previous post next post  

On reforming the VA.

 Oh, it's never going to happen.  No one in the right places actually gives a proper damn.

Secretary Shinseki knows better than this. The organization does well what the boss checks. He and I grew up in the same Army. We know that if you set a reporting metric, and never do anything but accept the report at face value, the weak will prefer to game the system rather than make it work. That was one of the purposes of the Annual General Inspection. To make you prove that what you reported was true. That was the purpose of the Unit Status Report - but the AGI is what put veracity to your USR.

The Secretary has set the standard, and he is *not* the one to fix it. Sure, I accept it was broken when Mr. Obama took office. I also know it was broken when Mr. Bush took office, too, as it took me 18 months in peacetime to get rated. It was broken back in 1975 when my father retired - so broken in his case that he refused to deal with the VA up until the day he died.

So, clearly, you aren't the guy to fix it. You've had six years. It's time to admit you've failed and move on.

And it's time for a Night of the Long Knives in the VA administration.

Which will never happen.

Me, I'd take the administrators involved in the false reporting, and if I couldn't fire them direct, I would appoint them as "Special Assistants" with duty at Minot, North Dakota, no relocation assistance provided.

If I couldn't collect them all in some place so uncomfortable they wouldn't want to go, fine. Leavenworth Centurion made a good suggestion for "rubber rooming" them: A nice double-wide trailer in the back parking lot with fans and DRMO furniture, and rotary phones. And a 300 baud modem for internet access.  And a nice sign that said, "Office of the Special Assistants."

Then perhaps, I could get someone into position who actually gives a damn.


All good suggestions. In my nearly 30 years in the VA, I've worked with some exceptional people. Up to 70% (maybe more) are good. The other 30% are, unfortunately, exceptionally stupid, lazy, self serving, just plain evil, or some combination of the above. It is nearly to the point at my facility that the good people are unable to overcome the effects of those others.

You're correct that it comes from the leadership failing to enforce, well, much of anything. The laws are written to impede the mission and the leadership hasn't got the energy to overcome the friction. The deadwood just piles up.
Oh, be still my beating heart. My Rubber Room suggestion is out there in Internet World for the whole world to see. Unfortunately, that's as far as it will go. I have not touched the VA since my retirement physical, but I have friends who have received excellent care, know people who have received indifferent care, and am aware of some who enjoyed fatal neglect. All of this is a foreshadow of America's healthcare via Obamacare.
  John, how do we reform the VA? First, let's start with your last suggestion and make it your first suggestion. "Then perhaps I could get someone who actually gives a damn." But the question becomes where do we find that type of person? I believe the answer is in looking for somebody within the organization to head it up. I think the biggest problem is this, the leadership is absolutely clueless to running the VA. I have seen good people and I have seen some lousy people try to administer this behemoth. Good leaders of the people that everybody wants to follow and not this nonsense.

I do not believe that we should just fire the people involved with the Phoenix debacle. We should take all of them and send them to Thule, Greenland for snow removal BY HAND. I just can't let this drop without commenting on Centurion's suggestion of his beloved Rubber Room with an Internet connection that runs no faster than 5 baud per second and a dial telephone on a party-line with the operator and her famous question, "Number please?" Then they could feel what we all feel, rampant frustration.
Rifles, post, minor assembly required.

Can you still get a 300 baud modem? They were starting to get hard to find when I granulated from Engineering School in '92.
I'm with your Dad about the VA. Had two nasty encounters shortly after retirement (one of which, I swear to God, had me reading my supporting documentation to a blind advisor) and decided the best way to deal with the VA was never to deal with them again.
Not for anything.
Perhaps a more local specialty for those responsible for the Phoenix debacle?  The ocotillo suppository and the cholla catheter come to mind (or is it the cholla suppository and the ocotillo catheter?)  Maybe they could try both and report back.
 Navig8r, I believe you have an important insight about the Phoenix VAMC being a "local issue". This is important in our thinking, In many ways, the VA thinks of itself as a monolithic enterprise, which it is not. Actually, it is a gathereng of regional players, some better than others. What does the Veteran do to improve the VA? I found the best thing to do is to communicate to your healthcare provider about your concerns. Please, do not forget we are only beginning a process. "Hey Grumpy, they won't listen to me! Grumpy, you don't understand, they have their own agenda and will not listen!" My question to you would be this, "Would you be willing to listen to yourself?" Be honest, this is especially true if you disagree with their approach. Are you speaking calmly and making sense when you speak? If you go in to your appointment with an attitude, you have not just lost a battle, but you have lost the war. Your ability to control yourself is paramount to achieving a working objective. Leave your anger at home and start with a fresh page. You can save yourself a whole lot of grief by taking this approach. Have you taken the time to talk with your own family about your ideas and expectations, this is a time for a reality check.

This is my goal, I do not always achieve it, but I always try. I have also made it a point to learn as much as I can about my own situation. I always want to have realistic expectations and ideas. This helps me to keep my anger and frustration in check. I have been in the situation where none of this actually works. OK, Grumpy, now what do you do? I also maintain contacts with my "Congress-Critter", they all have their contacts at the different VA Medical Centers. I always make it a point to get the email address of this "Congress Critter Contact" and learn to work with and through them. This is the secret that has saved me a lot of trouble. I would ask you to consider this as a new strategy through a difficult time in your life.
Grumpy, Thanks for the credit, but I wasn't trying to be so lofty as to bring up the subject of  local problem vs larger problem.  In this particular case, some  individuals in Phoenix did some particularly rotten things for which they should probably receive individual punishment which may or may not  have great bearing on any larger problem that may exist.  My focus was more on how the local environment offers options to be compared and considered with the other suggestions like exile to Minot, ND, 300 BAUD modem, etc.  Not practical solutions to anything, but sometimes it can be temporarily emotionally satisfying to design custom karmas for the perpetrators of egregious offenses.  Your suggestions are definitely more constructive.

For my part, I have not had any dealings with the VA medical system yet, so I have no experiences to compare with the folks who have.
In ref to Grumpy, (Great name by the way) I agree with your two points completely, 1. Your attitude and demeanor when dealing with the VA (both admin and healthcare professionals) are paramount. and the main problem I see has to do with the admin and not the actual healthcare providers themselves. My personal opinion is that the entrenched and untouchable administration must be addressed if any change is going to be made. Since starting my waltz with the VA in November of 2009 I have been told on every single visit (avg 3 times a year) that "yes it has been bad, but we have this new program that was just started that will clear the back log and fix the problems, we just need to give it time to work". They have told me about their "new" miricle program EVERY time I visit for the last 5 years, and yet surprise surprise surprise, the back log is worse than when I started and the bad decisions are worse. My personal opinion is that this will not improve until they are FORCED to kick out the union that protects the deadwood and rewards those who are best at breaking the system. One metric that I will watch for that might actually indicate that they are serious about fixing the problems is when the first individual from admin actually does the perp walk to prison. Until that day all of the fan fare saying how much they are improving is just window dressing.
* Just one side note: I saw the story today that AG Holder has said that NO investigation into the VA appointment/document fraud that has killed at least 40 of my brothers will be done. Prayers for my brothers/sisters that are being chewed up by this system.
 MSG Grumpy, I am just plain old "Grumpy", by the way, it is the best descriptor of my personality. As much as I don't like it, I have still found that your attitude and demeanor mean a great deal in the service that you receive from the VA. This problem is not new, they are part of the legacy of every President of the US since 1930. There are absolutely no exceptions. The "Founding Fathers of this Great Nation" had a particular strategy for the purpose of going to war. I believe they recognized the right of this nation to defend itself against an active attack. But, if we have enough time to establish a plan or strategy for a counter-offensive, then we have enough time to pass a Constitutional Declaration of War. Once this nation crosses that threshold a series of responsibilities are placed upon both the Executive and Legislative branches of our government. A nation going to war does not have the luxury of tax cuts, the cost of war goes up exponentially over time, even after the war is over. If we are not willing to go this route, then we should NOT declare war.  This just might be the place where we start the process of being honest with ourselves, first and second, with our veterans. Wars are very expensive over the long haul and never should a politician benefit financially from a war that he or she supported.