Fixing the VA
Regarding the shortage of VA primary-care doctors ["Editorial," May 21], how about promoting nurse practitioners and physician's assistants as primary-care providers? I was shocked when Russia did this decardes ago, but I think this is the trend of the future.
Also, let's remind everyone of tax cuts and how they can kill. Thank you!
Valerie Sanfilippo, Linda Vista
Politicians and the VA
Regarding your May 21 editorial, "Deep problems at Veterans Affairs": Perhaps the most important point alluded to is that Congress shouldn't be let off the hook.
Politicians are the root of most evil within government—and not just in the VA. Politicians are behind things such as unfunded mandates, unqualified crony appointments, pork-barrel spending, extreme partisan politics, quickfix mindset, etc. Bureaucracy and pressure for quick fixes likely was behind flawed bonus incentives that led to "the need to cook the books" mentioned in the editorial.
We've seen this movie before; it's reminiscent of things like No Child Left Behind incentives that resulted in teach-to-test instead of real learning. And this is not unique to government; it happens in the private sector, as well.
And as the editorial stated, "the mess has fallen into the lap of Eric Shinseki" and "what appears to be happening around the country is a symptom." Sure, the VA is a large entrenched bureaucracy, but that notwithstanding, the VA has been given a near-impossible task by the politicians who, as usual, blame all but themselves through scapegoating, stunts and theater, playing fast and loose with the facts and figures, etc.
A case in point: Sen. John Thune of South Dakota, on one of the Sunday-morning shows, stated that VA funding increased 60 percent over five years, so funding is not a problem. First of all, the BS detector should go off whenever someone starts the clock running at the start of the Obama administration. Secondly, Thune implied that funding increases all went to healthcare when the reality is that VA spending also covers other programs like homeless vets and education. In addition, VA healthcare is inherently more costly because of things like illness related to Agent Orange, post-traumatic stress disorder, traumatic brain injury and reconstructive surgery—things the private sector doesn't have to contend with to the same degree.
Gen. Shinseki was faced with a monumental task not of his own making, and calling for his resignation made no sense. In addition, a replacement more up to the task—if one exists—will be difficult to find. Shinseki seemingly has more integrity in the tip of his pinky than any of those who were calling for his head.
Now, if we could only get a Congress that's up to the task.
Dan Jacobs, Mira Mesa
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