There is more than meets the eye in the current controversy concerning the Veterans Administration. Lurking behind the legitimate issues that have surfaced is the reality many conservative ideologues do not want the VA single-payer system to succeed.
The just-released VA Inspector General’s preliminary report confirms lengthy wait times for appointments with a physician, sometimes as long as a year. A retired VA physician claims at least forty people died while waiting for appointments at the Phoenix hospital.
There is strong evidence of human failure, possibly criminal violations, in the scheduling of appointments, notwithstanding revised regulations to prevent employees from delaying appointments and “gaming the system” for personal gains. Such practices apparently continue and are unacceptable. Responsible personnel should be disciplined, up to and including termination. Criminal conduct, if any, should be prosecuted.
To an individual veteran who has been denied timely diagnosis and treatment, the system failed. But that does not mean there is a general systemic failure. To the contrary, the VA generally gets high marks for the quality of care and patient satisfaction.
It should be noted the VA health care system is by far the largest in the country. It has 152 hospitals, 800 outpatient clinics, 126 nursing home care units, 35 residence facilities and more than 300,000 employees. It serves almost nine million veterans and handles a reported 85 million appointments annually. The largest U. S. private hospital company has 165 hospitals, 115 surgery centers and 204,000 employees.
The VA’s proposed 2015 budget for health care is $59.1 billion or an average of $6,500 per veteran served, compared to per capita health spending in the U. S. of $8,233 (Kaiser Family Foundation). Admittedly, these gross numbers need a lot of parsing for an accurate comparison, but they suggest the cost of VA health care is not out of line with private sector costs.
The tragic wars in Iraq and Afghanistan have resulted in a surge of up to 1.5 million military personnel requiring medical treatment. The future medical and disability costs for veterans of those wars are estimated to be as much as $750 billion.
These are the realities. The VA burden is staggering.
Thoughtful consideration should be given to the changes and resources required to enable the department to meet service demands. One meaningful step would be to provide medical care only for service-related injuries or illnesses, and the department may well be underfunded to meet escalating demands.
Instead, some Republican congressmen are calling for measures that could be the first steps in dismantling the way medical care is provided to veterans. Representative Jeff Miller, chairman of the House Veterans Affairs Committee, proposes veterans have the option to get private care, presumably subsidized by the VA. Other House republicans are calling for a voucher system. Senator Richard M. Burr, senior republican on the Senate Veterans Affairs Committee, says “there has to be some level of competition” in the provision of veterans’ health care.
These proposals express a political agenda, not a constructive approach to improving veterans’ health care.