“Third-rate treatment of first-rate men.”

This is how journalist Albert Maisel, writing for Reader’s Digest, described the health care available to veterans through the Veterans Administration – in 1945.

Today, the Veterans Administration is known as the Department of Veterans Affairs. While the name changed, instances of low-quality care at many VA facilities persist.

In 2014, administrators at more than 26 VA facilities, including hospitals in Phoenix, Austin, San Antonio, Durham, St. Louis and Chicago manipulated wait lists to appear as though veterans were receiving timely care when they really weren’t. Three years later, VA facilities in North Carolina and Virginia were found to still be doctoring wait times.

“The culture of the VA has become rather toxic, intolerant of dissenting views and contradictory opinions,” former VA director Kenneth Kizer told the New York Times in 2014. “They have lost their commitment to transparency.”

This resistance to reform is one of the reasons expanding veterans’ health care choices is so complex. Throw in the policy intricacies of the VA’s interaction with the broader health care system of the United States and it becomes clear that any substantial reform of veterans’ choice needs a set of foundational principles to strengthen the effort.

In 2014, CVA assembled a bipartisan task force of health care and policy experts to review the health system structure at the VA and make recommendations on how best to improve that structure. This task force put together a comprehensive report of policy recommendations for fixing the health care veterans receive at the VA. Those recommendations are built on 10 key principles for reforming veterans’ health care.

The veteran must come first, not the VA.

The VA’s stated mission is to ‘care for him who shall have borne the battle,” not to care for the VA. Veterans should thus be the first priority when making decisions.

Refocus on, and prioritize, veterans with service connected injuries.

Choice reform should free the VA to focus on what it can do better relative to other health care providers.

VHA should be improved, and thereby preserved.

This requires reforming the VA so it can endure – and improve the quality of care it offers veterans.

Grandfather current enrollees.

Those who already receive care through the VA should be grandfathered into the new system – with options to receive care in the old or new system.

Veterans should be able to choose where to get their health care.

This is essential. Veterans should have choice over receiving care from the VA or private providers, knowing they will carry some of the additional cost of choosing to seek care outside the VA.

Veterans health care reform should not be driven by the budget.

Fiscal concerns and making health care more efficient are important but, again, veterans are the top priority. Conversely, throwing more money at the VA won’t solve the problem. That’s been the solution for years, and it has resulted only in a broken cycle of reform-and-fail, reform-and-fail.

Address veterans’ demographic inevitabilities.

Veterans’ demographics are changing. Congress and the VA need to take that into consideration when creating reform.

Break VHA’s cycle of “reform and failure”.

Previous reforms aren’t enough. Veterans are still limited by restrictions on where they can seek care outside the VA. The cycle of “reform and failure” must be abandoned for comprehensive, fundamental change.

Implementing reform will require bipartisan vision, courage and commitment.

It should transcend party divides.

VHA needs accountability.

The scandals that have plagued the VA throughout its history clearly illustrate the need for new incentives and hiring-and-firing practices, so good employees can be adequately rewarded and bad ones held accountable.

These principles should inform any comprehensive reform proposals to reform the VA. The goal is for veterans and their care to come first, and the VA should be structured in a way that achieves that goal.

Read more about CVA’s proposal to bring reform to the Veterans Health Administration

The post What Would It Look Like to Make Veterans the Priority for VA Health Care Reform? appeared first on Concerned Veterans for America.