Problems in the Department of Veterans Affairs' medical system have been years in the making, and it's shameful that it took a scandal like the one now engulfing the department to prompt Congress to act. But the bi-partisan deal announced Thursday by Vermont Sen. Bernie Sanders and Arizona Sen. John McCain appears to be a solid effort to put veterans' needs, not politics, at the forefront of the national response to the debacle.
Inspectors general have found thousands of instances of veterans who had to endure long waits for care and cases in which VA officials sought to cover up the delays through secret wait-lists and other means. The resignation of VA Secretary Eric Shinseki was perhaps an honorable gesture on his part, but it does not begin to cleanse the rot from the system's bureaucracy.
Republicans were outraged that the VA secretary could not simply fire officials who engaged in such egregious conduct, but he was limited in his ability to do so by civil service protections afforded to VA staff, which many Democrats were reluctant to do away with. This is not just an issue of one party being pro-union and the other not. Civil service protections are a key advantage the VA system has in recruiting health care workers and administrators who could easily earn more in the private sector.
The deal the two sides came to splits the difference: The VA secretary would be allowed to fire or demote those who are linked to mismanagement or care delays, but those workers would have the right to appeal to the Merit Systems Protection Board, which would be required to rule quickly on their cases.
Likewise, the two sides found a way to compromise on the question of whether veterans should be allowed to seek care in private facilities rather than just VA hospitals. Republicans have generally pushed for such a solution, and Democrats have resisted it. Again, this is not just a matter of one party being pro-privatization and the other opposed. There are legitimate questions about whether siphoning patients away from the VA hospitals would rob them of resources they need to conduct research into things like advanced prosthetics that are needed by military veterans but of limited commercial interest in the private sector.
Again, the deal strikes a balance: Veterans who live 40 miles or more from a VA hospital or clinic or are experiencing long waits for care could instead got to a private facility that accepts Medicare or to some other government facilities. Meanwhile, the department would be authorized to lease 26 new medical centers nationwide and to spend up to $500 million on hiring new doctors and nurses.
There is some grumbling about the proposal, particularly from fiscal conservatives upset that the new funds would not be subjected to previously agreed upon spending caps. But the measure is nonetheless expected to advance quickly in the Senate, where it could hit the floor this week, and likely in the House as well, since it combines elements of various proposals already advancing in that chamber. Given the usual gridlock in Washington, there's no small amount of back-patting going on about Congress proving its ability to respond to a national crisis.
Indeed, it is heartening to see. It's just too bad that more things aren't considered a crisis. There is little that tugs at the heart-strings more than the prospect of veterans dying while tangled in government bureaucracy. But there are plenty of other big problems with the potential for devastating consequences if they are unaddressed that have not lit a similar fire under our elected representatives. It would be nice to see a similar urgency to grapple with, say, climate change, entitlement costs, immigration or transportation funding. The VA scandal inflamed such public outrage that politicians in both parties recognized that there was more to fear in doing nothing than there was to gain from blaming the other side for failure. Until the public is ready to speak so forcefully on any number of other major issues, this respite from gridlock will be an anomaly.
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