The non-profit, for profit and government sectors in American
society are intertwined and interdependent.[1] A recent example of how these sectors behave
synergistically is the change in
leadership of the government’s second largest t agency, the Department
of Veterans Affairs, from a venerable and highly decorated military general,
Eric Shinseki, to a corporate business manager.
In August 2014, Robert McDonald became secretary of veteran’s affairs
after a 30-year corporate executive career at Procter & Gamble. Following scandals of poor management, cover
ups regarding enormous waiting lists for health care benefits for Afghanistan
and Iraqi veterans and a whistle-blower’s disclosure that delays in care had led
to deaths at the VA’s medical center in Phoenix, Arizona, McDonald was
appointed by the Obama administration and confirmed by the United States senate
to lead an agency whose information processing technology dated back to the
1980s.
Using a business perspective, McDonald proposed an aggressive
restructuring of the VA that would give veterans a single point of contact for
health care and other services and consolidate functions under a smaller number
of regional executives to make it easier to manage problems locally.[2] He increased the salaries of VA physicians
and nurses. Understanding the paucity of
physicians and psychiatric and mental health professionals in the VA, McDonald
started an aggressive recruiting campaign of students and medical residents by
personally visiting medical schools across the country. His plan was to offer competitive salaries and
school debt forgiveness up to $120,000.
What is most interesting about the intersection of corporate
and government expertise is that McDonald opposed privatization trends
advocated by Republicans in Congress, some of whom advocated decreasing the
breadth of services and employees of the VA by substituting a voucher system that
would allow veterans to access private physicians. McDonald argued that a voucher system “would
erode the three independent VA missions of treatment, research and teaching.”[3] In this instance, legislators promoted a “fiscal
bottom-line” approach while the erstwhile business executive encouraged solutions
based on non-profit principles and purpose.
However, Congress decided to pass the Restoring Veterans’
Trust Act introduced by Democratic Senator Bernie Sanders and Republican Representative
Jeff Miller, to allow
veterans facing long delays to get care outside the VA, if VA doctors are
unable to treat patients within fourteen days, at private doctors' offices,
military bases or community health centers. This expanded
funding opportunities for non-profit
service and advocacy organizations like Iraq and Afghanistan Veterans of
America, Wounded Warriors Project and Disabled American Veterans to name a few.
This example underscores that for profit, nonprofit and
government sectors must rely on each other to prosper.[4]
[1] Berman,
H.J., “Doing ‘Good’ vs. Doing ‘Well’: The Role of Nonprofits in Society,” Inquiry
39: 5-11, Spring 2002.
[2] A
single regional framework plan-MyVA Initiative-was officially announced by the
VA on January 26, 2015. Office of Public
and Intergovernmental Affairs, http://www.va.gov/opa/pressrel/pressrelease.cfm?id=2672.
[3] Richard
Oppel Jr., “V.A. Creates Plans to Consolidate Services,” The New York Times, November 11, 2014, page A20.
[4]
Berman Inquiry 39: 5-11, Spring 2002; Hall, P.D.; Van Til, J., The Jossey-Bass
Handbook of Nonprofit leadership & Management, Chapters 1 &2, Second Edition, Herman,
R.D. & Associates, 2005, John Wiley & Sons, Inc., San Francisco, CA.
