- - Tuesday, July 3, 2018


The birth of our great nation in 1776 was predicated on a few core tenets: life, liberty and the pursuit of happiness. Those tenets were preserved over the years by those who had volunteered, or in some cases, those who were conscripted, to take up arms and defend the ideal of “independence.” We have celebrated this ideal for the last 242 years in the United States on the Fourth of July.

However, this tradition would collide with a cruel twist of irony in 2014. That year, the Fourth of July would come to represent anything but independence for veterans, the very individuals who gave the day its meaning.

The Phoenix VA Medical Center became the flashpoint for what would be considered one of the biggest scandals in VA history after hidden waitlists were reportedly linked to the deaths of veterans awaiting health care.

The VA secretary and under secretary for Health were forced to resign soon after. The VA itself would become an easy target for politicians looking to demagogue the issue as well. And the story-hungry media could rely on the VA to eventually deliver bad news whenever the 24-hour news cycle needed an adrenaline shot.

This, as veterans continued to bear the brunt of a bureaucratic health care system that had otherwise employed well-intentioned people, but was plagued by a long-standing culture of inefficiency, complacency and moral hazard.

This Fourth of July, it’s time for veterans to declare their independence from the status quo: A fragmented health care framework that’s starving for innovation and limits access to care, rather than one that empowers veterans to overcome barriers to access through expanded care options. Thankfully, when it comes to health care, the veterans’ declaration of independence was recently codified in the VA Mission Act.

The precursor to the Mission Act, the Veterans Access, Choice, and Accountability Act of 2014, while well-intentioned, unfortunately, was hastily implemented. This quickly enacted law introduced the notion that veterans ought to be able to choose a health care provider, either in the VA or within their local communities.

But that choice created new problems in terms of how authorizations were administered and physicians were reimbursed for providing care, arguably leaving veterans even more disenfranchised than they were before the Phoenix VA scandal-era.

It also stoked fears of VA privatization, both real and imagined, as proponents on all sides fought in social media, cable news and print publications to advance their respective objectives.

This Fourth of July, veterans will enjoy a new sense of independence as a result of the VA Mission Act of 2018. The new law passed with bipartisan support in Congress and was signed into law by President Donald Trump on June 6, 2018, before an eclectic mix of veterans’ advocates representing all sides of the “veterans choice” issue.

That’s why AMVETS, the nation’s most inclusive congressionally chartered veterans service organization, and CareSource, a leading non-profit managed care organization that offers health care options for those who need it most, have recently partnered to define what it means to provide real and viable independence in health care access for veterans, a joint effort that offers no easy answers or quick solutions.

The most famous line in the Declaration of Independence is “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.” In this regard, the VA Mission Act is a declaration of independence for veterans:

All men are created equal — in this regard, the VA is supposedly a “separate but equal” health care system. Because veterans, at least, are equal to their civilian counterparts, they should have equal access to all types of health care, including both VA and non-VA care, depending on their individual needs.

Life — veterans have lost their lives as a direct result of their inability to access care. Greater access to care, both within the VA and outside of it, will help save veterans’ lives.

Liberty — veterans will now have the autonomy to choose the option that is best for them, and will be free from the previous restrictions imposed by the Choice Act of living more than 40 miles from a VA medical center or being unable to access an appointment for 30 days.

The Pursuit of Happiness — health is precursor to happiness, and allowing veterans the freedom to pursue the health care choices that are right for them and their families allow them to live healthier, happier lives.

Thus, like the document we all honor on July Fourth, the VA Mission Act is a unified statement of independence, at a time when an appetite for consensus over conflict rules the day among legislators, veteran service organizations and a public starved for progress.

Independence, however, must be more than a matter of principle and compromise, especially where veterans are concerned.

It must be about the actual enjoyment of life through effective health care, liberty through the freedom to choose among viable choices and a pursuit of happiness through the full realization of wellness for those who have faced the enemy, sacrificed on behalf of the nation, and now just want to be made whole. Then, and only then, does Independence Day in our country retain its true meaning.

• Joseph R. Chenelly is the national executive director of AMVETS. Erhardt H. Preitauer is the chief executive officer of CareSource.

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