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Veterans Choice Program Will Get Better, VA's Shulkin Says


We've been reporting this week on the Department of Veterans Affairs' $10 billion problem. Two years ago, it was revealed some VA clinics were covering up how long it took for patients to get to see doctors. And from that national scandal, a fix was born, a program called Veterans Choice allowing veterans to find private doctors. NPR, in cooperation with member stations, has spent months investigating the Choice Program and found that, by and large, it has not been working as planned. The network of providers isn't big enough. Doctors are waiting for payments. And some veterans like Amanda Wirtz, who left the Navy in 2003 and later developed a rare tumor, have been enduring even longer waits for care.

AMANDA WIRTZ: January - I'm considering suicide because I'm in so much pain. I'm asking for relief. The Choice Program is getting me an appointment in March.

MONTAGNE: For a response to those and other stories, we reached the head of the Veterans Health Administration, Dr. David Shulkin. Good morning.

DAVID SHULKIN: Good morning.

MONTAGNE: So you did hear this clip of Amanda Wirtz. You know, what is the VA's explanation for not just long wait times, but growing wait times for veterans seeking medical attention?

SHULKIN: Well, we do know that the demand for veteran's health care is extraordinary right now. But when I hear stories like that, it's completely unacceptable. The first responsibility that we have to our veterans is to make sure those that need urgent care are getting care on time. And so we want patients like her to be able to be seen right away. And we're making sure that our veterans who need urgent care are getting care at the right time.

MONTAGNE: Although, of course, that's what we have been reporting - that they're not. And this is in this window of time since this Choice Program went into effect. Let me just say Veterans Affairs Secretary Bob McDonald told a congressional hearing a couple of months ago that the VA should not have outsourced customer service - that this was a mistake. Why did the VA do that?

SHULKIN: Well, what we've learned over time is that while the Choice Program is absolutely well-intentioned - that it was a very complex program. And many of the things that have been working for the VA, such as working with community providers for years, actually got more complicated. And so that's what - we now have legislative proposals to fix the Choice Program.

MONTAGNE: One of the defenses put forward by the VA for the Choice Program was - it was to say that it only had 90 days to get this new system up and running. It has been about 18 months. And people in our reports have been talking to us about problems in those 18 months. In fact - are hearing from vets on Facebook this very day about these sorts of delays. What can be done to fix this - or is being done to fix this program right now?

SHULKIN: Well, I can tell you there is no issue the VA is more focused on than fixing this. That's why we've put in legislative proposals to fix it. And we're not going to stop until we get this right.

MONTAGNE: Well, I would guess that people hearing the words putting in proposals to Congress will think that's not a quick fix. How soon is it - will any good come out of that?

SHULKIN: Well, I can tell you I think that we have bipartisan support - that Congress understands that this program is very complex. We believe we are going to get quick action because everybody understands that not getting veterans timely care and getting veterans the care that they deserve is simply not acceptable.

MONTAGNE: Well, you know, again, one of the big issues in this program before was that the VA was highly bureaucratic. Then the Choice Program came in, and that became highly bureaucratic. Why do you think now that would change? Why do you think you would have a handle on it with any new proposal?

SHULKIN: Well, I think, Renee, this is a different VA. We've brought in people from the outside who have private sector experience. And what we're saying is that we have to do business differently. You know, we are the only system in the country that delivers care to every corner of the country. And so it's a very, very big system. And there are many places today where the Choice Program is working well.

But, of course, we are most concerned about those parts of the country where the choice program is not working well for veterans. And we've heard some stories this week from NPR on those situations. But we absolutely need the Choice Program. We are not scrapping the program. We're suggesting that we've learned a lot. We know how to make this program work better. And we're well on our way to making the system - the type of system that everybody wants for caring for our veterans.

MONTAGNE: Dr. Shulkin, thank you very much for joining us.

SHULKIN: Oh, thank you, Renee.

MONTAGNE: David Shulkin is under secretary of health for the United States Department of Veterans Affairs. Transcript provided by NPR, Copyright NPR.