Voucher system should be part of plan to fix VA long-wait woes
Weekend news shows featured coverage of the ongoing scandal at VA medical centers across the country. There is broad agreement that the resignation of VA secretary Eric Shinseki will not solve the problem, which predated his tenure. But Shinseki’s departure could make it easier to impose new culture, one that does not tolerate gaming the system as many VA hospital officials appear to have done by creating false paperwork regarding patients’ wait times.
Once a new VA secretary is in place, all those found to have faked paperwork about wait times, to not only avoid criticism but to increase their performance bonuses, should be fired. If possible, they should lose some pension benefits. The message needs to be clear; the VA will not tolerate cheating and gaming the system for personal profit and in ways that hurt veterans.
Beyond punishing those responsible for false reports, there are things that can be done to address the immediate problem of long wait times. An editorial column on this page Friday mentioned U.S. Sen. John McCain, R-Ariz., and his support for giving veterans flexibility in where they get medical care. McCain, and others, have suggested a voucher system in which veterans could go to their local, community hospital for some types of care. They would present their VA health care card as proof of coverage and the local hospital would bill the VA system.
Critics of vouchers suggest its advocates want to destroy the VA health system. But so far, vouchers are only meant to target the long-wait crisis.
Most supporters of vouchers understand that VA hospitals have expertise in certain combat-related health issues such as amputations, prosthetics, post-traumatic stress disorder (PTSD), burns and ailments directly related to military service.
But many veterans face some medical issues that are not related to military service. Why not let veterans decide if they would like to get treatment at their local, community hospital, which is often closer than the nearest VA hospital.
Keeping VA hospitals as centers for specialty care related to military service makes sense. Maintaining the VA health care also nurtures the sense of camaraderie that veterans can feel when in a VA health care facility.
But not every medical issue requires treatment in a VA hospital. Vouchers would make the system more efficient and cost-effective.
McCain was joined on the Sunday news shows by others supporting the idea. But Congress is, so far, quiet on what appears to be a practical, common sense solution tp the current crisis facing the VA hospital system.
Describing his plan, which has the support of several members of Congress, including former House Speaker Nancy Pelosi, D-Cal., McCain wrote that he wants to give “far greater flexibility to veterans to get the care they need and deserve, where and when they want it, whether in the VA system or not.”
The long wait times and secret double lists used by VA personnel to hide the problem — while also earning performance bonuses — is a huge scandal and one that deserves immediate and nonpartisan efforts to find solutions. As troubling as the long-wait crisis is, is that it just didn’t happen in the past weeks or months — there have been warnings about long waits for treatment going back years.
President Obama vowed early in his first term to make fixing the VA’s wait problem a top priority. He clearly failed, but serious VA problems go back to earlier presidents, by some accounta as far back as the Vietnam era and the Kennedy and Johnson adminstrations.
Decades of mismanagement and failure to plan throughout the VA system will not be solved with a voucher program. But it can be part of a solution to at least fix the long-wait problem.
