Reform and Modernization of the VA Health Care System

For the past several years, DAV has worked closely with VA and Congress to address longstanding problems in the timely delivery of medical care to enrolled veterans.  Due to staffing shortages, insufficient infrastructure and management deficiencies, too many veterans have had to wait too long or travel too far to receive health care they have earned and deserve.

Although Congress created the temporary “Choice” program in 2014 to address waiting lists and provider shortages uncovered several years ago, it has become clear that a more comprehensive approach will be necessary to achieve the next evolution of VA care.  DAV has been working with VA, Congress and other VSOs to develop a plan that would create an integrated veterans’ health care network, in which VA serves at the coordinator and primary provider of care, with highly qualified community partners providing additional options to fill gaps in coverage.

DAV will continue advocating for reform and modernization of the VA health care system until Congress and VA finalize, approve and implement a plan that ensures all enrolled veterans receive high-quality, veteran-focused health care, when and where they need it.


“Choice should be part of the solution to fixing VA health care, but it has to fit into the big picture to ensure better health outcomes for veterans.


New VA MISSION Act, P.L. 115-182, reforms and modernizes the VA health care system

On May 23, 2018, following years of debate, collaboration and finally compromise, Congress gave final approval to historic veterans legislation that would reform and modernize the VA health care system. The “John S. McCain III, Daniel K. Akaka and Samuel R. Johnson VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018,”—referred to as the “VA MISSION Act,”— expands access, improve quality and strengthen the VA health care system. The bill reforms VA’s Choice and community care programs by requiring the development of integrated health care networks. Importantly, VA will remain the coordinator and primary provider of care for enrolled veterans, and will have oversight over the whole patient to ensure quality care at every step of the individual’s health care.

The law also requires VA to develop a long-term plan to transform and properly align its health infrastructure to match 21st century medicine. The bill’s Asset and Infrastructure Review provides significant checks and balances by Congress, the administration and outside veteran stakeholders to enhance the veterans health care system and ensure it remains viable for future generations of disabled veterans.


There are many ideas for fixing the VA. But some of them will hurt veterans.

Some people say that choice is the answer to everything…

But choice has to fit into the big picture.  Choice can lead to fragmented care, lower health care quality and will close some VA facilities, meaning less access and less choice for veterans.

Now veterans advocates, Members of Congress, an independent commission and VA leaders all agree the best way to improve veterans health care is by creating an integrated network that combines the strength of the VA system with the best of private care.   That’s real choice.


Finally, a Clear Direction for Veterans Health Care

By Garry J. Augustine, DAV Washington Executive Director 

“After more than two years of debate, there is finally agreement about how best to meet the health care needs of veterans today and over the next 20 years.”  [Read Full Op-Ed]

A bad idea for veterans…

Reducing VA to just “centers of excellence” will shrink the number of VA medical centers and clinics, putting them farther apart and primarily in urban areas. Hundreds of thousands of disabled veterans would be forced to travel farther or wait longer to access care.

A better solution…

Expand access and improve timeliness by creating a nationwide system of urgent care for veterans and expanding telemedicine and web-based health services.

A bad idea for veterans…

Having the VA only treat combat or service-related injuries to reduce the demand for care is completely contrary to best practices in medicine – treating the whole patient. It will fracture care between VA and private providers, leading to less coordinated and lower quality care.

A better solution…

Ensure that VA resources are properly aligned with demand for necessary medical services, and are available when and where veterans need them.

A bad idea for veterans…

Turning the VA into an insurance program to pay for private sector care will just create a new government bureaucracy, and get rid of all the expertise VA medical staff has regarding the unique needs of veterans.

A better solution…

Seamlessly integrate community care into the VA system to create veterans health care networks in every local market, providing a continuum of care for veterans and new, high-quality care options.

A bad idea for veterans…

Giving veterans plastic cards or vouchers to go buy health care in the private sector assumes that private providers are ready and able to take on the care of millions of veterans. They are not.

A better solution…

Empower veterans by eliminating arbitrary access standards, like the current 30-day and 40-mile standards for “choice,” and allow veterans and their doctors to decide when and where to get care, without bureaucrats in the middle.

A bad idea for veterans…

Privatizing VA health care or transferring governance of VA to an independent entity, similar to Amtrak or the U.S. Postal Service, will shift management of the VA to an unaccountable entity driven by corporate considerations, with little oversight by Congress or veterans themselves.

A better solution…

Transfer more of VA’s nonmedical support services, like construction, facility maintenance and IT infrastructure, to the private sector. Allow the VA to focus on its core mission of providing high-quality care to injured and ill veterans.