THE VA IS BROKE AND SCREAMING TO BE FIXED
By
Maj. Gen. Jerry
R. Curry, US Army (Ret.)
CurryforAmerica.com
According to the New York Times, “More than 57,000
patients have been waiting more than three months
for medical appointments at hospitals and clinics
run by the Department of Veterans Affairs.”
According to a recent VA audit, corruption in VA
facilities is systemic to the point of being
endemic. Further, the VA audit reveals that Phoenix
is the epicenter of this health care scandal.
Indications are that in Phoenix at least eighteen
veterans have died while waiting for a timely
scheduling of a medical appointment. The situation
is so dire that the Federal Bureau of Investigation
is opening a criminal probe into the VA’s scheduling
practices.
It is not uncommon for a new patient to have to wait
two months or more to get a new primary care
appointment. These unconscionable delays didn’t
happen all by themselves. Two things got them
started. First came a shortage at the VA of doctor
and nurse practitioners, which placed a strain on an
already poorly functioning system.
Then there was an attempt to overcome the shortage
by significantly increasing doctor-nurse patient
visit output, even going so far as to falsify
medical records. This was because job performance
reviews were in part based on how quickly a new
patient could be scheduled for a doctor’s
appointment. The goal was to schedule an appointment
within 14 days of an initial request.
If new patients were seen within 14 days, it was
duly noted on the administrators’ job performance
reviews which helped qualify top performers for
bonuses. Evidently it never occurred to the VA that
employees would, for personal financial gain, game
the system by altering data and manipulating the
record of patient wait times, especially when they
came to realize that the 14 day new appointment goal
was unattainable.
So over a period of many years when whistleblowers
pointed out that the 14 day goal created perverse
incentives for administrators, they were ignored or
told that the problem was being fixed. Of course
there is nothing more ludicrous than having those
who originally created a criminal problem to
prescribe and implement a suggested cure for it.
But that is exactly what the VA did; then it
punished the whistle-blowers for trying to fix the
system. Leaders who can be identified as having
taken part in such reprisals against whistle-blowers
should be summarily fired.
In the VA, the buck stops with the Administrator and
his Deputy or Assistant Administrators. They are
responsible for all the VA does or fails to do. So
let us begin addressing VA problems by acknowledging
that there is such a thing as leaders taking
responsibility for their own actions and for the
actions of those who work for them, including being
responsible for acting on information which may or
may not be public knowledge; but which they should
have ferreted out on their own. This includes the
timely scheduling of veterans’ health care
appointments.
A new Administrator must demonstrate to all of his
employees that he is deadly serious about cleaning
up the mess at the VA. This can most effectively be
done by placing an indefinite moratorium on all
bonuses paid out to VA employees.
At the same time criminal charges should be filed
against all those involved with “cooking the VA
books” and defrauding the American people, the
government, veterans, their families and VA
employees. In addition their security clearances
should be suspended, along with their access passes
to all military and government facilities.
Veterans retiring or being honorably discharged from
the military services should stay on the military’s
active duty payroll until their VA benefits are
approved and they start receiving them. They should
have an opportunity to seek private health care if
VA doctors, hospitals and clinics are not available
or if they live farther than an hour’s driving time
from a VA facility.
The VA should determine what are a reasonable number
of patients for a doctor to see each day and --
within reason – see that they daily treat that many.
VA clinics and hospitals unable to schedule a
medical appointment within two weeks should
immediately issue a voucher that can be presented to
a private civilian doctor or hospital to pay for the
veteran’s medical treatment.
The number of VA facility staff at hospitals and
clinics should be based on actual patient needs and
the number of patients receiving care. Staff
personnel found guilty of abusing or being
disrespectful to patients, providing unsatisfactory
care, or otherwise failing to perform their duties,
should be summarily fired or demoted.
These are a few things the VA can do now to help
reduce its systemic problems and, as necessary; it
should increase its numbers of doctor and nurse
practitioners. Such actions can help, but they
cannot replace the need for strong, dedicated,
enlightened leadership at the top of the VA. The VA
isn’t failing because it lacks medical expertise; it
is failing because it lacks strong, aggressive
leadership.
The federal government and the VA don’t need leaders
who point their fingers at the failures of others,
but leaders who take responsibility for their own
failures and the failures of those they lead.
Phoenix should be encouraged to trail-blaze the way
in implementing these reforms.
Key words and phrases:
Patient waiting times
Medical
appointments
Schedule veteran
health care appointments
Whistle-blowers
Leaders, leadership
Taking responsibility
Fixing the VA system
Bio:
Jerry R. Curry enlisted in the US Army as a Private
to fight in the Korean War. He worked his way up
through the ranks and retired a Major General. He
was Military Assistant Secretary of Defense in the
Carter Administration, Press Secretary to the
Secretary of Defense in the Reagan Administration,
and Administrator of the National Highway Traffic
Safety Administration in the Bush senior
administration. He is the recipient of too many
awards and decorations to mention, including the
“Secret Service Honor Award,” and “Washingtonian of
the Year award.”