My 2 Cents on the VA
In the late 70's the Richmond Mercury ran a story about dire conditions at the local VA hospital. The story described neglect and poor care. I recall something about having to bribe orderlies to change bedpans. Safe in my employer-based health plan then, I hoped I would never be so destitute that I would have to rely on VA for health care.
Twenty years later the VA was running a much-improved health system that served me well beginning in 2003. Imagine that. Scheduling appointments can be challenging at times but for the most part, I'm satisfied with the care I receive from VA. But then, I'm reasonably healthy and my health care needs have been minimal. I have employer-based health coverage these days and see a private doctor for my routine health care but I also see a VA primary care physician once a year to keep current. A friend who is a member of my VA doc's Quaker community tells me that my doc says his supervisor complains about him taking too much time with patients. VA care can be a backstop but I hope never to need it again.
Working with veterans at Coffee Strong tells me that the VA experience is different if you need intense or extended service, especially for mental health problems. I hear stories from stressed-out vets of long waits for and between appointments. When they finally get an appointment the result is often drugs (usually added to what they are taking already).
I bring all this up as some context to the current VA scandal. The VA has been a troubled organization in past decades as well as the most recent. The current scandal is not exactly brand new; previous investigations raised red flags. If Shinseki never saw them, he is clearly out of the loop, relying on senior administrators unwilling or afraid to speak truth. If he did see the reports, he didn't take effective action or relied too heavily on subordinates whose concerns were more about themselves than the veterans they supposedly served.
The system is broken--at least for those who need it most--and it's nothing new. Any student of organizational behavior and VA history can easily learn about the department's dysfunctional culture. Apparently General Shinsheki missed that lesson along with the various warnings about problems. As much as I admire him for his willingness to speak truth to CheneyBush about the number of troops needed to stabilize Iraq and his genuine compassion, I think he's unlikely to ever again have much credibility as VA secretary.