Reforming any bureaucracy is hard. President Franklin Roosevelt, assistant secretary of the Navy during World War I, is supposed to have compared efforts to get the Navy to change its ways to punching a feather bed. President Harry Truman, commenting on the problems that would face his successor, Dwight Eisenhower, said, “He’ll sit here, and he’ll say, ‘Do this! Do that!’ And nothing will happen. Poor Ike—it won’t be a bit like the Army. He’ll find it very frustrating.”
Now the Government Accountability Office has found President Barack Obama is suffering from the same malady. In 2014 he forced out the Secretary of Veterans Affairs and brought in a new one to reform the VA. The new secretary, Robert McDonald, launched a reform program called MyVA, aimed at the Veterans Hospital Administration (VHA) and designed to overcome delays in seeing veterans requesting service by the end of 2016.
The GAO, however, concluded that the VHA had become top-heavy without improving health delivery or efficiency, and needed “significant restructuring.”
The reforms, announced with great fanfare by Secretary McDonald, were supposed to bring that about.
But the GAO found that the VA did not follow its own 2014 plans for reorganization. The reason? According to the GAO, the deputy secretary for health at the VA, David Shulkin, did not like them. He blocked 13 of the 21 reforms, and told the auditors he did so because reforming the VHA would be too disruptive to his top objectives: hiring new staff and “improving access to care,” the GAO reported.
The VA’s own reviews continue to show that the VHA has not significantly improved access to care as measured by how long it takes to get an appointment at a VA hospital. Meanwhile, it has done little to streamline a bureaucracy that has been diagnosed as too top-heavy to begin with.
The GAO found that Secretary McDonald had not put in place plans to follow up on his proposed reforms to the VHA to measure progress in achieving them. That, it said, “is inconsistent with federal standards for internal control for monitoring, which state that management should remediate identified internal control deficiencies on a timely basis.”
The good news, if any, from this report is that the VA agrees that it should do a better job in the future.
The current administration’s track record, however, does little to encourage the expectation it will be able to accomplish much in the weeks remaining in Mr. Obama’s term.
On the campaign trail, Donald Trump repeatedly decried the treatment of America’s veterans. In January he will have the opportunity to start making good on his promises to do better by them.
The VA is a good place to begin.