Refine focus on vets' care
It was late 2014 that the Hampton Veterans Affairs Medical Center had the worst average wait times of any of the agency's hospitals nationwide.
In the three years before that, the hospital saw its workload jump by nearly a third, courtesy of aging Baby Boomer veterans and lots of soldiers, sailors, airmen and Marines coming home from wars in Iraq and Afghanistan.
Since that time, however, the staff at the Hampton VA has worked hard to reduce the logjam, with patient wait times being dramatically reduced.
Now, in trying to further drive down those times, the VA wants to build a new 155,000-square-foot outpatient center in South Hampton Roads.
Putting such a facility across the water makes perfect sense, given that much of our local veteran base is already there, and given that crossing the water isn't always exactly easy. Sadly, however, Congress has dragged its feet for more than a year on authorizing the new facility.
It's been a tough several years for the VA, the nation's largest integrated health care system.
The Department of Veterans Affairs is required under law to provide health services. But in 2014, widespread patient wait time problems came to light throughout the system's 1,700 hospitals, clinics and treatment centers.
The VA's Inspector General also found that some agency employees had falsified data to make wait times look better than they really were.
With our numerous military bases in Hampton Roads, we have one of the largest concentrations of veterans in the world. We owe these men and women — who fought bravely in wars from World War II to Vietnam to Afghanistan — better than this.
The idea for the proposed outpatient center is that veterans from South Hampton Roads would go to the new center for many needs. It would offer primary and specialty care, an eye clinic, a pharmacy and radiology services, among other things.
But when those patients need a hospital stay, they would still go to the Hampton VA. (The planned center is also separate from a proposed state-run veterans facility for geriatric patients in Hampton Roads).
Congress' delay on the outpatient center stems from a new rating system for government projects. Four years ago, the Congressional Budget Office changed the ways it scores these endeavors — now analyzing them for their costs over the long-term, not merely annually.
The planned outpatient center, for example, is not scored for its $18 million annual lease payments, but for how much it will cost over a lease term of 10 or 20 years. (Well into the hundreds of millions of dollars).
Looking at long-term spending is necessary, of course. The full price tag to taxpayers must always be clear in advance. Moreover, it's important to note that Congress would still have to separately sign off on the lease payments as part of each year's budget.
But here's the problem: Once lawmakers see the actual costs of the VA projects going further out, they might begin to get sticker shock. The higher the cost, the worse the project looks on the CBO score sheet.
Last week, U.S. Sens. Timothy M. Kaine and Mark R. Warner contended that their fellow lawmakers are letting the CBO's scoring system get in the way of good decision-making.
In a letter to the House and Senate Veterans Affairs Committees leadership last Monday, Kaine, Warner and 13 other senators asserted that the CBO's scorekeeping system "has stymied efforts" to authorize 18 Veterans Affairs leases in 12 states.
The senators asked their fellow lawmakers to take "swift" action. "Inaction on this issue hampers the ability of veterans … to access timely and quality care from the VA," they wrote.
And if the Veterans Affairs Committees don't authorize these leases, we believe that Congressional leadership should explore other options to ram them through.
In the longer term, we also need to loosen the rules on how the more than 15 million veterans enrolled in the system get their health care.
Under the current rules, these enrollees are generally required to use a VA medical center if there is one within 40 miles of their home. If there isn't, they can ask for approval to go to a private doctor.
Veterans who don't live within that radius miles can also use that outside network if they so choose.
Finding ways to streamline the process and encourage veterans to get outside care will help matters. And breaking ground on the Hampton VA's planned South Hampton Roads outpatient center is also a crucial step forward.
