A few years ago a woman sat down next to me in the departure lounge at Reagan National Airport and commented on the weather. Our flight had been delayed. We were stuck for at least another hour. To pass the time we struck up a conversation.
I introduced myself as a tech industry executive who had made an unsuccessful run for Congress on a platform advocating a simpler and more efficient government. Anne said she was a retired military officer who had joined General Shinseki’s staff at the Veterans Administration to do her part to reshape government to address the complex challenges of the 21st Century.
For the next hour Anne described the obstacles that had to be cleared to remove the most blatantly incompetent VA staff member.
Her narrative could be inspiration for a Seth McFarlane comedy featuring Whoopi Goldberg and Dolly Parton playing the fossilized bureaucrats and Tina Fey the former officer – except that there’s no happy ending.
Long Story Short: Outdated Record Keeping Is Bad For Business
I’d had some VA experience of my own. My team evaluated and recommended rejection of a proposal from SAIC to Kaiser to design a second generation Electronic Health Record (EHR) based on the VA’s VistA system. SAIC was and remains the VistA prime contractor.
After 35 years and annual information systems budgets in the billions of dollars, VistA continues to be a number of disconnected electronic note pads dependent on people walking printed reports from one computer station to another – what we call “a system-on-legs”.
No audit trail – no accountability.
This is business as usual for a government department still organized to respond to needs of World War II veterans – stoically resistant reform that addresses 21st century reality.
Resisting Even Common Sense Accountability
Business as usual, that is, until a Veterans Administration primary care doctor in Phoenix retired. He couldn’t reconcile his duty to his patients with VA policies. His phone call to CNN triggered a scandal now splashed across the nation’s news media.
Is it possible that the combination of bureaucracy and antiquated systems caused the unnecessary deaths of 40 veterans? Congress and the White House exclaim their outrage – if only we had known – we “just read it in the newspaper”.
VA staffers fall back on their standard excuse – doubling our budget is still not enough money.
We’ve Heard It All Before
The American people are very familiar with this pattern of government behavior. A scandal erupts. The denials, followed by the excuses, the hasty investigation, the Congressional hearings, the sacrificial resignation and some symbolic action by Congress to treat a single symptom instead of understanding or attacking the underlying cause.
Think intractable Medicare Fraud. Think Obamacare’s $1 Billion website Think FEMA’s response to Hurricane Katrina.
President Obama and his three predecessors all came to Washington proclaiming their determination to make the Federal Government “work”. Clearly they’ve failed.
Where are the “tiger teams” President Obama promised in 2009? Where are the teams of “experts” empowered to modernize and simplify, to integrate the activities of separate government agencies – to improve service at a lower cost to tax payers.
Knee Jerk Reaction both Predictable and Pointless
The VA Scandal is just the latest example of government bungling driven by politics.
It’s predictable – Congress fires first and aims the gun second.
- Predictable: the Cabinet Secretary resisted and then succumbed – to resignation.
- Predictable: Congress is rushing out legislation to make it a tiny bit easier to retire or fire fossilized bureaucrats at the VA, only.
- Predictable: Congress is urgently calling for some veterans to get primary care outside the VA system in limited circumstances.
Just as predictably, none of these steps will make the slightest dent in the intractable federal bureaucracy or streamline government. It’s an axiom of good management – more money, more people, the same antiquated processes and systems just makes the problems more visible and more acute.
Why Not Solve the Underlying Problem Instead?
Congress and the Administration resisted the urge to quiet the scandal and fix the problem. It’s time to right size and reform the VA!
The underlying issues – bureaucracy and antiquated systems, are common across the major agencies of the Federal Government.
The specific issues at Veterans Administration boil down to one simple fact: The VA duplicates services other government departments provide more efficiently to the general population!
I have many friends who are Vietnam era and Afghanistan/Iraq veterans. To a man they opt for Medicare or corporate health insurance benefits rather than the VA for their regular (non-combat injury) medical care – faster, more convenient, better quality – they believe.
Congress should enroll eligible veterans in Medicare or Obamacare for all non-combat related veteran health care and focus the VA on its core mission – caring for our wounded warriors.
Photo Credit: Karen Bleier/AFP/Getty Images
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