Thursday, May 15, 2014

Shinseki under attack...again


Calls for General Shinseki's resignation as Secretary of Veteran's Affairs have gone out. In case you haven't heard what this is all about, here's a summary.
The latest scandal erupted when a former VA doctor alleged the department’s Phoenix health clinic developed a secret system to hide treatment delays, possibly affecting dozens of patients who died while waiting for care.
But this isn't the first time Shinseki has faced the fire. In 2003 he was Army Chief of Staff when the Bush/Cheney administration was beating the war drums for an invasion of Iraq.
Appearing before the Armed Services Committee a month before the invasion of Iraq, Shinseki said that occupying the country would require “something on the order of several hundred thousand soldiers.” That estimation put him at odds with the war’s chief architects, Defense Secretary Donald Rumsfeld and Deputy Secretary Paul Wolfowitz, who dismissed his opinion as “wildly off the mark.” Their plans called for only 100,000 soldiers.
Shinseki "resigned" his position after that - even though his estimation was eventually proven to be correct.

In order to understand the current issue about the backlog of claims for medical treatment of veterans, this article about Shinseki's work in that area (published prior to the current controversy) is critical. It outlines the following steps taken by Shinseki to reform/improve VA services (and likely ruffled a lot of feathers):

1. Reduced the definition of "backlog" from 180 days to 125 days, raising the number of cases that fit in that category from 85,000 to 150,000 overnight.

2. Expanded eligibility for veterans affected by PTSD and Agent Orange, raising the backlog to 450,000.

3. Improved VA outreach - especially to Vietnam veterans.
VA’s actions since 2009—not coincidentally under the leadership of a Vietnam veteran—have, in fact, revealed the extent of the longstanding estrangement between Vietnam veterans and the government which sent them to war nearly 50 years ago.

And after four years of concerted outreach, along with special care taken to bring Vietnam veterans back into the fold, the awareness campaign has paid off.
4. Began the process of automating a system that was still based on paper claims - thus beginning the process of actually reducing the backlog.

Here is a graph demonstrating how each of these actions impacted the situation.


It seems to me that what we're seeing now is an example of the old adage that "no good deed will go unpunished." Its true that there might have been managerial issues that resulted in VA employees "skimming the books" under the pressure to do something about the backlog of claims. But there's also the very real possibility that Shinseki has once again rattled the cages of the system in a way that is producing backlash - just as other Obama cabinet secretaries like Holder and Sebelius have faced. Keep that in mind as you watch him come under fire.

2 comments:

  1. At various times individual VA hospitals have been found wanting. Under Reagan then Bush, the hospital in Buffalo, NY was found to have high rates of death in cases where there was open heart surgery. I do not recall anyone targeting the VA leadership but, rightly, targeted the hospital per se for its awfulness. Much changed, and that VA unit became one of the best. More to the point, I have spent decades with friends who are Vietnam vets who never got any help for their physical and mental suffering. Now, with this leader, the cases have vastly increased, but the funding and support for those vets has not. I don't know enough about how the VA works to know if all that can be done is, but I know the VA hospital where I now live is amazing, and it is taking in even homeless vets and providing quality care at long last. They all tell me that while it took decades, now they have the services they need. How can I not look at coincidence and see causality? Gen. Shinseki seems to be the catalyst for good even as the caseloads have risen and thus strained the underfunded system. What happened in Phoenix must, as with Buffalo, be changed. But what is happening with the responsiveness to veterans nationwide is - at long last - what we have needed for decades. Now if only Congress would actually 'support our troops' and provide the money that could ease the strain, we'd finally be doing the right thing for our veterans.

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  2. This General is absolutely THE BEST! Congress wants to withhold the funds, then blame others when the results are less than admirable. Their sequester game was the worst ever for all of the services. Dems wont come on television and speak "truth to power", the media wont speak so public remains ignorant. Sad! Shame!

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