Calls for the resignation of Department of Veterans Affairs Secretary Eric Shinseki over ridiculously excessive wait times for VA medical appointments and, moreover, for the falsification of data that would have illuminated these and related problems, while understandable, are premature — and will do little to address the VA's more deeply rooted problems. These problems are systemic in nature. Their solution will require a long term, strategic approach in addition to some strong-handed management reforms in the short term, to ensure that the planning for the care of military veterans — along with the care itself — is on equal footing with the planning of our military's force sizing and its plausible employment and deployment, over both the near and long terms.
Back in early August 2000, while addressing the Republican National Convention in Philadelphia, then-vice presidential candidate Richard Cheney pilloried the Clinton administration for extending military commitments (so small by comparison to those that followed as to appear almost invisible in hindsight) while simultaneously depleting America's military. Mr. Cheney closed by promising our military, in his words, that "help is on the way." Much of what followed over the next 10 years, though, was anything but helpful, to those that actually served and were wounded or worse.
Under President Clinton, the military was in fact substantially larger and more heavily budgeted than it would be later, when a smaller, leaner force was ultimately deployed into heavy combat in two theaters of war for over a decade with nearly 7,000 killed in action and well over 50,000 wounded.
That the Department of Veterans Affairs could not keep up with the effects of these two most recent wars — in addition to caring for veterans of the World War II, Korea, and Vietnam eras — should come as no surprise. The VA's resourcing and the planning for its long term demands was little more than an afterthought in the run-up to the Iraq War, to say nothing of the war in Afghanistan that would follow. Simply put, it did not meet with the kind of deliberate forethought that good managers expect to accompany a major, long term commitment. The same could be said for active duty military medical care. Until the Washington Post exposed grossly inadequate care and neglect of wounded service members at Walter Reed Army Medical Center in early 2007, it was not clear that planning for the care of wounded service members so badly lagged the conduct of the wars themselves.
Paradoxically, the Army chief of staff, in February 2003, testified to the Senate Armed Services Committee that the force to fight a war with Iraq, and preserve the peace, would be on the order of several hundred thousand deployed soldiers. Army planners, in turn, envisioned a time frame of years of combat and occupation — upwards of five to 10 — as altogether possible in Iraq alone. The estimate was rejected by Bush administration officials as "wildly off the mark." The officer giving the testimony? Gen. Eric Shinseki.
For the VA's problems to be fixed and care improved over the short term, summary dismissals of managers at all levels who fail to meet a minimum threshold of performance must be made possible and easy to carry out. Entrenched government bureaucrats, many long-term government employees, cannot be so easily dismissed without new legislation to permit it. Congress should act now; an ample supply of competent managers, many former military themselves who are accustomed to long work days and arduous conditions, is waiting in the wings. In turn, each of four VA regions should be systematically reviewed and overhauled, with every facet of veterans' care reviewed — from benefits processing to medical. This should happen ASAP over the next 12 months.
Over the longer term, planning and budgeting — to include staffing — of the VA has to be intrinsically tied to defense planning writ large; the run-up to the Iraq war is but one (albeit high profile) example of where this did not happen. This is not currently the case, and once again, and by law, it can be, and should be. The Lieberman Amendment to the Defense Authorization Bill of 1997 already requires that the Defense Department conduct a comprehensive review of military strategy, possible force employment, and budgeting every four years: the "Quadrennial Defense Review," or QDR. Making veterans' care a central part of that review — both ongoing care as well as that projected into the future as part of potential force employment — is a logical next step. The time to stop treating veterans' care as something of an afterthought in the national dialogue over resourcing priorities is at hand in any case, and solutions, and our veterans, should not have to wait.
Ralph Masi is a business professor with the University of Maryland University College. A retired infantry officer, he was a strategic planner in the run-up to the war in Iraq. After leaving active duty he studied the effects of the war on our wounded at RAND Corporation. His email is firstname.lastname@example.org.
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