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Cover -- Half Title -- Title -- Copyright -- Dedication -- Contents -- Preface -- 1. The SARS-CoV-2 Virus and the COVID-19 Pandemic -- Recommendation 1 -- Recommendation 2 -- Recommendation 3 -- Recommendation 4 -- Recommendation 5 -- Recommendation 6 -- Recommendation 7 -- Recommendation 8 -- Recommendation 9 -- Recommendation 10 -- Recommendation 11 -- Recommendation 12 -- 2. Pandemic Surveillance and Early Response in the Future -- Recommendation 13 -- Recommendation 14 -- Recommendation 15 -- Recommendation 16 -- Recommendation 17 -- Recommendation 18 -- 3. The Intersection of COVID-19 and Society -- Personal Story: Forewarning in the "Strangest of Snowstorms" -- Recommendation 19 -- Recommendation 20 -- Recommendation 21 -- Recommendation 22 -- Recommendation 23 -- Recommendation 24 -- Recommendation 25 -- Recommendation 26 -- Recommendation 27 -- Recommendation 28 -- Recommendation 29 -- Recommendation 30 -- Recommendation 31 -- Recommendation 32 -- Recommendation 33 -- Recommendation 34 -- Recommendation 35 -- Personal Story: "Rights Were Replaced by Duty" -- 4. The Haves and the Have-Nots: The Racial and Ethnic Disparities Revealed by COVID-19 -- Recommendation 36 -- Recommendation 37 -- Recommendation 38 -- Recommendation 39 -- 5. The Growing Fire: Public Health versus Public Protest -- Recommendation 40 -- Recommendation 41 -- Recommendation 42 -- Recommendation 43 -- Recommendation 44 -- Recommendation 45 -- Recommendation 46 -- Personal Story: "COVID-Crazy" -- 6. Man versus Virus: A Comparative View -- Recommendation 47 -- Recommendation 48 -- 7. Needed Changes to the Federal Response -- Recommendation 49 -- Recommendation 50 -- Recommendation 51 -- Recommendation 52 -- Recommendation 53 -- Recommendation 54 -- Recommendation 55 -- Recommendation 56 -- Recommendation 57 -- 8. The Future Role of the States -- Recommendation 58.

The "VA Mission Act of 2018" will expand the current "Choice Program" legislation of 2014, which has enabled outsourcing of VA care to private physicians. As the ranks of Veteran patients swell, Congress intended that the Mission Act will help relieve the VHA's significant access problems. We contend that this new legislation will have negative consequences for veterans by diverting support from our VA system of 1300 hospitals and clinics. We recommend modification of this legislation, promoting much greater utilization of Community Health Centers (CHCs) for veterans outsourced primary care. In support of this proposal, we describe (1) features of the "VA Mission Act" relevant to outsourcing, (2) the challenges of the present "Choice Program" and likely future obstacles with the new legislation, and (3) the advantages of expanding CHC VA outsourced primary care. This policy would focus more on providing specialized care for veterans in the VA system, while coordinating with CHCs for the necessary expanded outsourced, holistic primary care. We conclude that failure to develop an incremental, cost-effective alternative as described herein represents a potential threat to adequate future support of our VA hospital system, and thus outstanding care for our veterans.