The motto of the U.S. Department of Veterans Affairs is "To care for him who shall have borne the battle and for his widow, and his orphan." The nation has long accepted a responsibility to provide for the medical needs of men and women who have served in uniform in war and peace. But in recent years, it has struggled to fulfill that mission in a way that does justice to the sacrifices of those it serves.
For years, those in need of medical care have faced long waits to see doctors or had to travel long distances to get care. This problem arose under President George W. Bush and persisted under Barack Obama as two lengthy wars and the aging of the Vietnam War cohort boosted the number of people needing care.
The department has been dogged by patient backlogs, ethical scandals and unsatisfactory performance. Secretary David Shulkin was fired last March, and on Thursday the department's inspector general released a report that said he "violated federal statutes and regulations prohibiting the misuse of government property and the acceptance of certain gifts."
But the scandal at the top is less consequential in the long run than the failures in meeting the health needs of veterans. The department's shortcomings are not because it lacks adequate funds. From 2006 to 2016, the budget of the Veterans Hospital Administration, the VA's medical wing, grew from $38 billion to $91 billion. But it has failed to put that money to use in an efficient way.
One reason is that the VHA, like many an entrenched bureaucracy, is less than nimble at responding to new demands. A new plan from the Trump administration will apply both resources and pressure, by making it easier for veterans to get treatment from private doctors and hospitals, with the government paying. It would replace the popular Veterans Choice program, which has attracted 1 million veterans happy to obtain care in the private sector.
The new approach, building on a law enacted last year called the Mission Act, should also help focus the VHA on its most important function: treating the often serious and unusual ailments that stem directly from military service. As it is, reports Concerned Veterans for America, "59 percent of the current unique VHA patients do not have a service-connected disability."
Private providers are perfectly capable of taking care of veterans with high blood pressure or seasonal allergies. Those patients who don't need specialized care ought to have the option of going to private facilities. CVA Executive Director Dan Caldwell contends that veterans "should have the choice to access care in the community with their VA benefits ― especially if the VA can't serve them in a timely manner."
The Mission Act won the endorsement of a host of veterans groups. "It strikes that balance between improving internal care and relying on the community when necessary," said Carlos Fuentes, legislative director of the Veterans of Foreign Wars. "We truly believe the VA delivers great care, but the VA can't be everything to everyone."
Expanding options will relieve the VHA of some of the caseload, let it focus on its unique strengths, and force it to compete on a more level playing field. More important, the change should work to improve the lives of veterans.
The above editorial appeared in the Chicago Tribune. It was distributed by Tribune Content Agency, LLC.
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