And who was responsible for cleaning up the corrosive culture and poor leadership that was so obvious in 2008 that both Barack Obama and John McCain made it a major campaign issue? Well, don’t expect the report from the Obama administration to go that far in determining fault for the VA corruption that cost dozens of veterans’ lives in Phoenix, and possibly more than a thousand, according to a study performed by Senator Tom Coburn. This week’s Friday afternoon document dump highlighted the “corrosive culture” and incompetent leadership that went undetected by the Obama administration for more than five years — and which got massive budget increases without any apparent scrutiny:
The Veterans Affairs health care system needs to be overhauled because of unresponsive leadership and a “corrosive culture” that affects the delivery of medical care, said a report delivered Friday to President Barack Obama.
“It is clear that there are significant and chronic systemic failures that must be addressed by the leadership at VA,” said the report prepared by Rob Nabors, who is Obama’s deputy chief of staff and who the President dispatched to assess the situation at the troubled agency. …
The report called for an overhaul of leadership at the Veterans Medical Administration.
“It currently acts with little transparency or accountability with regard to its management of the VA medical structure,” the report said.
The VA central office could solve this problem with more transparency and by taking a more hands-on approach with regional leaders, the report said.
The report also blames the metric on wait time as being unrealistic. A 14-day average wait time to see a doctor is unrealistic? That would only be the case in a single-payer system. The report is correct that it’s not an indication of quality care, but it’s the only possible metric to measure access to the system in the first place. The problem at the VA isn’t that wait time was being measured, it’s that the VA leadership at all levels is focused more on protecting the bureaucracy than on serving its customers, because it has no competition to get it focused on customer service.
Another problem area in the report is “resources” — which means budgets:
— The technology behind the basic scheduling system is “cumbersome and outdated.”
— Additional resources, including doctors, nurses, trained support staff and other health professionals, are needed.
— Many of the resource issues facing the VA are similar to what exists in the private sector. But the VA has not clearly articulated its funding needs.
That’s a joke, right? In six budgets signed by Barack Obama, funding for the VA rose 78%, as I wrote a month ago:
In comparison to that final Bush budget — don’t forget that Obama signed the FY2009 budget in March 2009 with the omnibus spending bill after a Democrat-controlled Congress refused to deal with Bush — VA spending has risen dramatically as well. The annual budget rose 78% in six budget cycles, with double-digit increases in four of the six years — while Defense spending was flat. No other Cabinet agency had a larger budget increase by percentage during Obama’s tenure. The closest was Agriculture (64%), followed by State (59%, which tends to discredit the canard about the Benghazi failure being caused by a lack of resources). Only HHS had a larger annual budget increase in terms of dollars spent, but it amounts to a 37% increase in spending from the FY2008 baseline. The amount of increase in the VA’s budget in the Obama era, $65.9 billion, exceeds the entire VA budget in the FY2004 budget.
The FY2008 VA budget was $84.7 billion (which increased 83% during the Bush administration, too). Using that as a baseline, Congress has given the VA an additional $235 billion in six years over that FY2008 level. Where have those resources gone? Did the White House even think to ask before this scandal blew up? That’s almost a quarter of a trillion dollars in six years over and above what the VA had already been receiving, and the White House now claims that the problems are that the VA can’t articulate its own budget needs effectively enough.
The problem is the VA itself. It’s the inevitable outcome of single-payer systems, whose incentives all run to the protection of the bureaucracy because the customers have nowhere else to go. That is the essence of the “corrosive culture” at the VA, and only a paradigm change in its mission will solve it. The real long-term solution to the VA is to end its single-payer status, and provide veterans the resources to access a range of providers for their care while focusing the VA provider system on its core competence of service-related injuries and illnesses.
The leadership issues are obvious, but they’re not limited to the VA. Obama demanded and received an avalanche of funding increases for the VA but never bothered to follow up to see what the Cabinet agency did with the money. After making VA care an issue on which to campaign in 2008, Obama didn’t care enough to even do some cursory oversight of his own administration until veterans were dropping dead because of fraud and corruption. His answer now is to demand more cash be thrown at the problem and appoint replacement hacks so that the VA stays a single-payer system and White House can go back to ignoring it. There may be a few ways to describe that, but leadership isn’t one of them.