Politics & Policy

The VA Needs Reforming, Not Reshuffling

(Photo Illustration: NRO)
The veterans’ health system is broken, and cosmetic fixes won’t solve any of its problems.

It’s been over a year since the wait-time-manipulation scandal was exposed at the Department of Veterans Affairs (VA). Yet a year after it was revealed that VA officials nationwide had falsified waiting-list times — and after more than $16 billion in new funding from Congress — veterans are waiting even longer for care. Worse, each day since then — and still today — explosive stories of blatant VA waste and rampant VA mismanagement have hit the headlines.

These headlines provide glimpses of a reality that veterans across the country have known for far too long — VA is a broken, dysfunctional bureaucracy that all too often fails to provide timely, consistent, and quality health-care outcomes to veterans. Despite a growing budget of $165.6 billion (larger than the combined budgets of the Department of Transportation and the Office of Personnel Management) and an army of 323,000 staff (larger than the Marine Corps), it still takes months for most VA facilities to deliver both primary and specialty care to America’s veterans.

But let’s lay aside the mountain of evidence that the VA is failing in its mission of service to veterans to venture a prediction: As the 2016 election season gains momentum, the VA bureaucracy’s steadfast defenders will attempt to paint supporters of reform as stealth agents seeking to “destroy” the VA.

Okay, maybe that’s not really a prediction, as it’s already happening. Enthusiasts of the VA’s antiquated, bureaucratic approach to health care — residing primarily on the political left — are preparing a full-on assault against VA reform, particularly the effort to give veterans the real option to seek care from private-sector providers.

A recent MSNBC segment shows how that argument will be made. It’s a case study in half-baked conspiracy theorizing and ill-informed straw-man argumentation intended to frighten veterans and veterans’ organizations into closing ranks around the VA status quo, in spite of the department’s well-documented failures. They shouldn’t fall for the conspiracies.

MSNBC host Rachel Maddow, flailing wildly in search of new dragons to slay to shore up the network’s cratering viewership, suggests that expanded patient choice in veterans’ care is part of a dark plan to “privatize” and “scrap” the VA. She even points toward a report from my organization, Concerned Veterans for America, published earlier this year, claiming it’s the source of this nefarious scheme. But what’s clear is that neither Maddow nor her research assistants ever bothered to read the report.

If she had, she would have learned that our 100-page policy plan, the Veterans Independence Act, is aimed at restructuring the VA and expanding choice for those veterans who would prefer to obtain care from private-sector providers — but would preserve the existing system for those who would rather seek care directly from the VA.

Maddow tried to tarnish this (through the aforementioned half-baked straw man) as a “fringe idea.” But if more choice for veterans is a “fringe” idea, there are an awful lot of people out there on the fringe, including large numbers of congressional Democrats and Republicans that we work with, as well as an overwhelming majority of veterans who say they want more choice. Plain and simple, it’s long overdue that veterans receive the same health-care choices as VA employees and members of Congress.

Expanding veterans’ options for seeking private care is not the same as “privatizing” the entire department, any more than Medicare is “privatized” by seniors’ seeking care from their preferred doctors.

There is a lesson here: Precision matters. Any supporter — lawmaker or candidate — should take care how they discuss VA reform. “Privatizing” the VA is a non-starter, but more to the point, is inaccurate. Expanding veterans’ options for seeking private care is hardly the same thing as “privatizing” the entire department, any more than Medicare is “privatized” by seniors’ seeking care from their preferred doctors.

And the reality is that, in spite of the overheated charges, the Veterans Independence Act would retain — and improve — the VA as it currently exists for those who want to continue seeking care within the VA system. If the VA is as good as its proponents like to claim, under our plan it will have no problem competing with private providers to provide a higher level of care.

Thankfully, I don’t expect this latest attempt to revive the tired “privatization” scare tactics to work. The reality of VA dysfunction has become too clear to deny, and the momentum is firmly on the side of reform. As we meet with congressmen and senators from both sides of the aisle, they are eager to pursue real VA reform — rather than trim around the margins of a failure bureaucracy. That’s good news for veterans, and we look forward to working actively for real reform.

And as for candidates, reform advocates, and the media, they should be prepared to push back against the defenders of the status quo who attack and belittle the reform effort. The questions that opponents of reform should have to answer are: What sorts of changes would you recommend to help the VA better serve veterans? What’s your plan? Veterans chose to serve their country; why can’t they choose their doctor? They never seem to have an answer to these questions, other than to raise the tired canard “If only the VA had the resources it needs.”

Historically, the VA has largely gotten everything it ever asked for in the budgetary process. Its budget has grown at an impressive pace — seeing a 72 percent increase since 2009, jumping from $96 billion then to $165 billion in 2014. The current budget-request increase comes on top of the additional resources associated with the Veterans Access, Choice and Accountability Act of 2014.

Supporters of reforming the system have no reason to be defensive about demanding changes to a system so fundamentally broken and corrupt. It’s the VA bureaucracy and its rear-guard defenders who should be prepared to explain why they would block reforms that would restore caring for veterans to the center of the VA mission. Don’t let them get away with cheap smears and mischaracterizations.

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