June 10, 2017

Shaming the VA on Memorial Day

At the end of last month, congressional Republicans released a video commemorating Memorial Day, honoring those who made the ultimate sacrifice -  and, in one case, blasting the VA. Because that's how they roll, I guess.

Here's Rep. Jeff Denham of California, an Air Force vet, speaking in the video:
This is a day of remembrance and honoring those who paid the ultimate sacrifice. But for the last several years, far too often, we're spending time talking about the inadequacies of the VA. 
Sure -  in between solemn ceremonies of remembrance, and collective breath-holding as high school buglers play Taps in cemeteries or at veterans' memorials, and 21-gun salutes at parades in just about every small town in America, and thinking about friends and family members who were lost, we bitch about the VA.

Or, maybe, we do that when we're test-driving mattresses, I don't know.

New VA Secretary David Shulkin, an MD who was appointed as undersecretary by President Obama in 2015, has been making concerted efforts - and progress - since then, well before he was nominated by president Trump to head the agency earlier this year.

In a White House briefing on May 31st, Shulkin vowed
to turn the VA into the organization veterans and families deserve and one that Americans ca take pride in. 
 He mentioned several priorities, such as reducing the backlog of vets waiting for care; the high suicide rate; quality improvements;and faster disability claim processing, and noted
Though we are taking immediate and decisive steps, we are still in critical condition and require intensive care. 
And, he made clear, there was no question he had support from the West Wing, including both Trump and Mike Pence.

Shulkin, the first non-veteran to head the agency, was confirmed unanimously by the Senate to lead the VA. He's also got a long track record of innovating in the healthcare world, usually successfully but sometimes not - which is OK, because the only thing worse than failing is not even trying, right?

In this NY Times story, we learn a lot more about Shulkin and his plans for the VA. For example, Shulkin regularly sees patients, in person and remotely via telemedicine. And he was more than a handful down Trump's list to lead the agency, having been in the VA leadership during the time candidate Trump regularly trashed the agency. 

He's already had the VA facilities post wait times and quality information, and this month the VA will start offering mental health services to vets with less-than-honorable discharges, a group full of folks living with PTSD. He's also working on changing employment practices to allow for quicker hiring and firing; he wants more vets to see private physicians; about a third do now, but he wants to increase that number. And, things like hearing aids and eyeglasses (the latter, Shulkin notes, you can get in an hour in any mall) should be handled outside the system so that more time and resources can be put into treating vets who have been wounded. 

That kind of thinking is consistent with how he handled himself in his previous VA role; it was as under-secretary that he challenged suicide prevention leaders to do more. After being told it would take a "summit meeting" and "10 months" Shulkin gave them one month - by showing them that some 6,000 vets would kill themselves while the VA studied things. They ended up getting it done in a month.  Remembering that meeting with the leadership, Shulkin said
For me, it was a very important day. It taught our people you can act with urgency, and you can resist the temptation to say we work in a system that you can't get to move faster. I think they learned that you can. 
So why does all this matter?

I was looking through old posts, and it was on May 31, 2014 -- three years to the day before Shulkin's briefing -- that I posted about Congress ignoring repeated reports, going back more than a decade at that time, from the VA about the scheduling issues, and how Congress responded to the resignation of General Eric Shinseki, Obama's VA secretary.

From my 2014 post:
Since 2005, the VA Office of Inspector General (OIG) has issued 18 reports that identified, at both the national and local levels, deficiencies in scheduling resulting in lengthy wait times and the negative impact on patient care...
Apparently these "well documented and systemic issues" which the VA OIG has been complaining about for years, were not important enough for Miller's committee to jump on, like they jumped on VA travel expenses, for example. Spending taxpayer dollars on conferences is one thing, but years worth of information on poor treatment of veterans, well that's something else entirely. 
I ended the post quoting former House Speaker John Boehner, and noted that while Shinseki fell on his sword, as usual, Congress pointed theirs at someone else.
General Shinseki has dedicated his life to our country, and we thank him for his service. His resignation, though, does not absolve the president of his responsibility to make things right for our veterans.  Business as usual cannot continue...One personnel change cannot be used as an excuse to paper over a systemic problem. Our veterans deserve better, we'll hold the President accountable until he makes things right.
Fast forward to this year, and we learn that Denham has sponsored or cosponsored bipartisan bills to help move things along at the VA. In essence, he's doing exactly what he should be doing.

Which leaves me to think that everyone would be better served - those we have lost, whom the Memorial Day video was intended to honor, and vets who are still with us and in need of quality services of all kinds - if he just continued to work to make improvements, instead of slamming the agency that is finally, with Congress's help, at least moving in the right direction.

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