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Washington Post: Mending the VA

The Washington Post

First Published Jul 30 2014 10:32 am • Last Updated Jul 30 2014 05:32 pm

House and Senate conferees have agreed on a $17 billion bill to address the scandal over poor health-care service at the Department of Veterans Affairs. The legislation is now on a fast track to pass Congress before its August recess, showing that Republican and Democratic lawmakers can still agree on their concern for those who served their country in uniform - and their fear of facing those same veterans in town halls and, eventually, at the polls.

The problems at the VA centered on the long waits, sometimes months, that some veterans faced just to see a doctor at one of the department’s nearly 1,000 hospitals and clinics. On top of that, some senior VA officials allegedly knew about the excessive backlogs and covered them up by falsifying data. The new bill, a compromise worked out by Senate Veterans’ Affairs committee Chairman Bernie Sanders, I-Vt., and his House counterpart, Jeff Miller, R-Fla., attacks the wait-time problem in two ways: It provides $5 billion to hire more doctors and otherwise increase the VA’s capacity, and it offers $10 billion in emergency funds so that some vets can seek care outside the VA system.

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The former strikes us as throwing more money into a system that has already proven itself far too inflexible and bureaucratic to adjust to meet demand, hence the awful wait times. The latter component — money to help vets take advantage of a wider range of health-care options — seems more promising. Indeed, it could be the germ of the deeper structural reforms that the VA needs. Meanwhile, the bill could add billions to the deficit since its authors could agree to only $5 billion in spending reductions elsewhere within the department’s $154 billion budget.

More shortsighted is the bill’s approach to "accountability" for the senior VA executives who have been trying to make an inherently problematic bureaucracy work. Yes, a small minority of them did allegedly engage in outrageous data-fudging. But the bill would strip all of the department’s top civil servants of long-standing protections, exposing them to firing at a moment’s notice with only seven days to file an appeal and three weeks to argue it. Perhaps this is just the thing to instill new efficiency at the VA. More likely, it would have the opposite effect, as the most able federal civil servants choose not to work in a department where their job security might vary according to the scandal du jour.

In responding to the uproar at the VA with this mixed bag of a bill, Congress has shown that it can legislate on a bipartisan basis when the interests of a popular and influential group are involved. Whether Democrats and Republicans have solved any problem more consequential than their own short-term political difficulties with veterans, however, remains very much to be seen.




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