Understanding the VA Hospitals Scandal

The latest findings about the treatment of U.S. military veterans are almost inexplicable. Veterans are angry, the public is outraged, and politicians are demanding urgent reform — for the situation is simply intolerable. The resignation of Robert Petzel, the Veteran Administration’s undersecretary for health care, follows the most disturbing revelations: reports of widespread negligence in the form of treatment delays and falsified records at veterans’ hospitals, chronic inefficiency, cover-ups of inefficiency, bonuses for officials regardless of performance, and so on.

Worst of all are the horror stories of veterans actually dying while awaiting treatment. A former clinic director said that as many as 40 veterans died while languishing on the appointment list at the Phoenix VA hospital. How could such things occur without someone higher up in the bureaucracy taking notice that lives were at stake and stepping in to speed up treatment or call for federal help?

Part of the answer, at least, is that hospital staff kept a secret appointment list to cover up the delays. Those who had risked their lives and sacrificed their health were thus further sacrificed to preserve the good name of the bureaucracy and its bureaucrats. That those who gave so much for their country should be treated this way is a disgrace.

What is hard to understand is how the resources necessary for the proper and timely treatment of veterans could be lacking in the first place. Yet, such has been the case — not only this year and in this administration, but for many years under administrations both Democratic and Republican.

The problem transcends party. Indeed, it transcends generations. When has America ever taken care of its veterans the way it should? Perhaps after World War II, in the glory days of the GI Bill, when the government paid for veterans to get higher education, and the country mobilized its resources and ingenuity to provide them with housing and jobs.

But then came the wars in Korea, Vietnam, Iraq and Afghanistan. Unlike “the crusade in Europe,” as Eisenhower called it, to save civilization from the Nazis, the rightness and necessity of those latter wars were not so clear. Beginning as defenses of freedom and democracy, they had broad public backing; but in time both the morality and the strategy of those campaigns became harder to justify. In many cases — the Vietnam conflict in particular — even the civilian and military leaders responsible for putting young men and women in harm’s way found it increasingly difficult to explain the rationale. Many abandoned the cause themselves.

Not only did the wars become unpopular; the young people who fought those wars also became unpopular. Though they went abroad motivated by the highest ideals of serving their nation, they returned to a country that all too often did not appreciate them. The military had acquired a bad name, and those who served in it shared in the opprobrium.

The scorn and neglect they encountered has extended to their treatment by the Veterans Administration and its health services. The physical and psychological wounds of the battlefield were compounded by a wounding lack of respect and compassion. They who fought for their country with honor were treated dishonorably.

All of that is but one possible, partial explanation. There is also the very human desire to shun that which is unattractive and unpleasant, and that certainly includes the results of war, the corporal injuries and scarred psyches of the soldiers who come back. Even those who enter the VA work force with the best of intentions are susceptible to “mission fatigue.” The work is hard and unglamorous; there are few medals or photo-ops for caregivers to veterans.

Whatever the explanation, however, the problem has to be faced up to once and for all. As Senator John McCain put it, the Veterans Affairs Department is suffering from “a systemic, cultural problem” that cannot be solved by the resignation of a single top official.

“What’s needed is a total refocusing of the VA on its core mission of serving veterans — stretching from its top political leadership all the way through to its career civil servants.”

The crisis in the VA represents one of the most painful — and shameful — ironies of modern warfare: that despite the awesome development of the machines of death and destruction on the one hand, and the amazing advances in life-saving medical technology on the other, taking care of war’s victims still lags behind. We are very good at making war, less good at dealing with its consequences.

The Senate is holding hearings and all are agreed that a complete overhaul of the VA must come. We hope it will, and soon.