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“Will Congress Be As Brave As Shinseki?”: Will The Honorable Politicians Please Stand Up?

If you want a prime example of what’s wrong with our politics, study the response to the veterans’ health-care scandal. You would think from the coverage that the only issue that mattered to politicians was whether Gen. Eric Shinseki should be fired.

Shinseki is a true patriot, and his resignation as Veterans Affairs secretary on Friday calls Congress’s bluff. He played his part in a Washington sacrificial ritual. Will the politicians now be honorable enough to account for their own mistakes?

Thanks to Shinseki’s latest selfless act for his country, you can at least hope that we will move on to the underlying questions here, to wit: Why was the shortage of primary care doctors in the VA system not highlighted much earlier? Why did it take a scandal to make us face up to the vast increase in the number of veterans who need medical attention? And why don’t we think enough about how abstract budget numbers connect to the missions we’re asking government agencies to carry out?

It’s an election year, so it’s not surprising that the Republicans are using the scandal against President Obama and the Democrats, though there is a certain shamelessness about the ads they’ve been running, given the failures of the previous administration.

Shinseki and Obama might have averted this by pushing Congress much harder, much earlier to give the agency the tools it needed to do right by vets. And as a general matter, I wish Obama spent more time than he has on fixing government and improving administration. Progressives rightly assert that active, competent government can make things better — which means they need to place a high priority on making it work better. This would include, as The Post editorialized, a serious engagement with civil service reform.

It’s also fair to ask why Shinseki did not move faster elsewhere, notably on what the Iraq and Afghanistan Veterans of America called the department’s “egregious failure to process the claims of our veterans” in a timely and effective way. (For what it’s worth, I raised this concern in a column in November 2012.)

But this is where the story gets more complicated. Shinseki eventually made real progress on the claims issue and other inherited messes. He got little public credit, though many friends of veterans saw him as a reformer and refused to join the resignation chorus. Both House Speaker John Boehner and Minority Leader Nancy Pelosi deserve praise for insisting to the end that Shinseki’s departure wouldn’t solve the system’s problems.

The most important of these is not that VA employees falsified data about the excessive waiting times for veterans seeking appointments with doctors, as outrageous as this was. It is, as the New York Times reported last week, “an acute shortage of doctors, particularly primary care ones, to handle a patient population swelled both by aging veterans from the Vietnam War and younger ones who served in Iraq and Afghanistan.” Dealing with this isn’t sexy, just essential.

Sen. Bernie Sanders (I-Vt.), the chairman of the Senate Veterans’ Affairs Committee who wanted Shinseki to stay, is trying to push the discussion in the right direction. A Sanders bill to expand VA funding across a wide range of areas went down in a Republican filibuster in February. The new bill he hopes will come up for a vote this week focuses specifically on the health system.

It would authorize private care for veterans facing emergencies, which is similar to a House Republican idea. But Sanders would also broaden veterans’ access to other forms of government health care, fund 27 new VA facilities, and use scholarships or loan forgiveness to entice medical students to serve in the VA program.

Shinseki himself proposed other reforms in a speech he gave just before he quit, among them an end to incentives that have encouraged agency supervisors to produce fake information on waiting times.

If there is any cause that should be bipartisan, it’s care for our veterans. But too often, what passes for bipartisanship is the cheap and easy stuff. It tells you how political this process has been so far that so many of the Democrats who joined Republicans in asking for Shinseki to go are in tough election races this fall.

Now that Shinseki is gone, there are no excuses for avoiding the administrative challenges that Obama needs to confront and the policy errors for which Congress must also take responsibility.

 

By: E. J. Dionne, Jr., Opinion Writer, The Washington Post, June 1, 2014

June 2, 2014 Posted by | Congress, Politics, Veterans Administration | , , , , , , , , | Leave a comment

“Truly Something To Behold”: Republicans War-Monger, Then Complain When We’re Overwhelmed By Sick Vets

It took very little time at all for reports of falsified records covering up delays at a Veterans Administration hospital in Phoenix to balloon into just another who’s up-who’s down Washington political story. From the New York Timesfront-page article today declaring in its headline that the “V.A. Accusations Aggravate Woes for White House”:

Republican lawmakers intensified their criticism of Mr. Obama, and some made it clear they intended to use the incidents at the hospitals as fodder for a broader political theme about incompetence in his administration.

“The election of President Obama ushered in a new era of big government and with it a renewed flurry of mismanagement,” Representative Kevin McCarthy of California, the House Republican whip, said in a statement. “If the president truly did not know about these scandals and mistakes, we should doubt his ability to properly manage the leviathan government that he helped create.”

Representative Eric Cantor of Virginia, the No. 2 Republican in the House, told reporters on Tuesday that Mr. Obama had not acted swiftly enough. He added that “it is time for our president to come forward and take responsibility for this and do the right thing by these veterans and begin to show that he actually cares about getting it straight.”

Meanwhile, after Obama addressed the Phoenix scandal at the White House this morning, Republican Senate leader Mitch McConnell huffed, “Unfortunately [we] have yet to hear” Obama treating the “VA crisis with the seriousness it deserves.”

The hypocrisy on view here is truly something to behold. If V.A. employees in Phoenix, or anywhere else, were engaged in fraud and cover-up of the sort that is being alleged, that is a travesty and heads will have to roll, as one already has. And it’s fair to ask, as we did with the bungled rollout of healthcare.gov, why the White House hasn’t paid more attention to the nuts and bolt functioning of the federal bureaucracy. But for Republicans to expand the scandal into a broader indictment of Obama’s overall handling of veterans affairs means overlooking some relevant context.

For starters, there is the matter of funding. If there’s been one side pushing for greater resources for the Veterans Administration in the age of austerity these past five years, it hasn’t been the Republicans. It was the much-maligned economic stimulus package of 2009 that included $1 billion for the V.A. While the V.A. itself was protected from the budget sequestration that Republicans fought to keep in place last year, many other veterans programs—providing mental health services and housing, among other things—were hit hard by the sequestration cuts. And when the Senate was poised to pass a $24 billion bill for federal healthcare an education programs for veterans three months ago, Senate Republicans, led by McConnell, blocked it in a filibuster, saying the bill would bust the budget and complaining that Senate Democrats had refused to allow an amendment on Iran sanctions to be attached to the bill.

But there is a whole other level of context to consider here as well. There is a pretty basic reason for backlogs at V.A. facilities and in the disability claims process, the other ongoing V.A. mess. Put simply: when you go to war, you get more wounded veterans, and in a country without a universal health care system, they are all funneled into this one agency with limited capacity. Every one of the Republican leaders quoted above attacking Obama for the V.A. backlogs strongly supported launching the wars in Iraq and Afghanistan that resulted in nearly 7,000 fatalities and a huge surge in medical needs and disability claims. Nearly one-half of veterans returning from Iraq and Afghanistan have filed claims for permanent disability compensation. These claims need to be assessed for their validity, just as we attempt to do with claims for other programs, such as Social Security disability, unless we want to simply throw open the doors on a compensation program that is already expected to cost close to a trillion dollars for Iraq and Afghanistan vets. Making the assessment all the more challenging is the nature of the disability claims being made. Awarding disability status for a missing limb is easy. Harder are the much larger numbers of claims for traumatic brain injury caused by the IED explosions that were the greatest threat to our service members in these two wars of occupation. Consider this graph:

Something, it appears, happened around 2003 that caused the rate of traumatic brain injuries in the U.S. military to spike. Now what could that have been? Whatever it was, it happened while Barack Obama was in the Illinois state Senate, giving an obscure speech against invading Iraq. He is now having to reckon with the fallout from that event, as is his responsibility to do as commander in chief. But you’d think that those who had actually played a part in bringing about that event would have enough self-awareness to resist scoring political points off of the years-later fallout. Apparently, though, even that is too much to ask.

 

By: Alec MacGinnis, The New Republic, May 21, 2014

May 22, 2014 Posted by | Veterans, Veterans Administration | , , , , , , , , | 1 Comment

   

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