Throwing more money at VA won't solve problems

Regarding the editorial “Beyond the theatrics of the VA scandal,” you make some good points about the size and complexity of the Veterans Affairs system. However, I was sincerely disappointed by your last few paragraphs crying about how VA administrators are not paid enough money. Your statistical information is correct, but the pay scales have absolutely nothing to do with this scandal. For people willing to lie and cheat, paying a lot more just makes the stakes bigger. The only way to run a VA hospital is to work your way up through the federal employee bureaucracy, and very few if any of those hospital executives who get paid so much more would dream of doing that. Most of them could not even survive in that environment where the exceptional are shunned. I know the vast majority of VA employees are honest and hardworking, but they struggle constantly against apathy and dishonesty that is allowed to roam unchecked.

The problem is the federal bureaucracy. As multiple scandals (IRS, EPA pay bonuses, State Department and Benghazi) have exposed lately, there is no accountability. This breeds slovenly work and corruption. That is why the VA is a mess and will stay that way despite the majority being honest and hardworking.

I am truly disappointed that you do not understand that. It is the fault of Congress and the grossly overprotected status they have created for federal employees. Advocating Congress' favorite solution of throwing money at problems to make them go away will do nothing to fix the VA.

George Dillinger

Director of materialsWestern Arizona Regional Medical Center Bullhead City

Regarding the article “Senate bill would let VA hire more doctors, nurses,” U.S. Sen. Bernie Sanders' substantive ideas not only deserve prompt consideration, but also action. His idea of paying off student debt for doctors and nurses who come to work in the VA system is excellent and should be applied to other health professionals as well. The VA challenges are multifold; however, access to primary care is vital and it is one of the critically weak areas of the VA system.

Martin Diamond

Principal and co-founderZIA Healthcare ConsultantsSan FranciscoSenior fellow, UCSF Center

for the Health Professions

Regarding “CMS proposes stretching Stage 1 in EHR incentive program,” I'm a 65-year-old physician. Visiting another internist a good 20 years younger than I am, he apologized that converting to electronic health records was still slowing them down in his office. I asked, “How long have you been suffering during the conversion?”

“Since October,” he answered, and this meeting was in May.

I think EHRs are being forced on us so insurance companies and Medicare can use lightly trained clerks to gather utilization data. Those bean counters don't have to decide which square hole to jam each round peg into; EHRs make us do that for them.

Dr. David Grant

Medical directorSun Research InstituteSan Antonio