Shinseki Resignation Must Trigger VA Retooling

The problems that have come to light with the VA did not happen overnight, nor even in the course of one administration. And some of the problems result from the actions -- and in some cases, inaction -- of Congress, some of whose members would rather politicize problems than solve them.
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Eric Shinseki, U.S. secretary of Veterans Affairs (VA), adjusts his glasses during a Senate Veterans' Affairs Committee hearing in Washington, D.C., U.S., on Thursday, May 15, 2014. Shinseki said he is 'mad as hell' over allegations of treatment delays and cover-ups at VA health clinics in Phoenix and Fort Collins, Colorado. Photographer: Andrew Harrer/Bloomberg via Getty Images
Eric Shinseki, U.S. secretary of Veterans Affairs (VA), adjusts his glasses during a Senate Veterans' Affairs Committee hearing in Washington, D.C., U.S., on Thursday, May 15, 2014. Shinseki said he is 'mad as hell' over allegations of treatment delays and cover-ups at VA health clinics in Phoenix and Fort Collins, Colorado. Photographer: Andrew Harrer/Bloomberg via Getty Images

News that Veterans Affairs (VA) Secretary Eric Shinseki has resigned in the wake of misconduct and mismanagement at the agency's vast network of medical facilities is upsetting. As most observers, including veterans up close to the VA would agree, Shinseki was a visionary who began what could have been an effective reform agenda.

But make no mistake: The problems that have come to light with the VA did not happen overnight, nor even in the course of one administration. And some of the problems result from the actions -- and in some cases, inaction -- of Congress, some of whose members would rather politicize problems than solve them.

With 300,000 employees, the VA is the third largest federal agency, responsible for all services to veterans from acute medical care, to housing, education and employment benefits. Few organizations -- public or private -- can do all these things well. The VA's sheer size and span of responsibility render it ineffective at adapting to the ever-changing nature of war, the toll it takes on our troops and their families, and the ways communities are organizing themselves to respond.

Congress bears its share of the blame. VA hospitals are often the sacred cows of congressional districts and many services are legislated, rather than set by the VA. In some respects, asking Congress to fix these problems is like asking the fox to guard the chicken coop.

Shinseki's resignation must trigger a top to bottom re-examination of the VA -- its size and structure, its methods of delivering care in communities and whether legislation designed to protect veterans is inadvertently hindering effective management. We need to assess whether and how the VA is set up to solve the problems facing this generation of veterans, especially its signature issues of post-traumatic stress and traumatic brain injury.

And perhaps, most importantly, we need to make sure the VA doesn't check out of veterans' lives too soon. Often, the problems veterans face can take years to manifest themselves, and will emerge long after the drawdown of troops is completed. Short-term fixes will not do. The services of the VA and other military-support organizations need to be available for the long haul -- throughout the course of a veteran's life.

Our work at the National Organization on Disability (NOD) on behalf of severely wounded veterans has taught us that the transition from the battlefield back into their home communities is a lifelong journey -- with very high highs and extremely low lows. It demands personalized responses. An overly bureaucratized, assembly-line mentality won't get the job done.

If we as a country are going to avoid the mistakes we made with veterans of the Vietnam War, that kind of retooling must take place. Whatever the cost, it'll be less than the long-term unemployment benefits, mental health treatments, prisons and the other public systems veterans will draw on if they don't get the right services, for the right amount of time, by an agile, appropriately structured and responsive VA.

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