Is the VA ‘scandal’ just a means to privatize the VA?

I find some of the reporting on the Veterans Administration “scandal” suspect, i.e.,  The Arizona Republic. I would never rely on these reporters for the “facts.” Media pundits who rush to demand that someone be fired are premature, issuing their verdict before the evidence has even been presented — the Inspector General is still investigating, and has not issued a report.

It is not always wise to remove the individuals involved right away, they may have information needed by those stepping in to address the problem. It may be a case of “show me what you did and explain it to me,” so that it can be fixed quickly.

TucsonVAFurthermore, the vast majority of the media villagers who are using this for scandal mongering to bash the White House have never served in the military, are not veterans, and are clueless about VA care. (I spent 10 years taking my father for VA appointments at the veterans hospital here in Tucson (photo), and while there were waits for his doctor visits, he always received the utmost professional care).

One of the things the hyperventilating media villagers fail to point out is that there are long waits for care and shortages of medical specialists in the private health care system as well, the only difference being that the private sector (1) does not have a policy to reduce wait times, and (2) does not keep records whether it is meeting this metric. The VA does.

I do not know anything about the specific circumstances of the individuals the media claims “died while waiting for care,” and neither do you. For all we know, they were seeking extraordinary end of life care. Does the media mean to suggest that patients do not die while waiting for care in the private health care system? Because I assure you that they do.

Which brings me to why my “Spidey senses are tingling” as to what this is really all about: this “scandal” may be just a means to privatize the VA , a long sought after goal of Republicans. In fact, In Wake of VA Scandal, McCain Proposes Private Health Option for Veterans:

McCain said that three GOP senators are drafting legislation to allow veterans to access health care services outside the traditional VA system.

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McCain told KYFI radio in Phoenix that he was working to develop the bill with a pair of fellow Republicans: Senate Veterans’ Affairs ranking member Richard M. Burr and Sen. Tom Coburn of Oklahoma.

“In the long term … let’s let our veterans choose the health care that they need and want the most and not have to be bound to just going to the VA. The VA is great on traumatic brain injury, PTSD, war wounds, prosthesis and all that, but other than that why wouldn’t a veteran who has served his country honorably be able, that lives away from Phoenix, maybe hours away, not be able to go to the health care provider of his or her choice,” McCain said.

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While details are not yet available, McCain said to expect introduction of the legislation after the Senate returns from its weeklong Memorial Day recess, adding that a lack of urgency on Capitol Hill could put some of the blame on the legislative branch going forward. It is not clear when veterans’ issues will next make the Senate schedule, though the appropriations bill that funds VA programs is moving along.

“Unless we do something, then the onus is, is on us in Congress,” McCain said. “After we fix it, let’s hold the people responsible who caused this problem.”

This is an old idea from McCain who proposed a similar plan during his campaign for president in 2008.  It was  panned by veterans organizations. Veterans Pan McCain’s ‘Veterans Care Access Card’ Plan:

Sen. John McCain’s (R-AZ) plan to extend health benefits to veterans living in rural areas of the country received mostly negative reviews on Saturday from veterans attending the Disabled Veterans of America convention in Nevada.

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Indeed, prominent veterans organizations oppose McCain’s proposal to “give veterans the option to use a simple plastic card to receive timely and accessible care” outside of the VA system.

AMVETS, Disabled American Veterans, Paralyzed Veterans of America, and the Veterans of Foreign Wars all argue that while veterans should have access to private care, providing “rural veterans greater access to VA-sponsored care exclusively through private providers” may undermine the VA.

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Currently, the VA “outpaces other systems in delivering patient care.” A recent study by the RAND corporation found that “VA patients were more likely to receive recommended care” and “received consistently better care across the board, including screening, diagnosis, treatment and follow up.”

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Rather than taking veterans out of a system that consistently delivers “higher quality of care,” McCain should expand its services and improve access. As the RAND study concludes, “if other health care providers followed the VA’s lead, it would be a major step toward improving the quality of care across the U.S. health care system.”

You should note that this Rand Study was conducted before the memo that the Washington Times revealed in which the Bush Administration warned the incoming Obama Administration about problems within the Veterans Administration in 2008. Even with those problems, VA care was still superior to private health care.

Today Weeper of the House John Boehner revealed his hand, coming out in favor of  privatizing the VA. Boehner Suggests Privatizing The VA: ‘I Still Like The Idea, And Especially Now’:

House Speaker John Boehner (R-OH) is floating the idea of privatizing the Department of Veterans Affairs following multiple reports of abuses and delays of care at the agency. “I still like the idea, and especially now,” Boehner said in response to a question from the Columbus Dispatch about whether he still supported turning over veterans’ care to the free market. Boehner had considered the option “more than two decades ago,” reporter Jessica Wehrman notes.

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Privatizing or partially privatizing veterans health care was most recently considered during the 2012 presidential election by Mitt Romney, who proposed giving servicemembers government vouchers to “choose whether they want to go in the government system or in a private system with the money that follows them.” Veterans groups quickly rejected the idea, arguing that access to VA-sponsored care through private providers would undermine the existing system that is exclusively suited to meet veterans health needs and treat war injuries and could lead veterans to “lose the many safeguards built into the VA system.” Following the backlash, Romney abandoned the proposal.

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While veterans have struggled to gain adequate access to care since the Kennedy administration, the health services they do receive are the best in the nation. The annual Independent Budget, an aspirational budget published by the nation’s leading veteran organizations, has consistently found that the government-run VA serves as “a model health-care provider that has led the way in various areas of medical research, specialized services, and health-care technology.” It provides “quality and expertise on veterans’ health care” that “cannot be adequately duplicated in the private sector” and has become “the most efficient and cost-effective health-care system in the nation,” the document notes.

A 2013 survey released by the U.S. Department of Veterans Affairs found that 93 percent of veterans who use the VA health care system have a favorable impression of it.

Finally, Tom Philpot, who has been a military writer for more than 30 years, warns veterans about yet another “Kochtopus” front group that is using the VA “scandal” to privatize the VA. MILITARY UPDATE: Vets should be wary of CVA pitchforks and torches:

[I want] to shed light on a disturbing new force that is confusing veterans and darkening attacks on the Department of Veterans Affairs during the current health appointments scandal. I refer to a well-funded group called Concerned Veterans for America (CVA).

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I can’t claim to have covered VA medical appointments and wait times with enough depth or regularity to know if there’s gross mismanagement and deceptive bookkeeping at some or many VA facilities. That will be verified, or not, by independent audits and criminal investigations now underway.

Most veterans’ groups continue to support Shinseki. They say they know him well enough to believe he’ll address any abuses uncovered and will work to protect more veterans from harm. And we’ll see.

But in my 37 years covering veterans’ issues, I have never seen veteran issues used more cynically or politicized more thoroughly than during the past several years. At times the intent seems to be to shake trust in government generally rather than to address veterans’ needs.

In the thick of this is Concerned Veterans for America, posing as a vet advocacy group and being rewarded for it. CVA press releases usually are partisan attacks. Its spokesman, Pete Hegseth, an Iraq war vet and Republican who ran for a U.S. Senate in 2012, is quoted often by major news outlets without mention of press reports associating CVA with the Koch brothers, libertarian billionaires who create public interest groups to oppose big government. That’s fine. That’s protected speech. A CVA spokesman told me last year it doesn’t reveal donor information.

What should upset vets is the use of select facts about VA and its programs to reinforce fears rather than give reliable information. Last week a CVA press release hit a new low in purporting to document “lies” Shinseki told in congressional testimony, dropping any veil of respect for a decorated, combat-disabled soldier with a long and stellar career.

It is no coincidence only Republicans, including Rep. Jeff Miller (Fla.) and Sen. Richard Burr (N.C.), participate in CVA events. They should reconsider. Though CVA sponsors an occasional informative forum in Washington D.C., it produces no careful analyses of what ails VA. The goal seems to be to attack, relentlessly, while a Democrat holds the White House.

Traditional vet groups are alarmed by the rising profile CVA has on cable news programs and in newspapers where informed opinions on chronic claim backlogs and care delays should rule. Instead, there’s heated rhetoric that stirs dissent and attempts to turns the public against a department the CVA routinely portrays always as too costly and too ineffective.

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Long-time advocates like Violante worry that CVA’s arguments, over time, will give politicians cover to cut VA funding severely or even to dismantle much of the VA health care system.

“They have these people out there saying, ‘We’re giving VA too much. We’re giving the Defense Department too much.’ Their whole purpose is to give support to anyone who wants to cut government, particularly for veterans.”

The theme that VA is too costly and ineffective is critical to a message of doubt in government programs. If the vast VA bureaucracy can’t satisfy your medical needs, isn’t it best to get care from the private sector?

DAV, American Legion, Veterans of Foreign Wars want the VA preserved for its expertise and resources in caring for vets. They fear bills to supplement the VA care by sending vets into the private sector for care nearer to home is a first step toward watering down VA quality of care.

Shinseki concedes his controversial decisions to make ischemic heart disease, Parkinson’s disease and B-cell leukemia service-related conditions for anyone who stepped foot in Vietnam helped to create the tsunami of claims and health care obligations that has overwhelmed VA, even as hundreds of thousands of vets came home from long, recent wars.

On his watch VA also simplified the process for filing post-traumatic stress disorder claims from veterans of all wars, made compensable more illnesses for 1990-91 Gulf War veterans exposed to in-theater toxins, and launched an aggressive outreach to explain to vets potential disabilities. That’s why the typical claim today has a dozen compensable conditions to be reviewed versus three to four in past wars.

Congress must be aggressive in its oversight of VA health care delays and abuses. But politicians also need to take a hard look at why VA claims and health care have been overwhelmed, and avoid the bitter sound bite wars that give a group like CVA an equal voice with truly pro-vet advocates.

The real scandal here may be a right-wing plot to privatize the VA, something Republicans have long sought. The VA is still the best health care in the world, even if you have to wait for appointments (as you would in the private sector). Veterans should resist any attempt to dismantle the VA. You were promised that care in return for your service to the nation.

3 responses to “Is the VA ‘scandal’ just a means to privatize the VA?

  1. I am a physician assistant who works in the VA system. The care I provide is top-notch, as is that of my colleagues. The lies and misinformation I am hearing in the media make my blood boil. We all work long hours, and many of us work from home as well. I work 10-hour days (and longer).
    When I see a new patient, I spend at least and hour with him/her. And, that is just the beginning. I spend hours collecting and reviewing outside records, following up on tests, and making patient phone calls. I only wish I was a vet, because I am lucky in the private sector if I get 10 minutes with a doctor. For them, it is all about cranking out patients to please the shareholders. If my WWII vet father was still alive, I would definitely be taking him to the VA.
    A major factor is that Congress votes to decrease funding, and there is a hiring freeze. We need more providers (doctors, PAs, NPs, mental health). Most of us love working in the VA and would never go back to private practice. Been there, done that. And you are right: we have metrics to meet and are censored if we do not. When I was in private practice, I saw diabetics who had not had a hemoglobin A1c drawn in years. In the VA, we have made enormous strides in diabetic outcomes and management.

    And yes, for the GOP, it is most certainly about privatizing the VA, and everything else for that matter. We must fight them. We can see how well privatization of prisons and toll roads has worked out.

    Too bad the sore loser John McCain has been preoccupied with appearances on the Sunday talk show circuit and his relentless prosecution of Benghazi! Benghazi! until now. Of course, the only reason he is suddenly concerned with the vets’ plight is for political gain and to throw another one of his poisoned darts at the man who (thankfully) bested him.

  2. Stephen Ehre

    You have it right. As I read it, the “deaths by waiting” are for those who were already terminally ill and were going to die soon but couldn’t get back into the hospital for more treatment. the problem is simple…the WWII and VNam vets are aging and need more care. The Iraq and Afg. wars have given us many more Vets than expected, and with more serious injuries. In addition although spending by Obama has gone way up we also need more, many more, Drs.(gone up only 29%). None of the problems were properly accounted for over the last 30 years.