The cure for what ails the VA

The cure for what ails the VA:

If you have a sclerotic hospital system on which everyone else has given up, the solution is Dr. Ramanathan Raju, currently the head of the public hospital system in New York but previously chief executive of the Cook County Health and Hospitals System.  No one in Chicago public life gets an A-plus from everyone, but doctors, politicians and journalists alike agree that Dr. Raju took a failing system and turned it around: re-imagining its role in a changed health care landscape while dealing with its day-to-day personnel and quality issues. The improvement has been dramatic and rapid: though Dr. Raju was only in place for two years (much to our dismay), the improvement in the Cook County public health system is obvious to all.

Hire Dr. Raju to fix the V.A.  He’s never met a bureaucracy he couldn’t tame.

(I don’t know him personally and certainly have not solicited his permission to recommend him.  In fact, he was eager to return to his family in New York, which would probably not welcome his leaving again for Washington–but, when duty calls . . . )

Author: Kelly Kleiman

Kelly Kleiman is a freelance writer on the arts, feminism, travel and social justice. Her reportage and essays have appeared in the New York Times, Wall Street Journal, Washington Post and Christian Science Monitor, among other dailies; in magazines, including In These Times and Dance; in the alternative press; on the BBC; and on Chicago Public Radio, where she’s one of the “Dueling Critics” and a contributor to the Onstage Backstage theater blog. She is also a consultant to charities and editor and publisher of The Nonprofiteer, a blog about charity, philanthropy and nonprofit management. She holds undergraduate and law degrees from the University of Chicago.

4 thoughts on “The cure for what ails the VA”

    1. Seconding this: "If you have a sclerotic hospital system on which everyone else has given up,…"
      does not describe the VA. And that's after 8 years of Bush/Cheney!

  1. The sane estimates of the cost of the wars in Iraq and Afghanistan suggested that we would have to spend $50-75 billion a year extra for VA care and disability payments into the 2050s or 2060s for veterans of those wars. How much of that has been appropriated? (The numbers I can find suggest about half.) Great administrators can help when an organization has problems, but not when you’re trying to get blood from a stone.

  2. Welcome to the politics of true socialized medicine, as in the NHS.
    1. Managers tend to rely to much on arbitrary quantitative performance indicators, which promote strategic behaviour (i.e. cheating). See Goodhart’s Law. Targets are no substitute for a good organizational culture.
    2. When things go wrong, it’s the boss’ fault. British Ministers of Health answer in Parliament for delays in getting specialist orthopaedic appointments in Wolverhampton. The usual reply is “I have created another quantitative target which will stop this happening again”, which doesn’t help, see point 1. In France, this doesn't happen in health (delivery is decentralized), but it does in education. The day of the rentrée des classes in September – an important civic anniversary – the Minister of Education used to go on TV (and maybe still does) to report on how it went. If 153 children showed up at the primary school in Clochemerle-sur-Pisse to find it closed for asbestos removal, about which nobody had thought to tell the Ministry, it's his fault.

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