May 30, 2014--The Republicans Are Right

The title is not a pun about Republicans being to the right of the political spectrum. But rather about what they are advocating in regard to reforming the Veterans Administration healthcare system.

They are right about that and the Democrats are wrong in what they are proposing.

What was suspected--that corruption, greed, and incompetence at a number of VA hospitals have led to the maltreatment and even the death of many veterans--is now documented.

The acting inspector general of the Veterans Administration has completed his report and, among other findings, reported that more than 1,700 vets seeking appointments at the Phoenix VA alone were either ignored or never entered into the system. In spite of this, to generate bonuses for administrators, a second set of books was kept and submitted to Washington that showed them being treated within 30 days. In the meantime, many hundreds went untreated and scores died while waiting or ignored.

And, I suspect, as more is uncovered, we will see the same kind of malfeasance at other VA facilities as other administrators seeking bonuses cooked the books.

Putting aside for the moment why any government worker should be eligible for a bonus, why has it taken years to get to the bottom of this deadly scandal when alerts were filed by whistle-blowers from within the bloated system?

The head of the VA, General Eric Shinseki, should have been told about this in a timely way (and for all we know he was) and it should have been brought to the president's attention since for years since his first campaign he has been demanding better after-service care for wounded veterans (and, for all we know, he also was).

Minimally, Shinseki should be fired, a VA tsar should be appointed, someone with vast health-administration experience, and the system should be overhauled.

Serious consideration should also be given to the House Republicans' plan to privatize the VA hospitals and clinics. If that is too radical, minimally, as the GOP is proposing, any veteran who has had to wait for care for 30 days or more should be able to seek it through private medical providers at the VA's expense.

This is far better than the Democrats' approach--the Senate is preparing legislation to add 27 new healthcare facilities to the VA system to address the backlog of cases. Beyond the billions in additional cost, this is an unrealistic approach since it would take up to 10 years to get the hospitals built and functioning. For the nearly 8 million vets treated (or not treated) each year this is hardly a solution.

Each month a cousin who is a WW II veteran uses the VA for routine blood work since his out-of-pocket cost is just $15 per test, a third what it would cost if he went to his local hospital.

I asked him if he would prefer to go there if it could match the VA price. "Sure," he said, "It's much closer. And they do a good job."

This is true for most vets who require non-urgent testing and care. So why not give them an eligibility card to enable them to go to any hospital and have the VA cover the difference in cost? Sure this approach would have to be phased in over a number of years, but it would greatly simplify things, especially for service men and women who do not live close to VA treatment centers.

Over time we would no longer need a separate and unequal VA healthcare system. Veterans would get timelier and better care closer to home and taxpayers would save billions.