Policy and the branches of government | AP US Government and Politics | Khan Academy

As we've discussed in other videos, the federal bureaucracy is a huge part of the US government, sometimes even called the fourth branch. It has more than two million employees who work in various agencies dedicated to implementing the law. So, the bureaucracy has a lot of discretion to decide how best to achieve a policy goal.

But the sheer size of the bureaucracy, along with its independence, can make it difficult to monitor what happens when a bureaucratic agency fails to carry out its mission or deviates from the letter or the intent of a law. What can the other branches do to keep it accountable? Let's use a real example to make things a bit more concrete.

In 2014, a whistleblower came forward reporting that a hospital in the Department of Veterans Affairs was deceiving federal regulators about how long veterans were waiting to receive health care. Because officials at the VA got pay bonuses based on ensuring that patients had short wait times for medical care, they were falsifying electronic records to keep wait times within those acceptable guidelines.

In reality, though, the average wait time for medical care was greater than 100 days, and dozens of veterans died while waiting for delayed appointments. Now, this is a pretty complex story, so I'm just giving you the broad strokes here. But for our purposes, what you need to know is this was a case of very serious mismanagement in a bureaucratic agency.

So now, let's think about what the other branches of government could do using their formal and informal powers in response to this situation. I encourage you to pause the video here and see if you can list at least one action that the executive branch, Congress, or the judicial branch could take. Ready? Go!

Okay, so let's go through some of the actions that the other branches did take in response to the VA scandal, and you can check to see if you came up with any of them. So, what steps did the executive take? Remember that the bureaucracy itself is under the executive branch.

First, we saw internal investigations from the Secretary of Veterans Affairs, Eric Shinseki. The VA used its rulemaking authority to abandon the unrealistic wait time goal in order to remove that perverse incentive. It was within the power of Barack Obama, who was president at the time, to fire the cabinet secretary, but instead, Shinseki resigned.

Then, the president used his nomination power to replace him with a new VA Secretary, Bob McDonald. Obama also introduced a number of executive actions to address the problem, including establishing an independent accountability review board, a board of physicians to advise the secretary, a plan to upgrade the electronic health record system, and protections for whistleblowers.

What steps did Congress take? First, Congress used its oversight power to call hearings investigating what was going on at the VA. They subpoenaed Secretary Shinseki to testify. They also passed reform measures using their law-making powers and the power of the purse to fix the larger problems at the VA, funding a 16 billion dollar plan to hire more doctors and nurses, upgrade facilities, and allow veterans to see private doctors if necessary.

As part of this reform, Congress included legislation that made it easier to hold VA officials accountable for misconduct. Congress also used its power to approve presidential nominations by confirming the new VA Secretary.

The judicial branch, for its part, reviewed the constitutionality of the new rules holding VA employees accountable. The federal court system heard a case about whether it was constitutional to fire civil servants who weren't appointed without giving them a chance to appeal. The courts ruled that that was unconstitutional.

So, in 2017, Congress passed a new bill adding a grievance process for civil servants, which President Trump then signed into law. So, it's been a few years since the VA scandal, so how are things doing? Did the reform measures work?

In 2015, the New York Times reported that only three people had been fired as a response to the scandal, despite Bob McDonald's public statements that 60 employees had been fired. In 2019, Deborah Draper, the healthcare director at the Government Accountability Office, told the House Veterans Affairs Committee that although the VA had made progress in wait times and scheduling, there was still room for improvement.

She said that the VA's new system was still not accurately recording patient wait times and that veterans might still wait up to 70 days for an appointment, even though the VA was reporting a much shorter delay. On the positive side, the VA completed one million more appointments for veterans in 2018 than in 2017, showing that access to care for veterans had definitely improved.

So, what do you think? Were the other branches of government able to hold the VA accountable? If you had to solve this problem either as a member of Congress, a judge, or the president, what other steps could you take?