BY HERBERT E. SEGAL
The Veterans Access, Choice and Accountability Act of 2014 expands access to care by providing funds to hire staff, lease more clinics, renovate additional spaces and streamline the process by which senior VA officials suspected of wrongdoing can be dismissed. It does not address the many systemic challenges facing the VA:
Funding: Itās not clear that underfunding is the issue. Using 2008 as the base year, VA health care budgets have climbed 57 percent, and the number of full-time physicians has increased 40 percent, while the number of patients has increased less than 14 percent. However, increasing the extent to which veterans have access to non-VA providers, as is proposed, will come with significant cost increases.
The VA already has a growing outside referral program that last year consumed about $5 billion, 8 percent of its budget.
Care prioritization: The VA assigns a priority of āoneā to āeight. Those in priority one have
a VA-rated serviceĀ connected disability of 50 percent or more or are unemployable due to a service-connected disability.Ā Veterans who served in Vietnam are priority six, as are those who served at Camp Lejeune during the period in which water supplies were contaminated.
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