TAR HEEL EDITORS SPEAK OUT
For the federal Department of Veterans Affairs, the recent outbreak of quiet has been a reassuring thing. The agency has been wracked with drama and operating problems for too many years, conditions that got in the way of the mission of the second-largest federal bureaucracy: taking care of the health and other needs of this nation’s veterans of military service.
While there is doubtless plenty of politics playing out behind the scenes, the hallmark so far of the VA under Secretary Robert Wilkie has been a sense of greater calm than we’ve seen in a while. Wilkie, a Fayetteville native, son of a combat-wounded soldier, a veteran himself and a savvy political operative who also has served in high-level Pentagon posts, seemed tailor-made for the VA when the agency needed a steady hand.
It was clear during the Senate hearings on his nomination that there was intense political pressure to right a foundering department. As Sen. Johnny Isakson, a Georgia Republican, told Wilkie at the hearing, “Mr. Wilkie, there are no excuses anymore. Failure is not an option.” Wilkie agreed.
While the VA has made steady progress in improving care given at its hospitals and other health-care facilities, it ran into a host of problems when it created the Veterans Choice Program, which was meant to improve access but has had serious shortcomings. Choice allows veterans to seek health care from private providers, acting much like a private insurance program. But the program was hastily conceived and put into place, using private contractors to administer it. The program quickly ran into serious payment backlogs, and many providers dropped out.
A new analysis of Choice by the news organizations ProPublica and PolitiFact shows that in Choice’s four years, wait times have grown even longer than they were in the VA system — failing at precisely the problem Choice was created to solve. The cost of the health care was also higher than in the VA network, a greater expense, ultimately, for the taxpayers. The system also made frequent errors.
But significant reforms in the program arrived last June when President Trump signed the Mission Act, which was designed to eliminate many of the problems in Choice and other VA programs. It also eases another longstanding issue by improving reimbursements for in-home caregivers.
Wilkie says he sees Choice as the route to developing a better network of specialty care for veterans. But he’s adamant that this isn’t a step toward the ultimate privatization of the VA — one of the big, unsettling political battles that has shaken the VA in recent years. He believes most veterans prefer getting care from the VA and doubts that no more than 35 percent of patients will choose outside care.
The ProPublica and PolitiFact report notes that the contractor responsible for most of the problems with the Choice program is still running much of it, and that new providers still haven’t been signed to contracts. It will be at least a year before the new operators will be up to speed, so many of the old problems may continue to plague the system.
A system that size, of course, can’t be quickly or easily changed. But since last year, it appears that the VA is making progress. That’s an encouraging change.