ongoing VA scandal is indeed unfortunate and sad. In a speech on May 30, 2014,
in Washington, DC, Eric K. Shinseki apologized for the “systemic, totally
unacceptable lack of integrity” shown by some administrators in managing the Veterans
Administration health care system hospitals and clinics.
Within hours of the apology, Secretary Shinseki resigned.
is clear that the trouble within the VA has been brewing for some time. The
fuse that set off this latest explosion may have been whistleblower claims that
managers at the Phoenix VA Medical Center were keeping two sets of books which
logged wait times for veterans seeking primary care appointments. There are allegations that some of the delays resulted in veteran deaths.
Acting VA Inspector General Richard J. Griffin issued a preliminary report
confirming that Phoenix VA administrators had manipulated wait times possibly
to assure more favorable annual performance reviews and higher bonuses and
compensation for staff. The unethical behavior by those entrusted with the care of our veterans is
the question again: Does America really need a separate VA Health System to
properly care for veterans? It may be a far-fetched idea, particularly since
we’ve had a stand-alone health system for veterans in America since World War
I. To some it may even sound unpatriotic and disrespectful. It’s not meant to
be. But, it’s a very practical question given the America today as compared to
the US of 75 years ago when the Veterans’ Bureau (as the VA was called then)
was first established. After World War I, the federal government was not in the
health care delivery business to any great degree. The VA hospital system was created to provide care
to veterans who otherwise would have gone without. Now, with Medicare,
Medicaid, and the health insurance exchanges under the Affordable Care Act,
health care is a major component of the federal government. Medicare and
Medicaid programs alone account for about one-third of this year’s federal
the question implies that veterans should be properly cared for. It is their
due from a grateful nation. It is the right and fair thing to do for our
country to care for those who have borne the battle. But can we properly care
for them without having to have a freestanding VA health system? Why not
mainstream veterans and provide for their health care in a manner similar to
Medicare? In fact, why not allow them to enroll in Medicare rather than
maintain a health care delivery model that is plagued with its own problems? With one uniform administrative system under Medicare, the monies currently
used to fund much of the present VA health system could be funneled into
existing delivery channels.
course, for the recently returned veterans, more may be necessary to provide
them with quality health care. In addition to allowing veterans to enroll in
Medicare, the Congress could create centers of excellence for orthopedic and
reconstructive surgeries and rehabilitation medicine, and for mental health
treatments (particularly for post-traumatic stress syndrome), at academic
medical centers around the country to complement the Medicare coverage for these
question the Nation should properly care for its veterans, but with the present
scandal perhaps we should rethink how we do it? Which by the way is a lesson
from history: the very first director of the Veterans’ Bureau – Col. Charles R.
Forbes – was relieved after two years on the job. He later was convicted on
charges of conspiring to defraud the government on hospital contracts and was
sentenced to a prison term.
what’s going on now, justice requires our immediate deliberate action to
protect those who have protected the Nation.
The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI’s online graduate programs, please visit our website.