Published in the Democrat & Chronicle on May 7, 2016.
The U.S. Department of Veterans Affairs is again under fire for the dangerously long waiting lists for appointments at the nation’s VA health care facilities, and for calculating those wait times in a way that masks the true extent of the problem.
Veterans are waiting weeks and even months to get routine care, according to another damning report by the Government Accountability Office. Congress is again holding hearings on the matter. This routine is too familiar. Clearly, changes need to be made at the VA to ensure that all of our veterans have access to the care and services they need and deserve.
The VA system is a vital source of care for our nation’s veterans and needs to be preserved and further strengthened. It performs at least as well as and usually better than private hospitals on key quality measures related to screening, diagnosis, treatment, and follow-up care.
But we also know from research conducted by the RAND Corporation that nearly half of New York veterans prefer to receive their care not at the VA, but through civilian health care providers in their own communities. Nearly two-thirds of New York’s veterans have insurance coverage outside the VA, and prefer to see the same doctors that their family members, neighbors, and co-workers see. Some want to get their health care services close to home; others are actively turned off by the limited hours and long wait times at VA facilities. Still others are concerned about the potential stigma of getting treatment for a mental health or substance use disorder at a VA center.
Americans like to have choices, and our veterans should be able to choose where they get their health care, just like everyone else. Ensuring that choice means not only improving care at the VA, but also ensuring that veterans have access to appropriate health care options in their communities.
It means making sure that civilian doctors, nurses, and social workers have the skills to provide culturally competent care to veterans, to have a sense of—and a sensitivity to—how the experience of going to war and returning home to their families may have affected our service members.
And it means making sure that adequate resources, public and private, are allocated to support community-based care and services for veterans. It is encouraging that the U.S. Department of Veterans Affairs has increased funding to care for veterans in the community over the last several years. In response to concerns in 2014 about veterans’ ability to receive timely care in VA facilities, the Veterans Choice Program was established to streamline the VA’s sprawling network of private health care arrangements and allow veterans to use non-VA providers at the government’s expense under certain conditions. But community-based care and services still account for only about one-fifth of the total medical care allocation in the 2017 budget, and the roll-out of the Veterans Choice Program has been plagued by delays and confusion. More needs to be done—and not only by the government: philanthropy, corporations, schools, and community-based organizations all have a role to play in meeting the needs of our veterans,
I read an article recently about military personnel coming back from war, still in uniform, and how disorienting and distressing it can be for them to hear, “Thank you for your service.” It feels like lip service: perfunctory, ill-informed. If we are truly committed to honoring our veterans, we have to go beyond platitudes and parades. Let’s start by making sure that veterans have access to the health care and social services they need, when they need it and where they want it.
David Sandman is President and CEO, New York State Health Foundation.