By Jennifer Chow, DePaul University College of Law-
Earlier in 2014, Cable News Network (“CNN”) issued a series of articles on the extended delays for United States veterans to be seen in the Veterans Affairs health care system. CNN boldly stated that hospital delays were “killing war veterans.” That following April, CNN broke the news that United States veterans were not only dying as they waited for health care appointments, but secret waiting lists and falsified records were also being utilized to hide the thousands of veterans forced to wait months to see a physician. The breaking news launched multiple federal investigations, including an internal investigation by Veterans Affairs (“VA”), as well as investigations by Veterans Affairs Office of the Inspector General, the Justice Department and the Federal Bureau of Investigations. As the year comes to a close, this article examines the progress, or lack thereof, of the Veterans Affairs Administration and addresses what the future of health care looks like for our war heroes.
A System on the Edge
The Veterans Health Administration (“VHA”), a division of the United States Department of Veterans Affairs, is America’s largest integrated health care system, serving 8.76 million veterans each year. All those who served in active military, naval, or air service are eligible under the program. Nevertheless, even with the 150 medical centers, nearly 14,000 community-based outpatient clinics, and 53,000 licensed health care practitioners, the average wait time, in May 2014, for new primary care patients was 51 days.
Moreover, the cost of caring for veterans is on the rise, with no relief in sight. The aging members of World War II and the Vietnam War will continue to place stress on the VA as illnesses related to age become more prevalent. Additionally, servicemen and women from the wars in Iraq and Afghanistan will soon retire and seek medical attention, especially for chronic conditions such as post-traumatic stress disorder.
The Question of Progress
In the aftermath of the scandal, Dr. Robert Pretzel retired as the VA Undersecretary for Health, followed closely by the resignation of Secretary of Veterans Affairs, Eric Shinseki. In his stead, President Obama appointed Robert McDonald, a United States Army veteran and formed Proctor and Gamble CEO, as the replacement Secretary of Veterans Affairs. Additionally, Congress passed the Veterans Access, Choice and Accountability Act of 2014 . The key features to the Act provided veterans the right to access private health care and established leases for 27 new VA facilities with the hope of reducing patient wait times and addressing the overflow of veterans in need of care.
On Thursday, November 6, Secretary of Veterans Affairs McDonald announced that average wait times have decreased to 42 days as of October 2014. While McDonald touted the decrease as “significant progress,” criticism still hails down on the new Secretary of Veterans Affairs.
McDonald is slowly, but surely, navigating through the legal minefield of firing executive members who were involved in the original cover up, yet commentators on the Hill continue to call into question McDonald’s tactics and expediency. After allegations surfaced, executive members were put on paid leave while further investigations were conducted. Until due process has been given to each individual, those responsible for the mismanagement of veteran care will continue to be bankrolled by the VA, draining an already faltering system.
It is clear that something has to change in the administration of health care under Veterans Affairs. On the surface, it is easy to throw money at the problem. In addition to the $16 billion in emergency funds approved by Congress, the VA’s budget, under the Obama Administration, has increased from $100 billion in 2009 to $154 billion in 2014. McDonald is also seeking an unspecified amount of additional funds, on top of the $16 billion to be allocated to the backlog of disability claims for veterans. However, even with this allocation of billions of dollars, there seems to be no significant change in the provision of health care for war veterans.
The system is clearly broken. No patient should be required to wait 42 days to see a primary care physician. This practice is unacceptable for any civilian in the United States, let alone those who fought for our country. The simplest solution for this problem is the administration of veteran care outside the VA system, in the private sector. Where the VA lacks the infrastructure and locations to support the needs of all veterans, private and public hospitals can ease the burden. Although the Veterans Access, Choice and Accountability Act takes steps in the right direction by allowing veterans to seek VA-paid health care from local health providers with “choice cards,” it is ultimately not enough. The anticipated roll out of the “choice cards” will most likely be slow and not reach the 9 million members for months, if not years.
Veterans need care now. Instead of allocating funds to bolster the existing infrastructure, the VA needs to take advantage of the multiple health care systems that are already established and more equipped to handle the volume of veterans that stream into VA hospitals every day.
CNN was not wrong; wait times are killing war veterans. Despite the good intentions of the Obama Administration, Congress, and Veterans Affairs, money alone will not solve this problem. A fundamental change is necessary to heal those who fought so bravely for the United States. Until then, war heroes continue to suffer on American soil.
Jennifer Chow is a current student at DePaul University College of Law in Chicago. Ms. Chow is the current Editor-in-Chief of DePaul’s E-Pulse and Business & Managing Editor of the DePaul Journal of Health Care Law. She completed her undergraduate degree at the University of Southern California in psychology and advertising. Ms. Chow will complete her JD and LLM degree in health law in 2015.