America's Small Business Tax Relief Act Of 2015

Floor Speech

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Mr. McCAIN. Mr. President, I rise today to discuss the urgent need for Congress to reform how the Department of Veterans Affairs delivers health care to our Nation's veterans. One of the great scandals and shameful aspects of the greatest Nation in the world is the way we treat our veterans. I believe important progress has been made since the scandal in which veterans died, waiting on nonexisting wait-lists for care at the Phoenix VA medical center and VA hospitals around the country, but we have a long way to go to fulfill our solemn promise to every veteran who has served and sacrificed.

In the matter of that terrible scandal, I was proud that Congress quickly acted to pass the bipartisan Veterans Access, Choice, and Accountability Act. That bill was an important first step--and I emphasize ``first step''--in reforming the gross mismanagement and lack of accountability at the VA.

In my view, the hallmark of the bill is the Choice Card Program, which for the first time allows any veteran who is waiting more than 30 days for an appointment or who lives more than 40 miles from a VA health care facility to receive a Choice Card that they can use to visit a participating doctor in their community instead of being forced to wait with no recourse.

So how is the VA Choice Card working? My colleagues in the Senate and I continue to hear from veterans in Arizona and across the country about their ongoing problems receiving care. Veterans find that VA staff don't know about the Choice Card or how to authorize care through it. Veterans are forced to wait on hold for hours with a call center in order to schedule an appointment. Community doctors and hospitals that volunteered to participate in the Choice Program are not getting paid for their services. Veterans who are able to use the Choice Card once and need to use it again have to start all over from scratch. Veterans still have to drive long distances to get prescription medications.

There should be no doubt that the VA is failing to fully and effectively implement the Choice Card. In doing so, it is preventing our veterans from receiving the flexible care they have earned and deserve.

We know that when implemented correctly, the Choice Card Program is improving care for our veterans. After an extremely difficult start, the VA Choice Card is now authorizing more than 110,000 appointments for veteran care per month--over 5,000 per workday. Each of these appointments represents a veteran's appointment that would otherwise be delayed and pending for months in the VA scheduling system. It also frees up appointments at the VA for veterans who do not use the Choice Card, helping countless veterans receive an appointment faster.

We have also seen what can happen when the VA properly reimburses community doctors for their services. In the western region alone, community doctors participating in the VA Choice Program have increased from around 95,000 to nearly 160,000. More than 90 percent of all doctors are being paid within 30 days, and the vast majority of doctors are choosing to stay in the VA Choice Program--mainly because of their love of country--to treat our Nation's veterans.

Moreover, we have seen that when the VA is equipped to handle the demand for Choice Program appointments made through call centers, veterans are getting their appointments faster. Recent openings of new call centers have greatly reduced wait and on-hold times among our veterans. Today, wait time averages for veterans calling into the western region call centers for Choice Card appointments are less than 1 minute.

As a result of a positive VA policy change last year, contractors are now able to contact veterans and ensure that their authorizations for care are approved ahead of time so that appointments can be made much faster over the phone.

While we are seeing important progress as a result of the Choice Card, far too many veterans are still experiencing long wait and on- hold times with call centers and confronting difficulties getting an appointment. Unfortunately, some veterans, veterans service organizations, and opponents of the VA Choice Card cite these shortcomings as evidence that the whole Choice Card Program is broken and needs to be eliminated. These opponents are wrong, and they know it. The problem isn't the Choice Card; it is that the VA refuses to implement it correctly.

Instead of working to solve the problems at the VA head-on, the same bureaucrats who have completely bungled the implementation of the VA Choice Card are using their own failures as an excuse to shut down the entire program. Allowing them to do so would only send veterans back to the unacceptable status quo of never-ending wait times for appointments. Does anybody want to return to the status quo?

I refuse to send our veterans back to the nonexistent wait-lists that led to the scandal of denied and delayed care in the first place. Every representative in Congress and every official at the VA should too. According to a poll recently released by Gallup, the American people overwhelmingly agree. Ninety-one percent of survey respondents believe that veterans should be allowed to get health care from any provider who accepts Medicare, not just the VA.

This chart describes the main problems with VA health care before the Choice Program. Today, military and civilian retirees; Federal employees, including VA employees; ObamaCare enrollees; civilians on employer insurance plans; and refugees and illegal immigrants have the ability to choose their doctors. The only group of Americans who is still being denied universal choice in health care is disabled veterans. How is it that we have created a system where virtually everyone in America gets to choose their doctor except for our Nation's disabled veterans?

Our veterans want and need the opportunity to choose the health care that works best for them. It is simply unacceptable that half a million veterans nationwide today are waiting for a medical appointment that is scheduled more than 30 days from now. We can address this crisis now by making simple changes to the law. Under the law, the VA Choice Card pilot program expires next year. We cannot and will not go back to the way our VA operated before the scandal.

While some senior VA leaders are aggressively implementing the Choice Program, many others believe veterans should be forced to stay within the walls of the VA no matter what. Making the program permanent will send a clear message that we refuse to send veterans back to the days of denied and delayed care. That is why I introduced legislation to make the VA Choice Card permanent and universal. I believe every veteran--no matter where they live or how long they are waiting for an appointment--should have the ability to see a doctor of their choice in their community.

Last week I held a townhall meeting with veterans in Phoenix, AZ, along with Mike Broomhead, a distinguished leader in our community. With tears in their eyes and frustration in their voices, veterans described the unending wait times for appointments and difficulty obtaining and using the Choice Card to receive the care they want and need. More than 2 years after the scandal in care first arose in Phoenix, AZ, and more than a year after reform legislation was signed into law, the VA is still failing our veterans.

It doesn't have to be this way. There are additional steps we can take now to reform this broken health care system. That is why I recently announced my Care Veterans Deserve action plan. The elements of my plan address some of the most urgent problems still plaguing the VA.

First, the action plan proposes keeping the VA open later during the week and opening the VA on weekends for local doctors and nurses to treat our veterans. This would address the most common complaint we hear that wait times for appointments are still too long. In Arizona, wait times have gotten worse--not better--over the last year, with more than 10 percent of all the Arizona veterans having to wait more than 30 days for care at the VA.

Despite these long wait times, veterans are still not allowed to make appointments past 3 p.m. during the week and have very few appointment options on weekends. VA employees abruptly close clinics no matter what a veteran needs at the end of the day. By keeping the VA open later and adding hours on weekends, we can address these unacceptably high wait times and maximize the use of our VA facilities.

I have also proposed in the Care Veterans Deserve action plan that the VA allow community walk-in clinics to treat veterans for minor injuries and illnesses such as a cold, the flu, allergies, sinus infections, immunizations, vaccines, sore throats, and minor headaches. Again, this would greatly reduce the need for veterans to visit VA emergency rooms after hours and would free up appointments for everyone waiting for care at the VA.

The plan also proposes that we require VA pharmacies to stay open until 8 p.m. during the week and for at least 8 hours on Saturday and Sundays. This would tackle a common complaint among our working veterans who cannot visit VA pharmacies during their limited workday hours to obtain a prescription. It is absurd that a civilian can go to a pharmacy 24 hours a day in most cities in America, but VA pharmacies close early on weekdays and completely on the weekends.

I also propose in this action plan that individual VA hospitals undergo peer review from the best in health care: Mayo Clinic, Cleveland Clinic--there is a long line of them--and other top-tier health care networks. I was disappointed that the independent review required by the Veterans Access, Choice and Accountability Act only resulted in a high-level review of the VA health care system. Its findings were so broad and general that they provided Congress with very little guidance on what is happening at individual VA hospitals in our States. By requiring the VA to undergo peer reviews from the best in health care, we will have better insight into how to fully reform the VA health care system.

I intend to include the elements of that action plan in a bill I will introduce in this Congress. By enacting legislation as soon as possible, we can fix the serious inequity in veterans health care. It is absurd to me and many others that virtually every American receives Federal subsidies for choice and freedom in health care while veterans are forced to wait in line and ask permission from a VA bureaucrat before getting access to care.

I thank my colleagues for working with me on these and other measures that will help finish the work we started nearly 2 years ago with the Veteran Access, Choice and Accountability Act and urge passage of my commonsense reforms as soon as possible.

Before I close, I want to take a moment to applaud the efforts of my friend from Georgia, the chairman of the Senate Veterans' Affairs Committee, Johnny Isakson, for his leadership, particularly on the issue of accountability at the VA. One of the most disgraceful aspects of the scandal at the VA is that only a small number of senior VA executives responsible for the wait-time scandal were fired. This was despite the fact that Congress provided the VA Secretary broad authority to hold corrupt executives accountable for wrongdoing. I look forward to working with Chairman Isakson and my colleagues in the Senate to pass legislation that would ensure we hold all those responsible for denied and delayed care, even the deaths of some, accountable.

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