One Change Is Not Enough for Veterans
12:06 PM, May 15, 2014 • By MICHAEL ASTRUE
I did not get to know Secretary of Veterans Affairs Eric Shinseki when we served together in the Obama administration, but in our limited interactions I liked him. He struck me as polite, smart, earnest and hard-working. Over time he resisted the ego-tripping that many agency heads find irresistible in Washington.
Secretary Shinseki, however, has not been an agent of change. As his May 15 Senate testimony made clear, the management style which he brought with him—the only style he knows—is ill-suited for an agency that has serious management and integrity issues. Delegating and deferring to a broken bureaucracy that will not be candid about its failures has been a recipe for greater failures—failures that have caused the death of veterans—and now it is surely only a matter of time before President Obama sends Secretary Shinseki the word that he must resign.
Too often Washington sees this kind of ritual bloodletting as the full resolution to a problem, and White Houses of both parties then blithely reuse the same template that caused the bloodletting in the first place. It is time to step back from this particular tragic fall, and ask questions that Washington historically fails to ask.
A threshold question is “Where was the VA inspector general the past six years and why did the key whistleblowers have to complain to Congress instead of to the Department’s internal watchdog?” George Opfer, the longstanding inspector general, retired last year and his spot has not been filled. His entrenched deputy, Richard Griffin, is the acting inspector general. Business as usual practices caused both of them to miss the biggest problems on their watch.
To be fair, part of the problem is a broader one with agency watchdogs. The Obama administration has found countless ways to turn inspectors general into toothless “team players.” The HHS inspector general, Daniel Levinson, is a classic example—during the entire healthcare.gov debacle he did nothing more than issue a painfully brief report declaring that HHS had assured him that everything was fine; he did not even insist on seeing key documents that HHS withheld from him.
Congress has also contributed to a culture of sizzle but no meat among the inspectors general. Congress responds overenthusiastically to claims that cumulative recommendations for savings have increased each year; pressure to meet congressional expectations in this regard leads to inspector general recommendations for cost savings that have become increasingly flimsy and increasingly unlikely to produce real savings.
As a result of this counterproductive pressure from Congress, inspectors general tend to refuse to take on time-consuming but critical investigations that go to the heart of their agency’s mission—such as figuring out whether healthcare.gov is on track or whether VA hospitals are gaming VA management information systems in dangerous ways. For that reason, Veterans Affairs needs a new inspector general who will not play statistical games, and that inspector general needs to have a new deputy from outside the agency. Those appointees must create confidence in their office so that agency employees who are willing to challenge a languid status quo will file their grievances internally first.
President Obama and the Senate also need to reconsider the secretary’s job description. Another veteran is a political necessity, but yet another general or admiral with no private sector experience in health care would not serve the interests of veterans. The VA health care system simply will not improve until the agency’s leader understands what service should look like on the hospital floor and what the guts of its administrative operations should look like. There are plenty of veterans in health care who left the military after 20 years of service, and President Obama should not neglect that pool of candidates. Talent and experience, not rank, should be the key criteria for the next secretary.
There is also a risk that the recent focus on breakdowns in the VA hospital system will cause President Obama and Congress to overlook the other huge failing at the VA—a sluggish, error-prone disability system that will never work until it moves completely from paper processes to a state-of-the-art electronic system. VA disability paperwork is so voluminous that the General Services Administration became concerned a few years ago that a building in Virginia would collapse from the sheer weight of its stored VA disability paperwork. Predictably, waiting times for review have slowed to historically sluggish levels; a former soldier, whether injured in Afghanistan or Vietnam, should not have to wait years for a decision on his or her claim.
Entrenched forces within the VA are still resisting a modern system of disability review. President Obama and the Senate should insist that the next nominee commit to a fully electronic system, and they should also insist that an expert outside contractor hired by the Government Accountability Office regularly issue public reports on the progress toward such a system. It is clear that the VA Office of the inspector general has neither the inclination nor the experience to handle this important task.
Some of the problems at the VA are aggravated by those outside government. It is puzzling that some veterans groups have become so attached to the failed ways of the past that they are obstructing the VA’s most basic efforts to move its disability system forward. Seemingly obvious steps, such as establishing a single application form to promote efficient review, have regrettably become subjects of controversy rather than shared goals. Organizations that are reinforcing the VA’s failed status quo need to be more strategic in their thinking.
Washington excels at offering rhetoric about veterans, but on a bipartisan basis it consistently fails to live up to that rhetoric. The White House, Congress, the agency and veterans’ advocacy groups all need to change their ways with a sense of urgency. Replacement of Secretary Shinseki will be a sad but necessary start, not a mission accomplished.
Michael Astrue served as commissioner of Social Security from 2007-2013.
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