WASHINGTON, D.C. - The Veterans Affairs “scandal” story is fading from the news, as VA scandal stories always do. That is the scandal.
In a previous post, I talked about Congress’ culpability. For years, Congress has demanded that the VA expand its mission and services but has not provided the money to do it properly. And now Congress is outraged.
The truth is the government has been making a mess of serving veterans since the Veteran’s Bureau was commissioned in 1921. From the research I’ve done, there seem to be many complications that have endured for decades and are immune to repair.
Veterans have difficult health problems -- chronic conditions and complex mental health issues -- and addressing those issues has gotten even harder as soldiers survive catastrophic wounds that would have been fatal until recently.
Funding is often irrational, politicized and inadequate. Civil service rules might be OK for bureaucracies (they aren’t really), but they are a huge obstacle for an enterprise that needs to provide actual services. The VA can’t pay doctors and specialists enough and congressional and media scrutiny is episodic.
“These ‘scandals’ seem to occur about once every decade or so, and usually result in the dismissal of top officials and a round of reforms,” according to Colin Moore, a political scientist working on a history of the VA.
Moore says these scandals have lead to meaningful fixes in the past so it is worth a quick tour of that history. (One useful resource available online is a study by the libertarian-inclined think-tank, the Independent Institute.)
- In 1893, an incredible 41 percent of the federal government’s revenue was spent on veterans’ benefits. In 1900, there were still a million Civil War veterans alive in a nation of 76 million people.
- Woodrow Wilson created the Veterans Bureau in 1921. Moore writes, “Col. Charles Forbes, the first director the Veterans’ Bureau, devised ingenious ways to bilk the federal government out of millions of dollars. Under his leadership, the VA purchased huge quantities of hospital supplies—including a 100-year supply of floor wax—which were then privately resold as government surplus. For his efforts, Forbes earned a two-year sentence in federal prison, while the loss to taxpayers came in at well over $2 billion in today’s dollars.”
- In an email interview, Moore writes: “In the 1940s, a series of investigative reports exposed the VA’s lack of capacity and the poor quality of its physicians. (Albert Maisel’s ‘The Veteran Betrayed: How Long Will the Veterans’ Administration Continue to Give Third-Rate Medical Care to First-Rate Men?’ which appeared in Reader’s Digest was the most influential of these pieces). During this period, the VA was mainly focused on caring for elderly veterans of World War I and the Spanish-American War and, as a result of its civil service rules, had difficulty recruiting young physicians—at the time, for example, more than half of the doctors on the civil service list were in their 60s.” This PR crisis led to another purge-and-reform. President Truman appointed General Omar Bradley, one of the great generals of World War II, to run the VA.
- According to the Independent Institute, the VA had 65,000 employees when Bradley took over in 1945. Its budget had been $744 million in 1944. By 1947, it was $7.4 billion and the workforce had grown to 200,000. The American Legion started calling for Bradley’s head in 1946.
- In 1947, Congress appointed former President Herbert Hoover to oversee a massive examination of the federal government. The Hoover Commission recommended a thorough overhaul of the VA in 1949. The American Legion opposed all of the recommendations.
- In 1953, the now Republican Congress and White House created a second Hoover Commission that found pervasive inefficiency and waste in the VA. The average hospital stay for a tonsillectomy was eight days in a VA hospital, 1.4 days in non-VA hospitals. The biggest problems came not from caring for the 3,500,000 vets with service-related conditions, but from the 21, 000,000 others vets who were covered and had conditions that were not connected to their military service.
- In 1970, Life magazine ran a cover story headlined,“ Our Forgotten Wounded” (The Daily Kos has a look back at the piece here.) “With 166 separate institutions, the VA hospital system is the biggest in the world. The 800,000 patients it treats in a year, mainly men wounded in earlier wars, range from cardiac to psychiatric cases. It is disgracefully understaffed, with standards far below those of an average community hospital. Many wards remain closed for want of personnel and the rest are strained with overcrowding. Facilities for long-term treatment and rehabilitation, indispensable for the kind of paralytic injuries especially common in this war of land mines and boobytraps, are generally inferior.”
- The Life article kicked off a new wave of attention, protest and scandal. Vets fought to get compensated for the effects of exposure to Agent Orange, a toxic herbicide. Ron Kovic, later portrayed by Tom Cruise in Oliver Stone’s “Born on the Forth of July,” heckled Richard Nixon’s 1972 nomination acceptance speech, shouting, "I'm a Vietnam veteran. I gave America my all, and the leaders of this government threw me and others away to rot in their VA hospitals." In 1974, Kovic led a 19-day hunger strike in Los Angeles protesting conditions. The director of the VA, Donald Johnson, resigned a few weeks later.
- In 1982, VA director Robert Nimmo resigns after government accountability reports found evidence of wasteful spending and a failure to document the risks of Agent Orange exposure. From CNN: “Controversial VA director Robert Nimmo, who once described symptoms of exposure to the herbicide Agent Orange during the Vietnam war as little more than ‘teenage acne,’ resigns under pressure from veteran's groups. Nimmo was criticized for wasteful spending, including use of a chauffeured car and an expensive office redecorating project, according to a 1983 GAO investigation. The same year, the agency issues a report supporting veterans' claims that the VA had failed to provide them with enough information and assistance about Agent Orange exposure.”
- In one of many damning reports in this period, a 1988 report by the General Accounting Office found that two years earlier, the VA discovered 93 physicians on staff that had been sanctioned or suspended.
- In 1999, The Los Angeles Times breaks stories about how patients at VA facilities there were put into medical trials and experiments without their consent.
- CNN also reminds us that the VA had been struggling with waiting lists as far back as 2003 : “A commission appointed by President George W. Bush reports that as of January 2003, some 236,000 veterans had been waiting six months or more for initial or follow-up visits, 'a clear indication,' the commission said, 'of lack of sufficient capacity or, at a minimum, a lack of adequate resources to provide the required care.'"
- In 2010, the VA warned 10,000 patients in the South that they may have been exposed to HIV and/or hepatitis from colonoscopies done with improperly sanitized equipment.
And this is just a highlight reel.
The bottom line is that Congress, the press, the presidents and we the people have had countless opportunities to turn outrage into action. Sometimes, the scandal cycle led to important reforms, if never a transformation of the VA.
“Throughout its history, the VA’s very public failures have shaped its development as profoundly as its successes,” Moore wrote in The Washington Post. “If there is any silver lining to our current outrage, it is that in the past, acts of negligence or corruption have led to dramatic improvements in the care veterans receive.”
Dick Meyer is Chief Washington Correspondent for Scripps News. An experienced writer, reporter and author, Meyer was executive producer for the BBC's news services in America, NPR's executive editor and editorial director of CBSNews.com. Meyer also wrote a book on American culture and politics, "Why We Hate Us: American Discontent in the New Millennium" (Crown Publishing/Random House, August 2008).