The Sorry State of Veterans’ Health Care

How did government planners spend over $1,000,000,000 without anything to show for it?
April 4, 2013 • Commentary
This article appeared in US News and World Report Online on April 4, 2013.

Here is a sad lesson in government waste. Since 2008, the Departments of Defense (DoD) and Veterans Affairs (VA) have spent over $1 billion to create an integrated electronic health record (iEHR). Four years and $1 billion later, not a single line of code has been implemented.

As way of background, Defense and VA use separate medical databases that can neither translate nor communicate their data in a functional way. The National Defense Authorization Act of 2008 directed the departments to develop a single electronic health record system by 2009. They pushed that scheduled date of completion to 2017 after the plan hit a number of management, oversight, and planning snags, detailed in full here by the Government Accountability Office (GAO). The final cost estimate also exceeded initial expectations — from $4 billion to nearly $12 billion.

Notwithstanding the hundreds of millions of dollars devoted to electronic health records, journalist Aaron Glantz noted recently that 97 percent of benefit claims are still done on paper. An inspector general audit last summer found that a North Carolina VA office had so much paperwork it “appeared to have the potential to compromise the integrity of the building.”

How did government planners spend over $1,000,000,000 without anything to show for it? Reliance on contractors certainly played a role. In a review of DoD service contracting and spending data, the Project on Government Oversight reported that contractor employees cost nearly three times more than an average DoD civilian employee performing the same functions. 

A 2008 GAO report, with figures that are still accurate, also found that at offices within TRICARE, the DoD’s heath care program, contractor employees outnumber DoD employees significantly, comprising 88 percent of the workforce. Even with one of the highest percentages of contractors anywhere in the federal government, money was spent with nothing produced.

In February, Defense and VA suggested that their plan might change directions, but leave some existing aspects of the project in place. That’s when things got interesting. In a segment that debuted in late March, political satirist/​pundit Jon Stewart called out President Barack Obama for routinely promising to eliminate the backlog of veterans’ benefits but clearly failing to deliver:

The point is, if you’re making the case that government has a meaningful role to play in improving people’s lives, then when you’re not obstructed from doing what you want, you better (expletive) bring it.

Coincidentally, the day after Stewart’s rant, the DoD/​VA Interagency Program Office put everything on hold until further analysis could be conducted.

Many war veterans have gone through what may prove to be the most traumatic experience of their lives. They return home only to have their government fail to deliver efficiently on the benefits it promised. That nexus — of troop sacrifice on the one hand, and government ineptitude on the other — brings to life Bob Novak’s famous aphorism, “Always love your country — but never trust your government!”

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