Another day, another scandal at the beleaguered Department of Veterans Affairs. The real scandal, however, is not just the cynical manipulation of waiting lists but also the agency’s routine failure to deliver benefits and services to those who desperately need them.
This more systemic failure will become even clearer once the inspector general submits a final report to an irate White House and the Republicans and many Democrats pile on.
Politically, this critique of the VA is a no-brainer. After all, denying, delaying or incompetently delivering benefits to veterans who are entitled to them and have sacrificed so much for us is grotesque: the moral equivalent of kicking dogs and stealing food from children.
But this political consensus and opportunity for reform will all be for naught unless it targets the main cause of the VA’s problems: Congress. Attacks on the VA’s derelictions are easy and justified, but here, as in so many areas of policy, the seeds of failure are planted on Capitol Hill.
Congress hinders the VA in a number of ways:
• It has defined compensable disability broadly and often presses the VA to broaden the definition even further, thereby swamping the agency with claims. Today, veterans’ disability benefits extend to conditions that are not service-related, including common, age-related ailments such as hearing loss, lower back pain and arthritis.
This congressional subsidy for treatments not unique to veterans, in order to appease a politically powerful group, helps to account for the nearly 900,000 backlogged disability claims that the agency faced in 2013.
• Even as Congress pushes more claims into the system, it refuses to adequately fund the complex but necessary function of processing those claims. Although the VA has added thousands of claims processors in recent years, the number is still insufficient, so the constant flow of new claims ensures that the backlog stays at unmanageable levels.
The VA’s budget has doubled in real terms during the last decade – this year it is $162 billion, and the White House has requested a 3 percent increase for 2015 – but the congressional veterans affairs committees know that this is not nearly enough to solve the problem of delayed benefits and services, a chronic problem that predated the Iraq and Afghanistan wars. The VA generally provides high-quality medical care to those fortunate enough to be at the front of the queue; the problem is what happens to those who receive the care too late or don’t get it at all.
• Congress has made the VA almost impossible to manage by restricting the agency’s ability to fire, discipline and transfer its employees. This problem, of course, is not unique to the VA.
Congress has ordained a system of “merit protection” that, in effect, confers lifetime tenure on many federal employees, however incompetent. To fire or seriously discipline them, the VA secretary and his staff would have to invest immense time and effort.
This helps explain why the VA’s malpractice costs are so high, why the federal government’s employee discharge rate is only about one-eighth the private-sector rate and why Secretary Eric Shinseki did not fire even the senior VA officials responsible for so much documented, life-endangering negligence. A bill that would make it easier to do so recently passed the House and has bipartisan support in the Senate – but even if enacted, this reform would be too late for the victims of the VA’s incompetence.
• Congress has held scores of oversight hearings about the VA but has failed to produce adequate VA performance. For example, it has allowed the VA’s computerization effort to lag so badly that almost 40 percent of its claims files are still in paper form, while the VA has also bungled its interface with the Pentagon’s medical records.
Congress has countenanced an incentive system that encourages VA claims workers to prioritize the easiest cases, rather than those warranting the most urgent attention, and to make “provisional” rulings in old cases, encouraging payments with little or no scrutiny.
The VA’s failures are similar to the failures of numerous federal agencies. Only the details differ. Congress assures these failures by demanding what it is unwilling to pay for, by preventing agencies from managing their employees effectively and by tolerating operational inefficiencies that no funder of vital services should accept.
Pillorying the VA’s leadership is a necessary but not sufficient remedy. Congressional self-scrutiny must also be a big part of any meaningful solution.
Peter H. Schuck is a professor emeritus at Yale University and the author of “Why Government Fails So Often, and How It Can Do Better.”