Pundits of all stripes agree that fixing the ills afflicting the Veterans Administration is a daunting task and will require someone with a ‘particular set of skills’. However, much of the heavy lifting can be borne by competitive forces set in motion by allowing veterans a choice of medical care providers.
Proposals to give veterans a choice of health care providers have focused on providing prompt and effective care thereby significantly enhancing veterans’ chances of recovery or lessening their discomfort. While this goal is first and foremost there is another purpose served, the creation of competitive forces that will not only improve care but could also change the culture within the VA.
Assume under such a plan that:
1) veterans will be provided with a VA Card that will ensure any qualified medical care providers will be duly compensated for the care they administer;
2) veterans will NOT have to be denied timely service at a VA provider before being able to exercise their rights provided by the Card; and
3) the VA provider closest to the respective veteran’s residence will be charged for the medical expenses of the cardholder.
The net result of this plan is the creation of competition among all health care providers VA and non-VA alike. After a period of adjustmentcompetitive forces will encourage existing VA providers to improve or steadily lose their funding to other providers that will.
The successful completion of this proposal requires one further assumption: VA administrators must have the authority to suspend, reassign, lay-off or terminate (for cause) individual VA personnel. Causes could include insubordination, misfeasance, malfeasance, and nonfeasance of duties as well as incompetence.
This proposal is not a panacea but a mechanism that will aid and assist competent and ethical administrators address much of what currently ails the VA. Imposition of this plan would enhance the quality of health care available to veterans and significantly reduce their wait times for treatment.
Over the long term, quantity and quality of veteran care will improve and its costs will lessen for the rest of us.
Detractors of this plan state that alternative providers will not be versed in the special needs of some veterans. Nonsense. If the alternative providers do not have the requisite skills what is to prevent their administrators from referring certain veterans to other facilities, or recruiting health care providers who do possess the requisite skills? In addition, if individual veterans feel the alternative providers incapable of providing the care they need they are free to select an appropriate VA provider. More options are in everyone’s best interest.
DALE O. CLONINGER, BS, MBA, DBA
(GEORGIA INSTITUTE OF TECHNOLOGY, EMORY UNIVERSITY & FLORIDA STATE UNIVERSITY)
Currently Professor Emeritus at the University of Houston-Clear Lake, Dr. Cloninger began his academic career as an Instructor of Economics at the University of South Florida in 1965. In 1969 he was promoted to Assistant Professor of Economics and awarded the DBA majoring in finance & economics in 1973. A member of the charter faculty at the University of Houston-Clear Lake (1974) as Associate Professor of Finance and Economics he rose to Professor in 1980. He now serves as Adjunct Professor teaching a course entitled The Financial System to MS/MBA students. For ten years he has been listed in Who’s Who in America.