As a service-connected disabled veteran, a former hospital administrator, and a cancer survivor, I feel uniquely qualified to offer an informed opinion about the state of the Veterans Administration healthcare system. In addition to the above, I have spent approximately two months in three different VA hospitals during the last year in the cities of Spokane, Seattle, and Portland.

Let me begin by saying the healthcare clinicians, the doctors, nurses, techs, and others who provide direct care to patients are as good as the clinicians you will find at any reputable hospital in the U.S. Although their wages are not very high, a majority of these employees are totally dedicated to the care of our veterans, a dedication that should be the model for every provider in every healthcare facility, civilian or military. However, they often find themselves working under very difficult conditions due to the crushing bureaucracy of the VA healthcare system, attempting to serve a growing number of increasingly older ailing veterans.  These dedicated employees deserve our respect and our thanks. Just a side note: I frequently bring doughnuts to the staff of the VA emergency room in Spokane. They are great people and dedicated professionals.

The day-to-day workings of the VA are run by a massive, inefficient bureaucracy, administered by civil servants, administrators, managers, and workers who are very difficult, if not almost impossible to fire, regardless of their attitude, competence, or behavior. Because terminating a federal civil service employee is next to impossible, a manager or administrator attempting to do so, would find his/her time completely dominated complying with the repeated and required counseling, documentation, hearings, and follow-up it takes to fire one bad employee. Instead, it is much easier to move the difficult employee to a different department or location with the VA system. I am aware of one healthcare provider at a VA facility who has been moved six times from department to department within a hospital instead of being terminated. Unfortunately for the patients receiving care at this facility, this individual's duties involve daily contact with veterans. As a former hospital administrator, I know that in any hospital every employee's performance has direct consequences on the quality of care of patients - from the person who answers the phone to the most highly skilled physician.  One weak link in the chain can disrupt the continuity of care and have disastrous effects on the well-being of the patients. The process for disciplining and terminating employees who are negatively affecting patient outcomes should be simplified and streamlined to ensure that only dedicated, caring staff are attending to the healthcare needs of our veterans.

As in any organization, administrators, mangers, and employees are usually rewarded with promotions and bonuses for outstanding performance. Unfortunately in the VA, like many federal agencies, supervision of and accountability for the awarding of monetary bonuses is at best poorly managed and at worst corrupt. This is amply demonstrated by the existence of secret lists, unknown and unreported to Congress, from which and to which veterans awaiting care are moved to make it appear that the veteran's healthcare needs are being addressed in a timely and efficient manner. This delay or withholding of healthcare usually results in the quality of patient care being compromised, often resulting in the worsening of a veteran's condition, sometimes leading to death. The consequences are severe in the case of denied or delayed healthcare. Just this month whistleblowers at the Phoenix VA hospital admitted to being coached to conceal long wait times for patients which is said to have resulted in the death of up to 40 patients.

If the allegations are true, these veterans died so that an administrator could get a $9,345 bonus. It has also been reported that the same administrator, at the heart of the Phoenix VA scandal and cover-up, was also involved in a similar cover-up and scandal at the Spokane VA hospital while she was the administrator there involving the cover-up of the suicides of veterans awaiting treatment. Similar allegations are just coming to light regarding Los Angeles, Denver, and several other VA hospitals around the country.

VA Secretary Shinseki should resign. There have been at least 18 reports and investigations done during Shinseki's tenure. Congress should immediately order that no records be destroyed or deleted from any VA facility and that a full scale investigation be conducted by an independent party.  Those who are responsible should be terminated and criminally prosecuted in certain cases. I expect our senators and representative to immediately initiate an order and insist on a full and public investigation of the Veterans Administration. The only way to adequately address the problems with the VA is the appointment of a bipartisan presidential commission that investigates the VA immediately and aggressively.

Lastly, the issue of lack and misallocation of resources in the VA administration must be seriously addressed. Underlying long wait times and poor service are an inadequate number of healthcare personnel to address the physical and mental needs of the men and women who have bravely served our country. Until we Americans are ready to put our money and our resources into reforming this broken system and funding a better one, we will continue to see poor healthcare outcomes and tragic suicide rates among our veterans. It is time we demand that our public officials stop giving lip service to honoring our veterans and begin the task of cleaning up the Veterans Administration.

Bill Brooks is a disabled veteran and former hospital administrator living in Coeur d'Alene.