Fixing The Veteran's Healthcare Mess

Carolyn McClanahan | | June 4, 2014

What went wrong with our Veteran’s health care system? It comes down to two main culprits – first, the system was asked to do too much, and second, incentives put in place to make the system perform better backfired. In this post, I address the stresses in the Veterans Health Administration, how the incentives backfired, and ways to help get the VA health care system back on track.

Stress in the Veterans Health Administration (VHA)

The VHA has a tall order – to care for all our eligible veterans. The eligibility criteria are very generous. In the “old days” of the VHA, before President Clinton, many of those eligible for care wouldn’t use the system – the care was considered sub-optimal. Through reforms implemented during the Clinton years by Dr. Kenneth Kizer, the VHA went through an amazing transformation – and patient enrollment surged. Great primary care, a beautiful and relatively easy to use electronic medical record, AND a culture of accountability. Veterans received wonderful care for a great price. Unfortunately, in 1999, the GOP made it clear they were going to refuse Dr. Kizer’s renomination, and instead of being slung through mud, he resigned and went to the private sector.

Good things only last so long if not cared for in the appropriate manner. The cost of health care in the private sector had increased dramatically, so more veterans were accessing the VHA system...