Health care for veterans needs another big fix: Sens. Moran and McCain

The VA is not coordinating well with community care programs or paying them promptly, and funding crises threaten access to private care.

More than a century ago, President Abraham Lincoln signed a law establishing a new agency dedicated to the support of our Civil War veterans. Its mission was "to care for him who shall have borne the battle, and for his widow, and his orphan." Today, our Department of Veterans’ Affairs (VA) provides essential services to 22 million Americans who have served in the armed forces.

All Americans are indebted to our veterans for the enormous sacrifices they have made on our behalf. These men and women took an oath to defend the Constitution and served dutifully to preserve our way of life. Like their valiant forebears who humbled dictators and liberated millions from oppression, they exemplify what is best in our country.

Regrettably, the VA has at times struggled to uphold its obligations to our veterans. In 2014, our country was shocked to learn that thousands of veterans were denied care or experienced unconscionable delays in treatment at the Phoenix VA. Dozens of those veterans died while waiting for care. Unfortunately, this wrongdoing was not confined to Phoenix. The VA Office of Inspector General has completed at least 100 criminal investigations related to wait-time manipulation at VA facilities nationwide.

In the wake of that scandal, Congress gave veterans the freedom to receive medical care from providers in their local communities through the Veterans Choice Program. The program was intended to make certain that veterans would never again be forced to wait in long lines or drive hundreds of miles to access care they deserve. Demand for Choice has since grown considerably; more than a million veterans are receiving care closer to home, through millions of appointments with community providers.

From the program’s inception, however, we emphasized that Choice was only the first step toward broader reform of veterans’ health care. That’s why we have introduced legislation that incorporates lessons learned from Choice to transform the VA into a modern, high-performing and integrated health care system that will improve veterans’ access to timely and quality care — within the VA and in the community. This bill tackles some of the most significant flaws and problems we’ve seen in recent years, including the VA's slow payment process to community providers, poorly coordinated community care programs and — crucially — an inability to accurately predict demand for Choice, which has resulted in multiple funding crises that threaten veterans’ access to community care.

One of the fundamental undertakings in our bill is the creation of a Veterans Community Care Program, which would consolidate existing community care programs at the VA and increase care coordination with community providers. We would require the VA to use objective data on health care demand to set standards for access and quality, and to identify and bridge gaps in veterans’ care. We would also ensure that the VA promptly pays community providers, opens access to walk-in clinics, offers telemedicine, increases graduate medical education and residency positions for employees, and improves VA collaboration with community providers.

Unlike other proposals, our legislation creates and specifies the tools the VA must use to reform health care rather than relying on the bureaucracy to determine the rules. We have learned over time that Congress must provide clear direction and guidance to the VA to prevent inconsistent experiences, enhance veterans’ quality of life, and achieve better health outcomes. 

Key veterans’ service organizations such as American Legion, AMVETS and Concerned Veterans for America have expressed their support for this effort, which will transform the VA into a 21st century health care system that seamlessly weaves together both VA and community health care services.

Throughout history, the VA has undergone changes to meet the needs of new generations of veterans. Following World War II, General Omar Bradley led the effort to overhaul the VA for the millions of Americans then returning home. At the time of that enormous undertaking, Bradley rightfully kept the needs of veterans at the forefront, stating: “We are dealing with veterans, not procedures; with their problems, not ours.” The VA responded admirably to the challenge by constructing new facilities and expanding its capacity to serve a new generation of American heroes.

Today, the VA is in need of another major reform and we have the opportunity to deliver real transformation. Just as Bradley did, we must keep veterans’ unique wants and needs in mind as we reshape and reform the delivery of health care. Veterans require and deserve the best our nation has to offer, and the VA must not shy away from changes that help them achieve that outcome.

Sen. John McCain, R-Ariz., is chairman of the Senate Armed Services Committee. Sen. Jerry Moran, R-Kansas, is chairman of the Senate Military Construction, Veterans Affairs and Related Agencies Appropriations Subcommittee. Follow them on Twitter: @SenJohnMcCain and @JerryMoran

This op-ed ran in USA Today on Friday, December 15, 2017.