More BS from the VA by Pat Conrad MD


The more I watch the news, particularly when it involves health care, the more healthily, properly, joyously cynical I become. If someone is trying to sell me puppies and sunshine, salvation, or big, institutional compassion, I grab my wallet and scoot. I’m even cynical about veterans.

No, I’m not talking about the actual men and women who took an oath, wore a uniform, and faithfully served our nation. I’m talking about the board game tokens moved around inside the corridors of power, at political rallies, on both Fox and MSNBC, and perfunctorily praised by artificial politicians on designated high days, whose speakers by their actions are clearly uninspired by the objects of their praise. In the same way one cannot criticize Medicare, Social Security, or WICC, one cannot criticize anything to do with veterans, lest he be tarred as “anti-veteran”.

But being pro-veteran might require being “anti-veteran”, at least when it comes to the Veterans Administration. Even as the current secretary of the VA made an amazingly buffoonish gaffe, a new story broke that his creaky clown car of a bureaucracy has done some hilarious, tragic, and utterly predictable hiring.

  • In the past 3 years, only 1 in 11 new hires was an actual doctor.
  • In that same period, 39,000 new positions were filled, and average VA salaries rose 18.7 %. This in a time when real unemployment has remained high, and average wage earners’ earning power has remained very flat.
  • $ 454 million went to the VA legion of 1,060 lawyers; $99 million went to PR workers.

“But, but…!”, I can hear you sputtering, “that’s only a smidge of their overall operating budget of $99. 1 billion!” Okay, you have me there. So why are there ongoing, numerous reports of long wait times for vets? Where are the damn doctors?

Here’s a graph of the relative growth rates of physicians vs. administrators in recent years. Doug has published similar graphs numerous times. If the VA is such a great idea and such a great organization, and so awash in tax dollars, then will someone explain WHY there are inordinate wait times for vets? Are these vets whiners, or liars? Or is it more likely that the VA exists to serve itself, by building up more layered defenses of non-productive, clerical workers, and lobbyists, all with the goal of building public sympathy and cowing feckless politicians on the way there real goal, which is to provide a better appearance of total vet care, while growing the organization further still? It is now painfully obvious to the nation that it has become easier to endure the bad PR over a few dying vets than it is to fire wholesale pointless government clerical workers.

Sure, I know that any major organization will have some slop, needs some lawyers, and has to keep the walls painted and lawns trimmed. All three major party candidates are bellowing that they will pump more money into the VA. But with patients waiting, why didn’t they hire more doctors and fewer administrative parasites? How exactly will more desk jockeys help veterans who need medical care? If that’s where the money went, then I call it a plausible justification to cut the VA budget. Does this mean I want to kill vets?