Commentary: Part Of The VA Problem Was Setting An Unrealistic Standard
Too often governmental scandals become couched in blaming an administrator for the problem. Critics seldom look at a bureaucratic organization for its failings or how bureaus channel the behavior of their employees. One element that should be examined is how success is judged.
In the case of the Veterans Administration and Gen. Eric Shinseki, we see staff at VA hospitals responding to how they would be evaluated. Such evaluations affect compensation and promotion and hence behavior. Employees also tend to go along to get along.
Shinseki sowed the seeds of his own demise.
The New York Times reports that, after becoming VA secretary, Shinseki set the standard that new patients had to be seen within two weeks. Such a quantitative target is quite common in administration. In this case, it was highly unrealistic given the increasing number of veterans seeking care and the shortage of providers at VA hospitals. Hence, duplicate lists were created so that the standard appeared to be met and many veterans waited far longer for care.
Playing the numbers game has affected bureaucratic behavior in many cases and can distort the core agency mission. Remember the kill ratios during Vietnam? Body counts of Viet Cong and North Vietnamese troops were used to judge the war’s success. In retrospect, this evaluator mechanism was quite suspect.
Numbers can be subject to misuse and falsification.
Peter Blau studied an unemployment office in a northeastern city in the late 1940s. Counselors who were supposed to help people find jobs were evaluated by how many placements they made. The counselors concentrated on those easy to place, engaged in racial steering and neglected any job seekers with disability.
We also see evaluation affecting elementary and secondary education. Over the years, teachers and their schools have been judged based on standardized tests. Using these scores can be misleading. Above the first grade, there is no base for comparison. Pupils’ earlier scores are not factored in nor is the significant mobility of students in many districts. In addition, when everything depends on a test, the teacher teaches for the test and eschews other curriculum.
Returning to the VA, this cabinet department has long been a headache for its secretaries and the presidents they serve. Setting targets without examining resources and implementation is foolhardy.
Are resources adequate? Are they correctly targeted? Are the procedures appropriate to present conditions? Should routine care be separated from battlefield-related treatment? Are separate VA facilities the best way to address contemporary needs? Who are the current clientele? And these questions are just the beginning.
Bureaucracies present many administrative challenges that will not be answered with a quota system. Causes and effects matter and sometimes cannot be arrayed numerically.
Evaluation has affected the behavior of members of the Foreign Service in the latter half of the 20th century. Generally, evaluations were positive. Therefore, any negative comment would stand out and make the recipient a likely candidate for “selection out.” If a foreign service officer, did not move upward in seven years, he or she would be selected out. Coupled with the attacks on the State Department by Sen. Joe McCarthy, a spirit of extreme caution permeated the agency and briefings failed to reflect actual occurrences in foreign locales. It is no wonder that a common appellation for the department was “the fudge factory.”
On another front, a Post-Dispatch article mentioned the concerns of the University of Missouri-St. Louis about a new federal scheme to evaluate higher education. Officials want to know if the federal dollars poured into colleges and universities were paying off. Their measurement would be the average salary of graduates from a particular school. A singular measure such as this — without controls — would provide fallacious evidence. At a minimum, there should be controls for major, where the graduate is living and the type of institution. UMSL, with its high percentage of transfer students and first-time college attendees in a family, is going to be different than Mizzou, let alone Harvard. Again, when a simple measure is chosen, it can be misleading and can affect behavior and the allocation of resources.
When I learned to drive many years ago in Detroit, I was cautioned to be especially careful at the end of the month. Traffic officers would be out to fill their quota. Presumably you could get away with certain offenses early in a month. Assuming this was true, evaluation affected the behavior of police and drivers.
We can fault Shinseki for not understanding the effects of his standards and perhaps not comprehending the nature of bureaucracy. Regrettably, many governmental administrators do not.
Lana Stein is a professor emerita in political science at the University of Missouri-St. Louis.