PLS
Definitely more efficient, Wake, and applicable for some of the care the typical Vet needs. Don’t be surprised if there is hue and cry for such a change soon.
The problem is that there are two prongs of the model that the VA is tasked with in “caring for those who have borne the battle”: dealing with the illness and injury associated with their service and the ongoing (ie normal) healthcare needs throughout their life. The VA is responsible for both even though they are divergent.
There are calls for “vouchers” or the like and the elimination of the VA. Even though that may help some patients, there is a tremendous amount of specialized care that goes on in the VA that the commercial space is not geared to deal with: prosthetic implants and therapy, traumatic brain injury (TBI), PTSD, non traditional infections (agent orange, radiation) and all their co-morbidity. We need the VA and the focused, specialized care it can provide.
There is a lot of what the VA does (standard ER stuff, chronic care, diabetes (huge problem), cardiac issues and general aging) that could and possibly should be cared for outside the system effectively and that should be explored. I believe the VA should continue, as it is more than just a clinic or hospital. It’s a community … many Vets choose to go there just to be with their comrades and feel that connection that is such an important part of their lives. We should honor that and invest in that too.
I think what you’ll see in the short term is an offloading of some care to the commercial world, with the method of payment and sponsorship being a big problem. Then longer term perhaps an entrenching of the specific VA work with possible pressure to coordinate more closely with the DoD and share military treatment facilities for the highly specialized, service-related injuries and care.