By Peter Bearse (Candidate For NH CD-1 US House Seat)
If you really want to know how to improve an organization and its services, you've got to approach the challenge from the bottom-up, not the top down.
Do this with veterans to learn of their experiences with the Veterans Administration [VA] and you'll get a mixed picture. One young vet who served in Iraq reported to me that he had to wait weeks for the VA to allow him to use his own doctor. Others told of great delays obtaining VA approval for treatment, and mediocre services from VA doctors once treatment is approved. The delays in approval for treatment(s) seem to be contingent upon exhaustive checking of the precise details of a veteran's service record to make sure that the problem for which treatment is sought is indeed service-related.
The only unqualified praise came from a Navy veteran who spoke of fine treatment at the Portsmouth station, which serves only Navy vets. Meanwhile, calls for a full-service veterans hospital in Manchester continue to fall on deaf ears in D.C.
There are four major features of a solution to problems of slow and uneven treatment via the VA:
(1) Enable choice of medical service providers via vouchers for veterans to take to providers of their choice. Vouchers are employed by the Australian armed services, for example.
(2) Effect comparative performance benchmarking (PBM) of VA hospitals with each other and with comparable private hospitals with bonuses and prizes awarded to top performers and best practices spread to other hospitals in the VA system.
(3) Reduce differential treatment within the armed services. For example, provide medical services of the same quality, without time limitations, for members of both the National Guard and the volunteer army who have served in combat zones.
(4) Dispense with checking whether vets' problems are service-related. If someone has served, that should be sufficient.
(5) Recruit the finest graduates of American medical schools into VA service by forgiving their student loans for at least 6 years of devotion to veterans' medical care.
Since my conversations with veterans involved only those I was able to encounter during my people-based, person-to-person campaign, let's get input from others. Veteran readers, what say you?
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Peter Bearse, Independent Candidate for Congress in New Hampshire's First Congressional District