MEMO TO: Veterans Affairs Secretary-designate Robert A. McDonald
RE: The VA’s crisis is even worse than you think!
Your good news is that the White House, Congress and Department of Veterans Affairs are no longer in denial about the reality that things have gone terribly wrong in the VA hospitals. Indeed, all America finally knows the systemic shame of VA hospitals’ treatment delays, faked records and cover-ups.
And apparently the monstrous job of fixing the VA is yours. Republicans are praising your experience as Procter and Gamble’s CEO. Your Senate confirmation seems assured.
But your new bosses probably still haven’t grasped the full breadth, depth and pervasiveness of all that was allowed to go so wrong, for so long, at the VA.
The VA pension and benefits claims bureaucracies are failing our military veterans and their families as shamefully as the backlogged VA hospitals are. Among the major concerns:
• Pensions. Bill, a severely wounded World War II veteran, had a postwar career in the post office. When he died in January 2011, his widow, Diane, simultaneously sent the VA and U.S. Postal Service all the vital documents, requesting her share of both pensions as Bill’s surviving spouse.
The Postal Service immediately calculated Diane’s pension share and her first check arrived when Bill’s would have, in February. But half a year went by without a VA pension check. As her living expenses mounted, the VA asked for documents she’d already sent.
I asked a top VA official why the VA couldn’t simply do what the Postal Service did for the widow. The official launched into a long explanation about VA lawyers and the need to determine if Bill died due to old war injuries, which would mean a larger pension. So I naturally asked: Couldn’t the VA instantly pay her the base pension? And then pay her more, retroactively, if it proved to be a service injury death?
Yes, he said, that’s a better way to do it. He’s a good person, but his managerial mind has been shaped by the VA’s cultural mindset. Changing that mindset is the new VA secretary’s most urgent challenge.
• Benefits. When VA claim adjudicators issue denials – as they often do – an appeals process begins. The appeals court remands some 60 percent of the claim denials back to the adjudicators for reconsideration because of one mistake or another. And it all starts over again. The top appeals court has ruled the denials of the VA adjudicators and next level board of appeals were right in a mere 24 percent of the cases that got to the court. No wonder the VA’s benefits claim backlog was recently reported to be 1 million.
• Hospitals. Here’s a proposal: Give veterans a Vet-Med card that works like a Medicare card, and pays for treatment where service is best and waiting times are brief. Not all hospitals need to provide top-level treatment for all maladies.
Even in his last days, the previous VA secretary, Gen. Eric Shinseki, told Congress there were only a “limited” number of “isolated” cases where VA hospitals falsified delay records. Only in his last hours did the four-star general admit he’d been deceived by a “systemic … overarching environment and culture” within the VA.
There is one way our new bold VA secretary can change the VA mindset – by changing the VA’s name. Let all VA employees know, first and foremost, they now work for the Department of Veterans Advocacy.