Once again problems at the Veterans Administration are in the news.
Last year, Americans were alarmed by stories reporting a systematic cover-up by VA employees over long wait times at health facilities. This precipitated a national audit that showed over 57,000 patients waited for more than three months to be seen by doctors, and, unconscionably, over 64,000 veterans were enrolled in the system for a decade and had never been seen by any doctor.
The budget for the VA is over $160 billion, of which of which almost $60 billion is spent on healthcare, primarily delivered through the VA’s 150 hospitals and 820 outpatient clinics. Additionally, Congress agreed to a 3- year $17 billion cash infusion to reform the VA healthcare system. Of this, $10 billion will go to patients who live more than 40 miles from a VA facility or have to wait more than 30 days to receive government-paid care from a private doctor.
Rep. Jeff Miller, a Republican from Florida who chairs the House Committee on Veterans Affairs, said, “It appears the White House has finally come to terms with serious VA healthcare problems we have been investigating and documenting for years.”
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His comments and Congress’ record begs a few questions:
▪ First: If the Republican-controlled House was aware of all this, why didn’t they do anything about it and why do veterans have to go into a separate, flawed healthcare system?
▪ Second: Why not extend the ability of all veterans to enter the private healthcare system any time they need to? Maybe they’re onto something with this $17 billion going to private doctors to take care of vets.
▪ Third: Today we have over 22 million veterans, 9 million of whom are enrolled in the VA system. As WWII, Korean War and Vietnam vets age, that number is expected to go down to 17 million in 2030. Why shouldn’t they be entitled to the same healthcare benefits that people over age 65 qualify for?
In other words, upon completion of their term of duty make all veterans eligible for medical vouchers that would pay Medicare rates for hospital and physicians services. This would make the entire private system in America available to veterans. Probably half our veterans are Medicare eligible already, so we are only talking about the rest.
Republicans may say, “Oh no! We can’t afford to expand Medicare and this will lead to, god-forbid, a single-payer system.” The truth is people on Medicare like their benefits. Additionally, this does not have to be a government-run program. Using a competitive system, we can select qualified companies from the private sector to administer the funds and health programs.
We have over 5,000 hospitals in the United States including the finest academic centers in the world. This alternative would allow veterans access to all those facilities. This isn’t about trashing the VA, which has many fine professionals and provides a variety of other important services. The VA does have a depository of information that relates to the unique illnesses veterans suffer. But I believe there is a way to transfer those critical functions and the VA-specialized skills to designated academic/public hospitals. At Jackson’s Ryder Trauma Center, we train Army trauma doctors, so this concept is not unheard of.
I must disclose a personal interest in this issue. Last year, my brother wrote an oped for the Miami Herald about being part of the first permanent Marine division stationed in Vietnam 50 years ago. (Operation Shufly). Like many Vietnam vets, he suffers from the consequences of exposure to Agent Orange. I have seen him go through the frustrating and ultimately fruitless attempts to be treated at the VA Hospital in Miami.
The Congressional Budget office could run the numbers on the idea. Reducing and then eliminating the annual $59 billion VA healthcare cost and selling the land and hospitals may more than offset the costs of switching to a newer, more flexible system for our veterans. Maybe it might even allow us to pay for badly needed mental health counseling. Or if it costs a little more isn’t it worth it for our Veterans, many of whom have served multiples tours of duty in Iraq and Afghanistan?
The definition of insanity is doing the same thing over and over again and expecting a different result. If we don’t try something different, we can always continue to throw billions more at an irreparable system. Otherwise, just perhaps, we can reduce the size of government, save money and provide Veterans like my brother a better health care alternative.
Mike Abrams is former chairman of the Dade Democratic Party, former state legislator and currently a policy adviser to Ballard Partners.