Law & the Courts

Why VA Health Care Is So Lousy

(Dreamstime image: Sudok1)
The VA can’t avoid scandal because it’s designed to be unaccountable

My father is a veteran and, like many retirees on fixed incomes, gets his health care from the Department of Veterans Affairs. From what he tells me, his experiences have been mixed, to put it nicely. Right now, as he considers a move, the quality of the VA hospital in prospective destinations is high on his list of priorities — and with good reason.

As he knows from personal experience, and the rest of us observe in seemingly endless news reports on the subject, the VA has been dogged with scandals of corruption and incompetence for years now, and the department’s chain of failures seems to have no limit. Its latest link is the revelation that in the midst of a wrenching epidemic of veteran suicides, more than one in three calls to the VA’s suicide hotline go unanswered by VA staff. Some are forwarded to backup call centers, and in other cases they simply go to voicemail. In one facility, staffers had no idea that voicemail existed, so they never checked it.

The hotline suffers from overload, yes, but also mismanagement: Many hotline workers regularly skip out early, said Greg Hughes, formerly chief of the VA’s Veterans Crisis Line, in an e-mail to coworkers before he left his position earlier this year. Shiftless hotline staff “spend very little time on the phone or engaged in assigned productive activity,” he wrote, with some answering as few as five calls per day. Last year, more than 500,000 calls came in, which means at least 167,000 times veterans called and did not receive the help they sought.

If this were the VA’s first such egregious error, some grace might be in order. As it is, this story is only made more deplorable by how predictable it has become, with one screw-up following another.

There was the VA hospital in Illinois that left veterans’ bodies “to decompose in the morgue for months on end,” as Senator Mark Kirk (R., Ill.) told Fox News after speaking with a whistleblower from the facility. “Some veterans’ remains have been left in our hospital morgue for 45 days or more until they are stacked to capacity at times,” Kirk’s office reports the whistleblower said, and at least once “a body had liquefied and the bag burst when staff had attempted to move it.”

There was the $6.3 million the VA spent on art installations and fountains, mostly at two locations in California. One of the pieces consisted of quotes from Abraham Lincoln and Eleanor Roosevelt, depicted in giant, rainbow Morse code on the side of a parking garage.

There was the time it took the VA fully 270 days to fire a nurse who chugged five beers before assisting with an operation.

There was the Colorado VA hospital, already $1 billion over-budget on construction costs, that was given another $100 million because, hey, why not? Construction was a year behind schedule, and the extra money would pay for only three more weeks of work.

There was the time it took the VA fully 270 days to fire a nurse who chugged five beers before assisting with an operation. And the over-prescription shortcut with which VA doctors have unintentionally fostered pain-killer addiction and abuse. And the VA official who forced his underlings to pay his wife to tell their fortunes. And the time the VA used counterfeit and potentially dangerous medical supplies on veterans.

The list could go on, but you get the idea. On those occasions when veterans stick out literally deadly wait times to get the care they need, they have good reason to anticipate finding themselves in a mismanaged facility where one need not have the “stupid or evil” debate that plagues our politics more broadly, because the Department of Veterans Affairs seems intent on laying institutional claim to both titles.

Still, it is only fair to note that the VA is in one significant way set up to fail, as the Cato Institute’s Michael F. Cannon has explained at The Hill:

The VA provides life, disability and health benefits to certain veterans. But Congress does not fund those benefits until they come due, and the cost of those benefits typically peaks decades after Congress incurs them by sending troops to war. This lag enables members of Congress to ignore one of the largest financial costs of war. The VA lets Congress wage war on the cheap.

It is difficult to imagine how an agency thus designed for unaccountability will manage to avoid further scandal. Indeed, this is a dangerous set-up for veterans’ health care and foreign policy alike. It puts the former in peril and allows the latter to operate with reckless near-sightedness. And if the VA of the present is a mess, this arrangement means it can only get worse, as our overseas entanglements continue to churn out new veterans of foreign wars.

Already the long-term cost of Iraq and Afghanistan tops $12 trillion when we include health-care spending and interest. How much more financial obligation will we allow Washington to pile on future generations without accountability — and how much more of those trillions will be mismanaged into oblivion instead of being spent to make veterans well?


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