Beyond Time to Dump the VA Hospital System

A study released this past week by a consortium of researches including Grant Thornton, MITRE, the RAND Corporation and McKinsey, trashed the VA hospital system and the Veterans Health Administration (VHA).  Visiting 87 different VA facilities, it concluded that:

“The assessments … provided evidence that the organization is plagued by many problems: growing bureaucracy, leadership and staffing challenges, and an unsustainable trajectory of capital costs."

That was a fairly polite way of saying that the 300,000 American military veterans who died awaiting treatment at a VA hospital died not just from their ailments but from suffocation under a bureaucracy -- one designed not so much to provide quality health care for the veterans of our military, but career, entitled government jobs for an administrative class.

Can we not simply decide this: Start with the actual goal.  The goal is to provide an efficient and effective system for providing health care to American military veterans.  Ask, study, do what is needed to determine the best model for doing so, not based on what we now have, but based on what we need.  Based on what works.  Based on what saves lives and treats veterans most efficiently.

And let us not be bound to any model based on any other criterion, especially because it is what is already there.

Oh, yes -- there is that one other little component to the discussion, and that is the Tenth Amendment to the Constitution, the one that suggests that perhaps the Federal government ought not to try to do things it is not equipped to do, as if the Framers had a little foresight.

And so I ask for the next president to do this -- and for at least one candidate to stand up and advocate for this: Let us propose to take no more than six months to evaluate the concept of privatizing every one of the VA hospitals in the USA, selling their assets to private hospital corporations and turning them back into commercial, community, state or non-profit institutions no longer under the ownership or control of the U.S. government.  The proposal would convert the VHA from the hospital administration organization it has failed at, into essentially a management agency only coordinating the medical benefits of veterans.

Carly Fiorina says that "leadership is a willingness to challenge the status quo."  Here is her chance.

It should take no more than six months to orchestrate that study, because it is that important.  The study would validate the idea of selling every VA hospital to private or other non-Federal entities and making them simply "hospitals" -- or closing them.  We would then turn the VHA into something other than an administrator of hospitals; it obviously cannot do that.  The VHA would simply shrink by 95% and just administer the rights defined for our veterans.

Instead of a veteran going to a VA hospital -- no, applying to go to a VA hospital (and dying while waiting), he or she would go to the nearest hospital pre-approved to treat veterans, and get the same care any civilian would get there.  The only difference would be how the payment is made; in the case of the vet the "insurance company" would be the VHA, which would make sure the bills get paid and that the standards of quality care are enforced.

There may be certain institutions -- again, private or community hospitals, not Federal outposts -- which may be specially certified to treat certain veteran-specific issues such as PTSD, but that should be no different from certain hospitals today which have specialties in heart disease or cancer but which treat all comers.

Six months.  Evaluate whether the end state would provide more efficient and effective care.  Decide whether it will work and put in a three-year plan -- that's all that's needed if it is that important -- to implement it.  Pay for much or all of the cost of the study and the actual effort using the proceeds from the sale of assets.  There are a lot of VA hospitals, and that's a lot of real estate.

Those men and women who put on the uniform put their lives on the line to protect my freedoms.  I'm willing to shake up the existing unworkable, ineffective and contemptible system to save their health and their lives.

Come on, candidates -- who's with me?

 Copyright 2015 by Robert Sutton
 Like what you read here?  There's a new post from Bob at www.uberthoughtsUSA.com at 10am Eastern time, every weekday, giving new meaning to "prolific essayist."  Sponsorship and interview inquiries cheerfully welcomed at bsutton@alum.mit.edu.