On June 24th, 2014, members of the House and Senate Committees on Veterans’ Affairs held a joint meeting to discuss a potential overhaul to the Department of Veterans’ Affairs. The two committees met for the first time in fifteen years on Tuesday to negotiate the differences between bills passed in the Senate and the House.
The two bills (S 2450, HR 4810) both aim to improve Veteran access to health care and to increase accountability and transparency in the VA. As they are currently written, both bills would allow millions of veterans to access health care outside of the VA, give the VA the authority to lease new facilities, give the VA secretary the authority to fire and demote senior officials within the VA, and restrict the bonuses accessible to VA employees. The main difference between the two bills is that the Senate bill authorizes emergency funding, while the House bill requires that the reforms be funded through the appropriations process. This meeting was the first formal step towards passing a compromise bill.
Members from both committees expressed that in order to improve the VA, there needs to be accountability and there needs to be additional funding.
While the care provided by the VA may be good for Veterans when they get access to it, the VA bureaucracy hinders the process. The VA bureaucracy is the second largest in the federal government and according to Rep. Brad Wenstrup (R-OH), the VA lacks efficiency. Accountability is important, because, as Ranking Member Sen. Richard Burr (R-NC) shared, “of $55 billion appropriated to VHA, only 48% goes to direct patient care. 52% goes to administration and other programs.” Rep. Ann Kirkpatrick (D-AZ) pointed to “reports of additional cover ups at the Phoenix VA and reports of retaliation against whistleblowers” and called for comprehensive reform by mandating transparency and holding VA employees accountable.
Senate Veterans’ Affairs Committee Chairman Bernie Sanders (I-VT) expressed that “the VA needs more doctors, more nurses, more mental health providers.” Sen. Jay Rockefeller (D-WV) agreed and lamented that “you can’t get pediatricians, you can’t get clinical psychologists to come and serve their nation the way their veterans did.”
This is especially true for mental health providers, because, as Rep. Mark Takano (D-CA) noted, “the ratio is 1 psychiatrist to more than 30,000. Furthermore, the VA’s internal audit found that frontline staff members said that the single biggest barrier to care was a lack of provider slots.” The VA needs to figure out how to incentivize providers to work with them in order to provide adequate care for Veterans. Sen. Jon Tester (R-MT) explained that in Montana there is one mental health provider “about 250 miles to the east of Billings, and there’s a lot of veterans in there, and the private sector doesn’t have any providers either.” According to Sen. Tester, there is definitely a need to recruit more providers, because “mental health issues are the number one injury coming out of Iraq and now Afghanistan.” Sen Mark Begich (D-AK) agreed with Sen. Tester, stating that “more than 55% of the post-9/11 veterans have mental health diagnoses, and each year, approximately 6,000 veterans commit suicide. The single greatest workforce need in the VHA is for more psychiatrists, to meet the mental health and substance abuse treatment needs of our veterans.”
Additionally, Chairman Sanders raised the issue that VA providers do not see as many patients as non-VA providers do. As Rep. Phil Roe said, it is important “to find a way to streamline efficiencies, to allow doctors to see more patients” and each doctor in the VA should be seeing at least as many patients as doctors see in the private sector.
House Veterans’ Affairs Committee Chairman Jeff Miller (R-Fla.) has not set a specific deadline for the completion of a compromise bill.