Finally: Serious attention to VA mismanagement
The scandal in Veterans Affairs is shocking, and we don’t know at this point how widespread it could be.
Over 20 VA hospitals across the nation are under investigation for cooking their books. Documents purport to show that the “official” lists of veterans waiting for treatment, and the length of their wait times, are bogus in several hospitals, and that the real wait times are much longer, sometimes by several months.
What’s more, some veterans who applied for treatment don’t show up at all on the actual lists — it’s as though they don’t exist.
Some veterans and their spouses say that the problem has been going on for many years, since before the turn of the 21st century.
How widespread it was back then is not yet known to Congress and the Administration, but several committees and investigators are hard at work to uncover those details. Gen. Shinseki, the administrator of the VA, has now resigned.
A few aspects that probably contribute to the situation haven’t received nearly as much coverage as the publicity about the waiting lists.
One of those is the way that local administrators of VA hospitals are apparently reimbursed.
As with so many government officials, part of their income is in the form of bonuses. If you achieve a certain goal in your job — apparently, for instance, if a local VA administrator reduces the waiting list of veterans or cuts the wait time — he or she then receives an incentive bonus.
Why should such bonuses be part of the system?
I suppose part of it is the civil service regulations. If someone does the job, the salary should be enough reward. But if someone doesn’t do the job well enough, it’s more difficult to discipline or replace a civil service worker than a private sector employee. So bonuses are used instead, as an incentive to promote good job performance.
But a bonus system in a large bureaucracy like the VA creates a great temptation for an administrator to fudge the records to his or her benefit. If you can make it look as if you’re really looking out for your veteran patients, you get more money.
There must be a way to structure the pay system to reduce that temptation.
The system is similar, however, to certain aspects of the private sector, such as employees in certain businesses who are paid a commission for the sales they make.
Commission pay arrangements work well when the business sells fairly common goods and services. If the customer is familiar with the item, and seeks a lower price or better service, he or she can simply look elsewhere for it.
But when it is a specialized item, the customer is at the mercy of the provider. Many people, for instance, don’t know much about how their vehicle works. If a mechanic tells them they need an expensive replacement part, they accept it on faith. A mechanic, or medical specialist, or high-tech sales rep who is paid on commission, is tempted to oversell to pad his or her commission, just like the VA administrator.
Then there’s the shameful discrepancy between the public praise heaped on veterans while they’re on active duty, and the shabby way they’re treated when their service is done.
One in five Iraq veterans, for example, suffers from post-traumatic stress disorder (PTSD). In gearing up for the war, the government gave little thought to how to help them on their return home, and too many members of Congress give only lip service to providing real help, in funding and professional services, for them and other veterans who come home with a variety of serious problems.
And finally, it’s time for Congress to give serious consideration to providing veterans with a health services card similar to the one Medicare recipients use. The veteran could use it at any health care provider he or she chooses, if the VA hospital doesn’t provide the needed care promptly.
There’s no good reason a veteran should have to travel a couple hundred miles to a VA hospital to receive his or her government-paid health care benefits when there are facilities of at least equal quality nearby.
It’s scandalous that it takes something like the recent revelations to finally focus governmental attention on VA mismanagement.
Elected officials should not let up until permanent corrections are made.