President Obama promised to fix the Veterans Administration (VA) problems. “We need to make sure folks get the care they need without long waiting lists and long drives,” he said in early 2008 stump speeches.
In 2014, the VA scandal grows worse daily: USA Today reported more than 100,000 veterans are waiting to see doctors. In Florida, 8,500 veterans have been waiting more than 3 months for appointments. In Phoenix, 58 veterans died on secret waiting lists. A new audit found 64 percent of VA facilities falsified wait times, and 13 percent of schedulers were actually trained to engage in fraud. The longest waits are for mental health services. Veterans’ suicides, though reported to be falsely low, are at 22 per day or an outrageous 8,030 every year.
The evidence is damning: A single-payer, top-down, government-controlled monopoly does NOT work to meet the needs of patients timely, efficiently, or compassionately. The VA shows what Obamacare portends for all.
What can be done now to help veterans? Based on my experience working in VA hospitals early in my career, here are my top 10 prescriptions to fix egregious failures. These common-sense ideas are already working in the private sector.
1. End the VA monopoly. Cut the backlog of veterans waiting for appointments by immediately issuing VA-paid vouchers for private medical care for all veterans waiting more than 3 weeks for a VA doctor’s appointment. Give control back to the Veterans as to which doctor they see, and allow them to use VA benefits to do so.
2. Give every veteran a copy of every medical report and office visit note at the time of appointment. Reports show medical records data entry is backlogged for months, endangering patients. Empower patients with control of their medical information.
3. Stop rewarding failure with more money! It makes no sense to reward fraud and corrupt practices as at the Phoenix VA by awarding that facility more than $20 million dollars for a new “community” facility. Clean up the mess before doling out more taxpayer money.
4. End “death by bureaucrat.” Stop fattening the cow of bureaucracy. Provide funds for medical services instead. The VA budget has increased 106 percent from 2003-2013, but VA facilities only saw 30 percent more patients. There is far more spent on administrators and managers. Much less is spent hiring doctors, nurses, and providing actual medical care.
5. Investigate and prosecute fraud as the crime that it is, instead of continuing cover-ups and stealth transfers to other facilities. Employees guilty of fraud should be fired and stripped of all federal benefits and pensions.
6. Strengthen the “whistleblower” protections for VA employees who see fraud, mistreatment, and bad practices and want to come forward. The climate of intimidation, bullying, and threatened loss of job and pension continues to oppress honest, caring employees. Such practices must stop.
7. Require normal private-sector work schedules at all VA facilities for staff, nurses, and doctors to ensure that timely medical services can be delivered. Despite the huge backlog, VA doctors and nurses work far lighter schedules than peers in private hospitals.
8. Make every employee and every department accountable for quality measures that are properly monitored. Make it easier to fire employees who do not perform or who have bad attitudes toward the veterans they are supposed to serve.
9. Eliminate “bonuses” for doing jobs that one is being paid to do. “Pay-for-performance” has encouraged “cooking the books” to get that bonus. It needs to stop now.
10. Sell the VA facilities to private enterprise that can better meet the unique needs of Veterans. Free market forces will drive needed changes faster and more efficiently than government-run bloated bureaucracies can ever do. Use savings to pay for better quality medical care for Veterans.
The United States has a legal obligation to our veterans for their medical care. We have a moral duty to fulfill our commitment when our veterans have served this country with honor and at great personal sacrifice.
The key is to put control in the hands of the men and women who fought our wars. They know how to solve problems. Government meddling consistently makes problems worse, and for many has been a death sentence.
Do we have the moral courage, the WILL, the leadership, and the genuine concern for our veterans as human beings to make the changes that can save lives, lower costs and restore dignity for our veterans?
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Elizabeth Lee Vliet, M.D. is a preventive and climacteric medicine specialist with medical practices in Tucson AZ and Dallas TX that take an integrated approach to evaluation and treatment of women and men with complex medical and hormonal problems. Dr. Vliet is also President of International Health Strategies, Ltd., whose mission is twofold: liberty and privacy in treatment options and preservation of the Oath of Hippocrates focus on the individual patient.
