While Americans anxiously watch Congress debate the repeal of ObamaCare, President Trump and Congress are taking steps that will benefit millions of veterans who receive health care through the Veterans Health Administration (VHA). An extension of the 2014 Choice Program and the introduction of new accountability measures are two steps that are paving the way for even greater reforms to come.
The ultimate goal of reforming the VHA should be to ensure that every American veteran gets the highest quality care available from the provider of his or her choice when he or she needs it. Furthermore, the VHA should be held to the highest standard of transparency and accountability.
Sadly, reality is far from that goal today. It is an abomination that any veteran should have to suffer within a poorly managed bureaucracy, but in 2014, investigations revealed that 40 veterans died while waiting for care in the Phoenix VHA system on “unofficial” and manipulated waiting lists. Further investigations by the Veterans Affairs inspector general, Congress and the White House revealed that the problem was not isolated to Phoenix, but actually affected tens of thousands of veterans nationwide.
As a response, Congress passed and then-President Obama signed the Access, Choice and Accountability Act, which created the Choice Program. Veterans who are unable to get an appointment within 30 days at a VHA facility or who live more than 40 miles away from a VHA facility can seek care at a private facility, and the law authorized funding to pay those private providers.
The program has had mixed results: According to Sen. John McCain (R-Ariz.), more than 1 million veterans have received care at more than 7 million appointments with private providers, indicating that the need was there and that the program has successfully helped to address it.
On the other hand, the Choice Program still faces implementation challenges in the face of a slow and cumbersome bureaucracy. Just as recently as 2016, reports from the Veterans’ Affairs (VA) Office of the Inspector General and the Commission on Care (created by the 2014 reform law) showed that structural problems still exist within the VA and further reforms are needed.
President Trump’s extension of the Choice Program will allow it to continue operating through early 2018, rather than expiring on August 7, 2017, during which time Congress can debate even greater reforms that would allow more veterans to more easily access care from the providers of their choice. The extension also includes provisions to speed up VA payments to private providers and encourage greater sharing of medical records.
Ultimately, VHA facilities, like private facilities, should be optional to all veterans no matter where they live or how long their anticipated wait time. Studies have indicated that the care veterans receive at VHA facilities is high quality; it is simply the complex and disorganized administration of these facilities that makes them hard for veterans to navigate and can lead to poor outcomes.
By allowing more veterans to go outside of the system for care, policymakers can hit two birds with one stone. This would connect more veterans with the care they need in a timely manner, and it would take volume off of an overburdened VA.
This extension of the Choice Program isn’t the only good news for vets: The VA Accountability First Act would (as the name of the legislation implies) empower the VA Secretary to remove, demote, or suspend any VA employee, including Senior Executive Service employees, for substandard performance or misconduct.
The vast majority of VA employees — health providers and administrators — are honest, hardworking people. But basic accountability measures, like those that exist in the private sector, should be available to leaders to identify bad actors and hold them accountable.
Americans should applaud these latest steps to improve the VA, the agency tasked with providing healthcare to some of our most honorable citizens, our veterans. If Congress and the president want to do even more for veterans, they will continue to pursue an agenda that increases transparency, accountability, and choice.