As the VA scandal unfolds, with continued revelations of secret waitlists and delayed or denied medical care, calls have been building Veterans Affairs Secretary Eric Shinseki to resign. Today he did just that, resigning because, “He had become a distraction as the department struggles.”
President Obama, eager to show America that he was being proactive about the scandal, regretfully accepted the General’s resignation. But other than allowing the president to show that he is doing something about the problem, what will Shinseki’s departure actually accomplish or fix?
The VA health care system is an example of “integrated health care” or one-stop shopping for all medical care under one large government umbrella. Many have advocated for such a system of single payer healthcare for America writ large. Phillip Longman, a senior fellow at the Washington Monthly and the New America Foundation, wrote a book, “Best Care Anywhere: Why VA Health Care Would Work Better For Everyone,” praising the same system currently undergoing a massive crisis.
The fundamental problem at the VA is not that Shinseki is in charge, but that the VA is a form of government-run health care, which leads to high costs and shortages. Stories abound over long wait lists in the British NHS, with over a hundred thousand patients waiting more than 18 weeks to see a specialist. Or in New Zealand, where patients are simply removed from the wait list when the list gets too long.
The VA system represents government bureaucracy and inefficiency at its finest. At the Edward Hines VA Hospital, in the president’s home town of Chicago, only one fourth of their 4230 employees are actually providing primary medical care. What are the other 75 percent of employees doing? Shuffling papers, creating secret wait lists, or holding meetings?
The VA’s problems are not for lack of money. Their budget has doubled over the past decade with only a one-third increase in their patient load. So they are spending more money per patient with little to show for it — except for the bureaucrats and administrators who have been generously rewarded. The VA awarded more than $400 million in bonuses in 2011, according to Military.com. At the Phoenix VA, where this scandal first surfaced, one in five employees received bonuses in 2013, with a total payout of $337,885.
How will any of this change with General Shinseki’s resignation? The secretary already tried to fix the problem by firing the VA undersecretary of health, Dr. Robert Petzel, who was already due to retire this year. He was replaced by Dr. Jeffrey Murawsky, the director of VA’s Great Lakes Health Care System which includes Hines VA where most of the staff is busy administrating. This makes perfect sense within government bureaucracy – find someone responsible for overseeing an inefficient and bloated regional morass, and promote them to oversee the entire system.
With General Shinseki’s resignation today, who wants to bet he will be replaced by a Dr. Petzel or Dr. Murawsky, well steeped in the VA bureaucratic traditions that are the cause of this current scandal and General Shinseki’s departure? This may allow the president and members of Congress to feel good about fixing the problem, but in reality they are only rearranging the deck chairs on the Titanic.
Dr. Joondeph is a retina surgeon at Colorado Retina Associates and serves on the faculty of Rocky Vista University School of Medicine. Twitter @retinaldoctor.