Here’s how innovation can make or break VA health care
The passage of the Department of Veteran Affairs (VA) Mission Act of 2018 by both the U.S. House and Senate marks a much-needed shift in the national discourse on health care for veterans.
Ever since the scandal involving secret waitlists broke at the Phoenix, Ariz. VA medical center in 2014 — which led to the passage of the first Veterans Access, Choice and Accountability Act of 2014 — the debate on how to improve the delivery of health care to veterans has been colored by partisanship and position entrenchment that would not lead to any legislative wins.
{mosads}But after garnering the support of 38 military and veteran service organizations, the VA mission bill now awaits President Trump’s signature. The president has been eagerly awaiting this, as he campaigned on a promise to reform the VA.
Which is why, for those involved in the “sausage making” that finally led to consensus, a collective sigh of relief is in order. After years of accusations and counter accusations about the meaning of “choice” and its relation to privatization, all sides appear to finally be ready to compromise for the sake of progress.
However, progress may be a relative term depending on how the law is actually implemented. Just about everyone involved with crafting the law — regardless of their position on veteran health care —has either publicly denounced or denied supporting complete VA privatization. Even those who support rapidly expanding access to private sector health providers do so with a disdain for being labeled “pro-privatization.”
There is no question as to whether there exists a group of powerful influencers, who would like to see the VA go the way of the airline industry and other privatized government services for ideological reasons.
Similarly, there are those who stand to profit handsomely from the wave of new demand for healthcare outside the VA. But arguments for and against privatization — while perhaps necessary to an extent — have done little to address what ails one of the largest government agencies in the country and its future.
In fact, those arguments have raised the question of whether hyper vigilance for full privatization — the one thing the VA needs least — has inadvertently stifled the one thing the VA needs most: innovation.
The answer will start with Section 152 of the new law. How this section is implemented will be critical to the future of veteran health-care services because it provides VA the authority to establish a “Center for Innovation for Care and Payment” and carry out pilot programs.
What does this mean in real terms? It means finding a better way to ensure providers are paid on time, so that a veteran isn’t denied ongoing treatment for cancer because their account is flagged as overdue or unpaid.
It means improving data-sharing interfaces between providers so that a veteran with PTSD isn’t mistakenly prescribed a benzodiazepine, a drug found to worsen PTSD, to treat his/her seizures. It means developing policies and mechanisms in the system that provide for better coordination and integration of care so that veterans aren’t. In other words, it means replacing an idea-killing fixation on stopping VA privatization with a collective focus on driving game-changing innovations.
In the end, a tug-of-war for delivering on the nation’s obligation to veterans persists between a government agency undergoing an identity crisis and an untested industry of non-VA healthcare systems that wants the opportunity to prove itself.
It still bodes an uncertain future. But once the VA mission act passes, uncertainty will no longer excuse inaction, as it will start a new era of innovation in the delivery of better health care for veterans. At least that’s the hope for veterans who, going forward, see excuses as nothing more than a reason to fail and want no more of them.
Sherman Gillums Jr. served in the U.S. Marine Corps during the Persian Gulf War and Global War on Terror eras, and currently serves as the chief strategy officer for AMVETS.