Department of Veterans Affairs

The V.A. Has a New Boss, But Will He Fix the Agency's Problems?

New chief Robert Wilkie is in a position to tackle the agency's bureaucratic mismanagement. Will he?

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Alex Edelman/CNP/AdMedia/Newscom

The Senate confirmed Robert Wilkie as the nation's new secretary of veterans affairs on Monday. He now faces the task of implementing the VA Mission Act, a half-baked quasi-market reform aimed at transforming an infamously inefficient government bureaucracy.

The Department of Veterans Affairs is still recoving from a major scandal that broke in 2014, when the world learned that the VA had been keeping secret wait lists to avoid cuts to hospital bonuses. The operation may have killed more than 1,000 veterans, but only eight employees were reprimanded for their roles in the mess.

"The VA is so astonishingly bad it makes the DMV look competent," says Adrian Moore, vice president of policy at the Reason Foundation (which publishes this blog) and a veteran himself.

The VA has had constant problems managing transactions with private health care providers. Private care already exists in abundance, but the VA is unable, most of the time, to connect the provider with the veteran and to execute the necessary transactions. Moore says the agency should focus on "improving the operation of the interface between the veteran, the VA, and the health care provider."

That's the aim of the Mission Act, a bill passed this year to expand veterans' access to private care providers. Among other things, the law authorizes the VA to enter into contracts with some community health care providers. That will help more veterans gain access to the health care they need, and it will also help cut costs.

The Mission Act is a wobbly step in the right direction, but more serious structural reform is necessary if the VA is "to care for him who shall have borne the battle and for his widow, and his orphan," the agency's motto since its inception. "There has to be high pressure, top-down, well thought-out reform to the management structure of the VA," says Moore. At the very least, that means more transparency, more willingness to fire incompetent bureaucrats, and more willingness to transfer services to the private sector.

That last item will be the toughest one. While the White House says that David Shulkin, Wilkie's predecessor, resigned, he maintains that he was fired for his opposition to privatization. Yet Wilkie has pledged not to privatize the agency either. Whether he'll privatize parts of it remains to be seen.

In his capacity at the VA, Wilkie has the ability to affect serious reform, independent of Congress. But his track record shows little willingness to do much more than toe the party line. He's not likely to go much further than the mandate extended to him by the Mission Act.

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  1. What’s that rule about questions in headlines?

  2. http://twitter.com/RealJamesWo…..1082595328

    James Woods identifies a real American hero; Harold H the first grader. I want to adopt this kid.

    1. I’m saddened to tell you this, but Harold H. is a fictional character from the Captain Underpants series, and that’s viral marketing for a new book in the series.

      1. That is sad. I figured it was too good to be true, but sometimes you just want to believe. And some things should be true even if they are not. Bummer.

      2. Brilliant marketing campaign though.

  3. Was Wilkie granted authority to mount the heads of the incompetent on pikes at the entrance to each VA facility, pour encourager les autres?

  4. The V.A. Has a New Boss, But Will He Fix the Agency’s Problems?

    Nope.

    Next question?

  5. As as Vet, I would say no.

  6. One thing is certain. He’ll order the most glorious desk available.

  7. You can’t fix stupid and you can’t fix single payer. Yes, that sentence was redundant.

  8. How to fix the VA’s problem:
    Step 1: Ignore the Reason Foundation.
    Step 2: Increase funding to accommodate the increased use due to recent wars.
    http://www.rand.org/news/press…..ndex1.html

    Based on VA data, RAND researchers found no widespread evidence of long waits across the VA health system. Most veterans have appointments within a few days of their preferred date for care ? the date on which their provider recommends the appointment should occur or the date on which the veteran would like to receive care. More than 90 percent of appointments for existing patients and 80 percent of appointments for new patients occur within 14 days of the preferred date.

    The VA has long played a national leadership role in quality measurement and the quality of care provided by the VA health system generally was as good as or better than other health systems on most quality measures.

    1. So you’re telling us to trust a report that was based entirely on data provided by the VA right after reading an article detailing corruption, cover-ups and “secret lists” on the part of that same VA.

      I’m sure the people who wrote that report were smart and well-intentioned. But when you start with untrustworthy data, you can not get anything but untrustworthy results.

  9. https://www.rand.org/news/press/2018/04/26.html

    The VA hospitals performed the same or significantly better than non-VA hospitals on all six measures of inpatient safety, all three measures of inpatient mortality and 12 measures of the effectiveness of inpatient care. The VA hospitals performed significantly worse on three readmission measures and two effectiveness measures.

  10. Happy Chandler|7.25.18 @ 5:09PM|#
    “[…]
    Step 2: Increase funding to accommodate the increased use due to recent wars.
    http://www.rand.org/news/press…..ndex1.html
    Based on VA data, RAND researchers found no widespread evidence of long waits across the VA health system. Most veterans have appointments within a few days of their preferred date for care ? the date on which their provider recommends the appointment should occur or the date on which the veteran would like to receive care. More than 90 percent of appointments for existing patients and 80 percent of appointments for new patients occur within 14 days of the preferred date.”

    Exactly what the Brit NHS demands on a regular basis, and when they get it, it never makes a damn bit of difference.
    And they only get it, since the US taxpayer is silly enough to provide their defense for free.
    Given your level of ignorance, I’m certain you did not know that.

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