Who’s To Blame For The VA Scandal? Ctd

by Jonah Shepp

Drum defends Obama’s handling of the problems with the Veterans Health Administration:

Under the Obama administration, the patient load of the VHA has increased by over a million. Partly this is because of the large number of combat vets returning from the Afghanistan and Iraq wars, and partly it’s because Obama kept his promise to expand access to the VHA. It was inevitable that this would increase wait times, and the VHA’s claims backlog did indeed increase during the first three years of Obama’s presidency. Over the past couple of years, however, wait times have shrunk dramatically. A digital claims system has finally been put in place, and the claims backlog today is less than half what it was at the beginning of 2013.

What’s more, despite its backlog problems, the VHA still gets high marks from vets. Overall, satisfaction with VHA care is higher than satisfaction with civilian hospitals.

Mark Thompson argues that things aren’t as bad at VA hospitals as the scandal makes them seem:

Perspective is an important element in understanding any problem. “Over the past two weeks, the American Legion has received over 500 calls, emails, and online contacts from veterans struggling with the healthcare system nationwide,” Daniel Dellinger, the Legion’s national commander, told the Senate Veterans Affairs Committee on Thursday. Over that same period, the VA saw a total of about 3.2 million patients. That works out to a complaint rate of 0.015%. Including a wider date range drops that share even lower.

Carl Blake of the Paralyzed Veterans of America suggested the Senate panel go undercover. “If the committee wants to get the truth about the quality of VA health care, spend a day walking around in a major VA medical facility,” he said. “We can guarantee that you will likely hear complaints about how long it took to be seen, but rare is the complaint about the actual quality of care … It is no secret that wait times for appointments for specialty care in the private sector tend to be extremely long.” The public, he says, has gotten a distorted view of the quality of VA care at various field hearings where a handful of those with poor experiences have taken center stage.

Also, as Jonathan Cohn points out, “some of the problems… have very little to do with the VA and a whole lot to do with American health care”:

As Phil Longman, author of Best Care Anywhere, noted in his own congressional testimony last week, long waits for services are actually pretty common in the U.S.even for people with serious medical conditionsbecause the demand for services exceeds the supply of physicians. (“It took me two-and-a-half years to find a primary care physician in Northwest Washington who was still taking patients,” he noted.) The difference is that the VA actually set guidelines for waiting times and monitors compliance, however poorly. That doesn’t happen in the private sector. The victims of those waits suffer, too. They just don’t get the same attention.

It’s no surprise, though, that Obama is taking the blame here; he is the president, after all. Furthermore, Elias Groll writes, “The scandal is only made more politically potent by the fact that Obama has spent most of his career as politician describing himself as an advocate for veterans and has repeatedly promised to reform the VA”:

During the 2007 speech, delivered while serving as a senator and a member of the Veterans Affairs Committee, Obama pledged to deliver better service to American veterans and to overhaul a system that has all too often become shorthand for waste, inefficiency, and staggering wait times. “We know that the sacred trust cannot expire when the uniform comes off,” he said. “When we fail to keep faith with our veterans, the bond between our nation and our nation’s heroes becomes frayed. When a veteran is denied care, we are all dishonored.”

Two years later, in 2009, Obama was back before the VFW delivering a similar pledge: “cut those backlogs, slash those wait times, deliver your benefits sooner.” … By the time he returned to the VFW in the midst of his 2012 re-election campaign, Obama’s frustration had only grown. What was once a sense of invigorating optimism had been replaced in part by a weariness and anger at the VA’s practices.  “When I hear about servicemembers and veterans who had the courage to seek help but didn’t get it, who died waiting, that’s an outrage,” Obama said.

In Waldman’s view, Obama can and should turn the scandal around 180°:

As troubling as some of these allegations are, this controversy presents an opportunity for the administration. This isn’t some kind of phony scandal like Benghazi: it’s a real issue with real consequences. But it’s also a set of problems that can be solved, even if some of those problems go back decades. Two and a half years from now, this presidency will be over. If by then officials can say that every veteran who needs care is getting it without having to wait an unreasonably long time, and that every disability claim is being processed quickly, and that the agency as a whole is capable of handling the enormous task it confronts, then they’ll be able to claim an important victory.

That wouldn’t be just a victory for this administration. More broadly, it would be a victory for the liberal vision of effective government. Sometimes it takes some bad news to provide the incentive people need.

Joe Klein suggests he begin by sacking Eric Shinseki:

The question is, How do we change this situation? The simple answer is leadership, which is why some have called (as I did last year) for VA Secretary Eric Shinseki to resign. By all accounts, Shinseki is a fine man who has spent nearly six years lost in the system. An effective leader would have gone to Phoenix as soon as the scandal broke, expressed his outrage, held a town meeting for local VA outpatients and their families—dealt with their fury face-to-face—and let it be known that he was taking charge and heads were going to roll. Instead, Shinseki intoned the words “mad as hell” at a congressional hearing. And White House chief of staff Denis McDonough said the President was “madder than hell” about the situation. Does anyone actually find this convincing?

Previous Dish on the VA scandal here and here.