- - Tuesday, January 13, 2015


When a rare example of a bipartisan work produced a bill that passed Congress and was signed into law by President Obama, the country heaved a sigh of relief for our veterans: Something was being done to get them the care they need.

The centerpiece of the legislation was to issue those veterans on waiting lists or who lived more than 40 miles from the nearest Veteran Affairs facility a “Veteran’s Choice Card,” which would allow them to receive care outside of the clogged and broken VA system.

If only the Veteran’s Choice Card worked as well as its name sounds.

“It is important to know that the Choice Card does not provide guaranteed health-care coverage,” explains Veterans Affairs Secretary Robert McDonald in a letter to the first card recipients. “In fact, before your Choice Card for this benefit can be used, your eligibility must be verified and you must receive advance authorization from VA.”

And the situation at the VA for waiting lines is ongoing, as investigative reporting reveals. It is estimated that more than 600,000 veterans were enduring at least a monthlong wait for care at Veterans Affairs hospitals.

In short, waiting lists for veterans continue while those with a Veteran’s Choice Card must interact with a new VA bureaucracy to get permission to seek care outside of the VA.

We trust our veterans to operate the most sophisticated and expensive military equipment in the world and to make instantaneous life and death decisions on the battlefield.

Why not trust them to make their own health care decisions, and empower them with a Health Savings Account so that they can?

Mr. McDonald could add payment and authorization functions by giving those veterans who qualify for the Veterans Choice Card the option of selecting a VA-funded HSA. The veterans would receive part of their VA benefits in cash, which they own and can use for care as they see fit, instead of waiting lines.

This would immediately alleviate waiting lines at the VA as veterans go outside the system to get the care they need, which they have been waiting for from the VA.

In short, the VA bureaucracy had their shot. Why not try letting the veterans themselves seek their care from a doctor of their choice?

Nearly 20 million Americans now have and use their own HSA, and veterans could simply sign up at their local bank or use their own bank, since most banks now offer HSAs.

HSAs are proven, off-the-shelf, now-in-use products that will not need a new effort on the part of the VA to implement. They have been in the health care market place for almost a decade, and they represent the best and fastest way to allow our veterans to get the care they need.

With a Veteran’s Choice Card, there would be no pre-authorization by the VA or restricted doctor networks. Since all doctors take cash as payment, the veterans would have the widest array of choices possible.

All it takes is a little trust of our nation’s veterans who would self-select the Veteran’s Choice Card HSA option if it was offered. And it should be offered.

The political benefits to the VA would be substantial: no more complaints by veterans to Congress, the veterans could act as they see fit, putting themselves as the decision-makers — with their doctor — on their care. The VA could take its time on it’s grand reform plans — without compromising the mission of providing care to our veterans, as the reforms slowly unfold, or not, as the case may be.

Dr. Bill West is senior vice president at Health Equity, a company that specializes in helping Americans with Health Savings Account.

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