The Bolduc Brief: A Critical Look at the Veterans Administration: Navigating Bureaucracy and Implementing Change

“The Nation which Forgets its Defenders will Itself be Forgotten”

-Emperor Maurice and the Persians

Addressing Longstanding Leadership and Management Challenges

Many dedicated and talented people work in the Veterans Administration (VA). Unfortunately, they work inside a system where the bureaucracy is a tsunami of inefficient and ineffective disability programs. All veterans and their families that I talk with across the country appreciate the efforts of veteran organizations and elected officials in developing, supporting, and approving legislation that provides programs to help the disability of veterans.

What frustrates veterans is that these programs are administered inside the system, which could be more efficient and effective. The VA is rated seven out of ten of the ten federal departments, just ahead of the Justice Department and ICE. Let’s consider the PACT Act, which is needed legislation for veterans. Unfortunately, with the current issues in the VA, the implementation of the PACT Act will be hampered and plagued with the usual problems that have transcended every administration since the establishment of the Department of Veteran Affairs (VA). The PACT ACT is currently at a backlog of 266K and will grow to an estimated 450K and 730K.

Every President, Cabinet member, and elected Congressional member shouts from the rooftops that veteran care is a bi-partisan issue. This is not true because the Democrats and Republicans have different ideas and approaches steeped in political bias that are partisan. So, the biggest problem is ineffective leadership and partial political solutions that result in partisan political compromise. This prevents much-needed transformational change and results in the practice of short-term transactional band-aid legislation.

How are members of Congress supposed to know what veterans need when our Congress consists of about 17% veterans? Currently, the Secretary of Veteran Affairs is not a veteran; less than 1% of Americans serve in our Armed Forces, and ~99% do not. The Department of Defense needs to be more effective in treating its service members while on active duty and successfully transitioning them to civilian life. This must change.

In addition, the Department of Labor (DOL) and Housing and Urban Development (HUD) have programs for veterans. Spreading veteran services across four different departments is not effective and efficient in delivering veteran services. The bureaucracy of one federal department is complicated enough, never mind trying to coordinate, collaborate, and develop effective programs across four different government departments for veterans.

Ensuring that veterans get the disability care they need: The recognition that the VA is a disability care system, not a health care system, is required. It is a reactive system and a poorly managed proactive system. There is no reason why the VA, with the support of the DOD, cannot anticipate the disability care needed for a service member transitioning to be a veteran. Understanding the future of veteran demographics is a large part of getting the transformation right. About nine-in-ten veterans (89%) are men, while about one-in-ten (11%) are women, according to the VA’s 2021 population model estimates. By 2046, the share of female veterans is expected to increase to about 18%. The number of female veterans is also projected to increase slightly, from around 2 million in 2021 to approximately 2.2 million in 2046. The number of male veterans, on the other hand, is projected to drop from about 17 million in 2021 to around 10.3 million in 2046.

Recommendations

Ensuring timely access to care Improving mental health care, especially in rural areas. Ensuring proper funding and resourcing for Long-term care facilities at the state level that the VA provides funding for and the VA’s ONE CARE facilities. Improving management of the shortage of providers and rooting out the bad-performing providers. Ensuring employees pass the background checks needed to ensure quality employees are providing care to our veterans. Managing supply chains and VA’s acquisition workforce to ensure VA medical centers get needed medical supplies. This has been a huge problem and has negatively impacted the disability care of veterans. Other areas that have plagued effectiveness are a shortage in the acquisition and workforce, as well as insufficient training. Administering disability benefits to ensure that veterans get appropriate, timely compensation. The current system being administered is from a 1940s model. The Veterans Administration has taken too long to update and resolve compensation models for our veterans. The VA is eight years behind schedule. The other problem is the backlog, where they have 80,000 backlogged claims, which takes an average of seven years to resolve. Under the new system, there’s a 380,000-claim backlog. Securing veterans’ electronic health records and other sensitive data remains problematic. We owe our veterans proper security of their medical data. We also owe them a better transition of their medical records from the Department of Defense to the Department of Veteran Affairs. Although there is a system for this, it remains ineffective. Investing in VA hospitals to ensure proper disability care and not relying on privatization and contractors. We will either commit fully to veteran medical facilities or we will not. We need to stop politicizing this type of care. These promises are made every election, only to result in no action by the incumbent Administration and Congress. All of these issues are detrimental to the disability care that our veterans and their family members deserve.

Conclusion

More Problems on the Horizon The good news is that most Americans continue to see veterans’ services as an essential priority. Now, we need to get the system changed. This will only happen if Americans put the necessary pressure on the executive and legislative branches to clean up the bureaucracy and make the system effective. The Veterans’ Administration is top-heavy. The bureaucratic procedures get in the way of effectively administering the programs. The Secretary of Veteran Affairs must be a veteran. The recognition that veteran medical care is a disability program and not a health care system is an essential mindset to a successful transformation. Today, military recruitment and retention are at an all-time low. The Veterans Administration assesses that the veteran population will continue to decline over the next 25 years. This decline involves losing confidence in the national military and civilian leadership. The United States has yet to win a war or conflict since World II successfully. The Korean War was a stalemate, and the Gulf War was an operational victory and a strategic failure. Another contributor is the Heritage Foundation study that rates America’s military as weak. This causes parents and grandparents to be less likely to promote military service within the family unit, negatively affecting recruitment, retention, and support of the military academies. One of the biggest problems with the all-volunteer military system is that it does not adequately represent all levels of our society. Therefore, the disability system for veterans does not receive adequate attention from the top 1% of our society. In generations up to the Korean War, the service to the nation during a war or conflict drew young Americans from all levels of our society. So, there was a commitment by the most influential people in our country to ensure our veterans were taken care of by our government. Today that is not the case.

Nikki Haley in front of the flag — Nikki Haley has a viable plan to reform the VA and improve the lives of those of us who have served our country. Original art by SOFREP

I support Nikki Haley’s Veteran Plan. Nikki Haley is invested in our service members, veterans, and their families. Her husband currently serves in the South Carolina National Guard, is an Afghanistan war veteran, and is on a one-year deployment in Africa. I am confident that as our Commander and Chief, a responsibility she filled as Governor of South Carolina, she will transform disability for our veterans. Go to her website for more details and information.

Donald C. Bolduc

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