Unfit for Service: How the VA Continues to Fail our Veterans
Lieutenant Colonel Scott E. Rutter U.S. Army (Retired)
They lined up at the last debate and started the discussion about “Medicare for All.” Not a single candidate referencing our existing Government run health care, the Department of Veterans Affairs. We don’t need to guess the outcome, we have proof. It won’t work and its mind boggling expensive, just look at the VA with a budget of $220 billion in 2020. The current President, a strong supporter of the Military, still failing to make the critical, organizational changes needed to the VA to offer our Veterans high quality care. The current Congress and Senate embroiled in impeachment and the past Mueller investigation (remember this), spending millions and talking in circles. Experts in one up man ship and failing at leadership. Imagine they spent all this time and money on solving problems of this country, including those at the VA. Veterans continue, at exceedingly high rates, to commit suicide, die at the hands of mediocre VA care, and still can’t seamlessly transition with their injuries from the DoD to the VA and civilian life. There is always a good excuse, a talking point, but not a solution. Even President Trump, known for dramatic and decisive change, hasn’t been able to make it happen for our Veterans at the VA. Time marches on and another election year is upon us. The mindset of good enough needs to end.
No one joins the Military for the benefit of VA healthcare, but many are injured defending this nation and deserve the respect and unfettered concern of our leaders. We should never forget that when an adversary comes knocking at the door, our military is there to answer the call, anywhere and anytime for every American. They deserve solutions that allow them to continue to contribute to this great nation as full productive members of society. That is the role of the VA, to allow our Servicemembers to continue to serve in our communities, in our companies, in our Government and as strong members of our families. Every employee at the VA needs to understand that mission and go the extra mile, take the extra time and focus on this mission everyday 24/7/365. The goal is not to provide benefits or hand-outs to our Veterans, but to provide solutions to them so they can live their full life and continue to serve.
But that mission continues to fall short and our Veterans, their families and our communities pay the price. In a world of incredible technological innovation, the VA lumbers along behind the curve, laughably still using a health care records system developed in 1990. The Government has allocated billions to implement a transition to coordinate the care between the DoD and the VA, yet the process hits insurmountable bureaucracy, technological limitations and overall malaise. Little oversight and repercussions for failure, no one is called to task for the inability to make this happen and more Veterans struggle, having to settle for something, at least they have that. It’s an embarrassing situation in a nation that has developed the highest level of technological innovation in the world. Yet, we can’t make it happen for Veterans. Leaders say we are doing more, getting better, doing a better job. It’s just not good enough and the change is not fast enough, the VA must be held accountable and pointing fingers to committee decisions or group think, is just unacceptable.
Let me give you a few very specific examples, and there are volumes more and I am sure other Veterans can lend their experiences as well.
Appointments and Availability of Services
When Veterans leave the military they are generally young enough to engage in gainful employment and many that have been in only a few years, need to get a job or start a business. They may be the primary individual responsible for providing financial support to their families. So, what does the VA do? First the VA is only open during the day, primarily 8am-4pm Monday through Friday, so the Veteran has to take time off from their new job, career or business to get there. Secondly, it can take months to get an appointment. Even going on the private sector, there may be delays in getting an appointment or limited availability. Just because you have access to the private sector does not mean you get first in line. Third, if you need to change a VA appointment, a reschedule can again take months even if there is an available appointment. A cancellation by another Veteran does not necessarily mean that the slot opens for someone to take that appointment, instead it is often left vacant. Lastly, the VA does not allow Veterans to seek care in any VA, you have to be registered in that VA and if you want to go to another VA it is extremely difficult, even if that other VA may have more of the services that you need or available appointment. What was that motto, ONE VA? I think it is really each VA hospital for itself. This exists because registered Veterans drive allocations of budget to each VA hospital and therefore, if you are registered they count you for services and get additional funding. It’s not a good thing for you to get care in another VA as that would have a negative impact on your home VA and you would have to transfer to that other VA. Therefore, the use of the VA by a Veteran is actually very limited. How ridiculous is this? When you are in-network, you should be able to use any and all in-network providers and facilities. Veteran services should be available at any VA and the availability of appointments should be national. I should mention that the VA does not allow a Veteran to request a certain provider, strange? Wouldn’t it be better to have Veterans able to pick great doctors and even rate them? Why does this not exist in the VA? I want to know which one did a great job. Let’s redefine Veterans Choice, I want to go anywhere in the VA network and I want to be able to pick and rate my doctor.
DoD to VA Transition Minefield
This has been an ongoing battle with the VA. A few years ago they had backlogs of thousands of claims, they have tried to streamline this process online. The question that begs to be asked is why is there even a process at all? One hundred percent of the Veterans are injured in the DoD, the vast majority of them should have a seamless transition to the VA, no claims, zero, none. The Government knows who is injured as they out process from the DoD. The fact that the Government has been unable to implement this is a travesty of billions of dollars spent and no solutions. There is absolutely no excuse for Veterans not able to gain immediate care for their injuries. This would prevent massive issues related to mental health, medications, delays in follow on care and much more. It would provide a road map for a solution for that Veteran to re-integrate into the civilian society. The minefield between the DoD and VA can be more dangerous than some of the action experienced in the military and can rob the Veteran of the care they need right at this critical juncture. There should be no delay and no claims process for known, existing conditions when leaving the military.
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Failed Records Management
It still sucks, take your medical records and bring them to the VA. LOL, it’s 2020. The Government is spending billions on massive corporations integrating these medical records systems. The VA and DoD are operating on systems created back in 1990, simple math will tell you that is 30 years old!!!! How did we spend all these tax dollars on the VA and still have this in place? Time went by and there were so many other priorities, this same system just kept being used. Making a change is hard, but there is not a single private health organization that uses a system anywhere near this age. There are so many functions the Veterans Health Information System Technology Architecture (VistA) can’t do for us in terms of data management, security, data analysis, outcomes, and more. It’s time to change and leadership needs to ensure that these systems are integrated between the VA and DoD. In addition, new systems need to not only provide medical information, but ways to evaluate results, expand care using telemedicine, harness the benefits of artificial intelligence and interact with Veterans in a very personalized way so that care is targeted and responsive to each person’s needs. And just a reminder that the US has the most sophisticated cloud service providers (CSPs) in the world that have FEDRAMP certification, there is absolutely no need for the VA to buy servers that need patching and get old the minute they are installed. To stay ahead, the VA needs to invest in its relationship with our pre-eminent CSPs that are incredibly capably of moving the VA forward and developing solutions that focus the VA on their core mission, finding solutions for Veterans.
Veteran Employment and Entrepreneurship in our Community
This is my favorite section because for the last 10 years, this has been my personal focus. I own a teleradiology company that provides services to our DoD and VA facilities. I started the company with my own funds and to this day, I work tirelessly to meet the needs of the Government. Along the way, I have had the joy of dealing directly with the VA Vetbiz program, a travesty and completely failed attempt to validate the Service Disabled Veteran Owned status of companies for preferential treatment in contracting. I have also witnessed the VA try to skirt out of its’ commitment to set aside contracts for SDVOSB properly, resulting in many lawsuits over the years, even to the Supreme Court and even after that, continue to degrade the use of SDVOSBs.
Let me unpack this further by starting with the Vetbiz certification program. If any of you have experienced this, let me know how you like the website. The website is functionally the most laughable and sorry portal. The site constantly times out, goes to SQL error pages, has no flexibility of uploading documents, and if you try and use it past 8PM, it just freezes. Oh, and by the way, you must use Internet Explorer or you won’t be able to authenticate properly. Every action requires that you wait 30-60 seconds for it to complete. This is the portal that they use to encourage Veterans to do business with the Government. Then when you finally get everything entered and submit, you get a laundry list of additional information that they want you to submit that nowhere else is this required for any other set aside in the Government - small business, women owned, etc. The auditing and assumption of guilt is so obvious and blatant. So much so, that they even ask how you can volunteer for a charity and have time to control your business??? This process has morphed into an actual discrimination against Veterans making it harder and harder to do business. If this distorted process exists for Veterans, why not the rest of the set asides. Why does Congress, Senate and the President believe that only this subset of contractors needs to go through this intense vetting and not the others in which billions are spent. Women owned business and small businesses self-certify their status, do they not trust Veterans? Someone needs to figure out what is going on here because this process is out of control, the portal is broken, the reviewers don’t understand how a business is controlled, improper subcontracting abounds and Veterans are turned off from this level of invasion into their lives and their business decisions. And when all is said and you are finally done (yeah!), the VA tries to skirt out of the requirements for the Service Disabled Set Aside!
Now let us talk about giving jobs to Veterans and finding solutions in our communities. At my business, we hire Veterans all the time. They are phenomenal employees, bringing focus, life experience and commitment to the task. They are leaders and innovators and they understand what it takes to get the job done. Benefits should be given directly to firms, particularly small businesses, that do this as a permanent change in the tax code. Having a job is vitally important to success for a Veteran and those companies that make an effort to employ Veterans should be rewarded.
State and local Governments should provide tax incentives for businesses that hire Veterans as well as Veterans that become homeowners. One of the best ways to ensure affordable living for Veterans is to provide significant real estate tax benefits for Veterans. In the State of New Jersey, there are barely any benefits in a very high tax state. To prevent homelessness and encourage Veterans to be part of their communities, state and local Governments must recognize their role in supporting Veterans. The single largest expense of most families is their home and tax benefits should be provided to Veterans. I can guarantee that the return back to the community will far exceed the cost of the tax benefits afforded to our Veterans. They are people that understand the importance of service to their communities, volunteering, work hard at their jobs and often are entrepreneurial bringing new jobs and businesses. Instead of creating Veteran housing in segregated communities, it is far better to give them the means to integrate and live in the local community. Could some of the $220 billion budget go towards supplementing tax cuts in our local communities and encouraging entrepreneurship in our cities and towns? Veterans don’t want a hand-out, they want a solution.
Wrapping This Up
So let me finish by going back to our candidates for President, including President Trump, and ask you, will you be swallowed by the never ending investigations and fallacy of Medicare for All (see VA results) or will you rise to the challenge of the next decade? I ask our current and future leaders at the National, State and Local Level to step up to the plate and make the hard decisions to get things right when it comes to Veterans, share your best practices. I spent the last few pages decrying the condition of the VA because our society has an obligation to get them back on their feet and moving in the mainstream lock step with those that have not served, not for handouts or special favors. Being a Veteran is not a label or a tag, it’s a duty and an honor. It has been my honor to serve this nation and to be afforded the opportunity to follow in the footsteps of all those that have passed before me in the protection of this great nation. I am grateful for the care I get at the VA, but we can really do much, much better. We need leadership and we need common sense solutions and it is time that we recognize and properly honor our Veterans by really fixing the VA and making the American Veteran a high priority target in this next decade.
Silver Star Recipient Lt. Col. Scott Rutter commanded the 2nd Battalion, 7th Infantry, 3ID (M) destroying Republican Guard Forces as Baghdad International Airport during the combat phase of Operation Iraqi Freedom I (2003). Scott is an Entrepreneur and Founder and President of the Valor Network, a Service Disabled Veteran Owned Small Business that is one of the largest Telemedicine/Teleradiology providers to medical facilities in the Department of Defense, Department of Veterans Affairs and the Department of Homeland Security.