President-elect Donald Trump has yet to name his pick to lead the Department of Veterans Affairs (VA), a federal agency plagued by financial mismanagement, backlogged requests for service, and low quality of care during the administrations of Presidents Barack Obama and George W. Bush.
Former Alaska Gov. Sarah Palin (R) is on Trump’s short list for VA Secretary, ABC News reported on November 30. Some veterans groups are calling for Trump to keep current Secretary Bob McDonald, an Obama appointee whom the advocacy group Concerned Veterans for America (CVA) has criticized for being slow to implement promised changes, the Military Times reported on December 9, 2016.
Long Lines, Low Quality
Dan Caldwell, CVA vice president of policy, says the good intentions of VA officials are no guarantee of quality care.
“There are many wonderful and committed people at the VA, and many veterans are pleased with the health care they receive,” Caldwell said. “However, indisputable quality of care issues have emerged at VAs all over the country, from excessive wait times and unsanitary facilities to incorrect diagnoses made by unqualified doctors. No veteran should be trapped in this broken system.”
VA’s reliance on an underperforming contractor has shortchanged veterans on their health care benefits, Caldwell says.
“The other huge health care issue with [the] VA is with the Department of Benefits Administration, which has been a total failure on the current president’s watch,” Caldwell said. “The VA and Congress allowing continuing incompetence and non-contractual compliance by QTC [Medical Services], the out-source contractor doing the physicals to determine eligibility for service-connected injuries and illness, is a national disgrace.”
Calls for Transparency, Choice
Ed Timperlake, senior analyst and editor at the Second Line of Defense Forum think tank and former assistant secretary in the Department of Veterans Affairs under President George H.W. Bush, says the VA’s lack of accountability has resulted in poor health care for veterans.
“VA health care is very mixed and not uniform, and under President Obama it has gotten much worse,” Timperlake said. “Lack of accountability is to blame.”
Caldwell says greater accountability and cost transparency would increase quality and efficiency.
“First and foremost, Congress must pass legislation that increases accountability for VA employees in order to begin to change the toxic culture of the VA,” Caldwell said. “The new administration must also ensure transparency, including sharing more cost data with the public and Congress, to eliminate waste of taxpayer dollars.”
The current system deprives veterans of a choice of health providers, Caldwell says.
“Most importantly, veterans who served deserve the care they earned, and veterans should be empowered to choose where and when to see a doctor,” Caldwell said. “Choice-based reforms will ensure that all veterans are seen and treated in a timely manner to avoid the months-long wait lists.”
Calls for Criminal Prosecutions
Timperlake says improving the VA’s treatment of veterans must start with holding its leadership accountable.
“The most important issue for the VA is accountability first, then more money,” Timperlake said. “Consequently, the number one, two, and three change is to get a new attorney general who will prosecute [inspector general] referrals of criminal behavior. Attorney General [Loretta] Lynch did not do that.”
Trump’s pick for attorney general seems more promising, Timperlake says.
“[Presumptive] Attorney General Sessions, who became an Army second lieutenant in the summer of 1969—I was a Marine second lieutenant at that time—has the courage, insights, and life experiences to bring much-needed prosecution against VA criminals.”
Long-term, the U.S. wars in Afghanistan and Iraq will cost $4 trillion to $6 trillion, including medical care and compensation for disabled veterans and their families, according to an analysis by the Harvard Kennedy School of Government in 2013.
Caldwell says the conflicts have done less to increase demand for VA services than expansion of eligibility for veterans who did not serve in combat.
“While the wars in Iraq and Afghanistan have increased demand for certain services related to combat wounds and mental health, a lot of the increase in demand for VA services is actually a result of expansion of eligibility for VA services to veterans who did not serve in combat or who were not disabled as a result of their service,” Caldwell said.
Expanding VA benefits eligibility has caused more veterans to seek services even though the country’s total number of veterans has been decreasing.
“It is also important to note that the total number of veterans in the United States actually declined during the recent conflicts due to the passing of the World War II generation and the fact the military was not greatly expanded to support the conflicts,” Caldwell said. “Instead, [it] relied on individual service members deploying more and more.”
Peace Through Strength
One of the best ways to care for veterans is to reduce the likelihood of sending them into combat, Timperlake says.
“No nation can ever repay the total cost of a war, but [they] must always try,” Timperlake said. “President-elect Trump is exactly correct: Build the strongest fighting forces possible, which actually leads to strong deterrence.”
Caldwell says the Trump administration should serve vets by restoring discipline to their broken health care system.
“A new VA should have a transparent, accountable, and choice-centered approach to veterans’ health care,” Caldwell said.
Dustin Siggins ([email protected]) writes from Washington, DC.
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