VA Scandal Revisited – Is There Progress?

 

One year ago veterans were dying while waiting to get an appointment in a VA hospital. Today there have been changes, but there is still room for improvement.

About this time last year it was revealed by the Inspector General for the VA that at the Phoenix VA Hospital, primary care waiting times averaged 115 days, nearly five times what the hospital reported and eight times the VA target of 14 days. About 3100 veterans were actually waiting in line and more than half of them weren’t on the official waiting list. Whistleblowers at the hospital allege that forty or more veterans died while waiting to receive treatment.

This was not actually a new problem. According to an editorial in The Wall Street Journal, this is the 19th IG report since 2005 to document excessive wait times at VA Hospitals. The problem was first recognized during the Bush administration but got even worse during the Obama administration. Although it is true that President Obama was briefed on this exact problem when he first took the office of the presidency in 2009, there is little evidence he did much about it except increase the VA budget. By May, 2014, the scandal had reached the mainstream media.

Eventually, VA Secretary General Eric Shinseki was forced to resign and President Obama nominated former Proctor and Gamble CEO Robert A. McDonald to replace him. McDonald was quickly approved by the Senate. He has been on the job since last August and it is time to review the situation to see if there has been any progress.

New Options for Veterans

A big step in the right direction occurred with the passage of the Veterans Access, Choice and Accountability Act (Veterans Choice Program) last August. This legislation allows veterans to see non-VA healthcare providers if they live more than 40 miles from the nearest VA medical facility. They are also allowed this freedom if they can’t receive an appointment at a VA facility within 30 days. This should eliminate the long waiting times to receive care that were exposed last year.

John W. Stroud, national commander of the Veterans of Foreign Wars, writing in The Wall Street Journal, says there are more challenges to come. But further progress is the new interpretation of the “40-mile rule” announced by the VA last month. It has changed the rule from “40 miles as the crow flies” to “40 miles as the crow drives” to make it more realistic. For example: The north rim of the Grand Canyon is roughly 10 miles away from the south rim – well within the 40 mile rule – but actually 200 miles away “as the crow drives.” This shows the VA under Secretary McDonald is listening to the frustrations of its veterans.

But another challenge is unmet; when a local VA cannot serve the medical needs of a veteran. For instance, a Vietnam veteran from Jackson, Tennessee, currently seeks treatment for a neurological condition in Memphis, which requires him to travel 170 miles round trip. He would prefer to visit a non-VA doctor closer to home through the Veterans Choice Program, but he is ineligible because he resides within 40 miles of a VA outpatient clinic – albeit one that does not have a neurologist on staff.

Better Solutions

The VA scandal of 2014 has given rise to improvements in 2015. But much work is left to be done. Veterans need the freedom to seek the best medical treatment available, just like every other American. To achieve that goal will require further changes.

Last year several options were suggested. Avik Roy, senior fellow at The Manhattan Institute, writing in Forbes, made these comments:

“There is only one way to truly reform the VA, to truly ensure that veterans get the care they need. And that is to give vets the ability to take the money that the government spends on them and use it to buy high-quality, private insurance. There are two straightforward ways to go about it. One would be to give veterans subsidies with which to buy insurance from the Federal Employee Health Benefits Program, the popular private health insurance program for government workers. Another would be to allow those same subsidies to be used on the ObamaCare insurance exchanges. Either approach would allow veterans to seek care from private hospitals and private physicians.”

Considering that the ObamaCare exchanges offer only “narrow networks” shunned by the best doctors and hospitals, I would prefer our veterans be given option one. Dumping more people on the insurance exchanges will only exacerbate the waiting times those patients are likely to experience in the near future.

The Wall Street Journal editorialized their solution:

“Instead of paying for shorter delays, a better option is to fix the structure that causes delays. That means decentralizing the VA and selling off most of the institution. There is no medical or biological reason that former soldiers require special hospitals for routine treatments or even most complex conditions. The VA can prioritize specialized care for combat trauma and rehabilitation unique to military service, insurance vouchers for vets can replace socialized medicine, and markets will discipline a now-unaccountable bureaucratic culture.”

The VA system may be suitable for treatment of combat-related injuries but general medical care for veterans should be left to the private system. Veterans should be given the freedom to see any doctor who accepts them, regardless of where they live in relation to a VA facility. It’s time to privatize the delivery of non-combat-related healthcare to our veterans.

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