By Taylor Hughes
The Veterans Health Administration (VHA) is the United States’ most extensive integrated healthcare system, providing care at more than 1,300 facilities to over 9 million enrolled veterans nationwide. New Jersey has two major VA medical centers offering hospital services and several VA community-based outpatient clinics (CBOCs) dotted throughout the state. In response to a growing veteran population in Ocean County, the Brick VA clinic closed to make way for a new facility in Toms River. The county recently celebrated launching its latest addition in October. The following month, it held a ribbon-cutting ceremony. Rep Chris Smith (R-Manchester) noted the anticipated benefits from this change: more appointments, better access, and enhanced services for local veterans.
Access to care for veterans has been a hot-button issue, especially over the past decade, as a series of scandals came into the national spotlight. One such example was in 2014 when a whistleblower revealed more than 40 veterans had died while waiting for care at the Phoenix VHA. There had been a secret “off the books” waiting list, where significant delays were tracked by the Pheonix VHA but not reported, misrepresenting veterans’ access to care. President Obama signed the Veterans Access, Choice, and Accountability Act of 2014 into law in response. The law appropriated $10 billion so veterans could seek care at civilian facilities if they lived more than 40 miles from the nearest VHA facility or were waiting 30 days or more for care. It also granted an additional $5 billion to bolster VHA facilities and personnel. Many stakeholders believe legislation expanding access into the private sector was the right approach to the problem, calling for even more significant systemic changes in the VHA. Others believe that further privatization of the VHA would only make things worse for veterans.
Those opposed to privatization emphasize the value of VA providers’ specialization and their often-lifelong relationships with the veterans under their care. They say VA privatization would force the closure of VA health facilities, leading to less access for veterans and forcing them to compete with others for care. The for-profit motives of private healthcare could also make services more expensive for veterans. Further, surveys of veterans have indicated that VA hospitals perform better in all categories of patient satisfaction compared to private hospitals.
On the other hand, proponents of privatization say that veterans deserve to have the same healthcare options as everyone else in the country. A poll of 1,000 veterans commissioned by Concerned Veterans for America found that “91 percent agree… it is important to give veterans more health care choices even if it means paying a little more out of pocket.” Supporters of privatization would point to government bureaucracy and a lack of accountability as root causes of problems within the VA and may agree with legislation such as the VA MISSION Act of 2018, signed by President Trump, which shifted more funding into the private sector.
As a second Trump Administration draws closer, more change could come to the VHA, directly impacting veterans’ choices and access to healthcare in New Jersey and beyond.
Taylor Hughes is a graduate student pursuing a Master of Public Policy degree at the Edward J. Bloustein School of Planning and Public Policy. She serves as a research assistant with the New Jersey State Policy Lab.