Privatization of some VA care gaining popularity on Capitol Hill

posted at 9:21 am on June 2, 2014 by Ed Morrissey

The good news after the departure of VA Secretary Eric Shinseki over the wait-list fraud scandal is that a new consensus has developed on Capitol Hill that veterans should have the option to choose outside providers for their medical care. The bad news, at least at the moment, is that no consensus exists on what conditions should trigger that, or whether there should be conditions on choice at all. Sen. Bernie Sanders (I-VT), who heads the Senate Veterans Affairs Committee, has only recently and grudgingly accepted that a private choice should exist at all, and he wants to limit it to the crisis at hand. Sen. John McCain wants it to be a permanent option, and their competing bills will come to the Senate floor over the next few weeks:

For some lawmakers, this is a temporary solution while the VA fixes larger systemic issues. Sen. Bernie Sanders, I-Vt., the chairman of the Senate Veterans’ Affairs Committee, said on “Face the Nation” Sunday that he will introduce legislation this week that allows any veteran who is in a long waiting line for care to seek treatment at a community health center, military hospital or private doctors.

The bill will also give the VA the authority to immediately remove executives who have performed poorly, authorize the agency to lease 27 new health facilities in 18 states, and use emergency funding to hire new doctors, nurses and other providers. That, Sanders believes, is the root of the problem.

“What is very clear to everybody right now is that in many parts of the country, the VA simply did not have the doctors and the staff to make sure the veterans got timely care. The system was then gamed, which is absolutely reprehensible, which must be dealt with through criminal prosecution and bureaucratic reshuffling. But we need to make sure that that never happens again,” he said. …

In a separate interview, Sen. John McCain, R-Ariz., suggested what might be a more permanent solution to the agency’s problems.

Some VA facilities are “unique and wonderful” for treating military-specific issues like traumatic brain injuries, post-traumatic stress disorder, prosthesis and other war wounds, but shouldn’t always be relied on to provide veterans with more routine care, McCain said.

“Why should a veteran have to get into a van and ride three hours to get to Phoenix in order to have routine medical care taken care of? Why doesn’t that veteran have a card and go to the caregiver that he or she needs and wants?” McCain said. “That’s the solution to this problem, this flexibility to the veteran to choose their healthcare, just like other people under other healthcare plans are able to do.”

Sanders plans to offer his own bill that seeks to solve the “short-term need” while efforts at larger reform play out:

“We are going to introduce legislation, either [today] or Tuesday, which addresses the short-term need to make sure that any veteran who is on a long waiting line will be able to get the care that he or she needs, either at a private facility or a community health center or Department of Defense base,” said the chairman of the Senate Veterans Affairs Committee, and a Vermont Independent, on CBS’s “Face the Nation.”

McCain and others are looking at private choice as a long-term solution to the problem, but perhaps as a conditional choice in some proposals:

House Veterans Affairs Committee Chairman Jeff Miller (R-Fla.) is working on legislation that would allow VA-eligible veterans to seek care outside the system if they have to wait more than 30 days to seek medical treatment. The idea of at least partly privatizing veterans’ health care, or at least giving them the option to go outside the system, is popular among members of both parties.

“VA has a very important role,” Miller told reporters last week. “There are so many things that VA does well and only VA can do and that’s to care for those who have in fact borne the battle, that have the wounds of traumatic brain injury and post-traumatic stress, amputations, spinal cord injuries. The VA should be able to take care of those. But there are some things that you can do in the private sector and the veteran needs to have the option.”

McCain and Richard Burr have not yet released their proposed plan to reform the VA, but patient choice is supposed to be its centerpiece, and probably won’t include conditions on that choice. At least, that was McCain’s proposed reform in 2008, while Barack Obama argued that more money and better management was all that was needed to reform the VA. McCain won that argument by default over the past month, but it’s still not clear that he will have the votes for his original private-sector partnership proposal.

Here’s the problem with the conditional approach. All due respect to Rep. Miller and Sen. Sanders, but how exactly do they plan to measure wait times in order to allow veterans to exercise a conditional choice? Perhaps they missed this in the news, but the VA has been falsifying wait times for years now, and it seems doubtful that the culture will transform to that degree overnight. What happens if a veteran seek private medical care while the local office rigs the wait lists to show less than 30 days of wait time? Do they deny coverage of the private care and bill the veteran for the services?

Let’s build the private option into the system unconditionally, and give our veterans the choice they fought to allow the rest of us to enjoy. The competition will produce more reform at the VA than a thousand Congressional bills will produce, and it will allow the VA to focus on its expertise in service-related illnesses and injuries.


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Why Bernie, after all, this is what your beloved socialism looks like.

Flange on June 2, 2014 at 9:27 AM

If you like your VA hospital, you can keep your VA hospital…

Galtian on June 2, 2014 at 9:30 AM

If they are not service connected… private sector should absolutely be an option

cmsinaz on June 2, 2014 at 9:33 AM

Democrat recipe:
1. Allow a voucher-based private-service option for VA.
2. Gradually defund and overregulate the voucher system.
3. Pump boatloads of money into all-government option.
4. Poster-case the difference as an argument for single-payer system.

Rix on June 2, 2014 at 9:36 AM

and use emergency funding to hire new doctors, nurses and other providers. That, Sanders believes, is the root of the problem.

Yep, that’s the root of the problem in a government-operated medical system, too little money.

It’s noon somewhere in the world, right, because I need a drink or ten.

Bishop on June 2, 2014 at 9:39 AM

As usual, leftists come up with a solution that does not address the problem. The reason these waiting lists were secret is because administrators’ bonuses would have been adversely affected had it been known.

In a “conditional” choice situation, you have the same problem. They will hide the problem so as not to harm their income and vets will still be in the same boat.

Occams Stubble on June 2, 2014 at 9:43 AM

I receive my routine care from the excellent VA clinic in my town. The VA hospital is apprx 85 miles away and I go there for any service not done, here (ie, colonoscopy) and have had no problem with inordinate wait times. I do know that there are major problems, elsewhere. I like the idea that McCain (Bless his heart) has proffered. Makes sense. MONEY is not the problem; honesty and integrity, are.

vnvet on June 2, 2014 at 9:53 AM

Next thing you know someone will come up with the radical idea of privatizing healthcare for the rest of us too.

ConstantineXI on June 2, 2014 at 9:57 AM

Bishop on June 2, 2014 at 9:39 AM

I’ll join you with that drink

Can some please inform Bernie Sanders that there is a shortage of Drs. and nurses!

CoffeeLover on June 2, 2014 at 10:14 AM

Why is it that in every single picture of Bernie Sanders it appears that he has just realized that he has crapped his pants?

M240H on June 2, 2014 at 10:25 AM

Replacing a government health system with a private one…ironic, huh?

PattyJ on June 2, 2014 at 10:43 AM

Why not privatize all health care once again?
The cost went spiraling out of control only after Kennedy put in Medicare.

Don L on June 2, 2014 at 10:50 AM

Shorter Sanders:

Government-run healthcare doesn’t work.

BobMbx on June 2, 2014 at 10:52 AM

Why the got the secretary fired so I would assume every thing will be fine from here on out.

weedisgood on June 2, 2014 at 11:12 AM

i am disappointed in sen sanders. there is no evidence that privatisation has ever solved anything and it has often made things worse.

ThisIsYourBrainOnKoch on June 2, 2014 at 11:22 AM

…Bernie Sanders?…this is good…for a baker’s dozen…or bust!

KOOLAID2 on June 2, 2014 at 11:28 AM

America, internalize this, you stupidest of all, in the majority, nation.

Schadenfreude on June 2, 2014 at 11:32 AM

Never trust an avowed Socialist.

formwiz on June 2, 2014 at 11:41 AM

i am disappointed in sen sanders. there is no evidence that privatisation has ever solved anything and it has often made things worse.

ThisIsYourBrainOnKoch on June 2, 2014 at 11:22 AM

You have it exactly backwards.

Buck Farky on June 2, 2014 at 11:56 AM

i am disappointed in sen sanders. there is no evidence that privatisation has ever solved anything and it has often made things worse.

ThisIsYourBrainOnKoch on June 2, 2014 at 11:22 AM

Because, as the VA has shown, public entities are soooo responsive to their customer’s needs.

Buck Farky on June 2, 2014 at 11:58 AM

Choice is not a word in the marxist dictionary.

crankyoldlady on June 2, 2014 at 12:09 PM

This is not a criticism of our vets, but could someone explain how the VA is supposed to work? (I truly don’t know.)

Does the VA handle any/all medical needs for vets or only those related to their service? If the former, why? (And why would we want it to other than in return for his/her service to our country?)

I’m asking because my father served in Korea, but I don’t recall him going through the VA for his medical issues. Any help would be appreciated.

Sue Doenim on June 2, 2014 at 12:10 PM

Let’s put all the Senate in the VA system — with no special privileges!!

The only way any service gets move efficient is if the folks make more money the more tasks they complete. If you tell them they have to occupy space and pretend to do something, that will be the norm, it is the union norm when the minimum number of tasks is not specified.

Privatize/voucher ALL VA services. Subsidize appropriate research and get rid of the unions and bureaucrats.

KenInIL on June 2, 2014 at 12:14 PM

lets privatise social security while were at it! the market can solve all problems! our retirees will be living in style..no cans of dog food for them..

ThisIsYourBrainOnKoch on June 2, 2014 at 12:37 PM

lets privatise social security while were at it! the market can solve all problems! our retirees will be living in style..no cans of dog food for them..

ThisIsYourBrainOnKoch on June 2, 2014 at 12:37 PM

Not a bad idea. It takes the money out of the “fund” and puts it in individual accounts. Should make it harder to “borrow”.

Have it like the government’s TSP – defaults to government bonds (G fund), but the account holder has options.

Much better idea than taking the money form 401ks and giving it to the SSA.

Buck Farky on June 2, 2014 at 1:22 PM

My brother is a vet who lives just a few miles from the VA in Amarillo. He is 100% disabled. He told me a couple years back that the VA made a push for veterans to opt into the Medicare System and give up the VA benefit. Those that did go for the Medicare now have co pays and limits that those who chose not to change do not have.

That said, he is still in the VA system. I have been amazed where his health situation would have resulted in his being hospitalized, they schedule and appointment for a week or two later. It took them weeks to remove his gallbladder. While he waited he withered in pain. He also has delays because a doctor or the doctor he needs in off from work.

There is a provision to transfer vets to a local hospital but that is not used. It could be assumed to be cost, but for example, he needed have the arteries of his heart checked for blockage. That should be a simple process. Instead of doing it at the Amarillo VA, they flew him to Albuquerque New Mexico where a VA doctor who has a record of incompetency did the test and screwed it up. Fortunately he did not have blockage that was causing his problem. Once the test was done they flew him back by commercial airline. Just an example of waste.

It was mentioned that the VA is just the example of what to expect under Obamacare. If you want to know how bad it will be read the Dailymail.co.uk. Keep count of the number of children that die because the nurses misdiagnose the cause of the illness, or incompetence, or the work load is to high to take time to listen, or the doctor is not avaiable because its a weekend or holiday. Then count the adults that die or suffer for the same reasons. Long waits for medical care are common.

Franklyn on June 2, 2014 at 1:55 PM

Privatization is a GREAT IDEA!!

How about something like: “VA is obligated to pay for private healthcare out of its own budget if it cannot provide the best and most effective treatment in a timely manner using its own resources”?

landlines on June 2, 2014 at 4:43 PM

Veterans Affairs hospitals secret waiting lists allegations
8m
Internal Veterans Affairs data shows Phoenix facility recorded higher death rates – @WSJ
Read more on online.wsj.com

http://online.wsj.com/articles/veterans-affairs-hospitals-vary-widely-in-patient-care-1401753437

canopfor on June 2, 2014 at 8:40 PM

I’ll join you with that drink
Can some please inform Bernie Sanders that there is a shortage of Drs. and nurses!
CoffeeLover on June 2, 2014 at 10:14 AM

Perfect opening for Barry to use his pen and phone to allow illegal immigrants to be doctors. After all, they’re only veterans, right Barry?

AppraisHer on June 2, 2014 at 8:57 PM

Most of the abuse did not occur at the executive level. The abuse occurred at much lower levels which is why Shinseki never found out about it.

They need authority to fire people at any level who is not performing or is trying to cook the books.

schmuck281 on June 3, 2014 at 1:24 AM