(Washington, D.C.) –Today, Senator Patty Murray (D-WA), a senior member of the Senate Veterans’ Affairs Committee, spoke on the Senate floor to urge her colleagues to work with her to dramatically improve the VA’s program for providing care in communities and build a stronger model that better serves millions of veterans in Washington state and across the country. The new model should improve upon the temporary Choice Program, which Congress created in 2014 to help veterans receive timely care in their communities rather than waiting for a VA appointment. Although the Choice Program was an important step and has addressed some issues, it is still fraught with obstacles and delays. Concurrently, a recent independent assessment concluded the VA health system continues to experience growing bureaucracy, problems with leadership and staff, and massive capital costs. As demand on the VA is expected to increase in the coming years, Sen. Murray is calling on her colleagues to address ongoing issues with the VA’s implementation now, and work toward a solution that provides high-quality care for veterans.
In her speech, Sen. Murray laid out her five principles for reform, including:
- A veteran-centered system that provides clear and consistent eligibility criteria for veterans and eliminates confusion
- Clear and consistent procedures for providers, as well as standardized reimbursement rates and timely payment processing by VA
- Oversight of quality of care for veterans, including care coordination
- A system that is flexible to local needs and evolving needs of veterans
- A system that is efficient and uses funds most effectively
“This is a pivotal time for the VA, and the demands on the system will only go up as wars continue to wind down and the Vietnam-era veterans continue to seek more care for the injuries and illnesses that they suffer from.”
“As the daughter of a World War II veteran, I refuse to let substandard care be the status quo. I won’t accept long wait times, red tape, and understaffed hospitals as a reality for our veterans. I’m not going to stop fighting to make sure we have a system that works—no matter how long it takes, no matter how many obstacles we face, and no matter who is in charge at the VA.”
“I hear frequently from veterans in my home state of Washington about how difficult the Choice Program has been. From VA staff who don’t understand the program, to confusion about eligibility, to getting the runaround from contractors-- veterans are sick and tired of having to fight just to get an appointment.”
“It is time for VA to implement one non-VA care program for the future. As we approach the end of the trial period for the two-year Choice Program, the VA needs to use this opportunity to finally get it right on non-VA care. It needs to design a new system that truly meets the needs of our veterans.”
Full text of the speech as prepared for delivery:
“Thank you, M. President.
“Next month, our nation will pause to honor the millions of men and women who have fought for our freedom and worked to advance peace around the world. Veterans Day is our annual way to say thank you—and to honor those who’ve sacrificed so much on our behalf.
“And while I would like to stand here and say our country is doing everything we can for the people we owe the most to—that we are fulfilling the promise we made to them when we sent them off to fight for us—unfortunately, that is not currently the case.
“Because our nation is falling far short of its goal of honoring our veterans when it comes to VA care.
“Despite a sweeping bill intended to tackle some of the most pressing problems and give the VA new tools—and a change at the top of the VA more than one year ago—I continue to hear from veterans across my home state of Washington about care that is inconsistent, outdated, and often downright dismissive of individual needs.
“I’ve heard from a number of veterans in my home state of Washington, who are waiting on surgeries, MRIs, oncology appointments, mental health screenings, you name it. Far too often, they say they are told it will be months to see a doctor or specialist. I bring their stories here today—to the other Washington—to continue to make clear that this kind of outdated, inefficient care is unacceptable.
“This is a pivotal time for the VA, and the demands on the system will only go up as wars continue to wind down and the Vietnam-era veterans continue to seek more care for the injuries and illnesses that they suffer from.
“As the daughter of a World War II veteran, I refuse to let substandard care be the status quo. I won’t accept long wait times, red tape, and understaffed hospitals as a reality for our veterans. I’m not going to stop fighting to make sure we have a system that works—no matter how long it takes, no matter how many obstacles we face, and no matter who is in charge at the VA.
“The law we passed to give veterans more options for care has now had an opportunity to go into effect. We can see what’s working, what’s not—what we can build on, and what we need to tear apart.
“Last year I supported the inclusion of an independent assessment of the VA Health System in the Choice Act. Recently, that assessment validated what we have been telling the VA for years -- there is growing bureaucracy, problems with leadership and staffing, and massive capital costs.
“And while the independent assessment identified some bright spots in the VA system-- it also found that care and patient experiences differ widely across the system, and best practices and important policies are not instituted across the country.
“And that means we all have more work to do—because we all have a responsibility to our veterans.
“Here’s what we’re up against—the VA still has multiple non-VA care programs-- none of which talk to each other, none of which are coordinated.
“They all have different eligibility criteria, different procedures for patients and providers, and different reimbursement rates.
“I hear frequently from veterans in my home state of Washington about how difficult the Choice Program has been. From VA staff who don’t understand the program, to confusion about eligibility, to getting the runaround from contractors-- veterans are sick and tired of having to fight just to get an appointment.
“I also hear how frustrating some of the bizarre rules and restrictions on Choice are. For example, an authorization for care only lasts 60 days. Well, if you’re a woman veteran and you’re pregnant, you’re going to need more than 60 days of care!
“At the VA, the wait times are still far too high. But with long wait times in the private sector and the burdensome process to get into the Choice Program, veterans are finding they actually would have gotten care sooner if they’d stuck with VA.
“If the solution to the wait time problem takes longer than going to VA, it’s not working. So it is no wonder that veterans and providers alike turn their backs on the VA. The system is so complicated it’s impossible to just get good health care.
“It is time for VA to implement one non-VA care program for the future. As we approach the end of the trial period for the two-year Choice Program, the VA needs to use this opportunity to finally get it right on non-VA care. It needs to design a new system that truly meets the needs of our veterans.
“I believe this system must have five fundamental characteristics:
“First, it must be veteran-centered, with clear eligibility rules so veterans know what they can do and what they can expect—where they can go, for what care, and how the system works. This also means the experience for veterans trying to use the system has to improve. Veterans should never, for example, be turned away with a dismissive “we’re not taking new patients.”
“Second, it must be easy for providers, with simple and consistent procedures for them to deliver care, report back to VA, and get reimbursed quickly. The contracting system needs to be simple and clear, so that private providers can step in where the VA can’t.
“Third, a new system must provide high-quality care that includes effective care coordination and that requires electronic medical records be returned to VA. This includes oversight of the quality of care being delivered in the private sector – we have to know our veterans are being appropriately cared for.
“Fourth, the new system has to be flexible enough to compensate for local needs, types of care where VA is deficient, or locations where VA does not have a presence. Whether working with community providers to increase certain specialty appointments or seeing where the VA needs to move resources to hire more VA staff, the system has to maintain flexibility to adjust to new trends and needs.
“Finally--- it has to be cost effective for the VA, and not shift the cost burdens on to veterans.
“Earlier this year, the VA nearly ran out of money and threatened to shut down the healthcare system. While we should invest whatever we need to make sure our veterans are getting care—the new non-VA care system must be more efficient and the VA needs to be clear with Congress about what it needs. Without a change, I would not be surprised if next year we don’t find ourselves in the same position-- where we have underfunded the VA and need to come in and transfer funding to keep the VA operating. I will work with anyone and stand behind no one when it comes to getting the veterans the funding they need.
“Perhaps most important, when implementation begins, it simply must be better than what we saw with the Choice Program. VA staff must be trained and proficient, and third-party administrators in charge of the networks of private providers have to be efficient and responsive.
“Veterans deserve a system that works, not one that is torn apart and weakened over time. So the answer isn’t just to dismantle the VA and leave veterans to fend for themselves, as some proposals would do. The solution starts with a real conversation about what is going on at the VA and what the problems are, and then pursues an “all of the above” approach that finally strengthens the VA system, uses community providers to fill in the gaps where the VA can’t get the job done, and continues to make the best use of other federal health programs like DoD and Federally-Qualified Health Centers—all in an effort to truly build a veteran-centered VA health care system.
“I stand ready to work with anyone to do this and I hope my colleagues will join me from both sides of the aisle and not make this a Democrat or Republican issue. Veterans’ issues have never been partisan, and in my mind, there is no place for that when we sit at the table to solve a complicated problem.
“I hope the Administration is ready to fundamentally reshape this program. I hope bureaucrats who spend more time defending the broken system are ready to get to work implementing solutions built around the needs of veterans. I hope providers – those who work with the VA, DoD and TRICARE, as well as those who currently do not provide care to veterans-- play a role to improve veteran care.
“The wars may no longer lead the nightly news, but that does not mean the costs of those wars are gone too. Our veterans are still there-- they still need health care and services, and we will not forget them.
“So I expect VA to do better. Our veterans have already sacrificed so much. They should not have to come back and fight VA to get the care they have earned. Let’s act—and do something that truly honors our nation’s heroes.
“Thank you, M. President.”