The finger pointing over the VA scandal is wasting valuable time. The problem rests neither with President Obama nor Secretary Shinseki. Veterans have been on waiting lists through Democrat and Republican administrations. The problem is systemic and cannot be “fixed.”
I have a personal experience with government health care. Upon graduation from dental school in 1967, I was immediately assigned to active duty at Lackland Air Force Base in San Antonio. My plan was to use the Air Force experience to learn how to be a dentist. If a patient had several teeth needing treatment in one quadrant of the mouth I lengthened the appointment time to treat them all in one setting rather than needing several appointments.
I was called to a meeting with the commander and a few other career officers. They politely informed me that dentists are expected to treat one tooth per 45-minute appointment. To do more was making my colleagues look bad by comparison.
Every agency of the federal government measures its employees by benchmarks. That was ours.
The VA system has benchmarks too. Your superior rates you annually based on your hitting your marks. Your superior is the one you seek to satisfy in order to earn appreciation, promotions and increases in pay.
The private doctor is rated too. He is rated by his patients. Patients are cared for in such a way that they will not only return, but also recommend their friends. Everything that is done; the tests ordered, the appointment times and additional staff hired are all driven by patients’ needs.
The government employee’s reward comes from his superior. The private practitioner’s reward comes from his patient. Neither has any confusion regarding whom they must please.
A friend of mine, a World War II vet, spent a lot of time as a volunteer at the VA hospital in Atlanta. He told me of a very ill patient in the hospital who had lost control of his bowel and was lying in his own waste. The patient’s wife begged the nurse for two hours to change his bed linens. The situation was finally handled after the shift change. A private facility would go out of business with that kind of patient care.
Afghanistan and Iraq, plus the aging of the Vietnam vets, has added two million veterans to the VA health care system. Additionally, the eligibility for access to VA health care has been expanded. The number of providers has not kept up with the increased demand forcing the VA to decide: Do we ask more of our doctors or extend waiting times? Guess which idea prevailed.