Recently, the battle over the future of veterans healthcare increased in intensity because arguably the two most prominent politicians in the country weighed in on the issue, Rep. Alexandria Ocasio-Cortez, D-N.Y., and President Trump.
At a town hall in April, Ocasio-Cortez criticized the Trump administration’s efforts to expand healthcare choice for veterans through the Department of Veterans Affairs and said in regards to the VA that “if it ain’t broke, don’t fix it.” It isn’t surprising that Ocasio-Cortez would vigorously defend the VA while attacking reforms meant to give veterans more private healthcare options. Many of her ideological partners, such as Sen. Bernie Sanders, I-Vt., consider the VA a model government-run healthcare system and a positive example of “socialism in action.”
A week later, Trump responded to Ocasio-Cortez with a tweet that seemingly agreed with her assertion that the VA is performing well. Underlying his tweet was the implication that the uptick in performance is due to legislation he signed into law that increased choice for veterans and accountability for VA employees — bills Ocasio-Cortez and her allies have criticized.
This exchange between the president and AOC predictably set off a debate about who was right and who was wrong about the VA. Unfortunately, in a world of 280-character tweets and cable news segments that are clipped and shared without context, it is difficult to convey a nuanced position about any public policy issue, including the future of the VA. The reality is the VA is neither completely fixed nor completely broken but is instead an institution at a crossroads with an opportunity to break the cycle of reform and failure that has plagued it since its inception. This is especially true with the recent launch of the Veterans Community Care Program which, if properly implemented, will substantially increase healthcare freedom for veterans through the VA and improve access to medical services.
Even as someone who has been highly critical of the agency for years, I have to admit the VA has made some improvement since the deadly 2014 waitlist scandal.
Between 2014 and 2017, according to a study by the JAMA network, wait times across the VA have generally gone down. However, this decrease occurred while the VA increased the number of private sector appointments by over 50%, demonstrating better use of non-VA providers and the introduction of the albeit imperfect Veterans Choice Program helped improve wait times for veterans.
Despite this good news, the VA still faces many systemic issues that need to be dealt with. Too many VA hospitals are delivering sub-standard care and hundreds of thousands of veterans are still waiting long periods of time for appointments. Additionally, most of the VA’s healthcare facilities are over 50 years old, meaning not only are the buildings increasingly aged but they are not in locations best suited to serve the more dispersed veterans population of the future.
The VA MISSION Act, signed into law last year by Trump, was designed to address these issues. Over the next few years the VA will continue implementing the law, and it faces its first major test with the rollout of the Veterans Community Care Program.
It is critical for the future of veterans healthcare that the VA properly implement all the major components of the VA MISSION Act. Failure to do so will undermine the Trump administration’s VA reform agenda and compromise healthcare for millions of veterans. In addition, any attempts to roll back the VA MISSION Act by members of Congress who oppose giving veterans more healthcare choice — like Ocasio-Cortez — should be strongly resisted.
Finally, as more veterans get care from outside of the VA, elected officials at the state and federal levels must explore ways to eliminate barriers standing in the way of veterans making full use of their new private sector healthcare options. Critical reforms include expanded use of telehealth (as Virginia did) and repealing certificate-of-need laws (as Florida did this year). These and other patient-centered reforms, expand access to health care for both veterans and non-veterans while encouraging innovation.
The VA has improved since 2014, but challenges remain. We all want veterans to get the care they need and deserve. To achieve that, everyone needs to acknowledge that VA healthcare still needs some major improvements and to commit ourselves to ensuring the necessary reforms are made.
Dan Caldwell is a Marine Corps veteran of the Iraq War and a senior adviser for Concerned Veterans for America.