Most of us have seen the news reports on problems of veterans seeking healthcare benefits through the Department of Veterans Affairs. Several factors such as the misuse of funds and controversial bonus systems seem to have combined to create this current newsworthy crisis. Critics argue that the VA's performance bonus system created financial incentives for managers to hide the true number of patient's on their waiting lists. Whistleblower claims are backing up this argument. The fact that many veterans have died while on waiting lists has fueled this crisis. The previous Veterans Affairs Secretary has stepped down and according to a CNN report, the new acting secretary stated that the "...VA is taking action to accelerate access to care and reaching out to veterans to get them off wait lists and into clinics." They will be suspending bonuses for senior executives and working to improve the situation by seeking to add more providers and sending out mobile units. Although this is a step in the right direction, much more is needed to fix this broken system.
According to a CNN report, the following are some examples of the misuse of funds problem:
- The VA has allocated about $20 billion since the beginning of the wars in Iraq and Afghanistan to numerous non-health-related projects, such as office makeovers, unused software licenses, undocumented purchases on government debit cards and the funding of call centers that received an average of 2.4 calls per day, among others.
- In 2013, four VA construction projects in Las Vegas, Orlando, Denver and New Orleans cost an extra $1.5 billion because of scheduling delays and excessive expenditures, the report shows.
- Additional funds have been funneled into legal settlements. Since 2001, the VA has paid about $845 million in malpractice costs, of which $36.4 million was used to settle claims involving delayed health care.
In an effort to resolve some of these ongoing issues, new VA reform legislation is making its way through Congress. According to the Military Times publication, the VA reforms have a good chance of passing quickly in July because leaders of both the House and the Senate have expressed their support. The legislation would approve the building of new facilities, increase funding for hiring more healthcare providers, expand coverage to include non-VA doctors (private care options) and make it easier to fire under-performing VA executives. Of course, the price tag seems to be a major stumbling block because in June a Congressional Budget Office estimate said the expanded care could require up to $50 billion a year in new spending. Senator Bernie Sanders, the Senate Veterans’ Affairs Committee chairman, has vowed to get it to President Obama’s desk in early July.
The Protecting Access to Medicare Act included a demonstration program based on the Excellence in Mental Health Act. This demonstration program establishes the criteria for “Certified Community Behavioral Health Clinics (CCBHC)." At first glance, this may seem irrelevant to the VA issues, however, one of the requirements for a CCBHC is to have a formal partnership/agreement with Veterans Administration centers to provide easy access to care. A CCBHC should include comprehensive care with multi-disciplinary teams focused on the whole health of the patient. Although only 8 states will be participating in this demo project scheduled to begin in September 2017, it could prove to alleviate some of the VA's problems.