OPINION:
To fire Eric K. Shinseki or not — that is the question everyone in Washington is asking. Many, including major veterans’ organizations and a lot of Republicans, think he should have been fired yesterday while others, including President Obama and most Democrats, aren’t so sure. On balance, those in favor of firing the man are probably right, but as Hillary Clinton might ask, “What difference, at this point, does it make?”
The president, according to White House spokesman Jay Carney, really didn’t know there was a problem at the Department of Veterans Affairs until he saw a CNN report, but is now “mad as hell” and has dispatched one of his top assistants to find out what’s going on in the beleaguered department. This can be taken as evidence that he doesn’t trust the man he put over there to run things and who sits in his Cabinet meetings and reports directly to him. That man, of course, is Mr. Shinseki, who, if the president is telling the truth about what he knows of what’s going on in one of the biggest departments in his government, hasn’t been truthful or forthcoming in his reports to his boss. If he is as mad as his spokesmen claim, he ought to be even madder at the man he asked to run the department.
To be fair to Mr. Shinseki, however, the president actually knew there were big problems at the VA even before he was briefed in 2008 on preparing to take office. He spent more than a little time during his first campaign blaming George W. Bush for them and vowed that if elected, he would solve them. To that end, he asked Mr. Shinseki to help and then apparently didn’t give the matter another thought or ask his appointee to report on how things were going.
Still, one has to wonder what will be accomplished by simply firing Mr. Shinseki, who, like almost all his predecessors, has had about as much impact on the way Veterans Affairs is run as the guy who runs the McDonald’s on the corner. The VA is a behemoth of an operation, which encompasses more than 150 hospitals and 800 clinics around the country serving some 8 million veterans and employing as many as 350,000 people, none of whom apparently listen to or fear whoever sits at the top of the VA bureaucracy.
House Speaker John Boehner got it right the other day when, in response to questions as to whether Mr. Shinseki should be fired, he said, “This isn’t about the secretary. It’s about the entire system beneath him.” Mr. Boehner was exactly correct. Veterans Affairs has what some of its critics are calling “systemic problems,” and they aren’t going to go away if Mr. Shinseki is fired or allowed to sit around as past VA administrators have, doing nothing to reform a badly dysfunctional system. The problems were there when Bill Clinton was in the White House, they got worse under George W. Bush and are glaringly worse under President Obama.
Democrats are outraged that Republicans are suggesting that the systemic problems plaguing the VA are problems inherent in any system of government-provided health care in which the providers begin to realize their customers aren’t the patients the system was set up to service, but their bureaucratic superiors, who ultimately care far more about statistical metrics and budgets than in human beings. There can be no comparison, they complain, but it wasn’t that long ago that many of them, and especially those favoring a “single-payer” health care system, were lauding the VA as a great model to follow.
Paul Krugman, Obama cheerleader and one of the nation’s major supporters of government-controlled health care, before the current scandals broke, routinely pointed to the VA as proof that government provided health care is superior to that available from the private sector. The liberal Washington Monthly, in lauding Phillip Longman’s “The Best Care Anywhere,” opined that the VA proves that in health care, competition and choice are bad rather than good; that “when it comes to health care, it’s a governmental bureaucracy that’s setting the standard for maintaining best practices while reducing costs . It turns out that precisely because the VHA is a big, government-run system that has nearly a lifetime relationship with its patients, it has incentives for investing in quality and keeping its patients well .”
Mr. Krugman, Mr. Longman and those dreaming of imposing a VA-like system on all Americans have been tragically wrong in their assumption that government bureaucrats answerable to each other can provide the quality care veterans have been promised and that all Americans have come to expect of their health care system. It can take a veteran months to get eyeglasses through the VA, which is why many buy theirs at Wal-Mart or from an optometrist in the private sector, who provides what they need quickly at reasonable cost.
The news that patients are lied to about when they can see a doctor or that doctors in the system often see far fewer patients than their private-sector counterparts should surprise no one any more than the fact that the worst offenders within the bureaucracy often receive promotions and bonuses rather than reprimands when they ignore the needs of the men and women they were hired to serve.
The president’s supporters are trying to shift the blame. It was Mr. Bush’s wars, claims Nancy Pelosi, but Iraqi and Afghanistan vets make up only about 7 percent of the VA caseload, and less than 4 percent of the ever-expanding VA budget goes to providing services to them. Mr. Bush couldn’t fix a system with the inherent flaws so obvious today. The men he chose to improve things failed then as Mr. Shinseki has failed today.
Either Mr. Obama, who condemned Mr. Bush’s failure, tried and failed, or he didn’t try at all. Since he has supported no major reforms, one wonders how he can defend his actions. A president who really wants to fix the VA is going to have to devote time, attention and political capital to the task, something Mr. Obama has not done, though in 2007 he said, “America’s veterans deserve a president who will fight for them not just when its easy or convenient, but every hour of every day for the next four years.”
America’s veterans are still waiting for that president.
David A. Keene is opinion editor of The Washington Times.
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