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"...what have we got—a Republic or a Monarchy?” “A Republic, if you can keep it

Our View: VA Secretary Robert McDonald sees the problem, but is blind to solution.

Give the Department of Veterans Affairs some credit for realizing the challenges it faces.

Now, if it just could open its eyes to the obvious resolutions.

For the VA, American wars begin straining the agency's medical resources 30 to 40 years after the guns go silent. A profound accordion effect takes place.

As the nation's VA hospitals began straining to provide adequate health-care services to aging veterans of World War II, for example, quality-of-care issues dominated headlines until Congress flooded billions of new dollars into the agency.

Now, in the midst of yet another quality-of-care crisis, VA Secretary Robert McDonald tells us VA hospitals are being swamped with a new flood of aging vets, this one from the Vietnam War era.

OP ED: VA makes excuses, not reform

And, just as we saw with every expansion of the VA accordion in the past, the solution, according to McDonald, is more funding.

Our veteran population, particularly those who fought in Vietnam, is aging, McDonald told the Association of Health Care Journalists in California last week. "And the aging of that population is what created the stress on the system. Sound familiar? The VA is the canary in the coal mine."

McDonald then issued a warning to Congress, which is considering a VA request for a $1.4 billion budget increase: Failure to comply will prompt more delays in the delivery of health care, and will stymie efforts to reform the agency (however limited those reforms may be).

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Michael Chow/The Republic Investigators determined the urology department at the VA Medical Center in Phoenix was so troubled that it needed its own investigation. Michael Chow/The Republic The Carl T. Hayden VA Medical Center in Phoenix failed in 13 categories, each deemed critical. Exterior of the Carl T. Hayden Veterans Affairs VA Medical Center in Phoenix May 28, 2014. (Photo: Michael Chow, Michael Chow/The Republic)

There is no doubt health-care demands on the already overstressed VA are about to explode. According to agency records, the VA in 2009 processed 989,000 health-care claims involving 2.7 million medical issues. By 2017, the VA is expected to process 1.4 million claims involving over 6 million medical issues.

How does any organization, much less one as sclerotic and hidebound as the VA, deal with such an upsurge? How does it promise quality health care to all vets under such conditions?

According to McDonald, the answer is mostly in more bricks and mortar. He wants a more aggressive hiring program for more doctors and nurses. And more and bigger facilities.

How many times does this accordion have to play before VA administrators realize they are failing veterans at the most vulnerable moments in their lives, when their health is failing?

Yes, the VA needs to expand, but as a military version of Medicare, directing qualified vets to the private-sector health-care providers of their choice and paying the bills it is responsible for paying. It doesn't need to create a government version of a health-care system that already exists.

To McDonald's credit, part of his expansion plans include more emphasis on the Veterans Choice program, which refers some veterans to private-sector providers. The bad news is that enlarging the VA fiefdom is his primary mission.

Retired Spec 4 Army, Brian Stephen outside Carl T Hayden

Retired Spec 4 Army, Brian Stephen outside Carl T Hayden VA Medical Center on Oct. 22, 2014. Inspectors at the Department of Veterans Affairs caught Phoenix VA managers falsifying patient appointment records during a probe six years ago, but agency officials did not divulge those findings at the time, according to documents obtained by The Arizona Republic. (Photo: Nick Oza/The Republic)

In his address in Santa Clara last week, McDonald spoke of what he saw when he took over the agency and toured the Phoenix VA, the epicenter of the agency's current quality-of-care scandal: "I discovered we were short 1,000 (medical) providers. And we were short clinical space."

McDonald's response was to launch a hiring program. One wonders where McDonald thinks all those missing medical personnel spring from? Even the private sector in Arizona is straining to find doctors and nurses to meet demand.

The answer is not to create competing health-care systems.

As we have said many times before, the VA must focus its specialized medical skills on those treatment protocols it does best: treating war wounds and post-traumatic stress disorder. And advancing research into brain traumas.

The rest it should farm out to a complimentary private sector. With every word from the top about what ails the VA, that path to reform becomes ever more clearly the only sound choice.

Me Here......This editorial gets it right.  The problem is the answer from any bureauracy to a problem, build us more buildings and give us more and more money!  This isn't the best solution.  It isn't even a poor solution.

The problem is it is a single point of service agency.  It can only see treating Veterans in their facilities.  The VA can't fathom any solution that allows Veterans to get care outside of the VA system.  It is like once we take the Oath of Enlistment our bodies become so unique that the civilian medical world is incapable of treating us. 

Part of the problem is unions.  A great many VA employees are unionized.  The unions know that the more we are allowed outside of the system, the fewer union workers there will be.  The Democrat party which gets much of the union dues would loose that money.  So they will do all they can to prevent us from going outside of the VA system.

So in the end, it is money.  A VA system that wants more and more money and Democrats afraid of loosing the union dues money that is blocking the good solutions that will greatly help our Veterans to get their medical care.

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