The lack of outrage

I have found myself in an uncomfortable position.  I find myself getting angry at others for not being angry at what has been going on with the VA.  I mostly believe that my anger is misplaced, but I cannot help it.

There has been a laundry list of malfeasance on the VA's behalf, and every indication that little to nothing will be done to punish the malefactors, nor to hold the leadership of the VA or its hospitals accountable.  Good men and women are dead because of the bureaucratic game playing that may not be explicitly rewarded from the top, but certainly is not punished.  Shinseki has stated unequivocally that he will not resign, and mouths excuses that these problems existed before he took over.  He has been in charge of the VA for a half-decade.  If he is unable to affect change after five years, then it seems to me that he will never be able to.  It is past time for him to go.

Now, that's all well and good, but my specific problem comes in when I point this out to my friends and relatives.  I've been met with all but silence.  I do not feel that I can properly attribute this silence to partisanship or a lack of interest, but it is increasingly hard not to; especially when they get worked up about issues where it is their ox being gored.  I understand that less than 1% of Americans have served, and many of them never retired and will not ever step inside of a VA hospital.  This is true for me as well.  And while my family contains an abnormally high number of veterans (half of my immediate family, half of my aunts and uncles, a quarter of my grandparents, a few of my cousins, etc), only one of them (my father) is eligible for treatment at the VA, and he has better health insurance so he can seek better treatment from better healthcare systems.  So ultimately, it's not even my ox being gored.  And yet I am infuriated at the treatment of our veterans at the hands of the very government they served.  Why is this something that I feel, but no one else seems to care about?

Is it a feeling of "what can I do?"  Is it general apathy?  Is it because they don't really care since it doesn't affect them personally?  I'm especially cognizant of the fact that "raising awareness" is about as meaningful as shouting into your closet because of recent events.  But at a certain point, once I've written my Representatives and Senators, what else can I personally do other than tell everyone I know why they should be outraged?   Is that perhaps what is making me so angry?  That I am helpless beyond what I've done?  I'm not sure.

23 comments:

Grim said...

The conversations about the VA I have follow this form:

A: Did you see the stories about the VA?

B: Yep. There's no excuse for how we're treating our people.

A: Shinseki should be fired, but what did you expect from the guy after his career?

B: He's not the only one who should be fired.

A: Well, that's true. I guess we'd have to fire a lot of people.

B: A whole lot.

That's the point at which the conversation trails off, because it's the point at which you realize the scale of the problem. To fix what's going on at the VA, you'd have to do more than replace the commander. You'd have to eliminate its entire corporate culture. That would require replacing not only the whole -- or very nearly the whole -- leadership, but enough of the low-level employees to break the back of those who are living out (and encouraging) this culture.

You'd have to replace them all. With whom? Where will you find them?

The reason people stop there is the recognition that, in a very real sense, it can't be done without revolutionary change.

It's the same reason people trail off at that point when you're talking about Congress, or the IRS, or the EPA, or the Federal government generally. It's not that the levers left to the citizenry don't respond. It's that the scale of the problem is too vast for the kind of change those levers were designed to effect. The non-revolutionary solutions to these problems require eliminating whole bureaucracies or huge parts of them, firing thousands on thousands of people, eliminating the corporate cultures at deeply embedded bureaucracies, and trying to rebuild.

Can that be done? It would require a Herculean effort to even get the orders cut to do it. Actually effecting the change?

Ymar Sakar said...

They did tell us we should shut up and obey Democrats, because national healthcare is great, just like the VA. If our soldiers get such great care, imagine what civilians will get with politicians ruling over the death panels.

Back a few years ago, people were waving their hands, got their head stuck in the sand, thinking the tsunami would pass them by. Guess who the joke is on, those clowns.

Shinseki needed more troops in Iraq so that more people would end up dying, making him look better after winning a "hard fight".

Diversity Casey confiscated the weapons of Anbar Sunni families because... because diversity and Hasan will WIN US THE WAR. Win Us The War.

Ft. Hood 2, winning the war, yep.

Tick. Ft. Hood 1, winning the war. Oh wait, if we won the war with 1, why did they need 2?

With whom?

Hamsters and heads stuck on pikes. Doesn't have to work. I'd take a pic of that.

People have no clue what the true nature and Power of the Left is. They take the Left lightly. But we'll see who's laughing once the corpses start piling up to the moon like cordwood.

Ymar Sakar said...

Revolutions are over rated.

It merely spins things back to square 1, 360 degrees.

Re-Evolution is needed, not revolution.

Grim said...

"Re-Evolution is needed."

That's a phrase I chiefly hear from Leftists, especially environmentalists. I doubt you mean quite the same thing by it that they do, however.

What do you mean by it?

Elise said...

I think Grim is right about the scale of the problem and the fact that the citizenry's (my) ability to effect change is inadequate to the scale of the problem. I also think, though, that there's something else going on. It goes like this:

Something happens which is perceived as outrageous. A little wave of "do something-ness" is generated among the public. Someone steps in (media, politicians, advocates, all of the above) to explain that either:

a) the situation isn't as simple as those expressing outrage make it out to be; or
b)there's another side to the story; or
c) the people involved are doing the best they can, the best anyone could do; or
d)all of the above.

Those explanations somehow take the air out of the outrage. They give us an excuse to not stay outraged and, since doing anything constructive with our outrage seems somewhere between overwhelming and impossible, we gratefully seize on that excuse and say, "Well, I guess it's not as bad as I thought it was."

I'm pretty sure this has something to do with the lack of clearly delineated ideas of right and wrong, or appropriate and inappropriate. I'm pretty sure it has something to do with using argument as a weapon to undermine convictions. I'm pretty sure it has something to do with the idea that all truth is relative. But I don't totally understand why it's taken such strong hold. It's like living in world where everything is made of sand: when I try to grasp something, it disintegrates in my grasp.

Cass said...

I spent several years grappling with various issues at the VA and I don't think it's a question of right or wrong (or one of people not being sufficiently outraged) so much as it is a question of the VA being a very large system with a ton of moving parts.

People seem to think systems like this ought to be able to tap dance through a bed of tulips without so much as bending a blade of grass, but I've never seen an enormous system that worked this way.

People can get good support from the VA but it's like getting good support from the military medical system - you have to work hard at it. Because so much is free, they have to have systems in place to prevent fraud and abuse and those problems, sadly, are quite real.

When you make something free, the demand usually outstrips the supply. So you get waiting lists and people who need care don't get it while others who don't need it so badly (but for whatever reason are willing/able to navigate the bureaucracy) DO get care.

That was my experience with military medicine. I was not willing to make it my FT job to get basic medical care, so I went outside the system where the barriers to getting care were mostly financial.

I don't think it's possible to design a system that provides free medical care that runs well. If it's big enough to do what you want it to do, it's too big to be responsive or easily managed.

I think we would have done better to provide vouchers for private medical care to veterans but even that wouldn't be perfect, nor would it guarantee care for all who need it.

MikeD said...

Cass,

I accept that checks and fraud abuse suck timeliness out of the system. And they have been sometimes unfairly decried. What has sent me over the edge is the intentional cover up of practices mandated by senior VA management at the hospitals to hide patient records, alter or destroy documentation, and otherwise bury requests for treatment that have gone over the requisite timeliness requirements in order to look like they're handling everything in a timely manner. That's fraud, it's dereliction of responsibility, and it's directly responsible for several veterans' deaths.

I accept delays as inevitable. I do not accept letting veterans die because senior management doesn't want to look bad. And that's not even the half of it. Exposing vets to HIV and hepatitis with unclean medical equipment, non-completion of required suicide prevention followups, shredding of claims documents, and to put the cherry on this sundae... the administrators of VA hospitals caught doing these unethical, illegal, and dangerous practices are receiving BONUSES to "punish" their malfeasance? I frankly cannot express how angry this makes me.

Grim said...

I don't think it's possible to design a system that provides free medical care that runs well. If it's big enough to do what you want it to do, it's too big to be responsive or easily managed.

That's probably right, Mike's additional concern aside. My concern, likewise, has to do with scale and is more generalized than with health care (or free benefits): there comes a point at which the scale of these organizations is too vast to be reformed effectively. We just can't do it.

MikeD said...

"We just can't do it."

Problems like this remind me of the riddle, "how does one eat a whole elephant?" One bite at a time. I have a suggestion of how to start eating this particular elephant. Every hospital administrator of a VA hospital that has hidden "bad numbers" is to be immediately fired. Their position is to be given to the next in line at that same hospital. They are to be given explicit warning that bad numbers may be concerning, but that hiding them are grounds for immediate termination. So too for the VA hospitals where patients were sickened by unsanitary instruments. That strikes me as an excellent first step.

For a second step, require all VA hospitals to undergo an investigation into their backlogs by an outside third party agency. The days of the fox guarding the hen house must end. And for a third step (or perhaps step zero?) Shinseki must go. Period. Once again, five years is more than sufficient time to demonstrate leadership and take action to turn things around. He has done nothing but demonstrate that he is incapable (or unwilling) to do so. He must go. The fact that he has not even offered his resignation is indicative to me of his attitude towards command. He does not accept an OUNCE of responsibility for the malfeasance that has occurred under his watch.

Grim said...

I posted your first three steps at BLACKFIVE. Let's see what they have to say about it.

Ymar Sakar said...

Evolution is something the Left talks about, but knows as much about as they know how their microwaves and stoves work. (0)

While I would wish people would figure things like this out for themselves, humans are humans. Presuming they are human and not monster.

The Leftist alliance's true nature was originally designed to undermine and destroy, or take over, Western societies modeled from Western traditions/philosophies/concepts.

A Re-Evolution means to begin again the road of life, from single cell and beyond. Although for humans, it merely means a reset (reset buttons, we love those don't we, we need a Putin/Hussein/Holder/Clinton/Clinton2/Ft. Hood reset) back to one woman, one man.

Society, nullified. Laws, nullified. Tradition of philosophy, nullified and reset. Nothing left for the Left to take over or undermine, for capitalism itself would be meaningless. One man, one woman, they rebuild, from the ashes, based upon the current technological benefits. Only free will, only humans allowed. Sounds like a post apocalyptic novel, except the Legion author only had one guy in the wilderness of the urban jungle doing whatever.

A revolution merely resets the politics or perhaps the aesthetics of life, no more. It is not enough. 100 years later, slavery and the Left will still be making money and convincing the slave-citizens that everyone is equal and free. While re-engineering human society won't give people forever, it might give 200-400 years. Maybe even the infamous 1000 year Reich.

Or we go with my first advance. Let's burn it all down to ash and let God decide. No Re-Evolution, no Evolution, no revolution, no philosophy, no mankind. Equality under Death, for everyone. Only thing in life that never goes away is Death and Taxes. No life, no taxes.

And if we get rid of humanity, we can get rid of taxes too. At least, that's what the Left's Gaia fanatics fantasize about, the end of human pollution (no humanity, no pollution).



Well, whatever people decide to do, it won't matter much in the end. So long as the Left exists, the hydra will regenerate and Hercules will be the one wiped out. Solutions don't exit so long as the Left exists. And the Left is an alliance, but that's not their true nature. That's just their hidden nature which people ignore.


100 WACOs and counting. Maybe Americans will wake up. Maybe they'll suffocate in their sleep. No matter what happens, justice of a kind, will be given to the guilty.

E Hines said...

One argument I've seen proffered by VA senior "management" is that it's too hard to get middle managers to follow instructions: they're too far removed from their bosses. This strikes me as simply the excuse of the lazy or the cowardly who are too reluctant to do the hard work of firing the performance failures in the face of mendacious public service unions.

It's probably accurate, too, though, that firing such is in some way too hard. Fine. I've argued in the past that the VA should lose its Cabinet level status and be brought into the DoD where actual soldiers (no contractors; this would have been a job worthy of REMFs interested in redressing that reputation) would run the operation, with clear guidance to clean house, and to do it often and with enthusiasm. Things have gone too far for that, though.

It's time to break out the Bronze Disentagling Implement and disband the VA altogether, returning all personnel to the private sector. As heavily experienced workers and...managers...they'll have no trouble finding work in the Obama Recovery. Let the VA's current medical expenditures be audited by outside auditors (as a first cut, maybe each of the 50 States could audit the facilities in their States), and the funds paid originally for "insurance" or to VA hospitals or to... instead paid directly to the vets, and let them see the doctor of their choice at the hospital of their choice. The existing and ongoing VA annual budgets could simply be used to pay the vets directly in the out years.

FWA? No need for delays here; that's just an excuse not to do the work of disbursing the funds in the present system. Social Security and Medicare don't have an out of control FWA problem, and they get redress for those problems pretty well by going after the money on discovery after the fact, not on "preemption."

Getting this done will take a series of those elections I keep harping on.

This also gets at part of Mike's problem. In fact, we really only can elect a Congress and President in any given cycle on the basis of one or two (maybe getting to a third) major issues at a time. The problem then becomes how to elevate this sewage to the level of those top issues on which we elect a politician.

Eric Hines

MikeD said...

Let the VA's current medical expenditures be audited by outside auditors (as a first cut, maybe each of the 50 States could audit the facilities in their States), and the funds paid originally for "insurance" or to VA hospitals or to... instead paid directly to the vets, and let them see the doctor of their choice at the hospital of their choice. The existing and ongoing VA annual budgets could simply be used to pay the vets directly in the out years.

Eric... that is absolutely brilliant! Once again, sir, you've cut to the core of the matter and I am awed by your solution.

Cass said...

I frankly cannot express how angry this makes me.

I understand. FWIW, my comment was meant more to explain the apparent apathy/passivity you have experienced than as a response to your (entirely justified) outrage.

MikeD said...

*Important note: Cass did previously mention vouchers, and this is also a good step. In fact I'd go so far as to say if the political will is not there to disband the VA entirely and go with Eric's solution, then I would recommend a stopgap solution to the interminable wait times be that if a vet cannot be seen within the required time frame, that they be given a voucher to seek medical care in the private healthcare system with the costs coming out of the VA budget. It would rapidly have the same effect as dismantling the VA, as its whole budget would be eaten away quickly under the snowballing effect. And yes... I see that as a good thing.

Ymar Sakar said...

What has sent me over the edge is the intentional cover up of practices mandated by senior VA management at the hospitals to hide patient records, alter or destroy documentation, and otherwise bury requests for treatment that have gone over the requisite timeliness requirements in order to look like they're handling everything in a timely manner. That's fraud, it's dereliction of responsibility, and it's directly responsible for several veterans' deaths.

Nothing of the sort is happening. All Republican, anti Obamacan, racist lies. They'll get the caning those Republican weak pukes deserve, and all will be right with the world.

Hussein will make the oceans subsist. The light unto Heaven will open, and people will come to Believe.

(Whisper: Shhhh, they're listening)

Texan99 said...

Mike, I'm sorry you get the impression people aren't angry about this. I'm white hot over it. I could accept delays, though I agree with the idea that vets who can't get decent care should at least get vouchers. But what I can't tolerate is that at least five different locations now have been shown to be lying to cover up the delays. The idea that the institution could muddle around trying to decide what to do about such a thing makes me furious. How much more obvious could it be that anyone involved in such a coverup should be fired and lose any federal benefits? If a VA hospital can't get done what it needs to get done with the budget and personnel it's got, it should be trumpeting the fact to the sky, not hiding it.

Ymar Sakar said...

The idea that the VA or the American Regime serves the people's interest is an idea of Eric B's.

It's a fruit loop concept based around how livestock are humans and should be treated as humans.

Charles Gallo said...

I'm wondering if perhaps the BEST way to reform the VA system is to actually eliminate the VA system. Give vets a really GOOD (not a bronze plan) insurance plan, and let them loose on regular hospitals

Then sell off the VA hospitals, close them down, re-open as regular hospitals that take patients from the general public

Just a thought experiment. Might not work, but might

Ymar Sakar said...

Just put Hussein O's people under the same care. Watch it either improve or be dismantled.

Of course, that's a personal joke, that people here may not get.

E Hines said...

...at least five different locations now have been shown to be lying to cover up the delays. The idea that the institution could muddle around trying to decide what to do about such a thing makes me furious.

This is why I think things are too far gone for a simple military management fix to work. The VA must go. Full stop.

Eric Hines

raven said...

Malfeasance or criminality in government, could be solved very easily by simply convicting and shooting a half dozen of them.
Send a Message.

IIRC some Englishman stated similar thoughts, "every once in a while we have to hang an Admiral to make make the others pay attention". (paraphrased)

Unfortunately, we have reached a point where almost no offense by the political class will bring real physical retribution-even in the most heinous cases, the ones who could prosecute, fear to do so because of the blackmail held by the other side. Thus we have officials who believe and act like they are above the law-because they ARE, for any practical purpose.

Say what you will about the Chinese, when they have a big outrage or embarrassment they usually apply consequences- remember the melamine tainted milk scandal? There were a few top men in the industry shot over that-I doubt it was about the adulteration of the milk, I think they were shot because they made the Chinese Gov. lose face as a whole.

E Hines said...

the ones who could prosecute, fear to do so because of the blackmail held by the other side.

Here may be the place to start with some of those hangings. Pour l'encouragement des autres

Eric Hines