Reforming the VA: Safeguarding Service Members and Honoring Veterans

The Department of Veterans Affairs (VA) is frequently criticized for its inadequate services, with poor-quality care being a recurrent issue. However, the most significant failing lies in how Congress structures veterans’ benefits, which can detrimentally affect active-duty service members. A notorious example of the VA’s dysfunction is the Veterans Health Administration’s (VHA) long wait times for medical appointments. These delays persist primarily because the VHA lacks a pricing mechanism that could redistribute resources to meet high-demand areas. Whistleblowers highlighted that in 2014, many veterans faced extended wait times—exceeding 90 days for appointments—while some facilities even falsified records to embellish their performance. Tragically, it was claimed that over 40 veterans died while waiting for necessary care, spotlighting the severe consequences of the system’s inefficiencies.

In response to the public outcry regarding long wait times, Congress initiated efforts to allow veterans to seek care outside the VHA. However, even this solution proved inadequate, as a 2019 study by the Government Accountability Office revealed that veterans could still wait as long as 70 days for appointments with non-VHA providers. As of 2021, more than 810,000 veterans were still facing wait times of over a month, highlighting the systemic issues within the VHA. The organization also struggled to provide timely disability and pension benefits, with over 215,000 veterans waiting more than four months for assistance. The overarching theme of rationing care through waiting times reflects broader inadequacies that are often seen in publicly funded health systems, where price mechanisms are absent.

A critical issue regarding the VA’s financial structure is its treatment of veterans’ benefits in relation to military conflicts. The costs associated with providing these benefits significantly increase when troops are deployed. The VA estimated the present value of promised compensation and burial benefits had escalated to $6.1 trillion by 2022. If Congress funded veterans’ benefits concurrently with military commitments, the implications of military action would likely weigh more heavily on legislative decisions, potentially affecting the initiation or duration of conflicts. The current “pay as you go” system skews this dynamic by detaching the costs of war from immediate financial constraints, which can lead to Congress authorizing military action with little regard for the long-term financial obligations that arise from war.

The consequences of Congress’s funding approach mean that financial accountability is distorted; it might inadvertently facilitate decisions to send troops into dangerous situations without fully weighing the long-term costs to veterans. The adverse outcomes of this practice could even influence decisions during military engagements, as evidenced by discussions surrounding the Iraq and Afghanistan conflicts. To mitigate these dire implications, reforms in veterans’ benefits are imperative, specifically addressing the perverse incentives entrenched in the current funding model. One significant reform would be to pre-fund veterans’ benefits through increased active-duty pay, allowing service members to access competitive private insurance plans akin to those the VA offers.

By adjusting military pay according to risk levels associated with different roles, service members would benefit from higher compensation that keeps pace with potential hazards, thereby securing their access to health and life insurance post-service. This strategy could foster a climate where military pay and benefits are more reflective of actual risks faced in service, while also empowering service members to choose their preferred providers once they leave active duty. Additionally, privatizing the VHA could enhance overall healthcare delivery for veterans and non-veterans alike by introducing competition within the healthcare market and utilizing the VHA’s resources more effectively.

Ultimately, transitioning the VHA to a system owned and operated by veterans would afford them greater control over their healthcare options. With an estimated $36 billion in assets, privatizing the VHA could return these resources to veterans and allow them to shape their healthcare experiences to better meet their needs. The proposed reforms are designed to decrease reliance on military conflict, improve veterans’ benefits, and ultimately contribute to a safer experience for active-duty personnel, fostering an environment in which the sacrifices of veterans are met with the quality of care they deserve. These changes would seek to reconcile the existing failures within the VA and provide a more sustainable path forward for the nation’s veterans.