Behind Eric Shinseki’s Downfall

The VA secretary who was looking for a second chance after Iraq was undone by an overwhelmed health system and Washington’s hyper-partisan health care politics.

WASHINGTON, DC - MAY 21: Veterans Affairs Secretary Eric Shinseki arrives at the White House before a meeting with U.S. President Barack Obama May 21, 2014 in Washington, DC. The White House announced that Obama and Shinseki will speak to the press after their meeting. (Photo by Chip Somodevilla/Getty Images)
National Journal
James Kitfield
May 30, 2014, 11:21 a.m.

Eric Shin­seki’s staff was prac­tic­ally on a death watch Thursday, the pro­gnos­is dark­en­ing as the day wore on.

The early re­lease of an in­ter­im re­port by the Vet­er­ans Af­fairs De­part­ment’s in­spect­or gen­er­al had come as a sur­prise, and its find­ing that pos­sibly fraud­u­lent re­cord keep­ing to hide ex­traordin­ary wait times at VA health fa­cil­it­ies was a “sys­tem­ic prob­lem na­tion­wide” promp­ted dozens of House Demo­crats and a fifth of the Sen­ate Demo­crat­ic caucus to join a Re­pub­lic­an chor­us call­ing on Shin­seki to resign. An im­pas­sioned meet­ing between the VA sec­ret­ary and vet­er­ans groups yiel­ded only tep­id sup­port.

Then late in the day a thun­der­clap: a former ment­or and key sup­port­er, re­tired four-star Gen. Barry Mc­Caf­frey, told The Wall Street Journ­al it was time for Shin­seki to step down.

“Ric Shin­seki is right out of cent­ral cast­ing as the kind of per­son who should be lead­ing the VA, but my reas­on­ing was that Con­gress is deep in­to a polit­ic­al theat­er and hy­po­crisy right now on this is­sue and will be right up un­til the Novem­ber elec­tions, and Ric lacked the polit­ic­al in­stinct to go for the jug­u­lar and not be used as a con­veni­ent punch­ing bag on Cap­it­ol Hill,” Mc­Caf­frey told Na­tion­al Journ­al in ex­plain­ing his de­cision. “So at 72 years old, Ric has served his coun­try his en­tire life with quiet pro­fes­sion­al­ism, and I think he’s earned the right to hand over the reins now and let someone else try and solve these prob­lems.”

With sup­port crum­bling among Demo­crats and the White House eye­ing a mid-term elec­tion that could hand the Sen­ate to Re­pub­lic­ans and threaten the pres­id­ent’s leg­acy, Shin­seki’s pub­lic apo­logy this morn­ing, fol­lowed quickly by Pres­id­ent Obama’s ac­cept­ance of his resig­na­tion, were all but pre­or­dained. “He doesn’t want to be dis­tract­ing. That was Ric’s judge­ment,” Obama said in the White House brief­ing room. “I agree. We don’t have time for dis­trac­tions.”

In the end Shin­seki was un­done by his at­tempts to scale twin peaks of Amer­ic­an dys­func­tion: a VA health sys­tem over­whelmed by vet­er­ans wounded and dam­aged by more than a dec­ade of war, and Wash­ing­ton’s hy­per-par­tis­an polit­ics on the is­sue of health care. As a re­tired four-star gen­er­al and former sol­dier, he also knew that re­spons­ib­il­ity ul­ti­mately rests with the com­mand­er at the top, and Shin­seki had no ready an­swer to the ques­tion posed by the scan­dal: Giv­en prob­lems as­so­ci­ated with long wait­ing times and in­ap­pro­pri­ate schedul­ing schemes to mask them that trace back many years, why didn’t he know that a sys­tem­ic prob­lem ex­is­ted?

When Obama made Shin­seki one of his first Cab­in­et picks in 2008, the of­ficer seemed to check all the boxes. He was a dis­abled vet­er­an who lost half his foot to a land­mine and re­ceived Purple Heart medals on both tours in Vi­et­nam. As Army chief of staff, Shin­seki had clashed pub­licly with former De­fense Sec­ret­ary Don­ald Rums­feld, testi­fy­ing that the post­war oc­cu­pa­tion of Ir­aq would re­quire sev­er­al hun­dred thou­sand troops, far more than what the Pentagon was es­tim­at­ing. His­tory proved Shin­seki right — and Rums­feld dis­astrously wrong — a point not lost on a new pres­id­ent who made op­pos­i­tion to the Ir­aq War a fo­cal point of his cam­paign.

Iron­ic­ally, Shin­seki saw the job of VA Sec­ret­ary as a second chance to end his ca­reer on a less con­tro­ver­sial note (Rums­feld fam­ously made him a lame duck as Army chief by nam­ing his suc­cessor more than a year be­fore Shin­seki’s re­tire­ment). “I took this job be­cause you don’t of­ten get ‘do-overs’ in life,” Shin­seki told Na­tion­al Journ­al in a 2011 in­ter­view. “For me, this job is a big do-over, be­cause I get to take care of people I served with in Vi­et­nam, as well as people whom I sent to war as Army chief of staff.”

A change agent in the Army who worked to make the ser­vice light­er and more rap­idly de­ploy­able, Shin­seki set about re­form­ing the vast VA bur­eau­cracy with a stra­tegic cam­paign fought on three fronts: cut­ting a per­sist­ent back­log of dis­ab­il­ity claims; im­prov­ing vet­er­ans’ ac­cess to VA ser­vices; and re­du­cing home­less­ness among vet­er­ans. A large part of his leg­acy will be the not­able pro­gress he made on each front. The res­ult has been a VA health ser­vice that is con­sist­ently rated by vet­er­an pa­tients in in­de­pend­ent sur­veys to be among the best in the na­tion, and equal to or bet­ter than private-sec­tor hos­pit­als.

However, the VA health sys­tem has also struggled migh­tily to cope with a pop­u­la­tion of wounded vet­er­ans swelled by the wars in Ir­aq and Afgh­anistan, in­clud­ing nearly half a mil­lion ser­vice mem­bers suf­fer­ing from posttrau­mat­ic-stress dis­order by some es­tim­ates, and more than a mil­lion ser­vice mem­bers ex­pec­ted to sep­ar­ate from mil­it­ary ser­vice and join the ranks of vet­er­ans between 2011 and 2016. They are adding to the in­creased de­mands of an aging pop­u­la­tion of Vi­et­nam vet­er­ans, whose dis­ab­il­ity claims spiked by 250,000 after Shin­seki made the de­cision to fi­nally settle Agent Or­ange claims be­cause “it was the right thing to do.”

That is the con­text be­hind the re­cent VA IG re­port that the health care sys­tem in Phoenix grossly mis­stated how quickly vet­er­ans were re­ceiv­ing care, with some wait­ing 115 days for an ini­tial ap­point­ment and 1,700 vet­er­ans lan­guish­ing on an un­of­fi­cial wait-list. It was just the latest re­mind­er that the VA sys­tem’s sup­ply of health care lags sig­ni­fic­antly be­hind grow­ing de­mand.

Sources close to Shin­seki also be­lieve the scan­dal and his re­sponse be­came hope­lessly en­tangled in the par­tis­an polit­ics sur­round­ing Obama­care, with Re­pub­lic­ans de­term­ined to make the fail­ings of na­tion­al health care in gen­er­al a primary fo­cus in up­com­ing elec­tions. A num­ber of Re­pub­lic­ans have re­spon­ded to the scan­dal by call­ing for the privat­iz­a­tion of the Vet­er­ans Health Ad­min­is­tra­tion, for in­stance, and Sen. Richard Burr, R-N.C., en­gaged in an un­usu­ally vit­ri­ol­ic pub­lic ar­gu­ment with vet­er­ans groups after cri­ti­ciz­ing them, just be­fore Me­mori­al Day, for not de­mand­ing Shin­seki’s resig­na­tion.

“Part of the dy­nam­ic was Re­pub­lic­ans who fa­vor privat­iz­a­tion saw cri­ti­cisms of the VA health sys­tem and of Shin­seki as an easy way to im­pugn ‘so­cial­ized medi­cine,’ which made Demo­crats who might be sym­path­et­ic to such a single-pay­er sys­tem nervous,” said a seni­or VA of­fi­cial.

Shin­seki was de­term­ined to stay above that polit­ic­al scrum, and like a good gen­er­al he trus­ted sub­or­din­ates to bring him bad news as well as good. The hon­or and in­teg­rity that Shin­seki bought to the job, said the of­fi­cial, thus made him re­luct­ant to en­gage in polit­ic­al in­fight­ing, or to ques­tion the truth­ful­ness of his lieu­ten­ants. “It’s like a Greek tragedy that way,” he said. “The very at­trib­utes that made him per­fect for the job also con­trib­uted to his down­fall.”

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