Congress seeks to hammer out fix to veterans health care



WASHINGTON — Hire more doctors, build more medical centers, or expand the use of outside providers of medical care for veterans.

The House and Senate can’t agree on the best way to address long wait times for care that were exposed recently in a scandal involving allegations of falsifying records at VA medical centers. However, lawmakers universally agree something must be done to ensure that veterans receive in a timely manner the health benefits they earned through their military service.

The House on Wednesday rejected the Senate’s proposed fix, preferring its own plan. That triggered a bicameral conference committee whose work eventually will get an up or down vote in each chamber without amendment.

Sponsored by Sen. John McCain, R-Ariz., and Sen. Bernie Sanders, I-Vt., the Senate bill would have funded the opening and staffing of 26 additional VA medical centers to meet demand. Until the new centers are in operation, it would have permitted veterans to seek private treatment at government expense whenever VAs cannot provide timely and local care.

It also would have made it easier for the VA secretary to fire employees for poor performance and would have provided funds to hire more doctors and nurses and open new facilities to meet the demand for services.

The House fix, meanwhile, would direct the Veterans Administration to contract with non-VA facilities when government facilities cannot provide timely service within 40 miles of a patient.

It also includes a two-year moratorium on bonuses for VA employees and a provision making it easier for the VA secretary to fire or reassign top-level employees.

One Pennsylvania congressman, Rep. Glenn “G.T.” Thompson, R-Centre, prefers a blend of those approaches that end bonuses, provide for employee termination and use non-VA facilities when demand for services is high.

“I’m appalled that we have to pass legislation to let inept, corrupt employees be fired – to let people gaming the system be fired,” he said.

“We need to better operate what we already have and better manage our VA centers,” Mr. Thompson said in an interview.

Earlier Wednesday during a committee hearing, Veterans Affairs Chairman Jeff Miller, R-Fla., pressed for increased use of private facilities to treat veterans.

Others pointed out that the VA already uses outside providers when it can’t provide the needed services, when late times are exceedingly long or when it would be impractical for veterans to travel long distances sometimes required to obtain services at government facilities.

Mr. Miller said VA leaders haven’t prudently used their authority to augment agency services with private care.

“The VA has made it disturbingly clear it is unwilling to use existing VA authority when and where it should … and thousands of veterans have paid the price,” he said during Wednesday’s committee hearing.

Mr. Miller said his goal is to augment VA capabilities, not dismantle the system.

Contracting for additional outside services would be much faster than hiring more staff and building new facilities, he said.

The VA spent about $4.8 billion on outside care, or 11.6 percent of the agency’s medical services budget.

The House Veterans Affairs Committee has scheduled a separate hearing on Friday to discuss performance bonuses for VA executives. Gina Farrisee, the VA’s assistant secretary for human resources and administration, is expected to testify.

Washington’s attention turned to VA reform this spring after scandal came to light that led to the resignation of VA Secretary Eric Shinseki. Employees at some VA medical centers, including in Arizona, are accused of falsifying records in order to conceal long wait times.

The Veterans Affairs Pittsburgh Healthcare System also had long wait lists — with some waiting about two years for appointments, but problems there don’t appear to mirror those at the center of the controversy in Phoenix. Rather, a single employee had not been managing new enrollee appointment requests, according to Pennsylvania lawmakers briefed on the problem.

Still, the problem is more evidence of systemic problems at the VA, lawmakers said.

“The shocking discoveries in Pittsburgh showed that the VA suffers from a culture of complacency where lousy executives and managers are more likely to receive bonuses than to be fired for malfeasance and neglect,” U.S. Rep. Tim Murphy, R-Upper St. Clair, said in a written statement. “The House bill gives the secretary the tools needed to build a culture of accountability and guarantees veterans who need immediate care receive it as quickly as possible.


Washington Bureau Chief Tracie Mauriello: tmauriello@post-gazette.com, 703-996-9292 or on Twitter @pgPoliTweets.

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