General Shinseki: We're Not Doing Right By Him, Our Veterans, or Our Nation

We got word yesterday that Eric Shinseki, Secretary of the VA resigned his position. While we could all see it coming, I’m sorry that more members of Congress asked a few questions before demanding his resignation.

The story began earlier this month when it was learned that employees of the VA hospital in Phoenix were falsifying appointment records. If a veteran asked for an appointment at any VA facility, he or she was supposed to get that appointment no longer than 14 days out; this was shortened from 30 days as a way to cut down on long delays in getting appointments.

Unfortunately cutting the expected wait time by 16 days didn’t change anything else. The reason for the long delays is simple: we have too many patients and too few providers. Middle managers did what they normally do when faced with an impossible deadline: they cheated. The cooked the books to make it seem that they were hitting their numbers when they weren’t.

There are a few articles worth reading on this: The Associated Press and today’s Los Angeles Times give a much more complex picture of this scandal.

I had to do a little digging for this information. It seems the 24 hour news cycle has reduced the story to this: The VA is incompetent, we need to find a scapegoat, and it’s news to go to the top: Eric Shinseki. Congress followed suit and began clamoring for Shinseki’s resignation. It finally became clear that they could clamor (and get on TV) seemingly forever, and a good and talented man fell on his sword.

The problem with the VA is much more systemic. In the last half of the 20th century we had wars in Europe, the Pacific, Korea, Vietnam, along with countless other small actions. In the first decade of our current century we’ve already seen wars in Afghanistan and Iraq. According to the AP article, the VA has seen a 17% increase in enrollments since 2009. Right now the VA carries 9,000,000 patients with 85,000,000 appointments per year. The VA web page shows 2,962 job openings and 746 of these openings are for doctors.

Simply put they haven’t been able to provide enough staff to cover the patients they are tasked to care for. That’s the problem.

Congress needs to provide adequate funding and prevent staffers from having to do this.

And as for General Shinseki, he deserves better than this. We owe him an apology.

San Diego On Fire

If you accessed the news in any format this past week, you’ve been hearing about wildfires in San Diego. For those of us who live here, we’ve spent at least part of the week watching the news if only to know what to say to well meaning relatives and friends who think we are toast.

Every part of our country, and indeed every part of our world, brings challenges. Maybe it’s hurricanes, or earthquakes, or tornadoes, or blizzards. Here in Southern California it’s becoming wildfires. Many found their way here out of love for the weather and the false assumption that watered lawns and full taps magically appeared.

Many also falsely assumed that any fire would be put out before it costs us anything. Since I moved here in 1995 we’ve had a few years where we’ve had fires that have gone out of control. The years 2003, 2007, and now 2014 will remind me of uncontrollable fires. They will remind me that the price of a house with a spectacular view comes with the acknowledgement that a fire may begin far away but hungers for a house with a spectacular view.

Out of good luck more than anything, my home is generally pretty safe from these wildfires. But the homes of the patients I serve are not. I’ve gotten used to the process of learning about the location of the fires and determining which of my patients are in danger. I’ve gotten used to spending hours calling cell phones hoping to find where they went after getting word in the wee small hours of the morning that they have to leave. I’ve gotten used to preparing conversations with people in the last chapter of their lives who need to understand why they can’t die at home because their home no longer exists.

Is there something I can’t get used to? Yes. I can’t get used to hearing politicians who insist that dramatic changes in weather patterns are not due to our actions. I can’t get used to those who have the ability and willingness to trash the futures of our (and their) descendents because the cost of honesty is their re-elections. I can’t get used to the fact that their ambition for wealth or power is more important than anything else.

Nancy and I don’t have children. But we do have nieces and nephews. We do have neighbors, friends, and loved ones who do. We care about the world we’re giving them. We love Southern California. We love the idea that this is a part of the world that welcomed us. We grieve that this may well be a part of the world that will no longer be liveable. We grieve that, unlike our ancestors, we cannot give to the next generation better than we were given.

We don’t see the recent fires in the context of a random event. We see them as the natural result of climate change that our leaders choose to ignore. And we see the need to elect leaders who won’t do that.

Oh, and one more thing: a few days ago I had occasion to drive through one of the areas that burned. The burned areas look like the surface of the moon but I was amazed at how few homes were lost. Part of the reason is that the homeowners followed directions to keep brush away from their homes. But we also need to give a shout out to Cal Fire for their heroism in defending these homes. It’s going to be a long, hot summer and I’m grateful they are on our side.