Election-Year Politics May Hamper Proposals to Reform VA

Department of Veterans Affairs

House Veterans Affairs Committee members from both of the aisle acknowledged Wednesday that politics will be a major barrier to enacting the sweeping reforms to the Department of Veterans Affairs recommended by the Commission on Care.

Rep. Jeff Miller, a Florida Republican and chairman of the Committee, pointed to a proposal to begin a process modeled on the Defense Department's Base Re-Alignment and Closure procedures to shutter excess VA facilities.

Miller suggested that any lawmaker in a targeted district would be committing political suicide by voting for a BRAC for the VA.

"You can ask for a BRAC and you won't be here again," Miller told the panel members.

Miller, who is retiring in this term, also suggested that the proposed VA reforms would have to await the next Congress and the next president.

"Whoever sits in this chair after me will be responsible for and I'm sure will be more than capable of moving the ball forward," he said.

Miller spoke at a Committee hearing on the Commission on Care's 18 recommendations primarily focused on reforming the Veterans Health Administration, the $47 billion part of the VA that operates the VA medical centers, outpatient clinics, community-based outpatient clinics, and community living centers.

The hearing, titled "From Tumult to Transformation: The Commission on Care and the Future of the VA Healthcare System," took testimony from Nancy Schlichting, head of the commission, and Dr. Delos Cosgrove, the commission's vice chair.

Notably, the hearing did not invite testimony from VA Secretary Bob McDonald or representatives of the veterans service organizations. Instead, McDonald and the VSOs submitted statements.

Much of the event focused on the commission's recommendation to improve veterans' access to health care and cut waiting times by allowing veterans to have the choice of VA-purchased private sector services.

"Choice was a very difficult issue," Schlichting said, and the commission had to find a balance between VA and private care. She acknowledged that there is a "danger of weakening the current VA system if in fact choice was too broad" but added that "veterans should have a choice of primary care providers."

Rep. Mark Takano, a California Democrat and the committee's ranking member, said that the VA's current performance on delivering care "as we know it is unacceptable" but he was concerned that expanding choice "might in fact weaken the VA health care system" and "take desperately needed resources away from our veterans."

Prior to the hearing, McDonald, the VA secretary, defended the department's performance in an appearance on C-Span's "Washington Journal" and in an op-ed for the Hill newspaper.

On C-Span, McDonald said that the VA was already moving toward better integration with the private sector on veterans care. He said that 22 percent of the VA's appointments for veterans were now in the private sector but "we don't give up responsibility" for the overall care of the veteran.

In the Hill newspaper, McDonald took strong issue with the Commission on Care's recommendation for an independent board of directors to oversee the VA. The proposal was unconstitutional and also "doesn't make any sense. It would only make matters worse by complicating the bureaucracy at the top and spreading the responsibility for veterans' healthcare so that no one knows who's ultimately responsible."

--Richard Sisk can be reached at Richard.Sisk@Military.com.

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