My health care is under attack — but not from who you think 

I recently read an op-ed by Rep. Chris Deluzio warning fellow veterans “our health care is under attack.” My initial thought was that finally, more members of Congress are seeing the same problems at the VA that I am.”

You can imagine my surprise when I read on to learn Rep. Deluzio believes the attacks are coming from his Republican colleagues and even my own organization, Concerned Veterans for America.

We can agree on the warning — veterans’ health care is indeed under attack. But the call is coming from inside the house. Attacks on veterans’ health care have long been coming from the Department of Veterans Affairs itself. 

VA reform went into overdrive nearly 11 years ago when the Phoenix VA scandal broke, alerting the public that VA schedulers were using a secret wait-list system to hide true wait-times for care at VA facilities in order to improve their chances of getting performance bonuses. It turned out that this was common VA practice across the country.  

Congress responded with the obvious solution, passing the VA MISSION Act. This gave veterans more choice in where they could use their care benefits. In theory, we are welcome to stay at the VA if it works for us, but if it doesn’t, we can seek care from community providers. This concept is much like the care benefits we had while in uniform.

The VA has been working to undermine the law every step of the way by misleading people and concealing our community care options, even going as far as to override doctors' recommendations through a rigorous administrative review process.

The two bills Rep. Deluzio invokes — the Complete the Mission Act and the Veterans Health Care Freedom Act — fix these issues by putting veterans at the center of their own care.   

The Complete the Mission Act would protect veterans’ community care options from the bureaucratic meddling described above by making the program’s eligibility rules law. The bill would also address our suicide crisis by removing bureaucratic hurdles for veterans who want to access mental health treatment from community providers.

The Veterans Health Care Freedom Act would create a “full choice” pilot program, empowering veterans to use their VA health benefits at a provider they choose without having to get VA approval first.

None of this would even be necessary if patients were as satisfied with VA care as Rep. Deluzio claims. In reality, the VA’s own surveys show 83 percent of patients satisfied with community care, as opposed to 69 percent satisfied with VA hospital care. Those ratings have been respectively increasing and decreasing over a three-year period.  A JAMA study further confirms that those who receive all care through VA were more likely to report poor health than those VA patients with private coverage.

What about the so-called “independent report” that Deluzio cites, warning about the dangers of community care? Freedom of Information Act evidence shows that VA officials actively participated in drafting and editing that "independent" report, even while playing up its alleged independence to increase its credibility outside the VA. In other words, the document is biased and self-serving, period.  

As to Rep. Deluzio’s claim that community care is bankrupting the VA, community care spending is going up only because veterans are increasingly choosing it. I certainly am, after years of mishandled care, botched surgeries and overmedication that could have killed me, and delayed mental health care that led me to multiple suicide attempts.

VA staffing is driving budget increases more than community care spending. VA officials reported that Veterans Health Administration spending increased $42 billion between 2019-2023, even as in-person appointments decreased by 19 percent. Just 15 percent of the increase came from community care, whereas 74 percent was staffing costs.  

The VA budget has more than quintupled in the last 20 years, beginning well before community care existed and even as the number of veterans using VA has decreased. Any distress over spending should be focused holistically.  

The VA’s core function and mission is to “care for those who have served.” It is not to be the sole provider of care, or to withhold care because it comes from an outside provider, or to wield care in Congress as a justification for bloating its own budget.   

Veterans are voicing their support for choice. That’s probably why veterans service organizations, including the American Legion and Veterans of Foreign Wars, are generally supportive of the Complete the Mission Act.  

We have earned the basic dignity of deciding where our medical care comes from, whether that upsets the status quo in Washington or not.

Chris Enget is an Army and Afghanistan War veteran and a Purple Heart recipient. He is the strategic director for Concerned Veterans for America in Montana.