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With all the reports in recent weeks regarding the many veterans that were denied healthcare (report: 120,000 veterans on wait list for more than 90 days) and those that died waiting for healthcare (report: veterans die waiting for care), I can't help speaking up that we simply must acknowledge the bad outcomes large bureaucracies seem to be capable of and even promote.

Clearly, it is time to change our mindsets as to what is acceptable!

Sometimes we get into these philosophical discussions about government versus business. Which is better able to help society? Those on one side may suggest that only government has the best interest of the people at mind. And that, given enough funding, the government can fulfill its purpose to "take care" of us. Those would also hold that business is inherently only concerned about money and has no interest in helping anyone. 

The opposite point of view is that business must either offer a worthy, valuable service or product, or face annihilation by market forces, and or even legal action. A business that rips people off, or hurts people, can effectively disappear overnight, if customers won't purchase their wares. And a court of law can penalize or even revoke their ability to operate. This side often points out examples of government bureaucracy inefficiency and ineptitude, and that there's often absolutely nothing the regular people can do to correct a government entity that is doing wrong or providing ineffective service. 

I submit that what we are learning about the Department of Veterans Affairs (VA) serves to point out the absolute worse that can happen when a government bureaucracy is given greater and greater responsibility, in the absence of proportional transparency and accountability. Let me offer a few points for thought:

• Considering the charter of the VA, how could we imagine that such an organization - especially a "government agency" - would fail to do their best to fulfill their mission to provide healthcare to our veterans?! These men and women made sacrifices not imaginable for most of us. So then, if no other case illustrates what can go wrong, this one should make us take note.
• It is not one or the other political party that is to blame here. Problems at the VA have been known for a very long time. Even if they did go completely out of control in the last 10 years, its simply not a political party's fault. Both parties could have raised awareness and used their control to get on top of this. I can't imagine why they didn't! However, the blame can't fall mainly on them.
• Where the blame can be placed though, is the crux of this article. The government bureaucracy (i.e. the Department of Veterans Affairs) is responsible. It had a mighty charter. It had a huge amount of money (see Total VA funding has grown in 2015 by nearly 68% from 2009). It should have even had the "moral high ground of looking out for the interest of the people"!!!
• At least with a business, there would have been many factors to deter people from doing what the VA has done in mismanaging operations and denying veterans healthcare services. A business would have been subject to: Competitive threats. Individual concern for job. Lawsuits. Regulatory penalties.... The VA is subject to none of these, and apparently the people that make up the organization realized that, and took advantage.
• While I think it is not reasonable to blame one party or the other for the underlying calamity, I would not be fully transparent if I did not also mention that the current party in power is clearly trying to hide the truth. Do they think we are really this stupid? I realize we are used to politicians misleading us. But I for one am tired of thinking that is the best we can expect!!! As a society we need to turn this ship around and ensure that people we elect know what's expected of them, and hold them accountable.

My last, but not least point should test our sanity as a society. How would you answer these two questions as a general philosophy:

1. Should an organization be prohibited from firing people when there is valid cause, such as not performing their job, or breaking the law?
2. Is it reasonable for an organization to knowingly waste billions of dollars without end?

Unfortunately folks, the answer for government bureaucracies - and definitely for the VA - is Yes. Now, in my little old opinion this is a sign of our society's pending insanity. How is it sane to believe that an organization should be prohibited from firing bad people? This is some sort of warped sense of protecting the individual? How did we get to the point that it is even feasible to implement such a process? How do we rationalize paying bonuses to people that are knowingly cheating the system? And how is it an organization can operate with impunity even while it wastes billions of dollars? None of these things should be possible in a sane world.

We might be on a slippery slope with the whole healthcare transition. While we move toward the government-run model, perhaps we should do something drastic to the rules. Transparency would be one thing. With today's technologies, it is not acceptable to have a paper-based system. Transparency in operations is almost impossible (certainly impractical) with paper processes. And accountability is the second thing. If VA (and or our healthcare system) were run by a business, then the repercussions to the current scandal would be clear. Many people lose their job IMMEDIATELY. Many people probably go to prison, for anything from falsifying records to negligence or manslaughter! Such "organizations" would be jeopardized, and new ones would be created that address the issues. 

I know that these are difficult problems. But, if the people decide that the answer is with more government, it is absolutely mandatory that we change the rules on them. How am I wrong? I'm not saying we need to privatize VA (and keep healthcare private) but if not, let's act sanely. Demand transparency and accountability! Don't hope for it. Make it happen!