Shinseki Out

I haven’t been following this one closely, but it looks like the inevitable happened this morning:

President Barack Obama has accepted the resignation of his embattled secretary of Veterans Affairs after an admitted failure to prevent a systemic cover-up of dangerous backlogs in waiting lists across the nation’s largest hospital network.






151 replies
  1. 1
    Elizabelle says:

    I think he got scapegoated. Although his situation became untenable.

    And I hope the VA scandal blows back hard on Republicans. They have NEVER wanted to fund the VA adequately, and they’re the ones who pushed for the war in Iraq. There are not enough doctors, other providers, and sufficient funding. It’s that simple.

    That is the scandal.

  2. 2
    Alex S. says:

    I guess it’s a little unfair because he didn’t cause these problems, but then he was in office for more than 5 years and his portfolio isn’t that big.

  3. 3
    raven says:

    Shit rolls downhill, he knew that.

  4. 4
    Belafon says:

    The next nominee should answer every question with “Where’s the funding, Senator?”

  5. 5

    To use a baseball metaphor, you can always fire the manager but never the owner, as in the one with the money.

  6. 6
    Goblue72 says:

    @Belafon: they’ll turn it into an excuse to privatize the VA

  7. 7
    raven says:

    @Elizabelle: The Prez is doing a nice job addressing that right now.

  8. 8
    SiubhanDuinne says:

    @Elizabelle:

    And I hope the VA scandal blows back hard on Republicans. They have NEVER wanted to fund the VA adequately, and they’re the ones who pushed for the war in Iraq. There are not enough doctors, other providers, and sufficient funding. It’s that simple.

    That is the scandal.

    Q,B,AIFT (quoted, bolded, and italicized for truth) (complete with Oxford comma)

  9. 9
    Elizabelle says:

    @raven:

    Ah. I should turn on the idjit box. Thank you.

  10. 10
    Belafon says:

    @Goblue72: Let them try, with every veteran in the country watching.

  11. 11
    Belafon says:

    @SiubhanDuinne:

    Q,B,AIFT,CWOC

  12. 12
    Patrick says:

    @Elizabelle:

    It’s not much different than Benghazi in the sense that both Benghazi and VA suffered from inadequate funding. And both times, it was the GOP that refused the funding needed. And amazingly, the media and the voters keep giving the GOP a free pass.

    Shinseki has now been let go. A scapegoat. He will be replaced. But nothing will change until appropriate funding happens. Why is this so difficult for voters/media to understand?

    Bernie Sanders said he will reintroduce a bill with much more funding to the VA next week. Will the GOP filibuster it again? Will the media/voters call them on it this time???? I doubt it.

  13. 13
    c u n d gulag says:

    Well, it’s NOT like you couldn’t see THIS coming!

    The General who told Cheney, Rummy, and the Dummy, that they need more troops to secure Iraq after a quick victory, gets blamed for not being able to handle all of the MILLIONS of veterans years later, that those stupid and needless wars and occupations created.
    It was inevitable!!!

    Yeeeeeeeeeeeeeeeeeeeeeeesh…

  14. 14
    Anya says:

    It sucks that he was scapegoated. The media, cowardly Dems and the asshole republicans are not interested in solutions or addressing the underlying causes. They wanted a sucrificial head and the VA secretary had to pay to satisfy their lust for blood.

  15. 15
    raven says:

    @Patrick: It’s better than it was an still not good enough. It will always be that way.

  16. 16
    Patricia Kayden says:

    @Patrick: Good for Bernie.

  17. 17
    Patrick says:

    @Anya:

    Yes, it was shameful how the Dems just rolled over. Why was it so difficult to simply point out the the GOP had refused funding? Why was it so difficult to point out that this was the consequence of Bush’s ill-planned war against Iraq. But why be surprised? This is the same crap that took place during the 2002 Iraq war vote when half of the Senate Dems voted for the war.

  18. 18
    Goblue72 says:

    @Belafon: Like the ire of veterans has ever scared Congress from screwing folks over. Heck, American history is littered with vets having to protest because Congress was shafting their pensions and war bonuses.

  19. 19
    raven says:

    Fucking Mathews is all over Obama. Fucking punk.

  20. 20
    kd bart says:

    Underfunding and bureaucratic red tape at the VA has been around so long that Hollywood made a film, Article 99, about it in 1992.

  21. 21
    artem1s says:

    we need a mandatory 1% set aside law to fund the VA. you want more money for the department of defense? to build another useless billion dollar weapon that we don’t need? plan on funneling pallets of cash to freedumb fighters? get ready to set aside 1% of it for the inevitable need at the VA, asshole.

  22. 22
    Jay C says:

    I just turned off the live feed of Pres. Obama’s presser: when the reporters start asking questions about “scapegoating”, you know that nothing more intelligent is going to be said…

    Obama did little but laud the now-former-Sec’y Shinseki: justly so, IMO, though it’s too bad an otherwise distinguished career had to end on such a low note: I’m sure the scheduling problems at the problem hospitals were neither his doing, or his desire, but unfortunately, that chain of responsibility can sink you sometimes.

    But yeah, the ball is now back in Congress’ court: I think there are probably going to be the usual clutch of “gotcha!” attempts from the usual GOP vermin, but I think the problem is too exposed, and too obvious for them to get away with too much political grandstanding.

    Also, it’s an election year: despite the bullshit “CW” that the Republicans have some sort of unbreakable lock on the midterms, I’m sure few of them want to have “didn’t support Our Vets” popping up as a campaign theme; I don;t think they CAN just let it slide, or blame-shift. Not that they won;t try,. I’m sure.

  23. 23
    piratedan says:

    @raven: Chris has always been a fair weather ally because he still believes in BiPartisanship. It’s like his mindset has been hermetically sealed from 1982 and he’s never escaped the fact that a couple of old Irish boyos from opposite sides of the aisle found a way to put down the knives long enough to get some things done (O’Neill and Reagan). Obviously Chris has been sleepwalking thru the last six years and believes that the bully pulpit solves everything even though we have the most erudite President in office for the last 50 years who’s encountered obstructionism not witnessed since prior to the years leading up to the Civil War.

  24. 24
    Elizabelle says:

    @Patrick:

    Yeah, but you can also look at it as a fresh start, removing a distraction, and turning the spotlight back on the inadequate funding.

    Even while he’s resigned, we can have General Shinseki’s back, pointedly reminding folks his agency was grievously underfunded and in need of new technology as well as more doctors and medical providers.

    I do agree about not rolling over. I think there should have been a lot more pushback earlier over the “IRS scandal” too. The root of that was that Congress changed the law on who could apply for tax exemption. It is too broad. Do these overtly political groups deserve a tax break when our veterans and others are going without healthcare, housing, and education?

    These groups — Tea Party or Democrats for Preserving Redwoods — have free speech. They don’t need to be taxpayer-subsidized as well.

  25. 25
    Patrick says:

    @raven:

    Who can forget this comment from Matthews:

    “If [Bush’s] gamble that he can create a democracy in the middle of the Arab world” is successful, “he belongs on Mount Rushmore.” [Hardball, 12/16/05]

  26. 26
    Lolis says:

    I find it hard to care about this. Republicans wanted a scalp and they got one, but not like this means much. They are desperate for small victories.

  27. 27
    Elizabelle says:

    I think history will be kind to General Shinseki.

    And not so kind to Secretary Rumsfeld, VP Cheney, Bush the lesser, and that battleship o fools.

  28. 28
  29. 29
    Elizabelle says:

    @Patrick:

    Well, at least GW Bush can paint Mount Rushmore.

  30. 30
    raven says:

    @piratedan: He’s phony fucking jackass.

  31. 31
    Belafon says:

    @Goblue72: True, but I think you’re making my point. When Congress wants to cut money they have had trouble remembering people exist. If veterans are watching the confirmation hearings, though, and the new secretary does it right, they will have plenty of reasons to call their congress people.

  32. 32
    MattF says:

    I’m a bit surprised. After all, Obama held on to Sebelius until the Obamacare screwup was fixed. I’m guessing: 1) VA problems are not fixable in a finite amount of time, 2) Shinseki made some significant negative contribution to the problem, 3) Dems were driving the bus.

  33. 33
    Schlemizel says:

    @Goblue72:
    Where is Pershing & the horse cavalry when we need them? SIGH

  34. 34
    🌷 Martin says:

    My slightly OT rant:

    One of the biggest problems with management in this country is that it has become professionalized and detached from the actual job to be done. I don’t fucking care what kind of grades you got at Wharton, if you do not know the fundamental job to be done, in detail, you cannot manage and oversee workers effectively. You will inevitably put counterproductive metrics on workers, that cause them to jump through your little performance hoops rather than do what they were hired to do, they will resent the work, you will miss problem areas that would be obvious to the people on the ground, and you will fail to move your organization forward because you have no fucking idea how it got to where it is.

    I appreciate Shinseki doing this job. I think he was actually better for the job than most. But you need a health care professional running the VA. You need health care professionals in middle management at the VA. Finding people with subject matter expertise and strong management skills isn’t easy, but it is possible. Finding ones that will tolerate Washington politics on top of that is even harder, but I’m certain that it can be done. The director should have lieutenants that know every major level of the VA – admitting/administrator, nurse, doctor, mental health, etc. The VAs job is health care, and it should be damn near healthcare professionals from top to bottom.

    The military is better than most organizations of not falling into this trap, but whenever I see shit like this come down, it almost always at some level reveals that the oversight didn’t happen because nobody at Prestigious B-School™ taught that admittance would cut corners in order to make quota, or that upstream compounding pharmacy might be undercutting the bid by not being safe. You’ve got to know the fucking job to do the fucking job.

  35. 35
    🌷 Martin says:

    And FYWP moderation!

  36. 36
    Suffern ACE says:

    @Alex S.: Yep. the Hospital system is actually the most important thing he runs. Yeah, there are other benefits to manage, but the hospital system is the one the public thinks of. Its like SSA not being able to send out checks but happy that their relationship with the treasury department is going smoothly otherwise.

  37. 37
    am says:

    Bullshit, stupid move. Furthers the narrative that Democrats are weak on defense, and that government can’t do anything right. Lets the Republicans take further retribution of a political enemy. Anyone that stands up to a Republican administration is an idiot. They’ll run you out of town on a rail and never forget.

    The worst part is I’m starting to believe the narrative. Stupid, spineless party. If only the other party wasn’t a collection of sociopathic loons.

  38. 38
    mike in dc says:

    Give vets gold-plated health insurance–no deductibles, no copays and no annual limits, no restrictions on choice of provider–and let them go wherever they want for healthcare. I don’t see how the VA can be fixed on any reasonable timetable or at any reasonable cost.

  39. 39
    Belafon says:

    @am:

    Furthers the narrative that Democrats are weak on defense

    Yeah….no.

  40. 40
    Belafon says:

    @mike in dc: That won’t really save any money, not will it cover all of the situations. Do you want BCBS deciding if PTSD is treatable?

  41. 41
    Corner Stone says:

    Surprised Shinseki lasted this long.
    Now all the problems at the VA will be the Democrats/Obama fault, and the decades of massive underfunding will never be mentioned again.

  42. 42
    balconesfault says:

    I agree about the funding thing … but then Shinseki should have spent the last few months since the GOP blocked VA funding expansions in the Senate banging that drum long and loud to the media. This isn’t a game for the faint of heart.

  43. 43
    Elizabelle says:

    Interesting from NYTimes.

    But some in Washington [some who?] question whether it was the correct decision to put Mr. Shinseki, a military man who became a darling of Democrats after he famously clashed with the Bush White House over the war in Iraq, in charge of an agency that is essentially a health service organization. Some suggest the appointment was more symbolic than substantive.

    That’s immediately followed by a quote from a GW Bush military adviser saying of Shinseki, nice guy, not a virtuoso manager. (Uh huh.)

    But maybe the next Secretary should be health-service oriented. Someone versed in good healthcare and innovative technology. Less emphasis on military, although there are probably some good candidates from within the services’ healthcare programs.

    Personally, I would love to see a nun on the bus run the VA, but that’s probably asking too much …

  44. 44
    balconesfault says:

    @Belafon: Not only that – but I would imagine that for a LOT of the conditions that vets suffer from, familiarity with the conditions that vets suffer from is really important. Your local mediclinic isn’t going to have a damn clue.

  45. 45
    Gin & Tonic says:

    @mike in dc: Give vets gold-plated health insurance–no deductibles, no copays and no annual limits, no restrictions on choice of provider–and let them go wherever they want for healthcare.

    Why? What’s the fundamental difference between, say, a BM3 who gets a life-altering injury in a training accident 10 miles off San Diego and a coal miner who gets a life-altering injury a mile down in Utah?

  46. 46
    D58826 says:

    From the point of view of Congress it’s a simple 3 (+1) step process
    1. fire Shinseki
    2. declare mission accomplished
    3. go back to their vacations
    4. for the neocons and GOP its payback for him being correct about Iraq.

    I would like to see Obama look around and nominate (w/o asking first to maximize embarrassment) the GOP senator who has been yelling the loudest about the scandal while doing the least to fix it. McCain/ Graham come to mind. Tell them they have 6 months to work with Congress to fix it. The IG will come calling to see if its done.

    There is a long piece on Huffington about the VA’s sad history. Gen. Omar Bradley in the 50’s lead an investigation that listed the many sins of the old VA system (before it was a cabinet post). Not much gas changed.

  47. 47
    jl says:

    @MattF: Under the assumption that Obama’s action is not 100% a jackass cave-in to jackasses for political cover, my guess is that it was determined Shineski is not particularly needed anymore to solve the problems, so might as well get rid of him. As Raven said, if anyone understands that drill, it would be Shinseki.

    I was going to vent cynically about the crisis, but other commenters beat me to all the major points. Big sources of problem is underfunding after a surge in demand due to one botched war and one criminal blunder war. And what has become apparently a administrative scamming of a bonus system designed to reward efficient management of waiting lists, which may have gone over the edge into criminality.

    I have seen nothing from the GOP or the cowardly Democrat legislators calling for Shinseki’s head to indicate that they understand, or even care to understand the underlying problems.

    An additional ;cynical comment that I have not seen above, is that I note the contrast in how delayed and denied care is treated for veterans as opposed to ordinary civilians. It is asserted by Congresscritters as apparently obvious that all these vets died because of delayed care, from what I have seen in the news. That is an oddly generous and commie view of the role of medical care in population health. Since when has anyone been concerned about that? For anyone else, cynical politicians and BS pundits bend over backwards to explain that in the U.Sl the moochers get too damn much care, and would strain to fine reasons to explain why waiting or denial of care is not a big deal really.

    And, I suspect that some GOPers in their rushed proposals to shove the veterans into the private system, plan on that general attitude to sweep the problem under the rug, as well as start another attack on the VA. Once the vets are shoved into the private health care system, what they get will be by definition the very best, since crony corporate buddies are making bank off of them.

    So, hope I did my part to add to the cynicism count on this thread. You are welcome.

  48. 48
    Corner Stone says:

    A month ago or so, when the “scandal” news broke, why didn’t all WH members and all elected Democrats mention in every interview that the GOP routinely blocks funding for the VA?

  49. 49
    Alex S. says:

    @balconesfault:

    Yes, if money is the main problem, then it needs to be pointed out. Maybe his successor will do that (Maybe Jim Webb? Or Hillary, hehe).

  50. 50
    hoodie says:

    @mike in dc: Never as cost effective and open to massive abuse and poor care. Think about the predators that go after education bennies for vets. You might be able to shunt some conventional treatments to private providers, but there will always be a need for the VA. Conventional hospitals and docs don’t do rehab from war wounds, PTSD, etc.

  51. 51
    Corner Stone says:

    Isn’t one significant part of this problem that the system simply can’t recruit and sustain enough doctors and caregivers to meet demand?
    Is that purely a function of pricing/remuneration, or something much more complicated?

  52. 52
    D58826 says:

    @hoodie: I was going to make the same point. Assuming you could segregate the various medical conditions, let vets go to a local hospital for ‘normal’ stuff like high blood pressure, cataracts, cancer, etc. Save the VA for truly service related issues that require a unique medical skill set. Something like the hospitals that have a specialized burn unit. All the other hospitals in the are feed burn patients to the special unit.

    Of course not sure that this can be done. I may be wishing for pink unicorns but if it was possible it would lighten the load at the VA hospitals and for routine stuff the vet and his/her family wouldn’t have to travel so far

  53. 53
    catclub says:

    @Elizabelle: Kathleen Sibelius.

  54. 54
    Villago Delenda Est says:

    @Patrick: That was a safe prediction, because there’s no way in hell it would happen.

    The deserting coward does not belong on Mt. Rushmore. He belongs dangling from a lamppost.

  55. 55
    catclub says:

    Best Care Anywhere, the book, was written in about 2002, maybe 2004. They say that FEMA was an excellent organization at the end of the Clinton administration.

  56. 56
    ruemara says:

    The man was scapegoated. And how can you correct things when you keep getting rid of the person in charge of fixing things?

  57. 57
    Villago Delenda Est says:

    @Corner Stone: The VA is swamped with all the new veterans returning from the deserting coward’s marvelous adventures in Asia. Couple that with WWII vets who are all geriatric now, rapidly being joined in that status by Korean War and Vietnam vets, and yes, the system in overburdened. It still provides pretty good care, even if I have had to wait four months for an audiology appointment.

  58. 58
    raven says:

    @jl: If you are not cynical about the VA you are not a vet.

  59. 59
    Villago Delenda Est says:

    @catclub: Democratic Presidents appoint professionals to run FEMA.

    Rethuglicans appoint political hacks.

    There is a difference, no matter what that megalomaniac jackass Nader says.

  60. 60
    jl says:

    @Corner Stone: As I said above, I think it is inadequate funding, and a bonus system for administrators that became dysfunctional in the face of inadequate funding, given the surge in demand.

    I’m not familiar with all the efficiency metrics that compare the VA to other types of providers, but clinicians and health economists who are, say it has become a very efficient and high quality provider for many type of care. Very forward looking move to electronic records and inventory control, aggressive delegation of authority from MDs (who in the U.S. are vastly overqualified and overpaid for a lot of the care they monopolize -thanks to the AMA) to allied health professionals. Nurses, pharmacists, NPs and physicians assistance love to work for VA since they get so much more authority than in rest of SOP U.S. health care system.

    Maybe Cole or Mayhew can get someone with expertise to do a special guest post on it.

  61. 61
    Corner Stone says:

    I love how MSNBC keeps asking Friends of Martin from DIA organs on to defensesplain away the paper trail at the NSA re: Snowden. The one they said they couldn’t find for a year.

  62. 62
    Villago Delenda Est says:

    @jl:

    I have seen nothing from the GOP or the cowardly Democrat legislators calling for Shinseki’s head to indicate that they understand, or even care to understand the underlying problems.

    The Dems are craven, and the Rethugs will attack the near sheriff for anything that happens, even remotely bad, at the Federal level.

    Shinseki is a scapegoat, and as others are indicated, a scalp for neocon scum.

  63. 63
    Hagiographer says:

    Place your bets as to which member(s) of the Obama Cabinet will last all 8 years. With Shinseki out, we’ve got Holder, Duncan, Vilsack, and Donovan still in play. My money’s on Duncan, although Holder has lasted far longer than anyone might have predicted given everything he’s been involved in.

    Trivia: Who was the only Bush II cabinet secretary to last his entire presidency?

  64. 64
    Villago Delenda Est says:

    @Elizabelle: A bureaucracy is a bureaucracy.

    The fucksticks at the NYT don’t get that, I guess.

  65. 65
    catclub says:

    @jl: Or SoonerGrunt. You made points I was about to type.

    I think it would be funny to find out how much a gold-plated private insurance policy for every eligible Vet would cost. I would guess a factor of three more than the total VA.

  66. 66
    Corner Stone says:

    @Villago Delenda Est: I think that part is well understood. At least by anyone who isn’t in the GOP. My question is, how does the system put more assets in place? More funding, lack of supply, or lack of infrastructure, etc?
    Does funding and reimbursing caregivers mitigate some of the issues or is a total ramp up needed from all sides?
    Do enough caregivers exist if we just push money at them?

  67. 67
    MattF says:

    @Corner Stone: It’s a little… peculiar that NSA is implicitly suggesting Snowden wouldn’t realize that they would keep his emails. Hmm.

  68. 68
    catclub says:

    @Hagiographer: VA Secretary?

  69. 69
    Mike in NC says:

    Another scalp for the Benghazi Brigade. Not as good as impeaching the dusky usurper, but it’ll suffice for this week.

  70. 70
    jl says:

    @hoodie: I agree. Paying for access to private providers might be a necessary short urn recourse, but it will have to be watched and monitored carefully (which will itself require expertise and money).

    You can gold plate and remove deductibles and co-pays all you want. You will still have a large number of vets with specialized health issues like brain damage, PTSD, amputations, exposures to very unusual toxins, and history of severe trauma dumped into a system that does not deal with those very often.

    And you can write any kind of blank check you want for each veteran, but you will still dump them into a system with poor quality control and little accountability. Give the insurers and providers a thousand, ten thousand, a million per vet, they will still operate on the principle that if they can get the schmuck in and then back out for a dollar less they will make a dollar more. But it will look nice on the surface, at least as long as it gets the issue out of the news, until some outrage shoves it back into the news in a few years. IMHO.

  71. 71
    Mnemosyne says:

    @Elizabelle:

    Someone versed in good healthcare and innovative technology. Less emphasis on military, although there are probably some good candidates from within the services’ healthcare programs.

    Someone who knows the VA better than I do might be able to answer this, but do they have some kind of “surgeon general” for the VA who oversees the medical side? It would be pretty nice to have someone familiar with the actual medical practice at the VA overseeing the reforms.

  72. 72
    Corner Stone says:

    @MattF: How so?

  73. 73
    MattF says:

    @Corner Stone: Well, for one thing, keeping emails is what NSA does for a living. And obviously, Snowden knows that.

  74. 74
    Corner Stone says:

    @jl:

    Give the insurers and providers a thousand, ten thousand, a million per vet, they will still operate on the principle that if they can get the schmuck in and then back out for a dollar less they will make a dollar more

    Indeed. The competing interests of care vs profit.
    Lovely system.

  75. 75
    Jeremy says:

    @jl: I think the cowardly democrats were the reason he sent in his resignation. Even Boehner and Cantor didn’t call for his resignation.

  76. 76
    jl says:

    @catclub: thanks, I forgot about Soonergrunt. Maybe if we ask nice, he can post something on history of VA health system reforms.

  77. 77
    Villago Delenda Est says:

    @Corner Stone: Funding, as in staffing, is crucial.

    There just aren’t enough people in all support areas (ask Soonergrunt about this) to keep up with the patient load. I just talked with my primary care provider in March, for a checkup, and he told me he’s retiring at the end of September, and there is no MD available to take his place at the clinic I visit. So that’s one less doctor for veterans in a community of some 250000. Sure, not all of those are vets, of course not. But there are a lot of vets who depend on the VA for care, and one less doctor is going to be telling.

    We need to use some innovative methods to help with the staffing issues. Sign up to be a GP or work for the VA after your residency, and your student loans are forgiven, for example. Sure, you won’t be able to go into those high paying specialty jobs, but if you were after money, you should have become an investment bankster, or a mafiosi. Like there’s any difference between the two nowadays, anyways.

  78. 78
    MattF says:

    @Villago Delenda Est: It can make quite a difference– one primary care physician can have over a thousand ‘regular’ patients.

  79. 79
    Corner Stone says:

    @MattF: Ok, thanks.
    The schmoe MSNBC just had on said, “Ed Snowden took some 1.7M documents but he somehow didn’t take copies of his own emails with him?! That’s not credible.”
    Which I loved because after a year of denying there were ANY emails, they have now begun to really wash over the fact that, yes, there’s this *one* email we were able to find. After a year. But it’s really nothing. Nothing at all, actually.

  80. 80
    CONGRATULATIONS! says:

    Dems piling on the “shitcan Shinseki” bandwagon is the most disgraceful thing I’ve witnessed from my party since the Dems caved utterly to the GOP/neocon establishment post 9/11.

  81. 81
  82. 82
    Corner Stone says:

    @Villago Delenda Est: I think we need to break the AMA cartel. Let ’em be like lawyers, a drug on the market.

  83. 83
    jl says:

    @Corner Stone: The totally ‘free market’ system of Switzerland that totally free market economists and politicians were touting as an alternative has several totally ‘free market’ approaches to solving the accountability and control problem in private providers.

    One is very strict comparative effectiveness analysis (aka ‘death panels’) to ensure only efficient protocols and treatments used.
    Another is total, top to bottom, open book audits for any provider or insurer whose costs get out of whack, everything from insurer investment portfolio and how reserves are handled to what they are paying for aspirin.

    We do not have those in the U.S. because that would be the road to genocide and totalitarianism.

  84. 84
    shelley says:

    Crocodile tears allround

  85. 85
    Eric U. says:

    is there a list of dems that called for him to resign?

  86. 86
    Elizabelle says:

    @jl:

    You can gold plate and remove deductibles and co-pays all you want. You will still have a large number of vets with specialized health issues like brain damage, PTSD, amputations, exposures to very unusual toxins, and history of severe trauma dumped into a system that does not deal with those very often.

    Yup. Badly injured vets, returning to a jobless recovery. And our younger veterans, and Viet Nam and Gulf War vets too, got thrown into the Great Recession with good jobs with benefits fading, fading. Government jobs and programs they might have filled or benefited from have been cut. Their families are stressed economically too.

    So they need the VA that much more.

    And how have any of PBO’s job initiatives fared in the GOP House?

    It’s systemic all right, and not limited to the Veterans Administration.

  87. 87
    Villago Delenda Est says:

    @jl: Not to mention Sharia Law.

  88. 88
    Corner Stone says:

    Boehner just crucifying D’s and the WH on the VA.
    This is going to be just awesome.

  89. 89
    Fair Economist says:

    The VA has funding problems, mostly because of the Republicans, but the coverups at hospitals are not primarily a funding issue. Shinseki really *was* responsible for sussing that out. Sebelius’ inadequate oversight over the exchange launch is not comparable because a) that was a once-off thing and b) you didn’t have deaths resulting directly from the problem. There must have been hundreds or thousands of complaints about treatment delays rattling through the system; there’s no excuse for Shinseki not having made sure that coverups would be exposed.

  90. 90
    Belafon says:

    @Corner Stone: And, I’m sorry, but the email doesn’t actually do anything for Snowden’s claim that he brought the issue up. “Is an Executive Order equivalent to a law?” is not raising issues. Especially since the date on the email is after he started corresponding with Greenwald.

  91. 91
    jl says:

    An underlying problem, that is tied into a potential problem for the ACA is an undersupply of MDs in the U.S., some of whom earn way too much money.

    The U.S. has a low ratio of health providers to the population. It may not look low if you just look at MDs compared to some high income countries. But that ratio alone hides fact that in those countries, care that MDs have monopolized in the U.S. (often for no good reason other than more $ for them) is delegated to allied health professions, and those people are plentiful in those countries.

    I don’t know if primary care doctors in the U.S. are still wildly overpaid compared to other countries, but specialists still are, the the proportion of U.S. docs who are specialists is very high compared to other high income countries. Has been almost impossible to get adequate numbers of new docs into primary care, because AMA specialists control determining rules for reimbursement, so being a specialist is the way the way to make a living and raise a family while being able to pay back loans.

    So, getting more docs is not an easy proposition in the U.S. right now. Might want to talk about barriers for import of health professionals in the U.S., but Dean Baker talks about that all the time at his Beat the Press blog at CEPR.

    Edit: the point being for VA is that getting more doctors may take a while and be quite expensive. AND, that may be the real underlying problem that caused the scandal, in addition to criminal record fixing to get bonuses and hide problems.

  92. 92
    piratedan says:

    @Corner Stone: the e-mail to the NSA is hardly an example of whistleblowing CS, in it Snowden asks for clarification regarding an Executive Order not a revelation that the NSA was exceeding it’s mandate or violating constitutional rights of citizens.

  93. 93
    Belafon says:

    @Corner Stone: I won’t buy anything from Boehner until he gets around to repealing the law passed by Republicans under Bush that prevented me from going to the VA with an injury I suffered while in the Navy because I make too much money.

  94. 94
    Corner Stone says:

    @Belafon: Oh, criminy baby jeebus with tartar sauce on the side.
    You think this is the ONLY email the NSA has? Shit.
    I will be so happy to see you and your brethren and sistren here tell us all how this email doesn’t prove nothing! Nothing, I tells ya!
    Man, talk about history repeating itself.

  95. 95
    Corner Stone says:

    @piratedan: Loving it!

  96. 96
    RaflW says:

    So is McConnell also resigning in recognition that his Senate maneuvering to scuttle VA funding is a serious contributor to this problem?

    Huh, I guess he isn’t.

    Well, then, this is mostly a meaningless scalp, and while I fully support greater scrutiny of VA processes and a swift improvement, I also know that bullshit walks and money talks.

  97. 97
    Elizabelle says:

    @Eric U.:

    NYTimes vaguely on your question, from article on VA doctor shortages:

    In Washington, the number of lawmakers in Congress calling for the resignation of Eric Shinseki, the Veterans Affairs secretary, grew by late Thursday to nearly 100 — including almost a dozen Democrats

    I know both Virginia senators, Democrats Mark Warner and Tim Kaine, were in the resignation chorus. Warner is up for re-election this fall.

    ETA: Tammy Duckworth urged resignation.

    Saw some soundbite this morning that maybe 9 of 14 Democratic senators up for re-election in 2014 were clamoring for Shinseki’s resignation. Don’t hold me to that; was just passing through a room with a TV on …

  98. 98
    Corner Stone says:

    @jl: Tort reform!

  99. 99
    FlipYrWhig says:

    Has the media already moved from “Obama isn’t doing That Thing, which makes him look weak” to “Obama took too long to do That Thing, which makes him look weak”? That’s the usual trajectory for this kind of story.

    Also, can I just say, “failure to prevent a systemic cover-up” seems like a pretty goofy way to describe the nature of the wrong. Is it possible to _prevent_ a cover-up? I think I’d want to say, if I wanted to criticize the guy, that there was something wrong with his attempt to deal with the cover-up, not that a cover-up happened on his watch.

  100. 100
    Corner Stone says:

    @Belafon: I also don’t give a shit what Boehner has to say. But it’s just further that the entire GOP, part of the D party and most all the media will commence full scale bloodlust to blame all of this on Shinseki and/or Obama and every last one of them will deep six the non-funding/lack of funding issue that is decades old.
    Assholes love the troops. They love them, dammit!

  101. 101
    am says:

    @Belafon:

    Look, I don’t even recognize your name offhand, and you owe me nothing… but could you elaborate a bit? do you not think that narrative exists? do you think this doesn’t add to that narrative? are you just declaring you think the narrative is unjustified? I would agree on the last one but not the first two.

  102. 102
    FlipYrWhig says:

    @Elizabelle: That sounds like the same reason for why the “Bush tax cuts” got renewed in 2010: Democrats up for reelection wanted the President to make the issue to go away.

  103. 103
    Gene108 says:

    @Patrick:

    I think with the media it is all about setting expectations.

    The GOP has stated for 5 years their goal is to fuck Obama’s happiness.

    Obama said he’d fix the VA.

    The GOP is meeting it’s stated goals, while Obama is not. Thus Obama gets the blame for failing to live up to his hype.

  104. 104
    Cacti says:

    @Belafon:

    “Is an Executive Order equivalent to a law?” is not raising issues. Especially since the date on the email is after he started corresponding with Greenwald.

    He’s hanging his “whistleblower” hat on an innocuous question about the hierarchy of legal authorities?

    Really?

    Really?

  105. 105
    Corner Stone says:

    @Cacti:

    He’s hanging his “whistleblower” hat on an innocuous question about the hierarchy of legal authorities?

    Only a moron would conclude that was what happened here. Oh, wait…

  106. 106
  107. 107
    Original Lee says:

    @MattF: I think part of the problem is that they didn’t call up the vets on the secret list to start getting them care until this week, if what I’ve been hearing is correct. Shinseki should have ordered this done the day the scandal broke and figured out how to pay for it later.

  108. 108
    Heliopause says:

    @Corner Stone:

    A month ago or so, when the “scandal” news broke, why didn’t all WH members and all elected Democrats mention in every interview that the GOP routinely blocks funding for the VA?

    Maybe because the Dems have signed off on the current funding levels.

  109. 109
    Corner Stone says:

    @Original Lee:

    I think part of the problem is that they didn’t call up the vets on the secret list to start getting them care until this week

    If that’s accurate (and I’m not saying it isn’t), that is the absolute height of timidity and failure. The definition of fail.

  110. 110
    Corner Stone says:

    @Heliopause:

    Maybe because the Dems have signed off on the current funding levels.

    Noooo…what are you talking about?

  111. 111
    Cacti says:

    @Corner Stone:

    Only a moron would conclude that was what happened here

    Speaking of morons, what kind of person who was “trained as a spy” would neglect to keep copies of their complaints to superiors?

    If one is claiming whistleblower status, you’d think they might be able to produce a scrap of evidence to support it. Especially if they managed to purloin over 1 million classified documents.

  112. 112
    pseudonymous in nc says:

    The president should nominate every GOP senator, one at a time. Get the bloviating fuckers to turn down the job.

    The fundamental problem with the VA in terms of staffing/capacity is that a lot of doctors don’t want jobs that only pay $150k a year when they could be earning a lot more in cushier private-sector jobs — and there’s lots of muttering about the kind of doctors willing to take those $150k/year jobs.

  113. 113
    Corner Stone says:

    @Cacti: What kind of govt agency would lie for a year about something they obviously had? Why are they continuing to lie about further existing emails?
    And were you just being interviewed on Andrea Mitchell Reports? Because you sound just like that douche from Defense.

  114. 114
    pseudonymous in nc says:

    @jl:

    the point being for VA is that getting more doctors may take a while and be quite expensive.

    Yep. And given that the med school system is now built around churning out specialists because That’s Where The Money Is, it’s the kind of thing that will take a long time to sort out. But getting it right, by offering the right incentives, will have broad benefits.

    The VA offers loan forgiveness for doctors with a focus on primary care, but primary care is still considered the option for med students who weren’t good enough to become specialists.

  115. 115
    Hill Dweller says:

    @Heliopause: Obama(and the Dems) increased VA funding significantly when he came into office, but they’ve spent the last few years trying to defend the increased funding levels from the wingnuts wanting to cut it. Moreover, while the increase is/was helpful, it still isn’t enough to keep pace with the ever increasing numbers of vets using VA healthcare.

  116. 116
    Bobby Thomson says:

    @Heliopause: If by “signed off on the current funding levels” you mean “voted for a bill that underfunded the VA after the Republicans filibustered adequate funding, because the alternative was no funding at all,” then yeah.

  117. 117
    SiubhanDuinne says:

    Reading all these comments, I keep wishing there were a real-life Margaret Houlihan. She’d be perfect. For one thing, I seem to recall from the final episode of M*A*S*H that she was planning to get an M.D. She was already a helluva nurse and an experienced administrator (eventually even admired and loved by her nurses, though it took a while), and if she stayed in the Army she would surely be flag rank by now. Plus, there’s never been a woman in charge of the V.A. before. Plus, she takes no shit from nobody, nohow. Plus, “Secretary Hot-Lips.”

  118. 118
    Original Lee says:

    @Corner Stone: It’s kind of hearsay, but the nurses’ grapevine is usually pretty good for this kind of stuff. In support, I heard a soundbite of what one of the VA hospital administrators said in testimony yesterday, to the effect that they would “finish calling the affected vets by the end of the week.” Just sounds to me as if Shinseki didn’t chew enough butts fast enough or soon enough.

  119. 119
    Cacti says:

    @Corner Stone:

    What kind of govt agency would lie for a year about something they obviously had?

    Lie about what.

    Snowden has said he made multiple formal complaints.

    So where are they?

    Is he lying, or was the smartest guy in the room just too dumb to take copies of them along with his stolen materials?

    If Glenn Greenwald could have named names and pointed fingers at officials who ignored complaints, he’d have been shouting them from the housetops months ago.

  120. 120
    jon says:

    This is great news for John McCain!

    Imagine him in charge: getting funding, getting things done, bombing all the private hospitals, getting more funding, getting more things done….

  121. 121
    Corner Stone says:

    @Cacti: They’ve been denying for months that they had any emails from Snowden on this matter.
    But, I, for one, appreciate you jumping in early and often on this grenade.
    Loving it!

  122. 122
    RaflW says:

    @Heliopause:

    Maybe because the Dems have signed off on the current funding levels.

    If by “signed off” you mean that Democrats didn’t use the magic sparkle unicorn to pass a funding increase past Mitch McConnell’s Senate roadblock and Boehner’s pigpen of unruly faux-troop-lovers.

    ETA: also what Bobby said above.

  123. 123
    Hill Dweller says:

    @Original Lee: I think Shinseki could have survived if he hadn’t initially said this was just a problem in Phoenix. Once the IG’s preliminary report came out, saying the secret lists were commonplace, it sealed his fate.

  124. 124
    Cacti says:

    @Corner Stone:

    They’ve been denying for months that they had any emails from Snowden on this matter.

    They’ve said there was no record of any formal complaint.

    Snowden has said he made formal complaints to compliance officials.

    So, where are they?

    Why can’t “trained spy” produce any paper trail of his alleged complaints?

  125. 125
    Villago Delenda Est says:

    To really deal with these problems with the VA, we’re going to have to address staffing, and to do that, we’re going to need to increase funding, and to do that, we’re going to have to raise revenue, and we simply cannot ask the parasite overclass to pay any more in taxes, because it would make the baby Jesus cry if we did that.

    So fuck the veterans. The fee fees of the parasite overclass are paramount.

  126. 126
    Villago Delenda Est says:

    @Hill Dweller: That is probably true. It’s obvious that admins were gaming the system everywhere. Sometimes offering monetary incentives has unintended consequences. This is one of those times.

  127. 127
    Heliopause says:

    @Hill Dweller: @Bobby Thomson:

    I’m afraid Dem leadership supported the recent budget and continuing resolution compromises. They could perhaps rightly complain that the GOP made them do it, but then they’d look like a bunch of ineffectual dumbasses, wouldn’t they.

  128. 128
    Hill Dweller says:

    @Heliopause: I’ll agree the continuing resolution agreement sucked, if for no other reason than it omitted an unemployment insurance extension. That said, it didn’t cut VA funding. In fact, the WH and congressional Dems have done an admirable job defending the funding increases Obama got through in his first couple of years.

  129. 129
    jl says:

    @pseudonymous in nc:

    ” but primary care is still considered the option for med students who weren’t good enough to become specialists.”

    You are being a little unfair to some brilliant and idealistic people I know, but it is true that there are not enough of them, or at least not enough who have half a chance of making it work on a primary care doc’s pay.

    Edit: may have been unfair to you, I missed ‘considered’ in your comment. Many excellent students who I deal with LOVE the idea going to the VA, at least for residencies.

  130. 130
    jl says:

    Not sure if posted above, but interesting article at TPM

    Why Firing Shinseki Won’t Do Anything To Fix The VA
    http://talkingpointsmemo.com/c.....fix-the-va

  131. 131
    Cassidy says:

    Bullshit.

  132. 132
    pamelabrown53 says:

    @Corner Stone: The NSA was right,,,at least according to Snowden’s assertion that he was alerting the hierarchy and creating a paper trail. The found e-mail doesn’t support Snowden’s claims.

  133. 133
    Corner Stone says:

    @pamelabrown53: Loving it!

  134. 134
    Original Lee says:

    @Hill Dweller: I think he could have ridden it out even with that if they had jumped on getting the vets care right away. For instance, if somebody could have said to Tammy Duckworth, “We have been getting in touch with these vets and 25% have had office visits already,” Shinseki would probably still be at the VA.

  135. 135
    nellcote says:

    Sebelius for VA Sec!!!

  136. 136
    Ruckus says:

    @🌷 Martin:
    That’s not off topic at all. And it’s very good.

  137. 137
    raven says:

    @Gin & Tonic: Because heroes that’s why.

  138. 138
  139. 139
    pseudonymous in nc says:

    @jl: Yeah, I have the utmost respect for people who go into primary care, and the rest of the world shows that general practice is the foundation of a proper healthcare system.

    But there’s definitely the perception in the US that it’s the “bottom quartile of their graduating class” option for med students who couldn’t get into a lucrative speciality field.

  140. 140
    Mnemosyne says:

    @nellcote:

    I would have no problem with that. She has healthcare experience, which is what’s needed right now. She has management experience. She knows how to recognize bullshit excuses from providers when she sees them. Seems like a pretty good fit.

  141. 141
    Cervantes says:

    @Corner Stone: Overheard in New York: “Doctor, it hurts when I think like this.”

  142. 142
    Corner Stone says:

    @Cervantes: “This is it! The ONLY email! The absolute *final* word on the question of did he or didn’t he send “the right kind” of emails! Finit!”
    {and when more come out I’ll just dissemble and parse then, too}

  143. 143
    Sister Machine Gun of Quiet Harmony says:

    @mike in dc:

    I would be fine with giving Vets gold plated healthcare. However, VA care is drasticly underfunded and it costs A LOT less than private health care. Congress would never fund it.

  144. 144
    fidelio says:

    @SiubhanDuinne: Having worked with a federally funded state-government program for the past 30 years, I have to say the budget shenanigans and OMG-THE-DEFICIT-WIILL-EAT-US-ALL!!!1!!!!eleventy!!1!!! shrieking have been hard on every single agency, federal, state, or local that depends on federal funding for all or part of their operations. The VA was not cut as closely to the bone by operating on continuing resolutions as some agencies, but the lack of adequate funding (and please note who kept refusing to provide adequate funding through special legislation that would have bypassed the Budget Follies kthx) cannot be a help in an agency which is provding medical care to the aging veterans of three major wars (WWII, Korea–remember Korea?–and Vietnam) as well as the new veterans of Gulf I, Iraq and Afghanstan, and also handling lots and lots and lots of paperwork.for benefits and pensions.

    Unless Shinseki had been able to pull a miracle out of his ear (and he didn’t have the funding for that, and spare me the Green Lantern theory of management, please world–money talks, bullshit walks) they were going to get him. An honest man makes no friends in Washington. Remember Richard Clarke? Joseph Wilson? My grandma used to say “Speak the truth and shame the devil” but we must remember the devil will find a way to get even.

  145. 145
    Cervantes says:

    @Corner Stone: You know, “parse” was a perfectly good word for 5 centuries, until Gingrich and company ruined it in the late 1990s.

    Anyhow, yes, I agree, it is pretty amusing what people can bring themselves to say. Or embarrassing — that may be the word I’m looking for.

  146. 146
    AxelFoley says:

    @Eric U.:

    I know Al Franken and Alison Grimes were two Dems who called for Shinseki to resign.

  147. 147
    am says:

    @jon:

    If Obama were more sadistic, he would release a statement that his preferred nominee to replace Shinseki was McCain and let JM have to weasel out of it in the public eye.

  148. 148
    karen says:

    Does PBO appoint the next Sec of VA or does it have to be run by Congress? I hope it doesn’t because the GOP will never let one get through.

  149. 149
    Cervantes says:

    @karen: The Senate has to confirm or reject Cabinet nominees. A majority vote will do.

  150. 150
    rea says:

    @Alex S.: “he was in office for more than 5 years and his portfolio isn’t that big.”

    This is the guy that Bush fired as Army Chief of Staff for saying that we didn’t have enough troops to win the Iraq War. That always seemed like a pretty good credential to me.

  151. 151
    rea says:

    @SiubhanDuinne: “Margaret Houlihan. She’d be perfect . . . if she stayed in the Army she would surely be flag rank by now.”

    A Korean War major? Hell, she’d be in her 90s now.

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