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A Decent Start on VA Health Care


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Senate Democrats’ first response to the scandals at the Veterans Health Administration was predictable: Just throw money at the problem.

But Congress needs to fix a broken system, not reward it. The best way to do that is to hold the VA accountable and offer vets choices.

That is one of the aims of the bill that the Senate passed yesterday with an overwhelming bipartisan majority. It will establish large, permanent programs to get private health care for vets who don’t have a VA facility nearby or can’t get an appointment fast enough. It also includes, slightly watered down by Democrats, new ways to hold VA bureaucrats accountable for failure.

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But another of the Senate bill’s priorities is still clearly to throw more money at the VA. Three Republican senators — Bob Corker, Ron Johnson, and Jeff Sessions — voted against it, arguing that, as written, it’s fiscally irresponsible. They were right.

There will be significant pressure on the House to take up and pass the Senate bill. It’s an acceptable starting point, but the House needs to examine the bill carefully and excise its pricey and unnecessary provisions. Constructing new VA facilities and hiring new doctors, for example, would cost serious money while doing less to help vets than increased competition would. New offers of in-state college tuition for vets, meanwhile, are irrelevant to the problem at hand.

That said, offering vets choices and ensuring that they get the care they need is going to cost money. A lot of money, the Congressional Budget Office says: They’ve estimated that provision of the bill expanding access to non-VA care will cost $35 billion over the next three years, and up to $50 billion a year when it’s fully implemented. This is a problem, though the CBO admits it has little confidence in its projections (the bill’s authors argue they are much too high).

The reforms need to be specifically directed toward getting care for vets who are being poorly served by the system, not creating an open-ended entitlement for vets who don’t need it. The kind of fixes the House should propose may even mean curtailing VA eligibility to some extent, to help pay for better care specifically for service-related injuries.

The Senate bill was passed as an emergency funding provision. The VA scandal is indeed an emergency. But Congress is considering a long-term fix, so it ought to be paid for, as House Veterans Affairs chairman Jeff Miller has already indicated it will be. To find the funding, Congress should look at trimming military pensions (the Ryan-Murray budget deal’s cuts to which should be restored) and the overly generous, outdated retirement benefits that civilian federal employees get.

Ideally, the federal government shouldn’t be running hospitals in the first place, or paying its retirees pensions that the private sector has long since abandoned. But it does have a responsibility to provide the best possible health care to our veterans, which means offering choice and competition and holding the system accountable. The House should focus on doing that at the lowest possible cost.



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