The federal system that cares for millions of our veterans is badly broken, but dumping the problem in the lap of private medicine won't fix it.
The endless problems and scandals at the Department of Veterans Affairs have renewed calls for creating a voucher system that would transfer VA health care to private facilities, and the incoming Trump administration has indicated it might try to create a system that would allow veterans to choose between VA care and private care.
Giving veterans vouchers for private care seems like a quick and easy fix. But in practice, the vouchers would be inadequate and would become increasingly so over time as veterans financially unable to supplement the vouchers would struggle to get essential care.
Further, switching to vouchers would involve an enormous, years-long transformation that would expand an already bloated bureaucracy, leaving it dangerously exposed to fraud.
We don't need more of that. The VA system already represents government bureaucracy and inefficiency at its worst.
For example, at the Edward Hines Jr. VA Hospital in Chicago, only a quarter of the 4,230 employees actually provide primary medical care. What's everyone else doing?
The VA's problems are not due to a lack of money. While the department's budget has doubled over the past several years, its patient load has only expanded by a third. Meanwhile, administrators are being excessively rewarded.
The VA dished out more than $400 million in bonuses in 2011, according to Military.com, a veterans organization. At the Phoenix VA, one in five employees received bonuses in 2013, with a total payout of $337,885.
And as we know, bonuses haven't done much to improve efficiency.
Rather than create more of a mess by scrapping the VA altogether, what we really need is to tap the nation's best organizational minds for ideas to truly reform the VA's medical system and the department as a whole.
A step in the right direction would involve any panel or commission working on VA reform considering the key provisions of a Senate bill that would make it easier to fire senior VA executives, give the VA secretary expedited authority to hire and fire executives, and shorten the removal and appeals process for all VA employees.
Another focus should be the system's doctors, who are too few in number and are underpaid compared to private-sector physicians.
Fixing the VA will take huge political courage but it simply must be done.
Whitt Flora is an independent journalist who covered the White House for The Columbus Dispatch and was chief congressional editor for Aviation Week & Space Technology magazine. Readers may write him at 319 Shagbark Road, Middle River, MD, 21220. This essay is available to Tribune News Service subscribers. Tribune did not subsidize the writing of this column; the opinions are those of the writer and do not necessarily represent the views of Tribune or its editors.
©2017 Whitt Flora
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