Jeffrey Phillips, Executive Director
For those not familiar with Washington dysfunction: here is a prime example: a commission grappling with a tough issue (veterans’ health care) discusses some controversial ideas that don’t go over well with someone (in this case some veterans’ groups). These advocates, who have for decades done good and dedicated work for veterans, nonetheless essentially disapprove of outsourcing veterans’ care, with some exceptions. Yet, in a manner of speaking, veterans themselves have already shown readiness to make some decisions in this regard: only 9 million of the nation’s nearly 22 million veterans are enrolled in VA health care, and about 6 million vets are actually patients. Thus about 16 million vets get their care elsewhere, many presumably eligible for VA enrollment but satisfied where they are. (Ever hear of a congressman, senator or president getting care at a VA hospital for anything more than a publicity shot? – Pardon the pun . . .)
From its website, the Commission on Care, established by Congress, is charged “to examine veterans’ access to VA health care and to examine strategically how best to organize the VHA [Veterans Health Administration], locate health resources, and deliver health care to veterans during the next 20 years.” We have not taken any position on the commission’s work so far. We are, however, deeply interested in a robust and open exploration of ways to improve veterans’ health care and benefits administration and delivery. Many members of the reserve components use VA’s services and they deserve the best.
One valid concern is that if you bleed VA hospitals of patients, doctor skills get rusty (this fear, by the way, is largely why DoD is letting retirees back into its military hospitals and clinics: fear of rusty doc). VA health care is good care, once you get past the bureaucrats, secret wait lists, and so forth, to the actual clinicians -- who often also work at good private-sector hospitals (I once had excellent VA inpatient care from a VA doctor who also worked at a highly regarded DC hospital). But like everything else in the country, VA care would benefit from competition. (You should see the change in DC’s taxis after the arrival of a certain app-based transportation company that is helping transform the “taxi” business internationally.)
So forget ideas: instead of allowing the exploration and development of ideas – even ideas with which one may not agree – all too often the approach is to politicize, demonize, and smash the idea, insinuate it to death or discredit those associated with the idea. In this case the idea is attacked in part because it arose allegedly outside some narrowly prescribed commission process (if you want ideas to consider, who really cares how they arose?). Where would we be if the private sector worked this way? We’d still be using the abacus, the earth would still be flat, I’d be driving a Pinto . . .
Decreasing the brick-and-mortar component of a $182 billion-per-year federal system (it was under $50 billion in 2001) that now inhales well over $1 billion to build a hospital the private sector could likely build for half that (in less time), and allowing veterans more choice may indeed be a lousy idea; let a free, full, and public airing convince us of that.
Otherwise the shout-down drill so characteristic of this polarized and paralyzed town shuts down options, choice, potential, and the very liberty that vets served in harm’s way expressly to preserve.