It won’t be simple to solve the management crisis at the Department of Veterans Affairs, but it will be a lot easier than meeting the long-term needs of this nation’s veterans.
The current crisis is a symptom of a system that wasn’t built for the challenge. To meet objectives for reducing patient wait times, some VA managers cooked the books and declared success. Meanwhile, some patients awaiting care died. The acting inspector general for the VA says it’s not certain that delays killed anyone, but some patients who needed attention have suffered.
Managers involved in gaming the system must be held accountable, and the warped incentives that produced this outcome should be reconsidered. If VA Secretary Eric Shinseki is found derelict in performing his duties, he should be dismissed.
Sadly, that’s the easy part. Simply put, the government has made promises to veterans and their families it can’t keep, and the problem stretches back decades.
When toting up the costs of war, our leaders focus on the duration of the conflicts. But taxpayers may pay the bills for more than a century. Last year, the Associated Press conducted an analysis of federal payment records for war-related disability and survivor benefits. Relatives of the Civil War and the Spanish-American War still were collecting checks. It took 46 years for World War II payments to peak. Although the Vietnam War ended 40 years ago, those payments have yet to peak. Obviously, the same costs will accrue for the wars in Afghanistan and Iraq.
As U.S. Sen. Patty Murray told the AP, “When we decide to go to war, we have to consciously be also thinking about the cost.”
But we’ve never focused enough attention on that. Instead, wars are taken off-budget, which disguises the impact.
The VA is seeing more patients than ever, but resources don’t match the increased demand. Medical costs for Vietnam veterans are rising because they’re getting older and more infirm. Advances in battlefield medicine have translated into more survivors, many of them with horrific wounds that need a lifetime of attention. Greater attention to mental health issues, such as post-traumatic stress syndrome, adds to the VA’s burden.
So, after the congressional hearings subside and blame is assigned, we still need long-term solutions.
One possibility is to allow veterans with routine conditions to access civilian facilities if they can’t get a timely VA appointment. Government would pay the bills, as it does with Medicaid and Medicare. Reforms also are needed in claims processing, and that’s a long-term problem. In 2002, it took an average of 224 days to complete a claim. That has shortened somewhat, but the backlog is still a problem: Between 2009 and 2012, the number of claims doubled.
The VA is overwhelmed because our nation’s leaders are better at waging wars than paying for them. The horror stories are scandalous, but they also were inevitable.
We owe it to veterans, whose sacrifices we will commemorate Monday, to do better.
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