Historical Background of the Policy
The H.R 1909 bill was introduced to the U.S Congress on 21st April 2015 by Congressman John Adney Culberson. The Republican Congressman from Texas was also the sponsor of the bill. He introduced the bill on the floor of the House of Representatives, which was later referred to the Veterans’ Affairs Subcommittee on health for further deliberations (Library of Congress, 2015). Through this bill, the Secretary of Veterans Affairs is required to utilize existing authorities in ensuring that veterans residing over 40 miles from the nearest health care facility under the Department of Veterans Affairs get such health care service from a non-department of Veterans Affairs health facility that is closest to where they live (Library of Congress, 2015).
The authorities to whom the bill alludes to, include title 38 of the U.S Code (Section 1703) that deals with contracts regarding furnishing of medical services and hospital care via non-Department entities. Another authority that the bill touches on is the 2014 Veterans Access, Choice, and Accountability Act (Section 101). This deals with furnishing of medical services and hospital care to veterans via non-Department facilities in the event that the veteran cannot book an appointment in order to receive such services or care in line with the wait-time goals set by the VHA (Veterans Health Administration). The bill also touches on any other authority relating to legislations that the Secretary enforces, and which are concerned with the furnishing of medical services and hospital care at non-department entities (Library of Congress, 2015).
Problems that Necessitated the Policy
The policy has been necessitated by the excessive waiting time to which veterans are subjected to at a Department of Veteran Affairs health facility. Such unwarranted wait times have often resulted in increased incidences of preventable hospitalization or even deaths. Veterans also encounter another challenge in seeking access to health care in that some of them have to travel long distances in order to obtain this vital service. In the event of a medical emergency and a veteran has to be driven more than 40 miles in order to access health care, this could lead to increased suffering and preventable deaths. Brookie (2011) reports that nearly 41% of the veterans enrolled with the Department of Veteran Affairs’ health care system (or the equivalent of 3.3 million veterans report distance as being a challenge to accessing health care. By passing this bill into law, it will help to alleviate such challenges.
Goals of the Policy
Goals of a policy act as a yardstick for evaluating everything else in it (Kargey & Stoesz, 2013). The main goal of this policy is to ensure timely access to affordable health care to American veterans. The policy also aims to utilize existing legislation in ensuring that veterans enjoy improved access to health care even from a non-Department facility, in case it is closest to them compared to a Department of Veteran Affairs designated health facility. Finally, the policy intends to reduce the waiting times set by the VHA for the veterans in need of health services or care, especially in a case whereby the veteran in question is not in a position to book an appointment that will enable them to receive such services or care.
Population affected by the Policy
The policy directly affects veterans in the United States, especially those living over 40 miles from a Department of Veteran Affairs designated medical facility. According to the United States Census Bureau (2012), there are 21.8 million veterans in the United States. California has the highest number of veterans at state level (2 million), followed by Florida and Texas with 1.6 million veterans each. However, the main people that could be directly affected by the policy are the veterans living within 40 miles from the nearest Department of Veteran Affairs’ health facility.
Factors Leading to the Success of the Policy
The main factors that lead to the success of the policy are the political feasibility, economic feasibility, and the social feasibility. Economic feasibility enables the policy to be a success due to the financial support of the federal government. Both the government and private groups also support the policy due to its estimated importance to society. For example, the American Medical Association (AMA) has lobbied for the policy due to the medical issues that it addresses.
The policy is expected to succeed because of the support from other health sector actors. Even though the United States lacks a comprehensive health care system, the available systems support it mainly for public interest. The policy also attracts a large sentiment from the public. A large segment of the public supports the policy terming it as beneficial in terms of social, cultural, and other aspects of life.
The policy is supported due to its economic feasibility. There policy is receiving direct funding from the government and other well-wishers such as the NGOs (Non-governmental organizations). The policy requires minimum funding during its implementation and this supports its execution. Given the current political environment in the United States, it makes it important for the economic success of the policy (Katz, 2006).
The policy also enjoys administrative advantage. The policy has been made in such a way that it is easy to administer it to the affected parties. In the United States, there are relevant person who possess relevant skills and expertise for implementation and supervision of the policy. This will allow effective implementation of the policy. This is because the policy has the likelihood of accomplishing what is intended for it and the policy benefits will reach a targeted group.
Effectiveness of the Policy
The policy is expected to be effective in all spheres of life. One of the important aspects of the policy is its ability to reduce the dependency ratio among the veterans. The policy will ensure that health care facilities provide quality health care services. Once the health and medical facilities are furnished, there will be improvement in health care delivery. Majority of the veterans will benefit from the health care and mortality rate will then be curbed. All the veterans in the United States could be treated in all the hospitals of the U.S. The medical fee is also subsidized after the policy is implemented. Therefore, the quality of life of the target people could thus improve.
Challenges Facing the Policy
One of the challenges likely to face the policy is lack of sufficient funds to cater for the set budget. When this happens, the federal government is often compelled to reduce budgetary allocation of other existing programs to fund the new policy, thereby compromising delivery of service (Theda 2006). Another major challenge is raised payroll taxes that could affect the benefits accruing from this policy.
Description of the Policy
Description of a policy entails such issues as mode of operation, resources involved, and those that it covers, among others (Kargey & Stoesz, 2013). In terms of operation, the Department of Veterans Affairs, through its Secretary, shall provide the various medical services and health care facilities that do not fall under its jurisdiction (that is, non-Department of Veterans Affairs facilities). This is considering the list of all veterans in their health care system living within a distance of over 40 miles from the nearest Department of Veterans Affairs medical facility. This would then mean that the veterans would no longer have to travel long distances in order to obtain health care at a Department of Veteran Affairs affiliated health facility as they can do so locally any other health care provider nearest to them. The policy would thus result in reduced waiting times by reducing the backlog of veteran patients at the Department of Veteran Affairs facilities. In addition, it would translate into increased equity and access to health care among veterans, as well as reduced hospitalizations and emergencies as veterans can get medical attention locally. In terms of resources, the policy is expected to result in a trickle down of cash from the Department of Veterans Affairs to non-Department of Veteran Affairs health facilities as more veterans seek medical services and health care within their locality. This will also result in a demand for more health care professional to handle the increased number of veteran patients at these health care providers, and hence more jobs will be created.
The policy covers American veterans based on the definition of a veteran under Federal Law. In this case, a veteran is defined as “a person who served in the active military, naval, or air service, and who was discharged or released there from under conditions other than dishonorable” (Legal Information Institute, n.d.). Since the policy is based on a selective entitlement basis, it thus excludes all other Americans who fall short of this description. In the short term, the policy is expected to reduce the waiting time of veterans at Department of Veteran Affairs’ designated health care facilities. In the long term, the policy will improve overall health and wellbeing of American veterans. In regards to the expected outcomes, the policy will lead to a reduction in emergency hospitalization and avoidable deaths of this target group.
The policy shall be funded by the taxpayers through the funds allocated to the Department of Veterans Affairs by the Federal government. The same agency also has an overall responsibility in regards to the operation of the policy. Other agencies that are likely to be involved include National American Indian Veterans, Homeless & Disabled Veterans, and American Veterans Alliance, among others.
Under this section, Karger and Stoesz (2008) argue, “the analyst engages in a systematic analysis of the policy” (p. 30). The goals of the HR 1909 bill are legal as it has been subjected to the laid down legal procedure of introducing a bill in the House of Congress. The policy is also democratic because veterans have a right to access affordable and equitable health care like all other Americans. Besides, the bill will contribute to greater social equality by way of ensuring that the veterans living more than 40 miles from a Department of Veterans Affairs designated health facility have increased access to health equity. Besides, the policy will eliminate disparities in access to health care among this group of Americans. Moreover, the target population is poised to enjoy improved quality of life as they can access health services even from a non-Department of Veterans Affairs health facility, which is crucial in case of emergency medical attention. Moreover, the policy is poised to contribute to a better quality of life for the veterans through improved access to health care services.
It is also not anticipated that the policy will result in a frosty relationship between veterans and the larger society. This is because while such a policy is likely to result in political, social, and economic consequences on society, veterans have unique health issues that need to be addressed as a matter of concern. Besides, veterans have put their lives on the line while serving this nation, and are thus a source of pride for society.
Regarding the political feasibility of this policy, it is important to appreciate that the bill was introduced to the House of Congress by a Republican Member of the house. Therefore, the expectation would be that it would elicit political interest from both the Republican members and their Democratic counterparts. Of the 435 congressional districts in the United States, the Republicans have the largest number of representatives in the House of Representatives at 247, compared with 188 from the Democrats (Office of the Clerk U.S House of Representatives, 2015). Therefore, it would appear as though the Republicans would have more numbers to support the bill that was introduced by one of its members. However, The sponsors of the bill will have to do a lot of lobbying for the bill given that between 2013 and 2015, only 15% of all bills made it past the committee, and even fewer of these (about 3%) were enacted (GovTrack, 2015).
Brookie, D. (2011). Rural Veterans and the Tyranny of Distance.
GovTrack (2015). H.R. 1909.
Legal Information Institute (n.d.). 38 U.S. Code 101-Definitions.
Library of Congress (2015). H.R. 1909 114th Congress.
Kargey, H.J., & Stoesz, D. (2013). American Social Welfare Policy: A Pluralist Approach (7th
Edition). New York: Pearson
Katz, M. B. (2006). In the shadow of the poorhouse: A Social History of Welfare in America,
Tenth Anniversary Edition, Basic Books.
Office of the Clerk U.S. House of Representatives (2015). Congressional Profile.
Theda S. (2006) Protecting soldiers and mothers: The political origins of social policy in
the United States. Cambridge, MA: Harvard University Press.