“As the Vietnam generation passes on, the size of the veteran population will shrink considerably. In 2009, there were 24 million U.S. veterans; by 2029 the VA expects that population to shrink to 16 million.”Future wars and combat actions could obviously impact the numbers estimated by VA but the reality is our veteran population will decline going forward. “Despite a $91 billion cumulative increase in the VA’s budget since 2006 and a 101,000 person increase in VA staff the timeliness of health care delivery for the shrinking veteran population has not improved.” This is another example of big government waste at its worst. The heart wrenching reality here is that the main victims are America’s living heroes and their families. Further waste of taxpayer money, neglect of America’s veterans and lack of accountability at VA is unacceptable; the present course must change now. I propose the following corrective actions:
1.) PASS H.R. 1994: VA Accountability Act of 2015: on 29 July 2015 this bill passed the U.S. House by a vote of 256-170; all but one of the votes against the bill came from Democrats. The White House is opposing this bill on the grounds it will place VA employees at possible risk of dismissal without grounds of appeal.
My view: this bill represents an immediate albeit small step toward remediating VA’s toxic culture of intolerance for dissenting views and contradictory opinions from within its own organization as well as its lack of corporate discipline. “When the House Veteran’s Affairs Committee subpoenaed VA assistant secretary Sloan Gibson to inquire why certain VA employees who engaged in various acts of misconduct (sexual misconduct, sleeping on shift in patients’ beds, selling of heroine on VA property and embezzlement of $400,000 from VA to name a few) have not been fired, Mr. Gibson claimed that the firing of dysfunctional employee’s such as these does not represent accountability, as the VA understands it to mean.” Certainly conduct remotely similar to that described above would result in immediate termination at the least in the private sector. Restoration of accountability is sorely needed at VA and this bill is a good first step.
2.) PASS The Veterans Independence Act: To date no member of Congress has introduced a bill by this name but rather this comprehensive bipartisan proposal is the product of “Concerned Veterans For America”. If elected I will work with “CVA” to introduce legislation based upon this framework as a model of systemic overhaul and reform to the VA health system. Highlights of CVA’s proposal are as follows:
-Separate VA’s payor and provider functions into distinct institutions (VHIP &VACO). The aim is to separate the VA’s provider functions from the VA’s health insurance function. This mirrors the private sector and reduces bias and manipulation of care prescribed for the beneficiary.
-Establish the Veterans Health Insurance Program (VHIP) as a program office within the Veterans Health Administration. The purpose would be administration of the veteran’s health care benefits for both private and public providers.
-Establish the Veterans Accountable Care Organization (VACO) as a non-profit government corporation fully separate from the Department of Veterans Affairs. This non-profit would encompass the VA’s brick and mortar health care facilities.
-Institute/commission a VA medical center realignment committee (similar to DOD’s BRAC) for the purpose of streamlining and consolidation of government owned facilities. VA’s facilities are not properly balanced and aligned with demand; some geographic areas have inadequate service providers resulting in long commute times while other regions have significant over-capacity of service providers.
-Require VHA to report publicly on all aspects of its operation similar to standards specified in the Medicare Accountable Care Organization program. Transparency is a must to ensure fiscal accountability and operational efficiency.
-Expand current veteran’s health care choices: veterans who are satisfied with VA health care plan can stay on their current program “VetsCare Federal” or opt for an option to choose their own source of health insurance “VetsCare Choice”. Additionally VCA proposes a third plan for veterans age 65 or older called “VetCare Senior” whereby VA funds would help defray costs associated with certain Medicare premiums and supplemental coverages.
-Transition future veterans into a premium support system with cost sharing for providers outside of traditional VA medical facilities.
-Offer veterans an opportunity to enroll in the Federal Long Term Care Insurance Program (a program currently available to VA employees and active/retired members of the uniformed services).
-Create a non-partisan agency to implement this law once adopted. This would be a temporary agency charged with execution of this program as specified by the Congress in the bill. 
The proposal by CVA is comprehensive and is the result of diligent analysis. Please refer to “Concerned Veterans For America” for specifics on this proposal as I have merely summarized its content for the purpose of this paper. I support comprehensive reforms to VHA as articulated in this proposal; services must be upgraded and efficiencies found so we can restore confidence in America’s largest health care system provider-THE VA.
3.) Empower the Office of Special Counsel the ability to directly fire and/or discipline any SES (Senior Executive Service-Office of Personnel Management) employee found to have retaliated against a whistleblower, or allowed retaliation to occur under their leadership. 
4.) Deputize 100% of the attorneys admitted to practice before one or more agencies of the federal government as Ethic’s Officers thus giving them standing to prepare, present, and prosecute ethical complaints before the respective agencies’ ethics boards and if necessary the courts. 
5.) REPEAL 38 USC 511 which prevents the courts from intervening in VA misconduct or benefits decisions. 
6.) Veteran services organizations (VSO’s) enjoy too close a relationship with the VA which can encourage collusion between these two entities at the expense of the veteran. “VSO’s house a lot of their functional operations on VA properties at taxpayer expense and the VA often provides free rent. Veteran’s advocate groups should enjoy complete independence (monetary & otherwise) from the VA so as to insure total loyalty to their clients: America’s veterans. The current relationship between VA & VSO is too close and should be reformed to ensure complete fidelity on behalf of all who have served.
SUMMARY: The VA also has a proud heritage of achievement and service on behalf of Veterans to include but not limited to:
-development of the implantable cardiac pacemakers
-conducted first successful liver transplants
-created the nicotine patch for smoking cessation
-crafted artificial limbs that move off brain impulses
-paralysis patients’ break-through robotic arms controlled by thought.
The future must build on the past successes represented by the innovations listed above and not slide into further decay that is the present state of affairs. The agency needs to embrace systemic accountability and structural reforms in order to correct shortcomings and drive efficiencies all for one purpose: to deliver world-class health-care to America’s heroes- our veterans! Choice and private sector options should be part of these reforms. Cutting waste and over-capacity is necessary in order to re-align the service providers more accurately with the customer. CVA’s comprehensive proposal is a great place for Congress to start as a launch point for these reforms. This agency, its facilities and most especially our veterans cannot afford to endure further delay or political maneuvering as a solution must be a top priority in the 2016 Congress.
 CVA: “Fixing Veterans Health Care” (taskforce.cv4a.org), Concerned Veterans For America.
 Mr. Eric Hughes, Accredited Veterans Claims Agent