In discussions about military and veteran healthcare reform, innovation is often held up as the missing ingredient. But according to Jim Maguire, Co-Founder of Government Market Strategies, the real obstacle is not a lack of ideas or leadership. It is a deeply rooted culture of risk aversion driven by intense scrutiny and the fear of failure.
“The military is in the business of being constantly ready to go to war and protect and defend America and her interests,” Maguire said. “Failure is not an option.”
That mindset, while essential on the battlefield, carries over into the Military Health System and heavily influences health policy decisions. Readiness is the core mission of the Department of Defense, and military healthcare is viewed as a critical component of that mission. Any change that could disrupt readiness is treated with caution, even when the potential benefits are clear.
Maguire explains that this environment creates a strong incentive for leaders to maintain existing systems rather than pursue innovation. “Military health policy is at the heart of the readiness mission, resulting in risk aversion,” he said.
Leaders within the Military Health System operate under constant oversight from Congress, watchdog organizations, and the public. In that setting, even well-intentioned reforms can become liabilities if they do not produce immediate and measurable success. The result is a culture where avoiding mistakes becomes more important than pursuing progress.
According to Maguire, this reluctance should not be mistaken for a lack of vision or competence. Many leaders recognize the need for modernization and improvement. However, the consequences of failure can be severe, ranging from congressional investigations to public criticism. In such an environment, maintaining the status quo is frequently seen as the safest option.
A similar dynamic exists in veteran healthcare, despite the different mission of the Department of Veterans Affairs. Unlike the military, which focuses on force readiness, the VA’s mission is centered on providing care to veterans who have earned it through their service.
“Veterans are entitled to receive care, and that is undeniable,” Maguire said.
Veteran healthcare is also subject to intense scrutiny. Lawmakers and the public closely examine access to care, quality of care, and where that care is delivered. High-profile failures in the past have only increased attention on the system, making leaders cautious about implementing changes that could attract criticism.
Maguire notes that this scrutiny produces the same underlying fear of failure seen in the Military Health System. Even when reforms could expand access or improve outcomes, the risk of public backlash can outweigh the perceived benefits. Once again, maintaining existing processes becomes the least risky path forward.
The consequences of this approach are significant. While stability has value, excessive risk aversion can slow the adoption of new care models, limit partnerships with the private sector, and delay improvements that could benefit service members and veterans alike.
Maguire argues that acknowledging this reality should serve as a call to action for policymakers, agency leaders, and industry partners. Reform efforts must move beyond demanding change while punishing missteps. Lawmakers can play a critical role by creating space for pilot programs, phased implementation, and measured risk that allows innovation to occur without fear of disproportionate repercussions.
Without a deliberate shift in how success and failure are evaluated, Maguire warns that meaningful reform will remain elusive. The choice facing leaders is not whether to accept risk or avoid it entirely, but whether to manage risk in a way that enables progress. Until that balance is struck, the status quo will continue to feel like the safest path forward, even when better solutions are clearly within reach.
