Deeply rooted cultural problems, seemingly endemic within the Department of Veterans Affairs, have put veterans health care at the forefront of our national news cycle this summer. Last week, Congress passed a bill to address a culture of dysfunction that built for years under a layer of red tape. Will this rare compromise defeat the bureaucratic demons that led to some in the VA neglecting their mission?
Probably not on its own. That will take a cultural shift at VA. But it’s likely a step in the right direction, at least in the short-term, if VA uses the tools it gives them properly.
In a best-case scenario, the $10 billion this bill provides for veterans who need care but can’t receive it from a nearby or timely VA facility will serve as a bridge to quality health providers outside the VA’s boundaries, until the government can better serve them. In a worst-case scenario much of that money will go untouched, or misused, by a VA uninterested in referring patients outside due to an almost paranoid fear that it will lead to a privatization of the entire department.
An example of this worst-case scenario occurred when the VA hospital at Columbia, South Carolina, was granted extra resources in 2011 to deal with a long line of veterans seeking routine cancer screenings. Instead of using the money to refer vets to private physicians and reimburse them, staff sat on about 80 percent of the money while a backlog of thousands of veterans built up, with some waiting more than a year. Several dozen of those waiting for consults developed cancer that could have been caught and removed, according to an internal investigation.