VA medical scandal presents opportunity to right a wrong

In response to the emerging evidence of falsified medical records and appointment times at the Phoenix VA Medical Center, President Obama took to his podium in Washington to call for nation-wide changes to veteran health care on May 21.

Concerns about the quality of medical care at the veteran medical facility in Phoenix, Ariz., began in early 2012 when emergency room physician Dr. Katherine Mitchell told her supervisor that the Phoenix ER was “overwhelmed and dangerous.” Rather than investigating the complaint then, Mitchell was suddenly transferred out of the ER by her superiors. 

In July 2013, another employee, Damian Reese, complained about the long wait times veterans endured before receiving their first appointment. Reese said while appointments were made 14 days before the appointment date, administrators were waiting “6-20 weeks” to create the appointment. 

Reese said such treatment was “unethical and a disservice to our veterans.” 

Despite the complaints of many employees, the Obama administration never moved to improve the medical care. Instead, the administration opted to quiet the complaining employees. It wasn’t until May 2, when Dr. Mitchell went public with her complaints and documented evidence of falsified appointment times, that Obama decided to investigate the claims.

“My attitude is, for folks who have been fighting on the battlefield, they should not have to fight a bureaucracy at home to get the care that they’ve earned,” Obama said. 

Despite this pragmatic assertion, Obama has made no effort to minimize the bureaucracy to which he is referring. Instead, he has only extended the bureaucratic process by bringing in government employees outside the veteran health care system to investigate the Phoenix VA as well as other VA medical centers. 

Obama went on to say, “I want to know what’s working. I want to know what is not working. And I want specific recommendations on how VA can up their game.”

What’s not working is obvious — the VA Healthcare System restricts veterans’ medical care to a subset of the national medical community. Think about your hometown. How many healthcare centers and doctor’s offices are dedicated to serving veterans? How many are dedicated to serving every other medical patient? In Pennsylvania, there are more than 500 medical centers and health care facilities. But veterans receive medical care from a tiny percentage of these medical centers, as there are only 31 VA medical centers in the state and only 1,700 sites nationwide.

Not only is there a shortage of medical facilities to host patients, but there is also a severe shortage of physicians and other medical personnel. While the U.S. Department of Veterans Services provides health care to an estimated 85 million veterans and counting — as veterans of the baby boom population age and as soldiers return home from Iraq and Afghanistan — only 5,100 primary care physicians are employed by the VA medical system, a shortage aggravated by recent employee losses which are estimated to be about 400. 

This disproportionate patient-doctor ratio fosters an environment of desperation, an environment in which falsified medical appointments, miserable medical care and 115-day waiting times become necessity. On May 29, in an interview with New York Times journalists Richard Oppel and Abby Goodnough, Connecticut senator and member of the Senate Veterans Affairs Committee Richard Blumenthal said, “The doctors are good but they are overworked, and they feel inadequate in the face of the inordinate demands made on them … The exploding workload is suffocating them.”

The VA can still up its game by reintegrating veteran healthcare into the private healthcare field, where veterans will have access to thousands of medical facilities and millions of physicians. 

Instead of providing a separate health system for veterans, the U.S. government should provide veterans with a health savings account containing a designated amount of funds for healthcare depending on a veteran’s medical needs. While this will not eradicate the need for bureaucracy, it will dramatically decrease its size because veterans will be empowered to directly control their own medical care and allowed to seek out the specialized care they need among the plethora of private practices available.  

With a health savings account, veterans could see any physician anywhere in the United States, just like non-veterans do. Not only will this provide quality and timely care to veterans and allow veterans to choose their own physicians but it will also put veterans directly in touch with their own medical care and allow them, not a distant bureaucracy, to manage their individual medical needs.

There is one point on which Obama and I agree: Our veterans deserve the best medical care upon returning to the United States. A system in which veterans receive funds for medical care through health savings accounts rather than receiving medical care from a separate system would allow veterans access to easier and more simplistic care on their own terms. 

While this solution would require major renovations to the current healthcare system and require the U.S. government to give up some of its coveted bureaucracy, it allows the country’s warriors and heroes to receive well-deserved health care. That is only the least we can do for them. 

Write Jess at jnc34@pitt.edu