As Congress currently debates legislation to reform the VA’s health care system, the myth about insufficient VA funding once again rears its head. Rather than confronting the bureaucratic inefficiencies of the VA, many members of Congress reflexively call for more money and more employees in place of any substantive reforms such as legislation that would provide real health care choice for veterans and better integration with the private sector.
Senator Bernie Sanders, for example, blames many of the VA’s problems on a lack of money and staff. He argues that more money and an increase in staffing will make the agency more efficient and accessible to veterans. Unfortunately for Sanders, the data is not on his side.
From 2007 to 2017, the VA’s budget for medical care increased from $31.5 billion to $67.5 billion- a 114% increase in funding. Meanwhile, the number of veterans seeking treatment from the VA during the same period increased by only 1.8 million patients—just 33%. Additionally, since 2007, the Veterans Health Administration (VHA) has increased their full time employee numbers from 204,574 to 326,415 employees – an increase of 59%. Clearly, the budget and staffing levels for the VHA have far outpaced the increase in demand.
This massive increase in personnel and money has not solved the VA’s deep and systemic problems. Headline-grabbing scandals including the Arizona waitlist scandal and the abuses of power at the DC VA Hospital occurred during this period of rapid budget and personnel growth. If past budget and personnel increases have not solved the VA’s core problems before, how can we expect that it will work in the future?
Senator Sanders has touted additional money as the agency’s solution before. As chairman of the Senate Veterans Affairs Committee, he fought to include $5 billion for hiring healthcare providers in the 2014 Choice Act. NPR followed the funds, and found the number of hires between 2015 and 2017 was the same as if the additional funding had not been given.
The same NPR study also found that medical staff hired under the Choice Act were not necessarily sent to hospitals with the longest wait times or highest priority. NPR found that hospitals in Albuquerque and Cincinnati have about the same volume of appointments, but Albuquerque has some of the worst wait times for mental health appointments. Both hospitals received the same number of psychiatrists from Choice Act funding.
True change for the VHA can only come in the form of legislation that fundamentally changes how the VA delivers health care to our veterans. This includes legislation like the Veterans Community Care and Access Act of 2017 which is sponsored by Senators McCain and Moran. This bill is in an important step in offering more private health care options for veterans and stabilizing the VA system over the next several years. The bill also mandates the VA perform an assessment of where current provider gaps exist so that the VA can make wiser use of its resources and not continually dumping money into an inefficient system.
VA Secretary David Shulkin said it best: “I am not looking for non-sustainable increases year after year the way that we have in the past. The problems that we have in the VA are not primarily financial. These are primarily system issues that we haven’t kept up with and we haven’t modernized.”