This is a great article.
By Veterans Affairs Secretary Robert A. McDonald
Today, the House Veterans’ Affairs Committee will hear testimony on the Commission on Care’s final report on reforming the Veterans Health Administration. The Veterans Service Organizations and the Department of Veterans Affairs were not invited to participate in today’s discussion. That’s too bad — the VA and the VSOs could have provided compelling details to back up the commission’s call for congressional action.
From my perspective, the report is overall a validation of the course the VA has been on since I took the helm over two years ago. The president and I agree with 15 of the report’s 18 recommendations, and the VA has already accomplished or has been working on 12 of these through our ongoing MyVA transformation. That includes the report’s main recommendation: building a high-performing integrated health system combining VA care and VA-purchased community care. We are already moving in that direction, and our efforts are already improving veterans’ access to healthcare.
Last year, veterans completed nearly 4 million more appointments than the previous year. In March, they set a record for appointments completed at the VA: 5.3 million, 730,000 more than March 2014. That same month, the VA issued 268,000 authorizations for care in the community — twice as many as March 2014. In July, 96 percent of appointments were completed within 30 days of veterans’ preferred dates, 85 percent were completed within seven days and 22 percent were completed the same day.
The average wait time is around five days for primary care, six days for specialty care and two days for mental healthcare. Ninety percent of veterans we’ve surveyed are “satisfied or completely satisfied” with the timeliness of their care. Just 3 percent say they are dissatisfied. That’s still too many, and we won’t be satisfied until no veteran is dissatisfied.
I doubt there will be much mention of these achievements at today’s hearing. I also doubt there will be much discussion of the commission’s finding that VA care compares favorably in clinical quality to care in the private sector. The Independent Assessment came to the same conclusion, but some people have more to gain by ignoring the facts than by a full and open examination of them.
The commission did not recommend privatizing VA healthcare. Neither has any VSO. Privatization would be a boon for private-sector healthcare companies, including those represented on the commission, but as seven leading VSOs told the commission in April, it “could threaten the financial and clinical viability of some VA medical programs and facilities,” which would “fall particularly hard on the millions of veterans who rely on VA for all or most of their care.”
I strongly disagree with the commission’s recommendation of an independent VA board of directors. The Constitution won’t allow it, and, to me, as a business executive, the idea doesn’t make any sense. It would only make matters worse by complicating the bureaucracy at the top and spreading the responsibility for veterans’ healthcare so that no one knows who’s ultimately responsible.
The fact is, we already have a board of directors: Congress. If Congress worked the way it should, nobody would be talking about adding another layer of bureaucracy.
Veterans need Congress to do its job as a board.
Last week, I sent the Senate and House Veterans’ Affairs committees a detailed letter outlining urgent actions needed just to maintain current levels of care. These include approving the president’s 2017 budget request to keep up with rising costs and medical innovation; extending authorities to maintain services like transportation to VA facilities in rural areas and vocational rehabilitation; fixing provider agreements to keep long-term care facilities from turning veterans out to avoid the hassle of current requirements; and ending the arbitrary rule that won’t let the VA’s dedicated, conscientious medical professionals care for veterans for more than 80 hours in any federal pay period.
Only Congress can fix these problems, just as only Congress can modernize our antiquated claims appeals process. We have submitted to Congress a modernization plan developed with the help of VSOs and other veterans advocates. We have also submitted a plan to consolidate our many community care programs to make community care easier for veterans, providers and the VA.
We need Congress to act on these proposals.
The Senate Appropriations Committee has at least approved a budget nearly equal to the president’s request, and the Senate Veterans’ Affairs Committee has unanimously approved the Veterans First Act. The act isn’t all veterans need. It doesn’t address appeals. But it’s a start.
The act is aptly named. It’s time to put politics, ideology and special interests aside. It’s time to put veterans first.
McDonald is the secretary of Veterans Affairs.