Skip to Content

Support MinnPost

Can the VA fire its way out of its problems?

REUTERS/Jonathan Ernst
The Department of Veterans Affairs has been beset by scandals for the past two years.

WASHINGTON —  “Zero-sum situation.” “Culture of bureaucracy.” “Doesn’t make sense in the 21st century.”

These were some of the harsh words that some members of Congress, including First District Rep. Tim Walz, have spoken recently over an agency many are well past fed up dealing with: the Department of Veterans’ Affairs.

If you believe the headlines, Congress’ goal of improving the VA will be a monumental task: Over the past two years, the agency has weathered a lot of bad press, from reports of interminable wait times at hospitals to unfair medical billing practices to allegations of bureaucrats gaming the system for personal gain.

Those stories have prompted Republicans to hold up the VA, which operates a massive health care network that provides care to nine million veterans and employs roughly 250,000 people, as Exhibit A of federal government incompetence and complacency. In the past year and a half, they have put forth a raft of reforms aimed at streamlining the agency — or, depending on how you view it — placing punitive measures on VA employees.

Others, including many Democrats, dispute the idea that primary blame for the VA’s woes lies on its employees. Instead, they have favored a number of smaller, targeted reforms to do the heavy lifting to make the VA better without wading into union politics.

Members of Congress love to talk about honoring America’s veterans — but if the last months are any indication, they have a long way to go in figuring out the best way to do it.

Scandal upon scandal

Exactly how bad are things at the VA? If the past two years are a guide, very bad. The agency had a blockbuster scandal on its hands in spring 2014 when it was revealed that 35 veterans had died while waiting for care at a Phoenix, Arizona, VA hospital, and that officials had manipulated wait times to obscure the problem.

That scandal opened wider investigations from the White House, the FBI, Congress and the VA itself, which found similar problems nationwide. Top agency officials, including Secretary Eric Shinseki, stepped down as a result.

In the aftermath of the debacle, Congress and President Obama undertook a raft of measures aimed at helping veterans get care. Many were designed to help veterans circumvent problematic facilities, and one bill passed by Congress gave veterans more flexibility in going to non-VA doctors.

But problems with the institution persisted: In June of this year, it came to light that faulty billing practices at Minnesota and Wisconsin VA health facilities were confusing and putting undue financial burden on veterans. The entire Minnesota congressional delegation, joined by some Wisconsin members, sent an outraged letter to current Secretary Robert McDonald over the issue.

If that all were not enough, recently it was revealed that certain VA officials had maneuvered to create new jobs for themselves in different cities.

A government report charges that Kimberly Graves, a VA administrator from Philadelphia, persuaded a superior to leave a post in St. Paul, which she then filled. She received $129,000 in relocation fees — a move Rep. John Kline called “unconscionable … a clear violation of the public trust and blatant abuse of power.”

Graves failed to appear before the Veterans’ Affairs Committee in October and was promptly subpoenaed. Last week, she appeared before the committee in Washington and pled the fifth.

To lawmakers, it was textbook behavior from an agency that has circled the wagons. “It seems like the veterans administration has had this blank check — so they’ve gotten complacent and recalcitrant and unresponsive. Some heads need to roll,” Rep. Rick Nolan said.

Making firings easier

Many close observers of the VA agree that a negative culture has festered in the agency for years, with bad habits building up to create a bureaucratic mess unique in the federal government simply because of the immense size and scope of the VA.

To fix the problems, Republicans have taken direct aim at the public sector unions that represent VA employees, arguing that limiting their influence is perhaps the single biggest thing Congress can do to remedy the situation. Generally, Republican arguments on the effect of federal workers unions mirror their arguments on teachers unions: They believe that unions help protect subpar employees from being fired.

Rep. Jeff Miller, the Republican Veterans’ Affairs Committee chair, said last week that it is too hard to fire underperforming employees and too hard to hire new, eager ones. He said the most important thing the VA could do is “make it easier to discipline individuals who can’t or won’t do their jobs.” Since Shinseki stepped down as secretary last year, the rate of firings at the VA has slowed.

To that end, Republicans this year introduced legislation, the VA Accountability Act of 2015, aimed at giving top VA executive officials more authority to fire lower level administrative workers. It was co-sponsored by Kline, and passed the House with some Democratic support. In a statement, Kline — a former Marine and one of three veterans in the Minnesota delegation — said the law “would give the VA secretary new authority to fire corrupt or incompetent employees — putting the treatment of our veterans before bureaucrats.”

The bill, Kline said, “comes in response to the VA’s long and well-documented history of not holding problem employees accountable,” adding it would be a “significant step toward increasing oversight and transparency.”

Walz, along with many other Democrats, opposed the VA Accountability Act, saying it was purely partisan. At a Wednesday talk hosted by the Brookings Institution, he said “it doesn’t make much sense to strip workers of collective bargaining,” and that it’s the “only strength they have.” He added that Wisconsin Gov. Scott Walker’s weakening of public sector unions in that state has had a chilling effect on whistleblowers — like the ones who stepped forward this year to shed light on poor management, high workload and unsafe environments at the St. Cloud VA hospital.

On Thursday, Nolan spoke of a myth that “somehow because of federal employee protections and because of unions, it’s impossible to fire a federal employee. That’s just not true,” he said. “I think we need to leave those protections in place.”

Walz has emphasized the importance of unions that represent VA employees, but has signalled a willingness to work with his Republican colleagues on so-called accountability measures that may weaken the unions. “When I hear someone hasn’t been fired who should be fired, I’m madder than anyone,” he said.

“Whatever it takes to deliver the highest quality health care is the one we should choose. I don’t have an ideological dog that I’m tied to in this fight.”

Incremental improvements

For now, the likeliest scenario is that the VA will be improved incrementally, with lawmakers and the White House agreeing on noncontroversial laws, like one passed last year that expanded veterans’ access to care and hired more doctors and nurses for VA facilities.

Walz has been able to produce VA reform legislation that can earn support from both parties. In July, he introduced two bills: one that would require the VA to submit to an independent health-care audit every two years, and one to streamline how members of the private sector health-care industry operate at VA facilities.

And in the wake of the VA billing problem, Kline and Sen. Amy Klobuchar introduced legislation aimed at reforming how the health-care system bills patients. (Kline’s bill will be considered in committee November 17.)

In October, Walz, along with Rep. Tom Emmer, introduced a bill to make VA internal reports more transparent and accessible to Congress and the public. That was introduced in response to their joint visit this fall to the St. Cloud VA.

Whether there will be a grand showdown between Congress and VA employee unions remains to be seen. While Obama is in office, it’s highly likely he will veto a bill like the VA Accountability Act of 2015 — if it even survives the Senate. “There will be those who don’t understand the issue who will see this as a proxy fight over public sector unions,” Walz said.

“If you’re looking for a silver bullet that’s gonna weaken public sector unions and fix the VA, you’re gonna be looking for a long time.”

Get MinnPost's top stories in your inbox

Related Tags:

About the Author:

Comments (39)

Unions

"To that end, Republicans this year introduced legislation, the VA Accountability Act of 2015, aimed at giving top VA executive officials more authority to fire lower level administrative workers."

That sounds like it's just a way to beat up the rank and file union members. Doesn't it make more sense that the issues with the VA lay with the leadership? Those are the people who need to be sacked if they're giving themselves $129,000 relocation bonuses.

Beating up the workers is like railing on about some spilled water on the kitchen table while a flood rages through your basement, undermining the foundation.

Its what they do..

Republicans hate the average worker, they don't want them to have representation so they attack their unions and fight to privatize (hand government business to their corporate sponsors.)
They do it to the Teacher's Union, they do it to the Postal Workers Union and they're doing it here. They are relentless and won't rest until everyone is working for $9 an hour and with no unions representing them.

GOP Unionization

After the CNBC sponsored debate, the candidates organized to improved their working conditions. They banded together and demanded change.

Unions for me but not for thee.

That was a volunteer alliance

Unions are a mandatory collective.

What Unions Do For People

The NY State Teachers Union enabled my Mom, a single parent in the early 60's, to have a decent salary & benefits. Some of today's unions have become huge cash sucking juggernauts, but in general, they enable workers to have decent pay, benefits, and rights.

Actually

Union membership is voluntary in all states. Under the NLRA no one can be compelled to join a union. However, in many states, the government inserts itself into contracts between private parties by allowing the confiscation of private property (union dues) to represent fired for workers who have not paid anything for that service.

Who say conservatives want limited government, or are opposed to free loading. And who is compelled to work for any one employer any way?

As an average worker

And often voting Republican, I apparently hate myself. Who knew? And why would a moderator axe this comment?

Eliminate the VA

I've said this since before the recent scandals broke. Like any large government bureaucracy, they care more about the survival of the bureaucracy than they do about their customers. In this case, people died because of the lack of urgency inherent in organizations of this size and type.

Notice how the democrats' first instinct is to protect the union jobs and only pay lip service to the thousands of veterans who have depended upon the incompetent VA for their health care.

Well, enough is enough. Scrap the entire VA. Put their budget in a Pentagon account for "veterans health care," then issue ID cards to all veterans who seek medical attention for their service-related illnesses and injuries. Allow the veteran to seek medical attention at ANY medical facility of their choosing and send the bill to the Pentagon.

Problem solved.

Quite the solution

So your solution to the problems inherent in a large bureaucracy is to combine the two largest bureaucracies in government into one? Or are you just talking about VHA? If that is the case, who handles the myriad other benefit programs for veterans currently administered by VA? Would these be eliminated, or would they be administered by that model of efficiency DOD?

These throwaway bromides of yours do nothing to actual solve the problem.

Moving budgeted funds

from one government account to another is not combining two bureaucracies. And with Fiorina's zero-based budgeting suggestion, maybe much of the "myriad of other benefit programs" would go away. I've never used any and I've been a veteran for a long time.

Good idea...

Of course that means laying off 250000 people, scrapping billions of dollars of infrastructure, hiring new bureaucrats to handle the new system, but otherwise a solid, simple, four-word solution.

The corruption comes from the

The corruption comes from the very top and flows down to the very bottom. When you have a job that you cannot get fired from, get increases in pay/retirement benefits steady, have no accountability for performance, can lie and fudge paper work to cover ineptitude, have politicians claiming things are not that bad (Hillary) and nothing happens, surprise surprise surprise- you have terrible results.

A total revamp is in order. The VA has had a blank check for too long, we as Americans want to do well for our Vets and get caught in the DC machine of more money, more money. The 1st thing that has to happen is we need to admit there is a problem and it is a huge problem. 2nd, understand throwing money at ineptitude is a waste of money (hard for politicians on both sides to get that simple notion). 3rd, truly be committed to fixing it no matter how dirty the job gets (might go as far a medical vouchers for all Vets and getting rid of the VA department all together).

Hard for so many to admit failure, especially in Government, but this current VA Dept is not serving its Vets and changes are well overdue!! The lack of coverage and outrage by our main stream media is hard to understand also. We will cover Ferguson for 6 months but ignore our Vets steady. Sad state of our times today.

I...... agree???

Oh man, I agree with Dennis Tester.

I'll admit to having little knowledge about what the VA actually does, but this seems like a perfectly reasonable solution. Veterans just get put on Medicare Part V (for Vets). They can then go to any clinic, hospital, or whatever they want, and kick the bill to Uncle Sam. Makes perfect sense to me.

Now just do that for everyone in America while we're at it.

The difference is

the veterans earned it.

The difference

Is that I think superior policy ideas ought to be implemented, whether people "deserve it" or not.

Pulling your own weight

would be a superior policy idea. Giving away more free stuff because you'd rather not, not so much.

All bureaucracies have issues

All bureaucracies have issues (we've been trying to resolve a private medical insurance billing issue for months) but the VA seems to be a special case. I can attribute some issues to the drastic increase in demand (older Vietnam vets plus wounded Persian gulf vets) but certainly not all. There clearly needs to be a thorough house cleaning. And perhaps some criminal investigations.

But it's my understanding that the VA has some very special skills relating to combat injuries that may not be easily found in private medical services. So I don't know if wholesale elimination is an option.

There is no injury incurred on the battlefield

that a good trauma surgeon hasn't seen from the carnage on our roads. That argument doesn't wash.

At least one exception I know of....

...agent orange. This isn't for current traumas but the after effects. By the time a vet hits the VA the injury that a "good trauma surgeon" can address is long past. There are other issues too: chemical dependency, PTSD, to name a couple obvious ones.

I admit this system needs to be improved and stream lined, that its leaders seem incompetent but I think the union is there more to protect the low level people who are just decent people trying to do a thankless job under difficult circumstances. The original purpose for the VA and VA medical care is still valid.

Fire, Demote, Re-Train

These are proper and effective administrative measures in ANY organization.

One removes the possibility of further malfeasance by that bad actor, as well as negative influence pressed upon others.

Another penalizes lesser improper behavior and provides opportunity for redemption and future promotion or more fitting re-assignment.

The last offers needed help to those employees simply trapped within the bureaucratic dysfunction, by re-directing their potential.

These three actions, properly applied, stabilize the organization's future daily operations.

SOP

The standard answer of any politician any time the bureaucracy is involved is "fire them." It's mindless but is sounds tough. And sounding tough is all it takes to get re-elected.

Systemic

There is a reason the GOP goes after the School and VA systems. Both are fairly self serving monopolies, their most needy "customers" are trapped within the system, the systems are failing to meet the needs of some of the "customers", etc.

I agree that the Medicare Type V is needed to solve the problem. Organizations tend to be much more competitive and customer focused when those customers are free to go elsewhere for better service. Also, we know that management and union generated waste is identified quickly and dealt with or the organizations goes bankrupt.

Just watched VA administrator

Just watched VA administrator on CNN, he looked like a man overwhelmed by a huge problem. I am sure his hands are tied by red-tape and bureaucracy talking heads but I don't feel any better about a change for our Vets care after watching him try to deflect the problems. Admitting the problem is step one in fixing it! It is broken, fix it!

I see on this thread there are those who claim fixing the VA is a GOP witch hunt intended to hurt unions or Federal workers. Wake up folks, those people who fought for your freedom deserve better than that. The VA is broken, get off your Government is great, unions are the only way, this is a fight between Dems and GOP, this is doing the right things for folks have EARNED it no matter your political views.

It's disgusting

the fact that republicans will sink this low in order to pursue their union busting ani-labor agenda is simply disgusting.

Obviously they have absolutely no clue how health care systems work, nor do they care. There's no excuse for these scandals but they are NOTHING compared to what goes on the private health care sector on a daily basis.

Really

Please remember that many of our local healthcare providers are in a union.
http://www.seiuhealthcaremn.org/about/

The nice thing about private healthcare is that if we are not satisfied, we can go elsewhere. Not so for the unlucky poor people who are stuck in these questionably performing public systems. I am always amazed at your willingness to sacrifice the poor / unlucky to the unions and bureaucrats.

Wrong again

People in private plans are just as trapped as anyone else, try getting treatment outside your approved provider. Although Obamacare has made it a lot easier to switch plans.

I'm sorry but anyone who tries to blame labor unions for the poor quality of health care in the US simply has no idea how health care actually works.

Complicated

Sorry, my network is pretty big with lots of clinics and doctors. In fact my daughter accesses her care in Ames Ia now.

I agree that there are many factors impacting the cost and quality of health care in America. One of them being Union collective bargaining and bureaucracy which drives up compensation (ie cost), sets work rules, often limits pay for performance, etc. I am not sure how anyone who says that Unions help employees get more compensation and job security can deny that they also increase costs to the tax payer or consumer?

Other benefit programs

As an expert on how to fix the VA, I would have thought that you actually know what the VA does. As that is apparently not the case, let me describe some of the benefit programs administered by the VA:

-GI Bill education benefits
-disability and pension benefits for disabled veterans and their families
-VA home loan benefits, offering no down payment loans to veterans without mortgage insurance
-Vocational training

Maybe you would like to see some or all of these programs go away, and that is your right. But I don't see how eliminating them altogether does anything to serve the veterans that served our country.

Eliminate

I don't think anyone here wants to eliminate the programs or funding. I think Conservatives here believe that the Veterans should have their choice of service providers, not be forced to put up with the poor treatment they are receiving at this monopoly.

I just used this comparison on my site. What would your car look like if the Big 3 still had a monopolistic lock on the American market? Would your quality be as good? Your features? Your performance? Your cost?

Until ~1980 the Big 3 had that near monopoly here, the cars were expensive, poor performing, and expensive. This was okay with the management and union workers who were happy to charge more and provide less.

Now would you support a monopoly like the Big 3 knowing what you know now?
How is the VA or Public Education system different?

The budget for the VA is 68

The budget for the VA is 68 Billion, I am sure we can keep programs that help Vets and still deliver great care also. Why is it so hard for liberals to admit the VA is broke and needs fixing. There is an almost delusional quality to the defense of the VA. Why are folks surprised when a huge Government program does not work? You would think after the "war on drugs" billions spent no results, "war on poverty" 22 TRILLION spent since 1965, no results, Obamacare, enough said, the list goes on and on. Don't be surprised folks, support fixing it not defending it.

It's important to understand

It's important to understand that the budget of ~70 billion is devoted to many more things than providing healthcare. Over 1/2 is payments for veterans with disability from their service- whether it be chronic arthritis from parachuting, or being wracked with PTSD from roadside bombs from our Mideast adventures. So doing away with the VA needs not just a replacement for the care, but also someone to administer the disability program. Many of us in the VA would prefer that the disability/healthcare roles were clearly split -- especially since the disability backlog is a chronic problem that is not a clinical care issue, but rather a judgement of "is this condition due to the military service".

Real problem solving vs. ideology

" I am not sure how anyone who says that Unions help employees get more compensation and job security can deny that they also increase costs to the tax payer or consumer?"

On occasion the truth can be quite easy to speak. Simply put, labor costs, union or otherwise are not driving force behind spiraling health care costs in the US. The health care systems in Canada and Europe are even more heavily unionized than the US system and they all provide more universal coverage more efficiently, and less expensively.

Space here prohibits an in depth explanation of our health care system suffice to say that I've seen hospitals pay $300 for thermometers you could by at Target for $40. Colonoscopies in the US cost 2-3 times more than those in Germany, despite the fact that German technicians actually get paid more to perform them.

But really there's not point in explaining the nature of almost any problem to republicans because they're by and large not interested.

Joe complains that "liberals" won't recognize problems; the fact is liberals were the first to recognize problems with the VA but unlike republicans liberals actually try to understand and solve problems rather than use them as an excuse to launch ideological attacks.

It would be funny if is weren't so vicious. Republicans never met a war they didn't like; they create combat veterans by the tens of thousands and add $100 billion dollars to the VA expense ledger then when it comes taking of the veterans they created all they can do complain about how much it's costs and whine about their taxes. Oh but they all have those little flag pins on their lapels. So republicans fight for magic budget cuts that ease their tax burden by screwing veterans out of services. It's magical thinking to believe that budget cuts "discipline" an organization into being efficient, or that busting unions will make the VA more efficient, but magic is they got. In reality all less money does is deliver less service.

Liberals recognize the problem, but their trapped in gridlock with magical thinkers who's only priority is dismantling the government as if Somalia does a better job of taking of it's veterans than we do.

T2

Now I assume you realize that you lose credibility every time you exagerate to that degree. I know of no one who desires to defund the government or reduce it's role to a point where it is similar to Somalia's government or lack there of. Maybe the extreme Conservatives would like to return us to 1950, however I am pretty sure we had law/order, adequate infrastructure and a pretty good government back then also.

Now as for Unions increasing costs, of course they do or they would not be doing their job. (ie more money and security for all their workers) However you are correct that there are many other reasons why costs are high in America. (ie High Direct and Indirect Tort Cost, High End of Life Costs (ie try to save everyone), No Easy Low Cost Physician Assisted Suicide, Americans are Unhealthy (little exercise, bad diet, high obesity, etc), Highly government regulated system, Arduous Licensing and Training Requirements, etc)

Well...

" (ie High Direct and Indirect Tort Cost, High End of Life Costs (ie try to save everyone), No Easy Low Cost Physician Assisted Suicide, Americans are Unhealthy (little exercise, bad diet, high obesity, etc), Highly government regulated system, Arduous Licensing and Training Requirements, etc)"

You lose credibility every time you use stereotypes to explain our health care system.

Factors

If you disagree with mine, please share with us what you think are the factors driving higher healthcare costs in the USA.

Same old problem

Dump the existing VA and the next problem will be fraudulent billing practices from the private sector, Pick your poison! No silver bullets.

PS: I flatly reject this notion that all "Union" folks are incompetents! Complete different discussion.

Human

I don't think Union folks are incompetent, I think they are human.

They want more money, more job security, more stability/rules, etc. Unfortunately when they are given these, the workplace becomes more rigid and less creative, the cost of operation goes up and mediocre performers are protected. I mean if they could terminate Bob, they could terminate me... We had best protect all of us.

Per above

Totally different conversation: We are 100% non-union, folks still want more job security, more money more benefits. Some folks want rigid operations, they feel better, more secure, when things don't change, (ironically the definition, of conservative) With over 50 years of working in big (Multi $Bil) industry, private sector, military, and 2 start ups. The point most folks miss is: Perhaps our job as a manager/director/leader is to grow those mediocre folks instead of casting them aside? Almost biblical don't you think?

Agree But

2 of my favorite management books are "First Break All the Rules" and "12 The Elements of Great Managing" and they support that view.

On the other hand after my time as a Supervisor, there are many employees who simply are not interested in self improvement / change. Being the tireless over achiever I would sit down with each of them and ask what they would like to learn or improve each year. Maybe 40% would have some ideas based on their past reviews and their future goals, however the majority just wanted to do their job and get their higher than cost of living raise... :-)

My point is that sometimes it is necessary to terminate employees who are not in synch with the organization / team. They are not necessarily bad, evil or lazy people, they just may not be aligned or a good fit. I got booted from my last job about 3 years ago because my beliefs and methods were not aligned to those of a Sr Manager. Probably better for the both of us and the organization. There has to be a reason why professional sports teams are often trading and changing staff.

It is hard to believe that one can have a winning organization when it has to keep all of those cogs that don't quite fit. So which is more important? Keeping all those cogs in the system or maximizing the effectiveness of the system for the good of the veteran, unlucky kid, customer, tax payer, etc?