The Department of Veterans Affairs made the right decision in deciding to demolish the earthquake-ravaged Sepulveda, Calif., VA Medical Center and replace it with a $65 million outpatient surgery center.
It wouldn't have made fiscal sense to spend the $188 million necessary to rebuild the Sepulveda facililty. The VA health system of the future must be focused on long-term care and outpatient procedures. In the Sepulveda case, VA Secretary Jesse Brown determined enough existing beds exist at other Southern California facilities to handle the acute-care load of the closed hospital.
Down the road, the VA may have to contract with private hospitals to treat veterans. Other VA acute-care hospitals may close or convert to different types of medical facilities.
Because of healthcare reform and federal deficit concerns, the VA must continue to focus on cutting costs. Ensuring that a pared-down VA healthcare system adequately serves its aging population will present a daunting challenge that requires leadership.