Fasten your seat belts.
Turns out that a massive - massive - Commission looked into the VA system extensively under the Bush Administration, and issued a nearly 400 page report.
Call them the CARES Commission, and their stuff is still around on the web.
THE ELEPHANT IN THE ROOM - BOTH OF THEM
Everyone knows that the VA system is a problem. In 2004, Bush's own deputy wrote [in a large pdf "Decisions" report/response to the Commission]:While the practice of VA medicine has evolved, VA's medical infrastructure has not kept up... VA's facilities average age exceeds 50 years while those of sucessful private sector health care providers average less than 10 years.
The Congress has been reluctant to appropriate the construction funding VA will need to bring itself into the 21st century until we have a coherent national plan for moderninzing our facilities. The process now know as "CARES" .. produced that plan. It was initiated in in 1998 ... to povide a 20-year plan ...
WAR, WHAT WAR?
Neither those reports nor the two five-year capital plans (FY2004, FY2005) make any mention that the nation is at war. None of them contain detailed, long-term cost estimates for capital needs that I've found. Jaw dropping.
The Secretary of the VA under Bush writes:
"VA will soon complete and validate utilization models for long-term care and for long-term mental health care, and the results of those models will be incorporated into the captial asset planning process. But I will not delay ... waiting for better data."
Shortly after the November election in 2004, he tendered his resignation to Bush. It would seem that no one ... er, updated the model fast enough, maybe because the war was always just six months from completion? Someone ought to see why none of this stuff was accelerated in 2005 and 2006 ...
