More than 4,200 living veterans were wrongly declared dead by the U.S. Department of Veteran Affairs between 2011 and 2015, according to recent news reports. Their benefits were restored after a Congressional inquiry, and while officials at the VA apologized for their blunders and pledged not to repeat such errors, they weren’t really able to pinpoint how it happened in the first place.
Of the many Cabinet-level departments in the Executive Branch, none seems more persistently dysfunctional than the VA. As the nation pauses this Memorial Day weekend to honor those who have given their lives for their country, we should be asking why we can’t do a better job taking care of those veterans who are still living.
These are highly polarized political times and things are bound to get worse before they get better, but one common value I am certain most in society share, is the right of military veterans to receive the timely care and benefits they deserve and need. At least since the Vietnam War, my span of adulthood, veterans have not received the treatment they deserve. Neither Democrats nor Republicans seem able to implement the necessary reforms.
Happy Memorial Day, men and women of the military. You kept your part of the bargain by serving your nation, many of you in distant wars where you suffered wounds, injuries, and trauma, and great strain upon your families. Many of you witnessed the combat deaths of fellow soldiers. A great number of you over the last 15 years have been sent back into harm’s way, again and again, for multiple tours. It’s shameful the government has not kept its part of the bargain. It’s a mystery how a nation that places such a high value on service and patriotism can’t honor its veterans by serving them well after their homecoming.
The VA estimates there are 22 million veterans living in the United States, and nine million of them are receiving VA services. They are served by 320,000 full-time employees in Washington D.C. and at 167 medical centers, 863 outpatient clinics, 300 vet centers, 56 regional offices, and nine regional loan centers. Three years ago, there were more than 600,000 vets awaiting the VA’s designation as disabled. That embarrassing bureaucratic backlog had been reduced to less than 100,000 vets by last year, still an unacceptable number. I couldn’t find a more current figure.
A federal study in 2012 concluded that 22 veterans committed suicide every day, with others disputing the number, saying it should be higher or lower. There were 49,000 homeless vets living on the streets of U.S. cities on any given night in 2014, according to the Department of Housing and Urban Development (HUD) and point-in-time counts conducted in cities across the country in 2014. Many suffer mental illness and from alcohol or drug addiction.
Here in San Antonio, the City, HUD, the Haven for Hope and USAA have made great strides in addressing veteran homelessness, as noted at a press conference earlier this month where Mayor Ivy Taylor declared an “effective end” to the problem. (Read more: San Antonio ‘Effectively Ends’ Veteran Homelessness)
Even if veteran homelessness remains a constant challenge requiring concerted efforts to manage, that is a major accomplishment for the city, and one that suggests the fate of veterans would be better if they were not so dependent on the federal bureaucracy for treatment.
I remember a visit to USAA headquarters in 2007 to attend a small ceremony welcoming the new Secretary of Veteran Affairs James Peake, a retired army general and physician who had previously served as the Surgeon General of the U.S. Army and as Commander of the U.S. Army Medical Department Center and School at Fort Sam Houston. It was a friendly, hometown “welcome home” for Dr. Peake, who outlined his aggressive plan to modernize the VA’s vast paper bureaucracy and record-keeping culture by computerizing all records and services and eliminating all backlogs.
Two years later, Dr. Peake quietly left the VA to accept an executive position with CGI Group, a global independent information technology and business process services firm.
The bureaucracy and backlog outlasted him. Fast forward to the Obama administration and the forced resignation of then-VA Secretary Eric Shinseki, the first-Asian-American Army general, who was forced to resign after it was disclosed that VA bureaucrats had deliberately manipulated data to show long waiting times for service experienced by veterans did not exist when, in fact, dozens of veterans had died waiting for surgery and other life-saving treatments. The message to the public was this: the VA’s bureaucrats couldn’t fix the problem, so they covered it up.
If this deeply-entrenched bureaucracy can defeat some of the most accomplished military leaders and their efforts to remake the department’s culture of poor service and ethical lapses, why not take a more free market approach to delivery of services and allow the private sector to compete for the business? Why not disrupt the entire system and allow competing outside entities and new technologies to provide alternative approaches and solutions?
One way of doing that would be to hire independent, innovative hospital and clinic administrators to oversee the system’s 153 VA hospitals and 863 outpatient clinics and give them space to manage without Washington paper shufflers having to approve every procedure and protocol.
How does it work now? Read one physician’s account of life inside a VA hospital that was published in 2014 by the Wall Street Journal which, unfortunately, has a firewall. He talks of veterans waiting months at the Audie L. Murphy Memorial VA Hospital in San Antonio to get an appointment for an X-ray or to have a surgery performed.
An even bigger step would be to allow private physicians at non-VA hospitals and clinics to offer services to all veterans all the time. It works for Medicare, the other big government health care services program. That degree of disruption, of course, would probably lead to the eventual demise of the VA hospital system, which might be the ultimate solution.
What to do about the giant bureaucracy in Washington D.C. that can’t seem to adopt a customer-first service culture or employ technology and leaner organizational structures to improve its performance? Well, it couldn’t get any worse if Congress broke it up. It might be worth asking whether states or private networks could better manage veteran programs under federal law and reimbursement schedules. Few people realize this country didn’t even have the Cabinet level Department of Veteran Affairs until 1988 when Pres. Reagan signed into law the new federal agency. If Reagan were alive today, he’d be arguing for its demise as a failed experiment.
Memorial Day is our day for honoring veterans who gave their lives for the country, a tradition rooted in the commemoration of those who died for the Union in the U.S. Civil War. While Veterans Day falls in November, what better way to honor the fallen than to pledge anew to take better care of those who served and came home?
Planting flags and laying flowers on graves is a time-honored tradition, but it would mean far more if first we took care of the veterans still struggling to make something of their lives.
Top image: David Parker is one of 1,335 homeless veterans in San Antonio who were identified for permanent housing. Photo by Kathryn Boyd-Batstone
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