The president has turned to a former chief executive of Procter & Gamble to turn the tide at the troubled Department of Veterans Affairs. Since woeful management is the chief concern, this could be an inspired choice.
Normally, the job is handed to a retired military commander or a political leader, but Bob McDonald is neither. He is a West Point graduate who served for five years in the Army’s 82nd Airborne Division before rising to the top of a multinational organization with more than 120,000 employees. He is known for having a mastery of complex operations, which should come in handy at a government agency that’s needlessly complicated.
The unusual choice seems to have mollified the president’s Republican critics, so the country may be spared a grueling confirmation process. Good. The VA needs a rapid turnaround in how it manages the health care of millions of veterans.
The task won’t be easy, and like many corporate chieftains, McDonald will find that trying to run government like a business has its limits. For starters, it is more difficult to move workers around because of civil service rules. Plus, the bottom line isn’t as easy to find in government, which delivers services, not profits. The interest groups are also different. For instance, politicians looking for headlines, rather than shareholders looking for better returns.
But even given those restraints, there is much room for improvement.
A recent White House review notes the VA’s “corrosive culture,” citing poor management practices, a lack of accountability and breakdowns in communication. All of those issues – and more – have affected the quality and timeliness of care.
The review found that the 14-day goal for patients getting appointments was unrealistic, but clinic managers pursued it anyway, and then gamed the system to report “successes” and gain bonuses. Those bonuses have since been canceled.
Since the scandal broke, Congress has passed a reform bill, adding funding for more doctors and other health care workers. Patients can now access private health care and have it paid for if they don’t live within 40 miles of a VA clinic or can’t get timely appointments. Also, Congress has made it easier to fire VA managers.
The VA is getting a surge of new patients from the Afghanistan and Iraq wars, and Vietnam vets are entering the age when they need more health care, so an infusion of money to expand resources was overdue. But this is not just about spending more money. The VA must become leaner and more flexible. The nation can’t afford to have billions of dollars squandered by “doing it the way we always have.” The money must get to the patients in the form of care, not be squandered by administrators chasing bonuses.
McDonald made $15.9 million in his last year at P&G. As VA secretary, he would be paid $199,700, so he’s not taking on this mission for the money. But if he can unclog bureaucratic arteries and pump life into VA care, his service would be invaluable.