DAVID GREENE, HOST:
Providing health care to veterans has seemed like a challenge for years now. One idea for how to fix this - shift away from a government program to a private one. It's an ideological fight much like the one over the Affordable Care Act - a debate over the preferred role of government. And yesterday, a government commission delivered a report to the White House on the way forward on health care for veterans. Here's NPR's Quil Lawrence.
QUIL LAWRENCE, BYLINE: Congress passed the Veterans Choice Act in 2014 to speed up veterans' access to health care. It was based on a simple idea - VA hospitals were stretched thin, so pay for vets to see private doctors. Republican Jeff Miller of Florida helped craft the legislation.
JEFF MILLER: What we have talked about is providing the veteran the choice of seeing a doctor where and when they want to see it.
LAWRENCE: The plan hasn't worked out so well. An NPR investigation found the program failed to reduce the number of vets waiting too long to see a doctor. Miller says one of the reasons it didn't work was that the V.A. resisted it out of fear that, given a choice, too many veterans would abandon the VA system and choose private care.
MILLER: The VA seems to be adverse to allowing veterans to make that choice. They think that they will flee with their feet, the system as we know it today will atrophy.
LAWRENCE: That's exactly what some supporters of government-run health care say Veterans Choice was designed to do. It was a Trojan horse to weaken the VA. Most veterans' organizations and their supporters in Congress think the VA delivers good health care.
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BERNIE SANDERS: The idea of privatizing the VA would be, in my mind, a huge mistake and a great disservice to the men and women of this country who put their lives on the line to defend us.
LAWRENCE: That was Bernie Sanders speaking on MSNBC this spring. He used to lead the Senate Committee on Veterans' Affairs. Almost 9 million Americans get their health care from the VA. It's the country's largest integrated health care system, and it's single-payer - that is to say a government-run system. Most people who don't like government health care don't like it.
DAN CALDWELL: The single-payer, universal health care model that is currently in place at the VA is not delivering timely and efficient care to many of our veterans.
LAWRENCE: That's Dan Caldwell with the conservative group Concerned Veterans for America. The latest round in this ideological fight focused on something called the Commission on Care, a bipartisan group created by the Veterans Choice Act. Rumors flew that it might push privatization. J. David Cox is president of the union that includes V.A. employees.
J. DAVID COX: I would probably use a different word than privatization. I believe I would call it closing of VA medical centers.
LAWRENCE: That's what some feared. The commission reported to the White House yesterday, and its recommendations probably won't scare anyone. It does suggest paying for some private care, but still directly under the umbrella of the VA. Quil Lawrence, NPR News. Transcript provided by NPR, Copyright NPR.