America has a responsibility to care for veterans who served honorably in our military. The question is not whether veterans should receive timely quality health care, but how to best deliver that care. We must keep faith with America’s wounded warriors and we must also ensure taxpayer dollars are spent responsibly. So, it is critical we get the how right.

In pursuing this goal, Concerned Veterans for America has outlined 10 principles that are essential for reforming veterans’ health care.

1. The veteran must come first, not the VHA. The institutional priorities of the VHA weigh too heavily in current planning, funding and care delivery decisions. Veterans’ interests should be paramount.
2. Refocus on, and prioritize, veterans with service-connected disabilities and specialized needs. Veterans with service-connected disabilities and specialized health care needs should be heavily prioritized; any reforms should ensure that VHA health care delivery centers on veterans with service-connected injuries and leveraging the VHA’s comparative advantage in specialized areas.
3. VHA should be improved, and thereby preserved. Those veterans who choose to use VHA facilities should receive timely and quality care. To achieve this goal, the VHA should be restructured and modernized—as an independent, government chartered non-profit—that can efficiently compete with private providers.
4. Grandfather current enrollees. Veterans should have the option to seek care outside of the VA system, but enrollees who wish to continue receiving care within the system should retain the option to do so. Currently enrolled veterans will also have the option to “opt-in” to the reformed system.
5. Veterans should be able to choose where to get their health care. Based on eligibility, veterans should have the option to take their earned health care funds and use them to access care at the VA or in the voluntary (civilian) health care system. Because private health care is somewhat costlier than VHA-based care, most veterans who choose this option will be expected to share in some of the costs of such care, through co-pays and deductibles.
6. Veterans’ health care reform should not be driven by the budget. More efficient health care for our veterans may reduce the cost of their care, but reform should not be viewed as an avenue to reduce federal spending. Conversely, increased funding is insufficient to address VHA’s deficiencies. Reform can be achieved in a revenue-neutral manner.
7. Address veterans’ demographic inevitabilities. In 2009, there were 24 million U.S. veterans; that population is expected to shrink to 16 million by 2029. The VHA must be reformed now, or these demographic changes in the veteran population will force difficult—and inevitable—changes in the future. Any reform proposal must consider the likely forthcoming shifts in the veteran populationand disproportionate decreases in future enrollment.
8. Break VHA’s cycle of “reform and failure.” Minor tweaks to the current system may incrementally improve health care in the near term, but the monopolistic VHA bureaucracy is likely to return to a standard operating procedure, heavily influenced by the desires and concerns of the institution and its employees. Only fundamental reform will break the cycle and empower veterans.
9. Implementing reform will require bipartisan vision, courage and commitment. A well-connected VA bureaucracy, parochial congressional concerns and powerful outside groups frequently stifle difficult reforms across the government—and the same could happen with VHA reform.
10. VHA needs accountability. The VHA must be accountable to both veterans and taxpayers. As an independent organization, the VHA will have more latitude to reward high performers, fire poor performers and monitor the quality of health care delivery.

To learn more about CVA’s proposals for fixing veterans’ healthcare read our bipartisan task force report, and visit CVA to sign our petition in support of these principles and timely, quality health care for America’s veterans.

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