In recent days came a welcome sign that new Veterans Affairs Secretary David Shulkin won’t tolerate business as usual at his notoriously dysfunctional agency.
Officials unveiled a new website to show how quality of care at veteran’s health facilities compares with nearby private hospitals and with national averages. Vets also can see average wait times at nearby facilities – a sore point since the 2014 scandal that highlighted dangerously long waits at some facilities. The site also shows how veterans rate the quality of care at each facility.
That’s a strong start on the full-blown transparency and accountability that Shulkin promised and that America’s veterans deserve.
A website, of course, won’t provide better quality health care; only VA doctors and staff can do that.
But vets who visit accesstocare.va.gov will find easy-to-scan information about Veterans Health Administration facilities so they can make better decisions about where to seek care. The quality information for many hospitals, however, remains sparse compared with similar ranking sites. The VA needs to build more into this site, along the lines of the more robust federal Hospital Compare ratings.
Shulkin will have to make sure his subordinates keep the flow of information scrupulously honest. VA administrators have shown great aptitude over the years at hiding facility shortcomings from public scrutiny. “The way to fix the VA is by making information transparent and understandable,” Shulkin told C-SPAN. “Where we are, particularly when it comes to people’s health is, you should not be hiding data from people, this is too important to them. By releasing data, the most accurate and comprehensive that we have, we are allowing veterans to ask questions and to understand what is happening.”
He’s right. Information helps veterans make better decisions about their care, whether to seek it at a VA facility or try elsewhere. It has the promise of holding VA personnel accountable for dangerous lapses and lackadaisical care.
But that only solves part of the VA’s problem. Shulkin should also focus on these goals to improve care:
▪ Allow more veterans to seek medical care with private doctors. Flexibility in choosing providers breeds competition and yields a better chance that veterans will get the excellent care they deserve. That would allow Shulkin to streamline and downsize the rest of the system to focus on specialized care for battle-related injuries – treatment many private doctors can’t perform as well as VA docs do.
President Donald Trump has said that expanding private care is one of his priorities for veterans. Shulkin told C-SPAN recently that he favors a “seamless” system “so veterans can get the best of what the VA offers and the best of what the private sector offers.” Sounds good to us.
▪ Fire workers who resist change or don’t perform well. That’s the way it works in other industries. But the VA is so mummified in red tape and protocols that firing subpar workers is far too difficult. A VA reform bill passed the U.S. House on a bipartisan vote and is pending in the Senate. That bill would accelerate the firing of poorly performing employees, Dan Caldwell, policy director for Arlington, Va.-based Concerned Veterans for America, tells us.
Senators, get to work. Health care is “like every other industry,” Shulkin tells USA Today. “Industries don’t change from within, they change from outside competition, and they change from outside forces, and that’s very much my philosophy.”
We hope to see that philosophy in action in the coming months, to uproot a culture that long resisted accountability, and to deliver excellent care. For now, though, it’s nice to see sunlight – the best disinfectant – stream into the VA.