In The Arena Shinseki: A Good Man, But Not the ‘Change Agent’ the VA Needs Let’s not kid ourselves: between an aging Vietnam generation and the survivors of Iraq and Afghanistan, our vets deserve better.

Douglas A. Ollivant is a managing partner of Mantid International, a strategic consulting firm with offices in Washington D.C., Beirut and Baghdad. He is also an ASU senior fellow in the New America Foundation’s Future of War project.

Memorial Day is about the men and women who fell in battle, but inevitably the holiday gives rise to thoughts of their close cousins — the veterans who survived, often with wounds, both physical and psychological, that never completely heal. On this particular weekend, the latest news about our country’s treatment of veterans is troubling. And we must confront the unpleasant fact that fixing the problem will not be business as usual.

We are kidding ourselves if we think that the Veterans Administration can absorb a new generation of 2 million or more veterans of the wars in Iraq and Afghanistan without new policies, culture and (most critically) money. Business as usual guarantees results like the allegations of veterans dying in Arizona while languishing on a waiting list.


General Eric (“Ric”) Shinseki, the head of the Veterans Administration, is an honorable man who cares deeply about his charges (full disclosure: I worked for Shinseki in the Army in the mid-1990s). But given the continuing issues six years into his tenure, it is not clear that he is a change agent who can break the “ricebowls” necessary for real reform. If this administration wants to fix this issue, it can. Here’s how.

The VA is antiquated from top to bottom. One reason it has remained backward is that veterans remain on the receiving end of benefits long after the shooting stops, spanning decades and wars. A recent Wall Street Journal piece documented that the Veterans Administration (VA) still pays pensions to not only 16 widows and children from the Spanish-American War, but also to the last surviving child of a Civil War veteran. While there is no—zero—excuse for secret waiting lists and veterans dying before they can receive care, it is also important to remember the scope and scale of VA’s mandate.

This leads to the obvious question—Is an institution with its roots in administering pensions to Civil War veterans prepared for the challenges of 21 st century veterans? If not, does the Veterans Administration have the work force required—from the secretary on down—to implement radical change (this assumes, of course, that implementing legislation and funding would be forthcoming from Congress). The events of the past year lead one to believe that the answer to both questions is “no.”

That the Veterans Administration is slow and ponderous in processing claims is not news. While there are workers in the VA who make heroic efforts, this has never been an agency that could be characterized as “agile.” Additionally, the VA is now experiencing a “perfect storm” of sorts. At just the moment that the generation of Vietnam Veterans is reaching the age where their demand for healthcare will naturally spike, it has been flooded with a new generation of Iraq and Afghanistan veterans. Many of these veterans come home with wounds that would have been lethal in earlier wars, saved by miraculous advances in battlefield medicine. And while we are overjoyed that they are still with us, we cannot help but note that many of these terrible injuries will incur large costs for the rest of their lives.

It may be that the problem with the Veterans Administration is even larger than we know. The VA tracks only the claims it receives. However, I am confident—at least based on anecdotal evidence—that a significant number of veterans choose not to file claims with the VA because it is too hard, too bureaucratic, too onerous. So in addition to the delayed (or rejected) packets, we must add the non-filed packets. I would posit that just as underlying the unemployment rate there is a cohort who have given up looking for work and are therefore not in the official statistics, so also underlying the backlogged claims, there is a cohort that has simply given up on making the Veterans Administration work and is likewise not in the official statistics. I know that when I received from the VA a largely incomprehensible packet with a request for more information—while working in yet another war zone overseas—I simply ignored it and never followed up on my own claim. I sincerely doubt that I am alone.

The work of the Veterans Administration is made more difficult by increased awareness, both within the medical community and in the public at large. Issues like post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) are not new by any means. But there is new awareness about both the seriousness of these ailments, and their pervasiveness in the veteran’s population. Both PTSD and TBI are under-researched and under-diagnosed (one advocacy group describes TBI as a “silent epidemic”), and it is unfair to put all the blame for a slow response on the door of the VA.

The Veterans Administration is also in the dark ages when it comes to information technology (IT), computers, and automation. The VA hospital appointment system is DOS-based (readers under 25 may have to ask what that pre-Windows operating system is) and may literally be older than some of the newer hires using it. The reasons for the lack of an upgrade are myriad, but most can be laid at the feet of the congressionally mandated Federal Acquisition Regulation (FAR), which lays out wonderful processes for procuring pens and copy paper, but is woefully inadequate for technology integration and engineering. Perhaps the best outcome that could come of the latest VA debacle could be a one-time exemption to the FAR, giving responsibility to one firm to automate VA’s records, allow easy electronic submission of claims, and let medical records flow automatically from the Defense Department to the VA.

To be blunt, were the VA information technology system to receive the same day-to-day attention from the White House as did the Affordable Care Act’s Healthcare.gov (after the disastrous roll-out), the issues might be fixed in relatively short order. In fact, this might be the best analogy. The VA record-keeping works about as well as HealthCare.gov did at its debut. Absent focused attention from the White House, the executive branch doesn’t do computerized systems very well (well, outside of the National Security Agency).

In the wake of the wars in Iraq and Afghanistan, the attention America has paid to its veterans has been, in many ways, overwhelming and humbling. If some of the attention at sporting events lapses into the schmaltzy, the sentiment is real. A small army of nonprofit agencies has emerged to help the wounded, to assist with job placement, and otherwise reintegrate veterans in society. Many major corporations have made real efforts to hire from a veteran demographic they might otherwise overlook. But civil society cannot do the heavy lifting that requires government.

There is nothing that will ever bring back the veterans who died while waiting for care. But if their deaths spur this country to truly examine the Veterans Administration, make its reform a priority and puts political pressure on the White House to truly prioritize this often-dysfunctional bureaucracy, then something good will have come from this tragedy.