Three years ago, a scandal broke in Phoenix, Arizona that spread over the entire country. Investigations found months-long wait times for veterans to see a doctor at any given VA medical facility and hospital staff manipulated those wait times to hide them from the public. Part of the reason for the appointment backlog was the lack of choice in health care for veterans. VA health care at a VA facility was all that was available to the veterans community unless the veteran chose to seek outside care on his own dime. After the backlog was discovered, Congress acted to pass the Veterans Choice Program, which allows those who meet specific criteria to seek their health care in the private sector if they so choose. This was intended as a temporary fix while lawmakers figured out a more permanent solution. That more permanent solution has yet to be established.
The program has not been implemented in a successful way, and thus has created unintended problems such as reimbursement and participation issues. However, the principle behind the program is sound and laudable – veterans should be in charge of the health care they were promised. When the VA does not or cannot fill the needs of veterans, private sector options should be available.
Currently, the Choice Program only allows choice in care for qualifying veterans – those who live more than 40 miles from the closest VA or who have to wait for more than 30 days for an appointment. An updated version of the Choice Program should expand those options to all veterans, not just the ones who fit into an arbitrary category. Not all VA facilities are bad. Some are very well run and run by excellent staff. Many veterans prefer to seek care at the VA, but veterans should be empowered to make that choice. If they choose an alternative option, their VA medical benefits should follow them. That choice will create competition for the VA thus bringing the VA to raise its standards of care and decrease wait times. However, it is apparent that veterans need to be educated more on the options that are or can be available to them – so that they can make the right choice for their circumstances.
Most importantly, broader access to choice puts the veteran first. The VA is tasked with a sacred job, “to care for him who shall have borne the battle.” Veterans and their care should be the priority, not where the care is received. Allowing real choice, choice that isn’t based on specific criteria but on veterans’ needs, is the best way to take care of veterans.