Specifics matter when discussing vets’ health care
As this campaign year unfolds, America’s 22 million veterans have reason to be frustrated, perhaps even angry. They deserve a serious and substantive discussion about how this country will deliver on promised health care and other federal benefits. Unfortunately, veterans’ issues have been relegated to little more than carefully crafted soundbites, some of which, upon closer look reflect radical reforms that could be bad for veterans.
This year will mark a watershed moment for veterans. When the dust settles and the campaign is done, we will either be positioned to finally create the health care system that veterans need and want — or we will be on the verge of shattering the promise our government made to meet the lifetime medical needs of men and women injured or made ill as a result of their military service.
An analysis of the plans put forth by presidential candidates, proposals advocated by activists, and statements by members of Congress reveal little in terms of how these ideas would actually improve the quality and accessibility of health care for the nearly 9 million veterans enrolled in the Department of Veterans Affairs health care system. In fact, they often mask the real impact. Take, for example, the idea of “choice” or plastic cards and vouchers designed to allow veterans to purchase care in the private sector.
Giving veterans “choice,” letting them choose where they will get health care — at a VA facility or a private clinic — sounds simple and straightforward. It’s certainly a popular refrain among those advocating for radical reforms for veterans health care. Let’s set the record straight: The reality is giving veterans vouchers to pay for care in the private sector assumes that private providers are both prepared for, and have the expertise to, take on the care of millions of disabled veterans. They don’t. Ultimately, this “choice” will result in fragmented and uncoordinated care. For example, it could disrupt VA’s integrated electronic medical record — which helps ensure a veteran and medical personnel are working together to ensure the best overall course of treatment — possibly resulting in over or under treatment of the veteran’s specific health needs.
One additional concern is providing accountability for payment. When veterans are simply given a card or voucher for care, the medical bill must be approved before payment can be issued. Under the current Choice program, some private providers have enforced policies to bill veterans directly for any delayed payments. This forces veterans to pay these bills out-of-pocket and wait for reimbursement, or potentially face credit problems and denial of care if they cannot. These are issues veterans should not be burdened with, but without a clear plan in place to address these known shortfalls, widespread use of cards and vouchers will mean more roadblocks for veterans.
There are other proposals gaining traction, at least at campaign events and congressional hearings, the implementation of which could result in less access to health care for veterans. Downsizing the VA health care system, for example, by creating a smaller number of “centers of excellence” that only focus on specific service-connected injuries or illnesses would force hundreds of thousands of disabled veterans to travel much farther and wait much longer for care. Rather, we should be considering proposals that have the potential to increase access by integrating private community care into the VA system to create veterans health care networks, creating a nationwide system of urgent care for veterans and expanding telemedicine or web-based health services.
At DAV, representing nearly 1.3 million veterans of all generations, we are committed to setting the record straight on any veterans-related proposal, good or bad, that is camouflaged by buzzwords and soundbites. It’s time for every presidential candidate, every member of Congress, and every advocate committed to strengthening how veterans receive health care and other benefits to join with us to launch a true national discussion. At the very least, America’s veterans have earned a transparent debate, from 24-hour cable news to campaign stops to social media, marked by clearly presented facts. Arming veterans with real facts, that’s our mission this election year. Join us.
Garry J. Augustine, a Vietnam-era combat-wounded Army veteran and Maryland resident, is executive director of DAV’s Washington headquarters.