Eliminate VA Mismanagement and Waste

An open letter and petition by Arthur Zynda


For several years our veterans organizations have been asking congress to increase funding for the Department of Veterans Affairs, the assumption being that the current level is inadequate. While I fully support the mandatory funding bills being considered by congress, the VAs problems have a lot more to do with gross mismanagement than a lack of money. Recent years have seen some inefficiencies eliminated, but this organization still has a very long way to go. As a recently retired employee as well as a patient of the VA medical system, I have had the opportunity to see the system from both sides. The amount of money I see being wasted while denying or delaying medical care to a massive number of veterans is nothing short of mind boggling.

At the heart of the problem is the extremely top-heavy management system. Nation-wide it has a very large army of highly educated and highly paid bureaucrats and managers (plus their staff) whose salaries, bonuses, and expenses suck up massive amounts of money that could be better used to provide medical care for a very large number of veterans who are being forced to go without. There is layer upon layer with each one second guessing the one below, and each one dreaming up ways to spend money everywhere except where it should be spent. They are constantly spending money to fix non-existent problems, but often cant find the funding to fix real ones. And when they do address a real problem, they often turn the simple - common sense - low cost solution into a multi-million dollar project, wasting tons of money that could be used to provide medical care for a very large number of veterans who are being forced to go without.

Until recently the VA was spending money to encourage more veterans to enroll in the medical system. This included advertising campaigns and sending enrollment teams into the field. They were spending money that could have been used to treat some of the many veterans who are going without medical care, to recruit even more who they dont have the money to treat. As crazy as this is, its typical of the way upper management spends money. While the dollar amount of this project was probably small by VA standards, this type of senselessness carries over to almost everything that VA managers do, including projects that cost millions and even billions of dollars.

In recent years this organization has spent billions on information technology systems that dont do what they need to do. Now theyre spending more money (again, probably billions) to get systems that (hopefully) work. There is no legitimate reason to have gotten it wrong the first time, and there is no legitimate reason to have spent nearly this amount of money. Part of this massive expenditure was for an incredibly expensive state of the art video conferencing system for upper management. I understand it has been installed in every major VA facility in the country. If the people who manage the VA cant have an effective phone conference without looking at each other, then they dont belong in management. At least not when the expenditure could have provided medical care for a very large number of veterans who are being forced to go without.

The Cares study is another example of a mountain of money being spent for no reason. The people at the top of this organization paid 60 million dollars to consultants for a bunch of facts, information, and suggestions that someone in this massive army of highly educated managers should have known all along. 60 million dollars that could have provided medical care for several thousand veterans who are being forced to go without. Apparently VA managers arent expected to know what is going on in the organization they are running, or how to run it cost efficiently.

Very expensive Building renovations seem to be never-ending. On rare occasions you will see a project that is worthwhile, but most are strictly cosmetic and do nothing to improve the quality or quantity of medical care (except possibly in the mind of someone with more education than common sense). At the same time, many needed renovations go without funding and staff shortages go unfilled. There should be no place in management for anyone who thinks that pretty is more important than taking care of sick and injured veterans. The April 8th broadcast of ABC NEWS PRIMETIME used the example of a VA hospital director whose mismanagement of construction funds was confirmed by testimony before congress and an inspector generals report. The response by his superiors was to put him in charge of several hospitals, where he promptly mismanaged a much larger amount of money. This is not an isolated incident. The people at the top of the VA have a long and clear history of rewarding mismanagement with promotions.

The same ABC report gave some examples of extremely poor medical care. Managers who employ uncaring or incompetent caregivers have no business being in management.

The VA is currently spending a lot of time and money trying to win the Baldrige award, which is presented to organizations that are (supposedly) well managed. Typically, millions of dollars and thousands of man-hours are spent trying to win this award. Millions that could be used to take care of many veterans who are going without medical care. And in case anyone thinks this award actually translates into good management, it should be noted that private sector winners have a bad habit of going belly-up.

Its important to note that the few things I have mentioned here are barely the tip of the iceberg. I could write several pages about the waste and mismanagement I have seen, and I certainly havent seen it all.

An estimated 200,000 veterans are currently waiting for medical treatment because the VA doesnt have the money to take care of them. Several VA reports have put the average per patient cost at about $4000. At that rate 1 billion dollars will treat 250,000 patients. Even if you double the per patient cost, 2 billion dollars in annual waste reduction should allow the VA to treat every veteran who comes in the door. This figure could probably be reached, or even exceeded, simply by reducing upper management to a comparative level employed by the most successful private sector businesses. More billions for health care could be found by insuring that those remaining have their spending priorities in the right place.

Many private sector failures are caused by highly educated managers who let their education get in the way of their common sense. I dont know if this is the problem here, or if these people are somehow using the VA as their personal gold mine, or if its a combination of both.

While the VA employs many veterans as workers and lowest level supervisors, there are very few in upper management. This is certainly a major part of the problem. Among those driven from the military by the Clinton Administration are some of the best and brightest people this country has to offer. They are the ones who should be running the VA. They are far more likely to have keeping the promise as their number one priority. More importantly, many have already proven their ability to solve problems by using their brain instead of looking for the answers in a book. (Or hiring a consultant to do it for them).

Therefore:

The undersigned petition the President of the United States and both houses of Congress to dismantle the insane management system of the Veterans Administration and replace it with a much smaller and efficient system that is staffed with people (preferably veterans) who are competent managers and have their priorities in the right place.

We further petition the President, Congress, the Attorney General, and the VA Inspector General to launch an investigation to determine if VA managers are somehow getting a piece of the Action from the many wasteful projects and programs they fund while 200,000 veterans are going without medical care.