The Department of Veterans Affairs has a problem. In 2014, after revelations of shockingly long wait times for veterans with serious ailments, it set up a program to let some of them go to doctors outside the VA system. Did it work? The Veterans Choice Program has been so popular that it is on the verge of running out of money.
That’s not a failure; it’s a success. And it should highlight the wisdom of expanding the options available to veterans to make sure they get the treatment they need and deserve. The VA system has been a mainstay for ensuring adequate care for the 18.8 million men and women who have served in uniform.
But it has also been plagued by mismanagement, insufficient capacity, lack of accountability and scandal. The Choice experiment is a welcome innovation and a signal of how the department could better achieve its vital purposes.
Whether Congress recognizes as much is yet to be seen. Recently, the House voted down a Republican measure to provide $2 billion to fund Veterans Choice for the next six months. This came after several major veterans groups voiced their opposition because the money was taken out of other programs. In a joint letter, they warned that “if new funding is directed only or primarily to private sector ‘choice’ care without any adequate investment to modernize VA, the viability of the entire system will soon be in danger.”
A few days later, the House and Senate reached agreement on a revised measure that will provide the Choice money along with more than $1.4 billion for hiring medical personnel and authorizing leases for 28 new medical facilities. It passed the House without a dissenting vote, and the Senate is expected to approve it quickly.
The value of the Choice approach is hard to exaggerate. “The department has already authorized more than 18 million appointments with private doctors this year, an increase of 26 percent over the same time last year,” reports The New York Times. These are patients who have found they can get better, quicker or more convenient treatment outside the VA system.
Even Sen. Bernie Sanders, I-Vt., asks, “If there’s some veteran in South Dakota or Vermont who lives a zillion miles away from a VA hospital, should that person be able to get their health care across the street in their community? Who would argue against that?” We’d take that question a step further: Why shouldn’t veterans be able to get health care where they prefer even if they don’t live in the middle of nowhere?
Sanders and the big veterans groups, however, worry that the goal is to privatize the entire system, which would be a mistake. The VA system fills a unique, critical role. But it would be good policy for it to focus more on treating the sort of illnesses and injuries that stem from combat and other military hazards, which private physicians rarely see. That responsibility will grow as those who served in World War II, Korea and Vietnam pass away and soldiers with combat wounds require a greater share of resources.
Making it easier for patients to get treated by private providers for commonplace ailments would empower those patients — and could save money. It is also likely to improve care for those patients in VA hospitals.
The question that should frame future choices by Congress and the Department of Veterans Affairs is: What’s best for veterans? The Choice program is forcing some rethinking on that issue — because it’s worked.
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