In what has become an all-too-common trope in Washington, some continue to think that throwing more taxpayer dollars at a problem and centralizing control over major programs is the best solution for the very decentralized and unique taxpayers they claim to serve with these “solutions.”
Unfortunately, such continues to be the case with veteran health care.
The VA has been a frustrating and demoralizing bureaucracy for veterans since long before the Phoenix VA scandal uncovered the inflexibility and insensitivity of a bureaucracy-first mindset and lack of accountability. Wait times at the VA were excruciatingly long and veterans were getting sick and even dying while they waited. And while the Veterans Choice Program and the subsequent VA MISSION Act — programs aimed to address the issue — are not perfect, they represent a huge stride forward in implementing a veteran-first approach to veteran health care.
Ultimately, more veterans have more access to the health care they need and deserve.
But due to political gamesmanship, special interest lobbying, and, fairly, a global pandemic, wait times have not fundamentally improved, and veterans are still in the lurch wanting for care.
President Joe Biden’s signing of the PACT Act will inevitably make the wait times at the VA longer as more veterans are now eligible for expanded care at the VA.
To fulfill the country’s promise to veterans to care for their needs, the VA must make some fundamental changes, that much is true. But removing options and requiring veterans to stay in the VA system is unsustainable and dangerous for veterans who need care in a timely manner.
First, health care is too costly in general, whether at the VA or in the private sector. Congress has work to do to remove barriers in the way of competition and innovation in the industry, but a monolithic, top-down approach is not going to drive costs down. In the case of veterans, limiting options and effectively trapping veterans in a one-size-fits-all system only ensures that veterans will be just that — trapped.
Second, the costs associated with the Veterans Community Care Program (VCCP) is a signal from veterans that they are accessing needed care and want to use the care available to them right in their own communities. The option to use the closest VA facility remains, and for some veterans it may well be the best option for them. The important point is that it is the veteran’s option to make the best decision for their own health care.
Third, opponents to veterans having more control over their health care are quick to cherry pick data from studies completed by VA doctors and conflate issues to make the best case for their special interests
A recent study comparing VA and non-VA appointment wait times is co-authored by a VA employee, which is a flag that the conclusions may be biased. And even if that wasn’t the case, the Office of Inspector General recently found Veterans Health Administration employees “employed several different methodologies (particularly using different start dates) for calculating wait times reported online, as well as for determining whether wait time criteria are met for community care program eligibility.”
Those differing methodologies mean different start times for assessing whether a veteran is eligible for community care. The report continues “the inconsistent use of start dates for calculating wait times can be misleading and may result in inaccurate reporting.”
Couple this with findings obtained through Freedom of Information Act requests that show VA employees regularly manipulate wait times to keep veterans in the VA system, and it’s easy to question whether any numbers comparing VA and non-VA wait times are at all reliable.
Finally, since 2001, the VA budget has increased more than 400 percent from $45 billion to nearly $270 billion for FY2022. All the while, from FY2016 to FY2021, the number of VHA department personnel grew by 17.3 percent while the number of VA patients grew by a mere three percent. Even with this infusion of funding and personnel, the VA’s core problems have persisted.
Of course, the VA should be properly staffed to meet the needs of veterans who choose to use it. The key, however, is for the VA to be a quality option for veterans, not the only option for veterans.
The VA’s No. 1 priority should be the wellbeing of the veterans it was created to serve, not the VA’s own self-serving interests. Creating more avenues for veterans to access care is the best way to ensure veterans can get quality care in a timely manner. It may not be a perfect solution, but it is a better one that honors the social contract our country made with those veterans when they agreed to serve.
Undoing the VA MISSION Act and eliminating community care options would take us back to the days of the Phoenix VA scandal, when veterans had no choice but to get in line, wait their turn, and hope they didn’t die before their number was called.
Veterans deserve better than that.
Darin Selnick is a senior advisor for Concerned Veterans for America and an Air Force veteran. He served as veterans affairs adviser on President Donald Trump’s Domestic Policy Council and as a senior advisor to the VA secretary. Brooks Tucker is a Marine Corps veteran and former chief of staff and the assistant secretary for Congressional and Legislative Affairs at the Department of Veterans Affairs.