Jeb Bush, the former Florida governor and current GOP presidential hopeful, wants more veterans getting their health care outside the Department of Veterans Affairs' system.
In a seven-point plan released Monday, he said, "Currently, only certain veterans are allowed to choose their doctor -- those who can't get an appointment within 30 days and those living 40 miles or more from a VA health facility."
He added, "That number should be broadened and limitations to private access reduced. If a veteran wants to see a neighborhood physician, he or she has earned that choice. The VA must remain the guarantor of that choice and that care."
Bush called for getting the VA out of the business of hospital construction, raising active-duty troop strength to 2010 levels to slow the increase in men and women seeking health care, enabling veterans to borrow against their GI Bill to start a small business, boosting services to female veterans, and using the White House as a "bully pulpit" to counter negative stereotypes of veterans as the "broken hero" damaged by physical wounds and post-traumatic stress disorders.
The former governor said money saved through ending waste, fraud and abuse and removing the VA from operations outside of its core mission of veteran care -- such as construction -- would go toward health care services. Indeed, he slammed the department for multimillion-dollar cost overruns and delays in hospital construction and instances of awarding no-bid contracts.
Bush's plan also appears to embrace some ideas already passed into law or headed to a vote on Capitol Hill, including a VA-issued identification cards for all vets and making it easier to fire any employee.
The campaign didn't respond to questions from Military.com on Tuesday. Some of its proposals, as spelled out in the policy document online, have drawn a response from veterans groups and advocates.
The plan to grow the number of veterans able to get health care outside the VA has widespread support, including among veterans groups when the circumstances warrant it. But such organizations also are wary of relying too much on private care options.
"Private care shouldn't be viewed as a panacea to the VA's nationwide access to care crisis," an official with one national veterans organization told Military.com on background. "There's a nationwide shortage of care providers. Private doctors have waiting lists, too."
In addition, there's no guarantee that a private doctor seeing a veteran today will be the same one seeing him or her at a follow-up appointment, the official said. The VA Choice option also doesn't give priority to a veteran over a civilian patient in a private practice, the official said.
And while the VA has trained many doctors across the country through internships, not all are up to speed on the kinds of wounds, injuries and illnesses from which veterans suffer, the official said. "Most VA patients want to remain with the VA, but we do support the intent of the law which gives vets that choice," the official said.
Benjamin Krause, an Air Force veteran and founder of the website DisabledVeterans.org, wrote in a post on his site that Bush's proposals "are little more than what is already going on now."
Greater access to community care, increased service to women vets, VA filling prescriptions from non-VA doctors, improved information technology, fire problem employees faster, getting the VA out of the construction business and improving career opportunities for veterans are at the heart of Bush's plan, according to Krause.
"Much of these reforms were in the works within agency forecasting plans under George W. Bush that originated under Bill Clinton in 1993," he wrote. "They continued largely unchanged under President Obama. And Jeb Bush's reforms are little more than the same old plan -- they lack substance and creativity -- and are little more than an unaccredited rip off of past presidential platforms."
--Bryant Jordan can be reached at bryant.jordan@military.com