The right – and the wrong – approach to VA reform

Some issues have been largely overlooked in this presidential race, not the least of which has been the dismal state of veterans’ health care. This omission is not only insulting to America’s veterans – it is downright dangerous.

The Department of Veterans Affairs has hardly changed since the wait-list scandal was uncovered in Phoenix – and then at other VA locations across the country – just over two years ago. When it comes to wait times, it is actually worse. You can hardly watch or read the news without hearing another sad story of how one of our nation’s warriors has been left behind by the one federal agency that is supposed to protect them. Just last month, a congressional commission put it mildly when it said the VA suffers from “profound deficiencies” that are endangering veterans’ lives.

{mosads}The saddest part is that so many people – doctors, nurses, support staff, and most importantly, veterans themselves – could have told you this would happen. I saw the festering problems firsthand when I worked at the VA at the start of my career. I took a job there as a doctor because I believed in the agency’s mission. But five years later I left disillusioned.

The VA’s problems stem from the fact that it is a top-down, bureaucratic system that leaves veterans without meaningful choice. There’s a reason why the phrase “red tape” was initially coined in conjunction with the agency.

For veterans, the VA is too often a bewildering maze full of pitfalls and dead-ends. It can take weeks, months, or even longer between scheduling an appointment and going to the appointment, to say nothing of obtaining a disability rating or contesting an earlier VA decision. At this very moment, more than 77,000 veterans have been waiting more than 125 days simply to receive a rating decision on whether they qualify for a disability.

This isn’t to say that the VA can’t provide excellent care. The agency is well-suited to help those veterans with service-connected injuries, whereas it cannot provide lifelong, comprehensive medical care as has come to be expected of it. Any reforms should begin by directing the agency to focus primarily on those veterans injured in the line of duty. Those who need help the most should be the first to receive it.

However, government also needs to keep the promises it made to our soldiers when they enlisted. So why not listen to veterans about what they want? Poll after poll shows that an overwhelming majority of veterans want the option of receiving medical care from the private sector.

No wonder: This would free them from so much of the red tape that currently restricts their freedom – and too often worsens their health – at the VA. It the agency could not or would not meet their needs, veterans could seek care privately and then bill the VA. Surely they earned the right to choose the medical care where and when it works best for them. And nothing would do more to improve the VA than facing some competition.

The good news is that Donald Trump has proposed serious reforms, including giving veterans access to private care. He laid out a comprehensive plan last month on this very issue, although it didn’t generate as much media buzz as many of his other statements. Republicans in Congress have repeatedly proposed similar plans as well. These lawmakers should be praised for seeking to deliver to veterans the freedom that they have been clamoring for. After all, did they not defend freedom for the rest of us?

I cannot say the same thing about Hillary Clinton and the party she leads. She has been largely silent about veterans’ health compared to Mr. Trump, and her party’s platform darkly warns against “privatizing the VA.” But that isn’t what anyone is calling for. Those who like their VA care should keep it – and that’s no lie. The party is fear-mongering rather than fighting for the men and women who fought for us.

Our military upholds the tradition of leaving no one behind. Apparently, only one of our two parties stands for this ethic. Now if only this important difference would get the attention it deserves.

Dr. Jane M. Orient, MD, a physician who formerly worked in a Veterans Administration hospital, is the executive director of the Association of American Physicians and Surgeons.

The views expressed by authors are their own and not the views of The Hill.