The VA Mission Act of 2018, H.R. 5674 and S 2732– Is Its Mission to Outsource VHA Care?

An analysis of House and Senate bill, and link to more information:

 https://static1.squarespace.com/static/58dc904117bffc5c456a98fd/t/5af1c2176d2a734252e27057/1525793303911/Multiple+Org+Analysis+MISSION+Act+of+2018.pdf

The VA Mission Act of 2018, H.R. 5674 and S 2732– Is Its Mission to Outsource VHA Care?

Federal lawmakers appear poised to pass the VA Mission Act,[i] which would, among other things, greatly outsource veterans’ healthcare to the private sector by making permanent[ii] the VA Choice Act.[iii] The law would:

 ** Channel veterans into private sector walk-in clinics and providers that fragment care,

** Establish a Commission that would close needed VA facilities,

** Place enormous administrative burdens on the VA without adding more staff and resources.

While giving options to veterans sounds reasonable on the surface, current Congressional proposals would cripple and ultimately dismantle the VA healthcare system by siphoning taxpayer money from crucial VA services into the pockets of private executives and jeopardizing the VA’s role in providing integrated healthcare services to veterans.

Outsourcing advocates argue that moving more veterans into private sector health care will improve access and quality of care to veterans, while maintaining the integrity of the VA. Yet voluminous research – including a series of blistering[iv] reports[v] from the agency’s Inspector General[vi] –documents that VA privatization efforts to date have created new problems for veterans across the country while doing little to ease longstanding concerns inside the agency. In fact, according a 2017 Inspector General review[vii], veterans seeking care through Choice waited, on average, between 45-72 days for treatment.[viii]

The Choice program is also immensely expensive, and the two contractors facilitating payments and the transfer of health records between the VA and the private sector are being investigated for bilking millions from the federal government.[ix]

Here are the facts about VA care and what veterans – and the country – stand to lose with outsourced care:

As private care expands, VA clinics and programs will close. Current VA funding levels are already inadequate to effectively treat the growing population of veterans and, as outsourced care expands, funding for VA care and facilities will dwindle.[x]

The vast majority of veterans are pleased with their VA health care and oppose dismantling the existing system.[xi]The agency offers high quality integrated[xii] care[xiii] targeted to veterans’ needs while the majority of private practitioners lack the skills and knowledge necessary to treatment veterans with war-borne ailments.[xiv]

Moreover, outsourced care is estimated to be three times as expensive as VA care[xv] and could lead to reduced eligibility for care[xvi] and, possibly, increased charges for the veteran.

If VA privatization increases, the public will also suffer.  This is because the VA offers training to more than two-thirds of all U.S. doctors[xvii], not just VA doctors. The VA also conducts path-breaking research that has brought about motorized prosthetics, medications for PTSD, liver transplants, the shingles vaccine and the first implantable cardiac pacemaker. The VA is now conducting a Million Veteran study that promises to reveal how genetics impact health.

Recommendations:

There is a role for care in the community when the VA is unable to provide timely or geographically convenient care. But the VA should retain the responsibility of deciding when to offer a veteran outsourced care, and Congress needs to increase funding for VA medical centers and clinics where staff/patient ratios are low.

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[i] https://veterans.house.gov/uploadedfiles/va_mission_act_summary.pdf

[ii] https://veterans.house.gov/news/documentsingle.aspx?DocumentID=2137

[iii] https://www.va.gov/opa/choiceact/documents/Choice-Act-Summary.pdf

[iv] https://www.va.gov/oig/pubs/VAOIG-15-03036-47.pdf

[v] https://www.va.gov/oig/pubs/admin-reports/VAOIG-17-00000-379.pdf

[vi] https://www.va.gov/oig/pubs/VAOIG-15-04673-333.pdf

[vii] https://www.va.gov/oig/pubs/VAOIG-15-04673-333.pdf

[viii] https://healthpayerintelligence.com/news/wait-times-still-high-for-veterans-in-va-choice-program

[ix] https://taskandpurpose.com/2-companies-managing-vas-private-care-vets-suspected-skimming-millions/

[x] https://www.stripes.com/veterans-groups-warn-against-unlimited-choice-for-health-care-1.456560#.WLg7mBCsn-A

[xi] https://www.rand.org/pubs/research_reports/RR1165z4.html

[xii] Pomerantz, A. S., Kearney, L. K., Wray, L. O., Post, E. P., & McCarthy, J. F. (2014). Mental health services in the medical home in the Department of Veterans Affairs: factors for successful integration. Psychological Services, 11(3), 243–253. https://doi.org/10.1037/a0036638

[xiii]http://advocacy.avapl.org/pubs/FACT%20sheet%20literature%20review%20of%20VA%20vs%20Community%20Heath%20Care%2003%2023-16.pdf

[xiv] https://www.rand.org/pubs/research_reports/RR2298.html

[xv] https://s3.amazonaws.com/sitesusa/wp-content/uploads/sites/912/2016/03/Estimating-Costs-for-Veterans-Health-%20022916.pdf

[xvi] http://cv4a.org/wp-content/uploads/2016/01/Fixing-Veterans-Healthcare.pdf

[xvii] https://www.va.gov/opa/pressrel/includes/viewPDF.cfm?id=2747

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