Congress finally got something done! The three-year, $17 Billion fix to the tragic holes in VA medical system should be considered only an initial step on the long journey to evolve the VA’s medical support for the great men and women who have fought America’s battles to defend our country. The most expensive part of this temporary fix is the care provision for certain patients — those who either live more than 40 miles from a veteran’s facility or who face a wait time of more than 30 days for an appointment. This pigeon-holed, private care band-aid will still be coordinated by the Veteran’s Department, most likely as a limited voucher benefit.
In fairness, all injuries and illnesses sustained while serving our country should be fully treated and compensated, just like the illnesses and injuries suffered on the job by any civilian employee through his or her worker’s compensation program.
With the passage and implementation of the Affordable Care Act, we should now look on the VA in a new light and catch it up to speed with the private medical health care system: VA should broaden its intrinsic brick-and-mortar facility approach to veteran’s health care and, in essense, allow each military veteran the option to enroll with an ACA-certified insurance program — and the VA would pay each veteran’s annual premium equivalent to the level of at least a Silver ACA plan. Thus, the VA “vouchers” the entire ACA system at the Silver threshold; the individual veteran has the option to readily seek medical care near home or may still choose to travel to a VA facility for appointments. To encourage each Vet to show his or her “Veteran’s Silver Choice” card at the nearest VA medical facility and not at a private clinic or hospital, the deductable and co-pays for the Silver plan would be waived at the VA facility.
So each VA health facility would become part of every state’s ACA network for those in-state residents who have honorably served our country. If not already done, each VA medical facility would strive for ACA certification and guarantee prompt, accountable care for its covered patients within each state’s approved ACA network. This in-state competition with the other private sector Silver ACA insurance network plans would thoroughly safeguard top quality, timely care. Our Vets would no longer be lost in a bureaucratic dark place.
Improving the access, accountibility, and quality of VA health care will increase the overall medical cost for this deserving population of beneficiaries, because whenever access and/or quality in health care increases, costs go up as well. For a unique perspective on why this dynamic always takes place, please visit the relevant chapters in the newly released novel, Spirit Made Smaller, by Phillip Douglas.