Amid much confusion regarding the state of America’s healthcare system, President Trump plans to sign a bill that will temporarily extend a program that gives military vets access to private-sector healthcare.
The bill, which Trump will sign on Wednesday, is designed to provide temporary services while Veterans’ Affairs (VA) Sec. David Shulkin develops a long-term plan that will enable vets to easily secure healthcare outside the VA medical system.
The legislation allows the VA to operate its Choice program until funding runs out. The Choice program has about $1 billion in its account; it would have expired in August without the bill.
As a candidate, Trump promised to overhaul the VA and make veterans' services a priority. He complained that veterans don’t get the respect they deserve, and released a 10-point policy plan to make their lives better.
This week’s legislation is a step in the right direction, but reforming the VA will be a long and difficult process.
For years, the VA has struggled with understaffed facilities and long wait times. The department’s infrastructure is in serious need of costly renovations. According to a 2016 VA survey, only 60% of vets trust the agency.
“I do think it is going take a combination of investing in the right types of devices to modernize the system as well as managing the system differently to fix the VA,” said Shulkin. “The president and I have talked about what it’s going to take to get the VA fixed, and he has provided us with the budget and the resources in order to accomplish that."
Shulkin, a former doctor, served as VA undersecretary of health during the previous administration; he is the only cabinet member to serve under both Obama and Trump.
In addition to improving access to healthcare, Trump’s plans for VA reform also focus on holding the agency's employees accountable. Last month, the House of Representative passed the VA Accountability First Act of 2017, legislation that would expand Shulkin’s authority to demote or fire employees based on misconduct or poor performance.
The VA budget is also a problem, with 57% of it going to vet benefits like insurance, pensions, and compensation to families after a soldier is killed. Of the remaining 43%, nearly 90% goes to medical programs.
Trump’s proposed budget, which will likely go through several edits before it is approved, includes $78.9 billion in discretionary spending for the VA (this is a 6% increase from the year prior). It also includes $3.5 billion to continue the Choice program.
The VA budget increased dramatically under former President Obama, and many complain that giving the agency more money isn’t going to help.
“If you look at the budget of the VA and simply divide it by the number of people enrolled in the VA, there’s more than enough money to fund veterans’ healthcare,” argues healthcare policy adviser Avik Roy. “The problem is too much of the money is being spent not on veterans’ healthcare, but on other institutional priorities like keeping open empty facilities that nobody uses.”
Long wait times are still an issue, with the most recent VA data showing that in February 2017, about 97% of the 4.5 million appointments were completed within 30 days. For some, 30 days is too long.
“If we don’t fix what is already a broken system, as our generation starts to uncover injuries, we’re going to have a harder time getting our care, or our care covered,” complains Allison Jaslow, a former Army captain and the current chief of staff for "Iraq and Afghanistan Veterans of America."