Context Free Journalism Makes it Harder to Help the Veterans

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They Served With Honor

Allegations that long waiting times for health services from the VA caused forty military veteran deaths; and that VA staff covered-up the problems by cooking the books on performance measures, were surely not buried on Page Seven as they emerged the past few weeks. The more we’ve learned, the sadder it gets.  But, unless you are an aggressive consumer of news, the context and background, vital to a resolution that truly benefits vets, has been scarce.  Context free journalism (which really is, or should be,  an oxymoron) makes it harder to help the veterans,

If you were expecting useful context on this latest affair to rock the federal government, it would have been real hard to find.  Even CNN’s serious, mainstream Sunday morning news shows were thin on nuance, to complement the sensationalism and finger pointing that dominated discussion.  We might as well have recitations of N.Y. Post headlines on Sunday mornings.  Lack of time on the one hour shows is not a satisfying excuse.

Why is context so important; and why is there so little of it?

First, it’s not entirely true that CNN, or news media generally, hasn’t provided context. The CNN talking heads last Sunday included quick, parenthetical allusions to (a) remarkably high ratings the VA receives from its clients;  (b) the fact that funding of VA health services has fallen far behind a rapid rise in caseloads; (c) that veterans’ health issues have become more severe, complicated, and costly to address; and (d) that real, documented progress has (finally)  been made by the Shinseki led VA on the claims backlog.

But if a barking dog distracted you for a second from Candy Crowley’s CNN panel on Sunday, you wouldn’t have heard any of that. If you are a passive consumer of news, like the vast majority of Americans, you would have come away from CNN with an apocalyptic view of veterans health care. The situation at the VA is bad, and we learn more disappointing things each day. Buy apocalyptic reporting leads to throwing the baby out with the bath water.  Amazingly, a few politicians, across the political spectrum,  including President Obama, Speaker Boehner, and Senator Sanders,  have expressly warned against that.  Wow!

I’ll admit, I almost jumped out of bed on Sunday to write a blog post calling for the immediate firing of Shinseki, dismantling the entire VA health system (right now) and putting all the veterans under Medicare, or maybe turning the whole ball of wax over to Halliburton or Blackwater, as soon as possible. Don’t laugh (or cry), something like the latter is already a serious proposal.

It should be obvious that understanding the context of a crisis (part of taking a deep breath) is vital for responding effectively. But we won’t see that any time soon from the outlets that feed news to most Americans.  All the more reason to have figures in public office willing to take deep breaths, even if their media handlers can’t stand it.

What about the broader context for the series of “scandals,” some real, others manufactured, that have shaken the federal government?  Lets just pick a few:  This VA Affair;  the (alleged) targeting of Tea Party organizations by the IRS; the deaths of four Americans in Benghazi; and website failures in the roll-out of the Affordable Care Act.

What do these have in common? They all seemed to blind side the President. They caused all of us to ask, ”what were they thinking?”  They involved an element of really bad management at some level.  Severe partisanship exaggerated the problems and preempted real solutions; which went hand in hand with apocalyptic reporting. And, all four had a legitimate “lack of funding” defense, even if that didn’t tell the whole story.

Indeed, a defense offered in all four “scandals” is that bad things happened because federal funding was cut or requests for more money refused; and thus agency budgets didn’t keep pace with rising workloads and pressures.  Among the four debacles, this argument is most legitimate in the current VA meltdown. Senator Patty Murray, from Washington State, who gained a lot of trust not long ago when she and Representative Paul Ryan brokered a rare bi-partisan budget deal, has already made the “lack of funding” argument in the VA Affair.

I don’t believe lack of money was the only or main factor responsible for bad behavior and outcomes at the VA, but there is more than a kernel of truth to the funding defense. The VA has had a flood of new clients, including returnees from the two middle east wars, aging Vietnam era and Persian Gulf war vets who need more medical care, and new commitments to pay real attention to PTSD and “agent orange” related illness. That represents a very hefty rise in clients, pressure, and appointments.  All the more reason to wonder why the VA committed to a 14 day waiting time for service to vets, without going to the mat on funding.  What were they thinking?

From personal experience, as a former state government bureaucrat, I can offer this perspective:  Just about every time my organization was charged with a major new responsibility, the Legislature provided just a fraction of the requested funding, but not (usually) with a commensurate paring of responsibilities. Budget cuts were often made with an express (Alice in Wonderland) assumption that “efficiencies” would allow service levels to remain the same,  Doing more with less was the mantra.  If you just say so, it will happen.  Budget writers are often in competition with economists to find creative ways of assuming away reality.

Yes, many government agencies can be much more efficient. And, yes, asking for more money all the time has worn out budget writers on both sides of aisles, at all levels of government. There is admittedly a “crying wolf” problem here. But there are too many cases where the budget “ask” is legitimate, and the refusal arbitrary and harmful, leading to everything from lies to death.

I respect the VA, but the system does seem kind of quaint. If we were starting a national program for care of military veterans today, we probably would make them all eligible for a form of Medicare or give them vouchers for private insurance (preferably ones that kept pace with medical care costs).  If you believe all the good things veterans say about the VA on their surveys, they wouldn’t (necessarily) be receiving better care through another system.  The main thing to be said for keeping the VA together, is the organization learns a lot about treating certain conditions which, alas, are found more often among military veterans, like PTSD, paraplegia, and loss of limbs. There is great value in concentrating this kind of expertise. Remember, in the current affair, the tragedy is around lack of access (and lies about it), not treatment (which we hear, from the Vets, is solid).  Keep your fingers crossed.

 

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2 thoughts on “Context Free Journalism Makes it Harder to Help the Veterans

  1. Dave

    I agree that the story is not as simple as it is sometimes portrayed (my perception is that is true of most things). And I think it will take a bit more time to fully identify the problem and consider potential solutions.

    It may well be that additional resources are needed given the increased volume and complexity of the cases. There is room for that debate.

    But, to my way of thinking, the most egregious allegation (and one that is almost certainly true): certain VA centers knowingly manipulated records and scheduling so they would appear to be meeting or exceeding certain benchmarks. That isn’t an issue of failing to meet a time target. That isn’t an issue of lack of funding (in fact the multiple list approach likely consumed additional resources). It is a lack of ethics and judgement. And, at least in Phoenix, it may well constitute criminal conduct.

    An honest portrayal of the wait list might have driven more resources to the system. Of course, a honest portrayal would have also reduced the likelihood of employees or facilities “earning” awards and bonus payments.

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    1. Irv Lefberg Post author

      Thanks for good comment, Dave. I agree that the cooking of books, especially here, is reprehensible. No doubt in my mind that these folks need to be fired; and possibly charged with criminal violations. Agreed! That said, these employees were in a culture that obviously provided incentives to behave this way. The combination of too little funding , while management still made commitments to improve services, was lethal.

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