Our executive culture of sloth

LeRoy Goldman
The Shadow Knows

Published: Sunday, April 7, 2013 at 4:30 a.m.

The entire executive branch is vastly overstaffed. Its accumulated dead weight induces monumental inefficiency. It stifles creativity and competence, and wastes billions of dollars.

Let's look at just one specific example of this outrage, the Department of Veterans Affairs. It is the second largest government agency. It owns and operates a vast medical care system that includes 171 medical centers, 350 outpatient clinics and 150 nursing homes.

More than 280,000 persons are employed by the department, and the president's budget for it this year is $140 billion. That budget is mainly divided into two major categories — mandatory spending of $75 billion for disability, pension and education benefits, and $64 billion for the operation of its medical care system. Its secretary is retired four-star Gen. Eric Shinseki.

The department has been under increasing criticism and scrutiny for several years because of its growing backlog of disability, pension and education claims. There are more than 900,000 such claims, and 600,000 of them are backlogged. The average wait for benefits is now approaching a year. In Los Angeles and New York City, first-time filers now are having to wait more than 600 days.

The rising flood of claimants comes as no surprise. More than 1 million veterans have returned from Afghanistan and Iraq over the past decade. In addition, Vietnam veterans have recently become eligible for disability based upon exposure to Agent Orange.

The backlog is caused by the fact that the department has failed in its attempts to process the claims electronically. Ninety-seven percent of the claims are on paper. Aaron Glantz of the Center for Investigative Reporting has obtained documents that show the expenditure of half a billion dollars in the failed attempt to computerize the claims process over the past four years. Glantz said, "There's a complete dysfunctionality; there's bad management at most of their regional offices."

At a recent hearing before the House Committee on Veterans Affairs, testimony revealed that promises the VA and the Department of Defense had made to merge all troops' medical records into a single electronic system had not been kept due to bureaucratic infighting. Committee Chairman Jeff Miller, R-Fla., urged the VA to fire problematic employees rather than transfer them from one regional office to another. He called that "a bureaucratic shell game."

Shinseki now promises progress by the end of 2015. Why would you believe that? It's on his watch that the problem exploded and the bureaucrats were allowed to dither.

And how about the medical care side of the VA? About two-thirds of the department's 280,000 employees are involved in medical care. It's a system that has long been troubled.

In 2009, 10,000 veterans were notified that they needed to be tested for hepatitis B and C and HIV because of improper cleaning of endoscopic devices at multiple VA hospitals. The improper procedures had occurred several years prior to their notification.

In a follow-up report by the VA's Inspector General's Office, it became clear that fewer than half of the VA facilities selected for surprise inspections had proper training or guidelines for colonoscopies. Investigators found that valves were missing from the devices and the devices' tubing was not cleaned between patients.

Shinseki told Congress that he would take disciplinary action.

In 2010, the Nuclear Regulatory Commission fined a VA hospital in Philadelphia for committing an unprecedented number of radiation errors in treating prostate cancer patients. The number of errors was large and occurred over a six-year period from 2002 to 2008.

A couple of months ago, it was disclosed that a VA hospital in western New York may well have been responsible for exposing at least 700 diabetic patients to hepatitis B and C and HIV by reusing insulin pens on many patients. What this amounts to is the highly risky practice of needle sharing. The practice had been going on since 2010. Shinseki was asked by Congress to get to the bottom of the issue.

Why do we need the VA medical care system? We don't. Polls show that the American people are overwhelmingly opposed to socialized medicine. Socialized medicine is when the government owns the hospitals, and the doctors and nurses work for the government.

That's your VA system! Let's get rid of it and give our veterans a VA card that will enable them to get treated in the hospital of their choice by the doctor of their choice.

And don't think for a moment that firing Shinseki will fix these problems. Shinseki, and every other Cabinet secretary, doesn't run his department, and he wastes little time trying. He and the rest of the Cabinet secretaries know something you don't. It can't be done. So they don't waste their time trying. When bad things happen and the press gets wind of it, they simply say they'll look into it and wait for it to blow over.

These executive branch departments are too big and too insulated. Their culture of sloth and incompetence is too deeply ingrained to be remediable.

The only way to cope with this problem is for Congress to rewrite the rule book for the organization and staffing of the executive branch in such a way that it becomes possible to systematically weed out hundreds of thousands of employees who have nothing productive to do.

No president or Cabinet secretary will do it. To the contrary, they keep telling us how dedicated, hardworking and loyal the executive branch is. It's a lie we can't afford.

The Shadow's filing a VA disability claim, but Goldman can be reached at: EmailMe