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After Shinseki

(Win McNamee/Getty Images)

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Eric Shinseki’s resignation is only the first step in the long process of getting the Department of Veterans Affairs to do its job properly. There is little doubt that Shinseki, an honorable man, truly wanted to fix the broken bureaucracy he inherited. But his failure to do so, and the scandalous practices under his watch, justified his removal.

Two other, immediate steps are called for: The Senate should take up and the president should sign the VA Accountability Act, which the House passed last week 390–33. It would make it easier to fire senior VA administrators. That is currently quite hard to do, which is why no one has actually been fired since the system’s scandals drew attention this spring. The White House has complained that the bill would raise the risk of litigation around firings, but it’s hard to see why that’s not an acceptable price to pay for punishing incompetence and dishonesty. The bill would make it as easy to fire people who keep our vets waiting as it is for congressmen to fire their press secretaries. That’s a good start.

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Second, the VA has an existing system for providing care to vets outside the system when it’s impractical to treat them in-house (because of geography or other factors). Veterans’ groups, which hold more or less a veto over VA policy changes, have suggested that expanding this program would be welcome. The wait times that administrators concealed for years suggest that it’s absolutely necessary. President Obama announced on Saturday that the VA would be implementing some of this, but the program should be wide-reaching. In the process of expanding it, the VA should emphasize cost-sharing and transparency — vets should be told if they’ll have to wait for an appointment and be given another option.

These two steps should help somewhat in alleviating the system’s current problems and discourage officials from letting them crop up again in the future. The prospects for more fundamental VA reform — moving toward a market-based system and providing insurance rather than services — are not good, because of institutional inertia and the special interests that control vets’ issues, but reform should push as far as possible in this direction.

If we built from scratch a system for giving vets care today, it would never look like the current fundamentally unaccountable, fully socialized system. But vets return from war to the VA we have, and there’s a long way to go to make sure it’s as good as they deserve.



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