06/07/2014 01:09 pm ET Updated Aug 07, 2014

Beyond the Scapegoat: Changing the VA

I go back.  Way back.  More than forty years.

 In the aftermath of Vietnam, my career working with veterans took a turn when I met Dr. Phillip May, head of the Neuropsychiatric Institute at UCLA and acting director for the VA Medical Center in Los Angeles.  My sergeant from ‘Nam, Bob Fraser, wanted me to meet him. Grudgingly, I went to the party. D­­­­­­­­­­­­­­r. May asked me why I thought veterans were not using the local VA. The research and interviews I did for him to fully answer that question ultimately led me to Washington, D.C. during the Carter Administration. At the invitation of Max Cleland (later Senator) and Sen. Alan Cranston, I made several trips to Washington to consult on veterans' issues and the model of treatment I had developed in Los Angeles. Towards the end of those trips, I invited another colleague from Vietnam, Rev. Bill Mahedy to help me. Together we co-wrote the Vet Center program for returning vets, still in use. Today there are over 300 centers nation-wide. Public Law 96-22, the Vietnam Veteran Readjustment Act was passed in June 1979.

But the flush of victory was short-lived.  The administration changed, and the new Reagan administration was determined to cut costs by cutting the program. Why am I telling you this?  Historically the head of the VA has been a political appointee. As such, the new head comes in not knowing the system and with no real power to change it or the culture underlying it.  That’s how we got here, folks.

I was elated to hear Medal of Honor winner Colonel Jack Jacobs (U.S. Army, Retired) state unequivocally that the VA Medical system needs to be taken down.  His simple model of delivering medical care—vet-sees-doctor/government-pays-doctor—sounded a lot like Senator John McCain’s remarks announcing the Sanders-McCain proposed legislation. 

Making medical care more accessible is great, and the long-term goal of building new facilities and refurbishing old ones sounds great.  But let’s address the real problem: the VA system as a whole, the staggering bureaucracy it’s become, and its culture of unaccountability. Just throwing money at the VA isn’t going to accomplish change.  That’s been proven.

The VA needs to change into a system that delivers first-rate medical care.  For that we need medical professionals, not layers and layers of management for thousands of office workers. And if we can’t get the facilities close to the veterans that need them, then let’s develop a system that uses the medical professionals already in place in those communities.

The road here has been a long and painful one. What I see over these last forty years is a pattern of VA heads resigning after a feeding frenzy from the public and the press when the situation gets so bad that it draws public attention—for a brief period.  Then things settle down and the old VA promises to improve and we’re soothed by the rhetoric.

Here’s the take-away: let’s stop blaming the head of the VA; let’s think before we build more hospitals. Let’s take a hard look at the current structure and culture of the VA and then let’s have the courage to break something that’s not working for our vets. Let’s not miss this opportunity to address the inherent flaws in the VA system. It’s going to take bold voices, bold thinking and a leadership that can affect real and lasting change. And it’s going to take all of us paying attention to whether or not that happens.  Here’s a link to your congressional representatives.  Do your part.  Tell them you’re watching.