Obama should clean house at the VA

If ever there was grounds for bipartisan action to punish egregious failure, the scandal erupting at the Department of Veterans Affairs provides it.

Whistleblowers and investigators allege that VA officials conducted fraudulent manipulation of waitlists to hide how long America's veterans have to wait for medical attention. The first office exposed in Phoenix may have cost 40 lives through its deceit, and the number of facilities added to the mix grows by the day.

Into this mess stepped Eric Shinseki, the retired four-star general and the man who has served as Veterans Affairs secretary since Barack Obama's inauguration in 2009. Shinseki pronounced himself "mad as hell," as did President Obama, and pledged to do whatever it took to impose discipline on an agency that had been under his direction for over five years. At a recent congressional hearing, Shinseki's key lieutenant Robert Petzel also testified to his own outrage, but in almost the same breath couldn't answer whether deliberate fraud in waitlist management constituted a fire-able offense. Soon after, Petzel got pushed out ahead of his scheduled September retirement date, and calls increased for Shinseki to resign as well.

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President Obama should heed those calls, and clean house at the VA. While issues of waitlists and slow treatments started long before Shinseki took command of the agency, his leadership has done little to resolve them, and there seems to be even less reason to believe Shinseki and his team can improve matters.

The White House has begun to push back against the calls for heads to roll by pointing out that the Bush-era VA had the same problems, which is true. The rapid increase in battle-wounded soldiers in two wars (Afghanistan and Iraq) did not get the attention required in the earlier years of the war. In the FY2003 budget, the first that spanned both wars, the VA budget was $56.9 billion, according to OMB data. That was an increase of 26 percent over the $45 billion FY2001 budget that almost entirely preceded the 9/11 attacks that initiated the war in Afghanistan. By the final budget signed by George W. Bush, the FY2008 budget, VA funding had increased 88 percent to $84.7 billion.

Even at that level, veterans did not get the attention they needed. The problem became acute enough that Obama made it an issue early in his presidential campaign. In October 2007, as then-Sen. Obama began to rise to the top of the Democratic Party's primary field, he told veterans that fixing the waitlist issue was a matter of honor. "When a veteran is denied health care, we are all dishonored," Obama said. "When 400,000 veterans are stuck on a waiting list for claims, we need a new sense of urgency in this country." He also promised more resources and better management to fix the problems seen at the VA. "As president, I won't stand for hundreds of thousands of veterans waiting for benefits. We'll hire additional claims workers."

After winning the election, the issue of veterans languishing on appointment rolls rose again in the transition. VA officials warned the transition team about unreliable metrics in the waitlist management system, which meant that any evaluation of average time waiting for medical treatment was suspect. But performance issues were secondary, the VA briefing instructed, to the issues of denied care for veterans. "[I]t affects quality of care by delaying — and potentially denying — deserving veterans timely care."

Everyone understood that the issue of veterans care was both acute and chronic when Obama took office. He appointed Shinseki in part because of his willingness to buck the general consensus and demand action. Shinseki got sidelined in the final months of his military tenure by telling Bush administration officials that their Iraq invasion footprint was too light, especially for plans to occupy and administer the nation after a successful war against Saddam Hussein's forces — advice which turned out to be well founded. His prescience and his dedication to his troops made Shinseki a hero among Obama supporters and an obvious choice to head the VA on a mission of reform.

More than five years later, nothing has changed — except the spending. Defenders of the administration have suggested that the scandal is actually a resource issue, but that would be difficult to argue from the spending. Since that final Bush budget of FY2008, the VA budget has grown by 78 percent in six budget cycles, to $150.6 billion. With the single exception of the FY2012 budget sequester, when VA spending dropped 2.2 percent, the agency's budget has increased by at least 8 percent every year of Shinseki's tenure. Veterans had every right to expect that the increase in resources meant that the Obama administration intended to rectify the problems that kept them from accessing medical care.

And yet, more than five years later, we are discovering that all of these additional resources have done little to help veterans. Dozens of veterans died while waiting for care at the Phoenix facility, and we still have yet to discover how many others may have perished while having their appointment requests manipulated by bureaucrats more interested in bonuses than in providing care to veterans.

Worse, no one wants to take any responsibility for the abject failure. Shinseki kept shrugging off action to clean up the VA, telling the Senate that he prefers to wait for investigations to finish before sizing up changes in the bureaucracy. That passive response infuriated Washington Post columnist Dana Milbank, who noted that the VA secretary "refused to acknowledge any systemic problem and declined to commit to do much of anything."

This is a failure of leadership. President Obama and VA Secretary Shinseki knew about the failings at the VA, making it a point to reform the agency and improve outcomes. Congress under the control of both parties approved big increases in budgets for that purpose. Not only does it now appear that nothing changed except doubling down on already-unreliable metrics, but both men now express surprise at the very problem they pledged to solve. Shinseki wouldn't even solidly confirm the problem existed during his Senate testimony, while Jay Carney told the press that Obama only found out about the nature of the problem from watching news reports — a familiar refrain from earlier scandals.

Presidents who face leadership failures have an effective option for resolving them: firing Cabinet secretaries and other political appointees involved. It sends a valuable signal to others in federal government that failure actually does have consequences, and allows for some confidence that the same people who contributed to the problem aren't going to be left in charge of the supposed solution. Obama has been strangely reluctant to use this option in earlier scandals, like the ObamaCare rollout or the use of the IRS to target the administration's political opponents. With the lives of America's veterans on the line, Obama has to get the failed leadership team out of the way and bring in fresh eyes and better management to fix the problem rather than cover it up.