February 9, 2015
Astrid Goh and Tara Longardner | US News and World Report
Six months after taking over as Secretary of Veteran Affairs, Robert A. McDonald has proven himself capable in the eyes of many of leading the scandal-ridden agency.
But experts agree that the Department of Veterans Affairs still has much work to do – especially regarding transparency and restoring the trust of military veterans.
“We want this administration to ensure every individual that put veterans in harm’s way is appropriately dealt with, swiftly,” said Louis Celli, the American Legion’s national director of veterans affairs and rehabilitation.
Unlike his predecessor, McDonald – a former Procter & Gamble CEO – can hardly be described as “ taciturn.”
Addressing reporters by their first names, giving out his personal mobile number at a press conference and insisting on being called “Bob” are only few of the things McDonald has done to increase the VA’s visibility and to promote an open culture.
Since he was sworn in July 2014, he has paid visits to more than 85 VA hospitals, facilities and cemeteries.
A lot of the trouble at the agency was a consequence of corruption and cover-ups at individual Veterans Health Administration facilities, which eventually tarnished the whole cabinet-level department. The VA is making progress in correcting these wrongs, “but it’s not a done deal yet,” according to Garry Augustine, executive director of Disabled American Veterans.
Claims of false record-keeping and long wait lists have been made for VA facilities across the country following the 2014 scandals, which involved manipulated patient wait-time data.
The VA took a blow last April, when it was revealed that 40 Armed Forces veterans had died waiting for care at a Veterans Healthcare Administration facility in Phoenix, Arizona. However, there has yet to be evidence that the delays directly led to those deaths.
An independent report by the VA Inspector General found falsified records on appointment wait times at the Phoenix medical center. Included in the findings was a more-than three-month discrepancy between reported and actual wait times, and 1,700 veterans absent from wait lists after they had made initial appointments.
The VA requires hospitals to provide care within two to four weeks of the time a patient seeks to make an appointment. But nearly 1,700 veterans waited an average of 115 days for their first primary care appointment, the report said.
As problems mounted, former VA secretary Eric Shinseki resigned in May, a month after the scandals came to light. McDonald was named by President Barack Obama to succeed him two months later.
Many doubted McDonald’s ability to reform the sprawling bureaucracy, given the former Procter & Gamble CEO’s lack of experience in health care or government. Despite successes during his tenure at the consumer products giant, critics including hedge fund investor Bill Ackman said the Cincinnati-based company was inefficient and underperforming under his leadership. McDonald resigned in June 2014.
He came to Washington as someone who has contributed to Republican campaigns in the past. But that does not stop criticism from the political party he supports.
“Our new secretary is not changing the culture of the VA as far as I can see,” Rep. Mike Coffman, R-Colo. said at a hearing in early February. “As a military retiree, I’ll continue to fight to make sure our wounded coming back from the battlefield… don’t go into the VA system.”
Others like Garry Augustine – the DAV executive director – think the VA is underfunded by the federal government. Funding for VA discretionary programs is set at $65.1 billion this year, up almost 5 percent from 2012. A total of $70.2 billion was requested for the 2016 budget.
“We saw it coming,” he said. “This was a perfect storm that was developing over many years.”
It should come as no surprise that McDonald advocates collaboration between private and public sectors, as well as between the VA and government.
“We are very much in favor of veterans being able to use outside care,” McDonald said during a briefing Tuesday at the VA Central Office in Washington. “It’s a shock absorber we need.”
Veterans groups, however, obect to the idea, saying the VHA provides quality health care that can’t be replicated outside the system.
Last year, the Veterans Access, Choice and Accountability Act, otherwise known as the ‘Choice Act’, was signed into law by Obama. The ‘Choice Card’ allows eligible veterans to seek care outside the VA system if their wait time for an appointment exceeds 30 days, or if they live more than 40 miles away from a VA facility.
The VA made almost 1.1 million authorizations for veterans to receive care outside the system from June 1 to Sept. 30, 2014 – a nearly 50 percent increase from the same period the year before.
Many find the VHA’s lack of transparency in its records troubling. The Congressional Budget Office struggled to compile an accurate report comparing health care costs between the Veterans Health Administration and private sector medical facilities as it had no access to individual VHA patient records. The office thus had to refer to a report from 2004, when researchers had access to said records, said a CBO official.
Nevertheless, for Ann Marie Buerkle, former New York congresswoman and head of the House Veterans’ Affairs subcommittee on health, the Choice Card initiative makes sense.
“It’s a realistic approach,” Buerkle said. “If you can’t get [more staff] you’ve got to partner with private health care because that’s when [the VA] starts to fall through the cracks. It’s smart of [McDonald] to reach out beyond the walls of the VA.”
“This cannot be a success story unless it is a collaborative effort," Rep. Jeff Miller, R-Fla., chairman of the House Veterans Affairs Committee said.
Despite criticism of McDonald’s lack of government or healthcare experience, many leaders of government and non-government organizations praise his work thus far.
“I think [McDonald’s business background] is probably what’s needed right now because this is a business,” Augustine said. “It’s big business. It’s the largest integrated health care system in America.”
The American Legion – one of the most prominent voices that called for Secretary Shinseki’s resignation – is another McDonald supporter. It cites the recent settlement of the 2011 lawsuit that claimed the VA neglected homeless veterans at its West L.A. campus as one example of McDonald’s significant leadership.
“Eric Shinseki had the same opportunities to cure these problems and did not,” Celli said.
“As a nation, one of our top priorities should be making sure the men and women of the military get what they earned and [what] we promised them when they volunteered to serve,” Buerkle said.