It has been in the news for weeks now.  It started with the Veterans Administration Hospital in Phoenix where 40 patients are alleged to have died waiting to see a specialist. Now the scandal has spread to more than a score of other hospitals and who knows how many deaths.  

Memorial Day has just passed.  And everybody agrees: This is a shameful way to treat our nation’s military personnel who have sacrificed so much for us.

The problem came to light in its most recent manifestation in 2006 with a report sent to the Bush administration.  They hardly had time to get corrective action moving, but in any case, President Bush’s VA chief deliberately refused to act.  However, the Bush transition team made a full report to the incoming Obama administration and pressed them strongly to take action and solve the problems at the VA.  For nearly six years the Obama people sat on it.  Until the scandal broke in Phoenix.

So what do we do now?  Some have blamed the problem on a bloated Federal government that seems unable to run anything right. And it is pointed out by those on the right that the problems at the VA are what await all of us with the imposition of Obamacare.  Very likely they are right.

Some have suggested that one solution would be to give veterans a health card that permits them to go to the private hospital of their choice for treatment.  But I am told, union pressure will render that solution DOA.

The very fact that private hospitals do a better job than the VA casts light on the real nature of substandard care and medical inefficiency.  One reason is that the chief administrators in the VA hospitals are paid bureaucrat wages.  For example, the chief of the VA system in Phoenix, who is now on paid leave, receives an annual salary of $170,000.  Plus bonuses that she fudged.

Care to guess what the heads of the largest private hospitals are paid?  Anywhere from  $1.5 million to $2.5 million annually.  That’s because at the top level, hospital administration is a high skill, unbelievably complex responsibility.  There are not many chief executives available who possess the necessary ability to run a hospital system efficiently and effectively and at a profit.  You get what you pay for.  But patients who need high level care are extremely thankful if a hospital has an executive who does the job well!  Whatever it costs.

The real problem with the VA-- indeed, with every government bureaucracy--is that there is no real accountability.  Who holds the clerks responsible, the orderlies, the techs?  Work your way to the top: Who holds head administrators’ feet to the fire?  Well, Congress has set up watchdogs to look over the shoulder of the government appointees who oversee the hospitals. And because that isn’t working, there are two more levels of watchdog groups appointed to oversee the watchdogs who watch the watchdogs who watch the hospitals.  Ludicrous.  Ultimately no one is in charge.

I must hasten to say that I know several doctors who practice in the VA system, and they are very good and very conscientious.  I would not hesitate to place myself in their care.  And I am sure there are very excellent nurses and staff at those hospitals as well.  So this is not about them.

But here is the root of it: The system as it is necessarily constructed, allows too many people to just not care what quality of job they do.  They get paid whether they do slipshod work or not.   And human nature succumbs easily to the temptation to put minimal effort into a job when no one is watching.   When no one seems to care. 

We have already mentioned the impossibility of creating sufficient accountability in the VA system.  It cannot be done.  In fact, work rules make it almost impossible to fire a lazy or incompetent worker.  So they stay and stay.  And that is not going to change.  And that discourages the good guys.

There is another way, however, to produce change.  It is within the hospital worker’s heart.  All the way to the top.  In the Bible, in Ephesians 6, the apostle Paul writes to Christian workers.  He urges them to do their jobs “not by way of eyeservice, as menpleasers,” --which means you don’t do your job at a quality level just because someone is watching what you do-- “but [serve] as slaves of Christ, doing the will of God from the heart.  With good will render service, as to the Lord, and not to men, knowing that whatever good thing each one does, he will receive back from the Lord.” (v 6-8)   Accountability to God.  Reward from God.  A spirit of excellence that rises from within.

What I am suggesting is that a profound change of heart and attitude comes only from God’s intervention in a person’s heart.  That is what the VA needs.   What I am calling for is a religious revival.

Do you laugh and respond with derision?  Got a better idea?

Dr. Rick Perrin is a minister in the Presbyterian Church in America and Chairman of the Board of World Reformed Fellowship..  He writes a weekly blog called ReTHINK which may be accessed at www.rethinkingnews.wordpress.com. He may be contacted directly at This email address is being protected from spambots. You need JavaScript enabled to view it..