By Adam Andrzejewski
Note: Friday, May 30, 2014- VA Secretary Eric Shinseki resigned. This action makes the question even more important: Can the systemically, bureaucratic VA reform itself by promoting an insider?
Last week, the Congressional testimony of VA Secretary Gen. Eric Shinseki was echoed by President Barack Obama; both declared they were "mad as hell" about the VA scandal rocking the nation. In an attempt at instituting reforms, Shinseki fired the VA Undersecretary of Health Dr. Robert Petzel and immediately filled the position with a long-time VA insider, Dr. Jeffrey Murawsky, who has served since 2009 as the Chief Executive Officer of Great Lakes VA Health Care System.
As the regional VA CEO since 2009, Dr. Murawsky has been in charge of Edward Hines Jr VA Hospital in Cook County, IL and the other VA facilities within the Midwest region. It’s a safe bet that he’s had a significant personal impact on the quality of care and cultural mores of the Hines VA hospital because he was a healthcare executive there from 2001-2006 before his promotion in 2009 to the CEO role.
If Dr. Murawsky is our country’s most promotable solution to the VA crisis, then the entire system needs to be overhauled.
Public records from Freedom of Information Act requests posted at OpenTheBooks.com, the work of recent investigative journalists, and public documents related to whistleblower complaints reveal a disturbing record of systemic operational breakdowns and a poisonous cultural environment at the very institutions that Dr. Murawsky has been in charge of overseeing. Here’s part of what lawmakers and citizens need to know about the Hines VA Hospital that Dr. Murawsky has had a CEO’s role in overseeing since 2009:
- The VA spent over $1 billion in employee salaries and $16 million on bonuses during the last three years at Hines. In 2013, Hines had 4,230 employees, but only 309 were doctors, 690 nurses and 75 practical nurses. Only 3 employees had the job title of Quality Assurance (QA), a job dedicated to making sure rules were followed and veterans received the care they deserved. To put this in context, $1 Million more was spent on the salaries of painters than on QA salaries since 2011 while our veterans waited to get an appointment.
- At Hines, whistleblower Germaine Clarno, a social worker and President of American Federation of Government Employees VA Local #781, has alleged that patients were kept on secret wait lists so hospital executives could collect large bonuses. A database maintained by Cox Media Group suggests that five patients died while awaiting care.
- Current Hines VA Director Joan Ricard seemed to confirm the whistleblower allegations in an internal memo written on May 8th: "Over the years, with the complexity of the scheduling process and the pressure to improve reported results, there may have been instances across the VA where staff has taken steps to make wait times look better."
- According to information on U.S. Senator Mark Kirk’s website, "Sadly, the VA’s Chicago Regional Office- which processes claims for all Illinois veterans-is the fourth most backlogged processing center in the country. Deserving veterans in Illinois have to wait an average of 483 days after their claim has been filed before being awarded determination."
- Hines VA employees have filed 650 complaints with the Equal Employment Opportunity Commission for bullying and harassment. A combative work environment is not a hallmark of a quality, thriving healthcare delivery system.
- These acute problems didn’t start recently, and Dr. Murawsky’s leadership was insufficient to the task of fixing them. In 1999, a VA study concluded, "Hines has the most inefficient physical plant for inpatient care and the most significant compliance issues with patient privacy." In 2005, a VA study rated Chicago the worst regional office in the country.
In leadership, the best predictor of future success is past performance. Is Murawsky’s record of performance one that deserves promotion to a national role where vets and their families can begin to expect relief in a broken system? At Hines, Dr. Murawsky was unable or unwilling to challenge a bureaucracy that is serving the bureaucracy, not veterans.
If Dr. Murawsky’s record is the most promotable one among senior internal candidates to a national problem solving role, then it says something about the depth of institutional shortcomings at the Department of Veterans Affairs. It’s time for the Obama administration to show some executive leadership here.
Small fixes, incremental changes, and internal promotions are not going to fix the problems at the VA. At a minimum, empowered outside leaders with fresh thinking must be quickly brought into the VA system. This still-developing story of incredibly poor service, misallocated public resources, and internal cover-ups bolsters the arguments of those who have been quietly arguing for years that dollars earmarked for veteran healthcare must follow the healthcare needs of the veteran and not the bureaucracy.