As a doctor, I saw veterans' bravery from the bedside, and now I can end the inefficiency and scandal. A few days before Labor Day, as Americans prepared for the end of summer, we learned that some 300,000 U.S. veterans might have died while waiting for health care at the U.S. Department of Veterans Affairs. Yet due to "generally unreliable" VA data and ineffective systems, even this critical statistic could not be confirmed.
These disturbing findings, revealed in a report by the agency's inspector general, confirm the urgency for VA reform. When it comes to veterans care, Americans are rightfully outraged, and can no longer be content with business as usual: We must seek — and our veterans deserve — real improvements that are bold and long-lasting.
During my career as a neurosurgeon, I worked at VA hospitals as a medical student at the University of Michigan in Ann Arbor and again in Baltimore. Both my internship and residency at Johns Hopkins involved actual patient care as well as supervising resident physicians attending at VA hospital facilities. I sat at the bedside of many veterans and witnessed their selflessness, their sacrifice and their need for extraordinary care. Their anguish was my anguish.
Today, while many committed leaders and servants toil at the VA, its performance is marred by incompetence and corruption bred by structural impediments and bureaucratic indifference. The astonishing findings of public and private audits have turned out to be much worse than anyone suspected. In May of last year, Americans discovered that VA employees across the country had falsified and manipulated patient appointment records — leaving veterans seeking treatment in long or futile waiting lines while the employees themselves were receiving fat bonuses. After the scandal, a new VA secretary, Robert McDonald, pledged to clean house, but as of February this year, nearly a year after the scandal came to light, only eight employees out of more than 340,000 on the VA's payroll had been fired for their role in manipulating wait times. Even Mr. McDonald, one of the finest corporate executives and management figures in America, could not break the logjam of dysfunction at the bureaucratic behemoth.
Meanwhile, decades of effort and billions of taxpayer dollars have been thrown at "fixing" the VA, and the results have been abysmal. The backlog of veterans waiting for treatment or disability classification is stupendous, and drives them to frustration and even desperation. The lack of integrated records management continues to defy the millions of IT dollars that have poured into the agency. Continuity of care from the Department of Defense to the VA is often non-existent, and malpractice within the VA system is underreported and often unaccountable. Even the simplest tasks of refilling prescriptions and getting preventive medical checks are inor
dinately difficult. Instead of making the military-to-civilian transition more seamless, the VA has made it more arduous.
Additionally, the VA's health system has not adapted to meet the changing needs of our veteran population. While tremendous advancements in battlefield medicine and treatment have occurred during the nation's decade plus at war, the VA hews to an antiquated health system that does not take into account changing veteran demographics, increased severity of non-lethal injuries, a more transient veteran population, enhanced civilian medical technologies or increased need for connectivity in the information age.
Amid the egregious care and system-wide ineptitude, we lose 22 hopeless veterans to suicide every day.
These failures cannot stand. The VA is like the federal version of the Department of Motor Vehicles: inefficient, incompetent and infuriating. Except the VA is much worse: at least the DMV's long wait times do not kill its applicants.
At a minimum, the Veterans Health Administration (the entity in the VA that provides health care) should be eliminated to forge a 21st century veterans health care solution. Such a significant organizational change no doubt requires further study and consideration, and I will be providing more details in the weeks and months to come. Meanwhile, the following improvements can and should be made immediately. The health of our brave men and women veterans deserve no less.
- OFFER CHOICE, including health savings accounts (HSAs), to allow veterans to access the best possible medical care at a nearby DOD, VA or civilian medical facility.
- PROVIDE PORTABILITY to allow dollars to follow the veteran, even when away from their primary care locale.
- ENSURE TIMELY RESPONSE for disability claims and medical requirements.
- MAKE SPECIALIZED CARE READILY AVAILABLE by utilizing military and civilian centers of excellence for treatment of military-specific post-traumatic stress disorder, traumatic brain injury, spinal cord injuries, severance of limbs and other issues.
- STRIVE FOR SEAMLESS TRANSITION that equips veterans with education, employment, life skills and continuity of health care to ensure immediate and successful transition into a contributing member of civilian society.
We simply must do better to serve those who have served us so selflessly. No more politics as usual, no more Washington-size excuses. We need results for our vets.
Ben S. Carson is a Republican candidate for president. He is the former director of pediatric neurosurgery at Johns Hopkins Children's Center in Baltimore.