The United States is doing a better job of taking care of its veterans than it was seven or eight years ago, but it’s still not doing well enough. On this Veterans Day, lawmakers and administrators should commit themselves to keep improving until they get it right.
One of the best reforms ever made to the Department of Veterans Affairs was subsidizing veterans to go outside the VA hospital system for care when the treatments they need are available closer to their homes. This first was accomplished on a limited basis through 2014 legislation crafted by then-Sen. John McCain and Sen. Bernie Sanders and signed into law by then-President Barack Obama. With President Trump’s full support and eventual signature, Congress expanded the opportunity for outside-the-system care in 2018.
Even the New York Times, whose news pages are loath to credit Trump for anything, reported that “the urgent care component is viewed largely as a success.” The New York Times reported, though, that various roadblocks have hampered the Veterans Choice program’s expansion into primary and specialist care. Among those roadblocks was the coronavirus outbreak, which made the VA nervous about allowing more visits outside the system. (The good news there, though, is that the pandemic spurred the VA to expand its telemedicine capacity, which might mean more and better options for homebound veterans.)
Still, Veterans Choice should be made almost universal, into a virtual voucher system, but with the government payout limited to amounts similar to Medicare formularies and veterans allowed to supplement the VA payout if they do indeed want more expensive options. Patients benefit from having alternatives, and the VA itself (and thus the taxpayers) might actually save money in the long run by reducing the need for hospitalizations if patients take care of ailments sooner and closer to home.
Meanwhile, Congress has passed other bills to improve the system, such as expanding hotlines for suicidal veterans and offering aid for veterans with substance-abuse problems. Yet with those, and with a new office meant to encourage whistleblowers, there remain kinks to be worked out, and greater congressional oversight is necessary.
Another move, perhaps controversial, could help redirect funds so they more directly benefit veterans. Because of the special nature of serving veterans — a cause uniquely and rightly embraced across the political spectrum — the temptation to politicize Veterans Affairs is less rampant than in other departments. Congress should consider relaxing civil-service job protections for some classifications of VA employees while offering greater incentive pay for exemplary service. In sum, make it easier to fire the bureaucratic deadwood while rewarding workers who truly make lives better for our veterans.
Allow me to offer some anecdotal insights, even though they are 34 years old. I worked in public affairs at the VA right out of college as a Reagan appointee, and what I saw then surely remains true of all federal bureaucracies: Plenty of federal workers care deeply about their missions and perform them with care and skill, but I saw a significant minority of them waste taxpayer money doing next to nothing but punching the clock. As very few improvements to the federal Administrative Procedures Act have been made between 1986 and now, those workers who don’t perform still enjoy the same, over-generous civil-service job protections now as they did then.
In most federal departments, that situation appears to be the price society is willing to pay in order to avoid a hyper-politicized “spoils system” in federal employment. What I suggest here is that because of the special obligations veterans do and should enjoy, and the lack of obvious incentives to politicize a department that is largely apolitical in nature, the VA’s civil service rules should be loosened. Departmental deadwood should be swept out, and good workers materially incentivized. We must create a culture of enthusiastic service on behalf of those who, under arms, have done so much to serve our country.
