May 23, 2014--The VA Mess

It's déjà vu again.

For my entire adult life I have heard stories about the Veterans Administration healthcare system. Mainly horror stories.

About how bureaucratic it is and thus difficult for our veterans to get timely, high-quality treatment. And now we are learning how delays and suffocating administrative procedures may have led to the deaths of score of veterans in Phoenix and elsewhere.

When Barack Obama first ran for office in 2008, he made fixing the VA system his highest priority so our troops could get the treatment they deserve. His promise came at a time when there were reports about the disgraceful quality of care and conditions at Walter Reed Hospital, walking distance from the White House.

Obama pledged to clean up the mess and bring the VA up to "21st century standards." He even designated his wife Michelle to make the care of veterans her priority.

So where are we five years later?

Business as usual. Maybe, business worse than usual.

And the mess cannot be attributed to George W. Bush. The full blame rests with the current occupant in the White House.

What has Michelle Obama been up to in regard to veterans' care? Mainly periodic hospital visits between planting a vegetable garden in the White House lawn and jumping rope with inner-city kids. I know this is overstated, but not by much.

Like almost everyone, I am mad as hell about this.

The president cannot honor those killed and shed tears at the bedside of the grievously wounded, hypocritically, for political reasons, calling them as often as possible "heroes," while presiding passively over this ongoing disgrace.

Obama's head of the VA, General Eric Shinseki may have been a good general (though not everyone would agree) but he was  not qualified to head the Veterans Administration. What job did he ever have to prepare him for such a huge and complicated assignment? He was selected mainly because he publicly disagreed with President Bush's approach to the war in Iraq and fit an Asian Cabinet demographic to which Obama was eager to pander.

In the VA system there are 151 hospitals and 820 outpatient clinics that serve 6.5 million people a year. The annual budget is more than $57 billion. To run that is a very big job, it's a highest-priority assignment, and who do we have running it?  Someone whose major responsibility previously was serving four years as Army Chief of Staff.

If fixing the VA was such a high priority, was there no head of a major healthcare system, Humana, HCA, or the Mayo Clinic, who could have been recruited to take on the assignment?

Sadly, Shinseki's appointment was typical of the kind of people Obama named to Cabinet-level positions--minimally-competenet lightweights such as Tim Geithner who would not challenge or threaten Obama's leadership.

Name one Cabinet appointment with a truly distinguished track record in public or private life who went on the serve with true distinction? Or on the White House staff for that matter. Even Hillary Clinton's record is at best mixed.

So, where do we go from here?

First, fire Shinseki. Do not ask him to reign, summarily dismiss him. That would be a first for Obama and send a message of concern and seriousness.

And then about the larger problem--restructuring the VA healthcare system itself--there are two good approaches.

Privatize the VA hospitals and clinics. Get rid of the ineffective bureaucracy and sell the whole thing to HCA or Mayo and in this way eliminate of the Civil Service deadwood.

Equally important, and not mutually exclusive, make all veterans eligible for Medicare. No matter that they are not all 65. Pretty much everyone with Medicare likes it so why not extend this cost-effective, high quality healthcare system to all those Americans who did so much to serve our country?

Tinkering at the margins of this massive problem will not solve it. Doing something radical and smart is the better approach. Our brave men and women deserve no less.