Providing health care services for military veterans has a long history, dating back to colonial times in America.  Contemporary surveys show that nearly 90% of citizens want to prioritize improving care for those who have risked their lives to protect us.  Special treatment to compensate and honor heroes is proper and desirable in every sense.  But why is health care treated so differently from other beneficial programs designed to recognize the same brave service? 

In June of 1944, the Servicemen's Readjustment Act, commonly known as the G.I. Bill of Rights, was passed by Congress, granting several new benefits to soldiers returning from WWII, including low-cost VHA loans to buy homes and also college tuition assistance so veterans could climb the ladder of success they had fought to defend. 

Imagine how things might have been different if the 1944 Congress had conceived of college attendance and home ownership within the same single-provider framework that veterans' health care had by then become. 

What if, instead of guaranteeing and subsidizing commercial home loans, the federal government had actually created a hom-building agency that employed hundreds of thousands of carpenters, plumbers, electricians, and others?  Congress could have easily created such a monstrosity and forced veterans to deal with the resulting leviathan.  All building sites, bulldozers, and building materials, and every small facet of the construction process, would then have been comprehensively and directly managed from within the federal bureaucracy.  It's hard to imagine the nightmarish outcome that would have ensued with government forms, appeals processes, and all the rest.

What if instead of merely subsidizing college tuition, Congress had instead insisted on physically constructing "Veteran Universities" from scratch, then directly hired the professors, provided food service and dormitories, and hired groundskeepers and janitors?  Again, it's hard to imagine the nightmarish outcome.  The U.S. Post Office would look brilliantly efficient by comparison, not to mention the obvious question of who would be in charge of establishing the curricula.

Yet, when it comes to VA hospitals, people somehow have a different perspective, but with zero logic to support the present structure and its underlying assumptions.

According to the most recent CDC data, there are 944,277 licensed hospital beds in the U.S., of which 44,772 are federal hospital beds (VA plus active military hospitals).  The remaining 899,505 beds are non-federal, or community hospitals of the sort we all patronize when circumstances warrant for every condition spanning colonoscopies, cancer treatment, gallbladder surgeries, stent placements, and on and on.  Nearly every city has several world-class medical centers that offer surgical and rehabilitative care of all types as well as outpatient care.

While the occupancy rate of federal hospital beds is 69.1%, the occupancy rate of non-federal hospitals is slightly lower at 67.8%.  Therefore, nearly 30% of the beds in both systems are routinely idle.  Simple calculation reveals there are 289,605 unoccupied private-sector beds available to be used for the 30,937 admitted veterans, active military, and other patients of our federally micromanaged parallel system.  As with any business, greater utilization of existing facilities equals higher efficiency and lower costs.  Enough private-sector capacity exists to care for over nine times more federal patients (veterans) than is currently required. 

In a voucher system, which would allow veterans a true choice, it is likely that the 144 current VA hospitals would experience a further decline of their census – a good thing.  The current network of buildings occupies some very expensive real estate in many cities, which could be auctioned off to the highest bidder with the proceeds plowed back into the VA budget to help defray the cost of transition to privatization.

According to the Washington Post on March 16, the Veterans Administration is the second largest line item in the overall budget, with 313,000 civilian employees and "a far flung hospital system."  The VA budget is slated to grow by 6% in 2017 over the prior year to nearly $80 billion.

Despite many ballyhooed "new start-type initiatives," scandals abound.  A Google search just from the past year reveals the following headlines on page one out of many:

Veterans Choice Act Not Helping Staffing Or Wait Time Problems At ...

Billions spent to fix VA didn't solve problems, made some issues worse ...

Veteran patients in imminent danger at VA hospital in Washington ...

VA Hospital in Washington D.C. Is Dirty, Disorganized, Inspector Finds ...

Phoenix VA problems? More than 2 years later, struggles continue ...

Whistleblower Faults VA Bosses for Problems With Vets Health Care

Opinion | Don't blame the director for the D.C. VA hospital's problems

Sources: Air quality problem growing at Atlanta VA hospital | WSB-TV

Feds step up investigations as drugs vanish at some VA hospitals ...

AP Exclusive: Drugs vanish at some VA hospitals

Let's not even quibble over the amount of money spent or budgeted.  Let's give deference to the brave men and women who deserve proper care and our compassion.  But must the actual care take place inside the federal gulag of designated buildings and performed by employees who have demonstrated such a stunning lack of unaccountability and ineptitude? 

Loren can be reached for comment at loren@twopare.com.