After last year’s shocking revelations of mismanagement and corruption at the Veteran’s Administration, President Obama has been committed to making wholesale changes to the troubled agency.
In what can only be called a dramatic understatement, after a round-table discussion at the Phoenix VA Hospital on Friday, the president said “there is still more work to do.”
When the scandal first broke a year ago, matters at the VA were unimaginably horrible. Many veterans had to wait weeks if not months for routine medical care, wait time which, for some, caused disability and death. At one Phoenix facility, approximately 40 veterans died while waiting for treatment. Meanwhile, government auditors were kept in the dark over the unacceptable conditions as VA hospital administrators falsified records to indicate that wait times were at a minimum. Not only were administrators cooking the books, but giving themselves fat bonuses based on their phony performance records.
Even when veterans were receiving care, they were putting themselves at risk from the ineptness and carelessness of the health- care providers at the VA hospitals. In 2009, for example, the VA revealed that 10,000 veterans who underwent colonoscopies at several VA centers could have been potentially infected with viral infections from poorly disinfected medical equipment. In 2011, a VA dentist revealed that he hadn’t bothered to wash his hands or use gloves properly for an 18-year stretch, placing thousands of veterans at risk from infection. One veteran went in for toenail surgery and died on the operating table because VA doctors carelessly ignored the medical history of the patient, who had an enlarged heart.
Treating our veterans in such a way is a slap in the face to those who served their country with valor and bravery, and will deter others from voluntarily joining the armed services. It’s enough to face the stress of enemy fire; it’s another to have to worry about coming out alive from a VA medical facility.
That’s why we applaud the current efforts to overhaul the VA — but we wonder if the Veteran’s Access, Choice and Accountability Act of 2014 that the president has signed into law goes far enough to root out mismanagement, medical malpractice and fraud at the agency. As part of the overhaul, the law permits veterans to use private physicians should a VA facility be more than 40 miles away or should the wait time for treatment or to see a doctor exceed 30 days.
While the provision is an improvement and recognition of the VA’s shortcomings, it still falls short of the kind of access to care that veterans need. A 40-mile trip could be made in less than an hour, but it could also take much longer due to traffic patterns, road conditions and the access a veteran has to transportation. Inexplicably enough, the VA computes the distance from the veteran’s home to the facility by drawing a straight line from one to the other. In reality, roads don’t work that way, and the true traveling distance could be far greater than 40 miles over roads or rail lines. In addition, many veterans are disabled, with limited physical mobility, unable to drive a car or use public transportation.
What makes even less sense under the new law is that as long as there is a VA clinic within a 40-mile radius, veterans can’t go outside the VA network, regardless of whether the facility offers the treatments or tests that the veteran needs. For example, if a veteran requires an MRI, but the VA facility within the 40-mile range doesn’t have an MRI machine, the veteran will still have to go to a VA clinic, even if that other clinic (with the MRI) is 100 miles away. It’s only if there is no VA clinic at all within the 40-mile radius that a veteran can use a private health- care provider.
Neither does an arbitrary 30-day wait time until a veteran can use a private provider seem very reasonable. Certain medical conditions require much more frequent treatment and monitoring. Why make veterans wait at all? Medicare and Medicaid patients have access to any doctor or hospital who will accept reimbursement from those programs. Similarly, there’s no reason veterans shouldn’t be allowed to pick their own doctors and hospitals. Certainly, the VA has expertise in certain illnesses and injuries related to combat, but veterans who require standard treatments and procedures should have the option of choosing the health care that’s best for them. If anything, permitting vets to go out of network will spur VA clinics and hospitals to be more competitive in the quality and timeliness of their health-care services.
There are more than 22 million veterans in the U.S. today, many of whom suffered amputation and other traumatic injuries in order to defend and preserve our freedom. It’s time for us to give them the freedom to choose their own medical care.