When President Obama nominated former Procter and Gamble CEO Robert McDonald to serve as the next secretary of the troubled U.S. Department of Veterans Affairs (VA), on June 30, he set a standard for the department’s future: “We’re instituting a new culture of accountability.”
The president’s speech was heavy on reform promises — he used the words “accountable” or “accountability” five times to drive the point home. This commitment to reform, if sincere, is surely welcome if it means finally bringing a measure of accountability, oversight, and transparency to the VA’s bloated, corrupt, and failing bureaucracy.
To be clear, my organization, Concerned Veterans for America, is pleased that Congress is finally addressing the dire situation at the VA, which has been allowed to fester far too long. But we worry that certain strong, unambiguous reform language from the House bill will be watered down in the negotiating process by the VA bureaucracy and their apologists in the Senate.
The consensus is that the bill is moving through reconciliation and will likely reach the president’s desk before the August recess. Beltway pundits have noted the degree of bipartisan cooperation that has allowed members of Congress to bring this contentious issue close to a final deal.
The final bill, which President Obama will be under great pressure to sign, needs to empower the next VA secretary with the strongest tools for enacting meaningful reforms: the ability to fire corrupt or underperforming executives, and the latitude to provide veterans with their choice of reimbursed access to private-sector care if they live too far from a VA facility or have been waiting too long for care.
However, both of these provisions — stronger accountability for VA executives and expanded health-care choices for VA patients — are likely to be targeted for dilution by the VA bureaucracy and their congressional enablers. For sustainable reform to take hold, these provisions simply must be enacted in their strongest possible form. (Of the competing House and Senate versions, the former is preferable, as its language is decidedly stronger.)
In an “open letter” my organization sent to the committee yesterday morning, the full text of which is available here, we outline four guidelines that negotiators should follow in crafting the final bill:
Establish clear, independent, and automatic wait-time and geographic standards for seeking private care. The final conference bill must reflect clear standards — no more than 21 days or 60 miles — to define what constitutes excessive wait times, or excessive travel, for VA care. The VA must not be permitted to set their own standard for what constitutes “excessive” waits or travel.
Establish enforceable guarantees of timely reimbursement payments to private VA providers. The final bill must include enforceable guarantees of prompt and sufficient payment (at least Medicare-rate) from the federal government. Don’t let bureaucratic delays undermine provisions for expanded choice.
Ensure that additional VA spending is discretionary, limited, and paid for. The Congressional Budget Office spending projections for the package remain contested; any final bill should limit additional spending and ensure spending offsets to prevent adding to the federal budget deficit.
Ensure that real accountability is maintained. A core aspect of this reform is the ability for poor VA managers to be promptly removed for cause. Any effort to further dilute accountability measures must be resisted.
“We’ve got to change the way VA does business,” the president said in nominating the next VA secretary. “We’ve got to regain the trust of our veterans with a VA that is more effective, more efficient, and that truly puts veterans first.” Those are fine sentiments, and long overdue.
But now the president should ensure that his allies in the VA bureaucracy and on Capitol Hill don’t undercut that promise by watering down in the reform bill the provisions for increased accountability and expanded choice. And pro-reform negotiators should hold the line for the strongest package possible. Anything less will derail the reform effort — and would be a betrayal of our nation’s veterans.
— Pete Hegseth is the CEO of Concerned Veterans for America and a Fox News contributor. He is an infantry officer in the Army National Guard and has served tours in Afghanistan, Iraq, and Guantanamo Bay.