Back in March of 2014 the FAMCare blog reported on a controversy that erupted within the Phoenix VA Healthcare System. VA employees had reported that patients were dying while awaiting appointments and that administrators were issuing phony wait-time data while collecting bonuses. This local scandal led to inquiries across the nationwide VA Healthcare System revealing untimely care, false data, and problems with transparency, whistle-blower retaliation, and accountability throughout the system.
The head of the VA in Phoenix, Sharon Helman, was fired and the Secretary of Veterans Affairs, Eric Shinseki, was forced to resign. Congress eventually passed the $15 billion Veteran’s Choice, Access and Accountability Act of 2014 that established the Commission on Care to come up with reforms for the Department of Veterans Affairs.
The Assessment Report concluded that the VHA offers care that is “in many ways comparable to or better in clinical quality” than what is available in private hospitals. However, the VA is plagued by “chronic management and system failures, along with a troubled organizational culture.”
Included in a long itemized list of recommendations, the report recommended the following systemic changes:
- Create a new community of care for all veterans regardless of wait times or geographic locations. The new system would include Department of Defense Medical Facilities and other federal health providers, as well as private doctors and hospitals credentialed by the VHA.
- The second systemic recommendation is to hire a qualified senior executive to oversee information technology. The agency is currently operating with “antiquated, disjointed clinical and administrative systems that affect all other programs.”
The report’s key proposals call for creation of an 11-member board of directors, accountable to the president and responsible for overall governance of the Veterans Health Administration.
Other recommendations include multiple changes to improve leadership, clinical operations, computer systems, and a simple-to-use personnel system.
At this time we can report, however, that 3 of the 15 commissioners refused to sign the report and issued a dissenting letter that read in part:
“The commission’s final report is largely a hodgepodge of perfunctory recommendations that, while well meaning, will do little to redirect the VHA’s troubled trajectory. The central problem is that these recommendations focus primarily on fixing the existing VHA provider operations, rather than boldly transforming the overall veterans’ health care system.”
What About Our Vets?
Large bureaucracies are like aircraft carriers. The captain charts a course that is difficult to alter once the ship is underway. The massive inertia of such an enormous vessel makes abrupt turns impossible. The Commission on Care created by Congress understands that the VA Healthcare System is an aircraft carrier that is well underway. Only carefully charted course corrections can effectively change such a massive bureaucracy’s trajectory.
Our veterans’ salvation is contained in the promise of the following finding: the VHA offers care that is “in many ways comparable to or better in clinical quality” than what is available in private hospitals.
As long as our vets get the care they deserve while administrators are attempting to alter the course and culture of the massive VA bureaucracy, we are on the right course.