Is the VA a scam?

Today, the VA health-care system is “separate but equal” for veterans. Of course, history has taught us that separate is usually never equal — it’s almost always worse — and segregated health care for veterans has, unfortunately, proven that it doesn’t work.

{mosads}In this regard, the VA system doesn’t do what it’s supposed to do in terms of taking care of those “who’ve borne the battle” because it is overburdened and promotes this notion of being a separate but equal system to other health-care systems.

However, upon further examination, the problem is not the idea of providing tailored health care to veterans in and of itself, but rather, the scam is in believing that an outdated infrastructure plagued by bureaucracy and a lack of accountability can continue to meet the evolving needs of a diverse veterans population in the 21st century.

The most obvious example of separate but equal comes from our public school system, another massively run government program.  Although in 1954, the Supreme Court held in Brown v. Board of Education that “separate facilities are inherently unequal” and ordered states to desegregate “with deliberate speed,” issues surrounding a fully integrated education system remain today.

Like the public education system, the VA health-care system cannot be fixed with a simple court order or piece of legislation that demands integration.  Even if Congress ordered the VA to have the same choice and access to health care as everybody else (which seems likely, given the Administration’s repeated statement of VA-related priorities), the result would include chaos, resistance and a slow path to acceptance.

Many aging veteran don’t have the ability to let this path take its course, so, let’s start shifting the conversation from whether veterans should have the same access as those in other government health-care programs (such as Medicare, Medicaid, Tricare and ObamaCare) to how to provide veterans with such access via a truly integrated health-care system.

By definition, an “integrated health-care system” is “a network of organizations that provides, or arranges to provide, a coordinated continuum of services to a defined population and is willing to be held clinically and fiscally accountable for the health status of the population served.”  

Although the VA currently professes to be “America’s largest integrated health-care system,” this simply isn’t true.

VA has struggled with long wait times and an inept community care program, resulting in an inability to provide a continuum of services to veterans and more importantly, has not been held clinically or fiscally accountable for veterans’ health — the VA’s budget has quadrupled since 2001, yet some veterans still struggle for access to care.

For example, according to Sarah Verardo, the executive director of the Independence Fund — an organization that helps wounded Veterans and their caregivers — “My husband’s catastrophic combat injuries were made even more difficult to manage when we entered into the maze of VA bureaucracy.  We experienced long wait times and questions about eligibility when I tried to seek repair of his prosthetic leg and wheelchair.  In our experience, it’s an ineffective system for the catastrophically disabled.”

Verardo’s experience as a catastrophically disabled veteran is the root of the VA’s problems – as has been highlighted by former VA Secretary Anthony Principi, the VA must “ensure [that] the department’s limited resources are focused on its core mission, rather than dispersed in an effort to remedy every possible problem for every veteran.  When everyone is first priority, no one is.”

In other words, if the VA can’t provide top quality health care for all veterans, let some of those veterans, particularly those with less complex health-care needs, choose to go elsewhere. Doing so would allow catastrophically disabled veterans like Verardo, who have ‘borne the battle’ either greater access to quality care for his combat-inflicted injuries from the VA, or at least the ability to receive treatment elsewhere.

Similarly, as summarized by Sherman Gillums, chief strategic officer of AMVETS, one of the nation’s largest veterans service organizations:

“The idea of establishing a federal agency with the focused mission of rewarding citizens who’d served in uniform with special benefits and making veterans whole again after suffering loss due to service is not a scam, in itself. To the contrary, it is the best recruiting tool the military has to ensure young men and women find value in serving as the shield against America’s enemies, and they volunteer to do so with relatively little upfront collateral from the government.

“But to ask the question of whether VA is a scam bears validity when one considers the number of service members who paid taxes, faced danger, and saved lives while serving only to be disappointed when the return on their investment came due. That return takes the form of timely delivered disability compensation, education assistance, health care, and other benefits.

But when those veterans face long delays, with many dying while waiting, and wrongful denials that must be appealed for years to undo, it’s a scam to the extent that this wasn’t part of the deal. No small print or back page got overlooked. These deals were simply made with disappearing ink, not in every case, but in enough to make this unacceptable; and it’s no wonder our country now suffers a military recruitment problem.”

To remedy this problem, the American people must accept the fact that forced participation in a separate system of veterans’ health care, while noble in theory, is unequal in reality.  Rather than attempting to maintain a separate health-care system for veterans, let’s allow veterans the choice to use the same system everybody else uses, which would also result in better care as plans and providers, including the VA itself, would compete to provide our veterans with the care they have earned.

Rory E. Riley-Topping served as a litigation staff attorney for the National Veterans Legal Services Program (NVLSP), where she represented veterans and their survivors before the U.S. Court of Appeals for Veterans Claims. She also served as the staff director and counsel for the House Committee on Veterans’ Affairs, Subcommittee on Disability Assistance and Memorial Affairs for former Chairman Jeff Miller (R-Fla.). You can find her n Twitter: @RileyTopping.