence of public employee unions and you have a recipe for the type of nightmare engulfing the VA.

Told by Washington that they had new standards for how long a vet had to wait for care, too many VA hospital administrators simply cooked the books, giving Shinseki reports reflecting the new standards while maintaining secret lists showing waits of months for veterans to see a doctor. Sometimes the date on which a former soldier finally saw a physician was entered as the date requested by the vet.

It’s hard to believe that administrators at so many VA hospitals coincidentally came up with the same scheme to save their pay raises and bonuses. A Justice Department investigation seems inevitable.

Administrators felt pressure from below as well. When a crowded VA hospital would send an ailing veteran to another facility, the American Federation of Government Employees would frequently complain about the “outsourcing” of the work of its members, according to the Wall Street Journal. Job protection is the first priority of public unions.

As several critics of the VA have noted, this so-called “outsourcing” is a partial solution to its problems. Vets who can’t get an appointment in reasonable time could be given a voucher to seek care elsewhere.

Perhaps a better idea would be to issue a Medicare-like card to all veterans so that they could seek care from doctors in their communities. Then, if a vet needed specialized care for complications from service-related wounds or illnesses, he could be referred to a VA hospital. Many of those facilities do give excellent care to the vets who finally make it through the long wait lists.

Those who risk all for this country deserve the best of care. The current bureaucracy-driven, government-run health-care system clearly doesn’t work. The White House and Congress should be open to all ideas.


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