When my son returned home from active duty military service a few years ago, he immediately got in touch with the Department of Veteran Affairs (VA) hospital near our town. He had served two combat tours in Iraq and suffers from hearing loss, an injured shoulder and mild post-traumatic stress disorder (PTSD).
At the time, we were appalled by the VA’s lack of urgency in attending to his needs: long, pointless days stuck in bureaucratic amber, appointments cancelled without notice (or rescheduling), and treatment that amounted to little more than he might have received at a field hospital in Baghdad. We chalked it up to the VA’s legendary incompetence, and since his injuries weren’t all that debilitating he simply moved on with his life.
Thus, it was no surprise when reports surfaced last month that as many as 40 veterans may have died while waiting months or even years for treatment at a VA medical center in Phoenix. Those reports were exacerbated by discovery and release of a confidential 2010 VA memo that outlines the various ways VA staff falsify or game the scheduling system in order to mask their ineptitude and thereby lower “missed opportunity” rates.
“Missed opportunities” is a metric used in evaluating the responsiveness of VA medical centers to patient need. Dr. Sam Foote, a recently retired physician who served for 24 years at the VA medical center in Phoenix, has charged that facility with maintaining a secret waiting list of 1,400 patients considered low priority, including some with serious health problems.
Among the most serious of those problems is mental health. In recent months, the epidemic of suicides among Iraq and Afghanistan War veterans has skyrocketed. According to VA records, 1,900 veterans – 22 per day – committed suicide during the first three months of 2014 alone. And there’s no reason to believe the rate has slowed since. In fact, the Iraq and Afghanistan Veterans of America organization believes the numbers may actually be higher. And the rates are positively frightening. Young veterans in the highest risk category – 18 to 24 years of age – have a rate of 79.1 out of 1,000. The civilian rate for the same category is 25 out of 1,000. Older veterans are less likely to commit suicide, but even their numbers far outstrip their civilian counterparts.
Against that backdrop, the only proper response to reports of the VA deliberately delaying treatment is anger and indignation.
Curiously, President Obama stayed silent on this scandal for three full weeks, from April 28 to May 21. But he hasn’t been silent about VA reform in the past. For instance, in 2012 the president said, “So when I hear about service members and veterans who had the courage to seek help but didn’t get it, who died waiting, that’s an outrage. And I’ve told Secretary Panetta, Chairman Dempsey and Secretary Shinseki we’ve got to do better. This has to be all hands on deck.”
Well, Panetta is gone, replaced as Secretary of Defense by Chuck Hagel. But General Martin Dempsey, Chairman of the Joint Chiefs, and Eric Shinseki, retired Army general and Secretary of Veterans Affairs, are still on deck. So, what have they been doing about the problem? Apparently very little because now the scandal is spreading across the country, with reports of secret waiting lists at VA medical centers in Florida, Texas, Wyoming and elsewhere. As days go by, it appears that the problem which first surfaced in Phoenix wasn’t isolated, but a sign of systemic rot throughout the VA system.
To date, there’s been no indication that Secretary Shinseki will resign, despite repeated calls on him to do so from both Republicans and Democrats. For his part, President Obama has defended Shinseki, all while claiming that someone will be held accountable. The question is whether that “someone” will be the Secretary or even the President himself (here’s betting on the former).
So, who is accountable? First, the political class, which has treated the VA as a political football for years, and which even now is using the current scandal as an opportunity for partisan preening. The president is accountable first and foremost. As commander-in-chief, he is uniquely and personally charged with a duty to care for those who serve or have served. But the VA secretary is accountable, too, along with oversight committees in both the House and the Senate. They should all be answerable for what has gone on in the VA.
Second, the American military establishment is accountable. It failed to develop coherent post-invasion plans in Iraq and Afghanistan, and apparently also failed to ensure that returning veterans would be properly cared for. It’s true that the VA is not a part of the Department of Defense, but the VA is where soldiers, sailors, airmen and marines wind up after having served. More insistence on the part of uniformed commanders at the highest levels might have made a difference.
Last, accountability also lies with the American people, who through their elected representatives sent 2.3 million fellow citizens to war and then promptly lost interest. The problems at the VA, though they are rising to the public consciousness now, are not really new. Nor have they been a secret. It’s just that despite the “support the troops” sentimentality and displays of yellow ribbons, few Americans had a real stake in either Iraq or Afghanistan, much less their aftermath.
In his Second Inaugural Address, delivered near the end of the Civil War, President Abraham Lincoln called on the nation to “care for him who shall have borne the battle and for his widow and his orphan …” He understood that the relationship between a soldier and his country isn’t contractual; it’s covenantal, a sacred trust. In our time, sadly, we haven’t kept that trust. We may yet be able to preserve our covenant with most young veterans, but for 40 families in Phoenix, and perhaps hundreds or even thousands elsewhere, it is too late.
Mark Gordonis a partner at PathTree, a consulting firm focused on organizational resilience and strategy. He also serves as president of both the Society of St. Vincent de Paul, Diocese of Providence, and a local homeless shelter and soup kitchen. Mark is the author of Forty Days, Forty Graces: Essays By a Grateful Pilgrim. He and his wife Camila have been married for 30 years and they have two adult children.
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