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Privatization goals inch closer to reality
The journalist who revealed the VA Shadow Rulers breaks down the long-term effort to funnel more veterans from the VA into the private sector. From ProPublica:
The veterans groups had endorsed the bill, but Trump’s description of it was not what they thought they were there to support.
The moment left no doubt that the Trump administration is determined to use the new law to expand the private sector’s role in veterans’ health care. The administration is working on a plan to shift millions more veterans to private doctors and is aiming to unveil the proposal during Trump’s State of Union address in January, according to four people briefed on the proposal. The people spoke on the condition of anonymity because they weren’t authorized to disclose information about the administration’s plans.
The cost of expanding private care is hard to predict, but VA officials have told Congress and veterans groups that it will range from $13.9 billion to $32.1 billion over five years, the four people said. Since the administration opposes lifting overall government spending, Democrats say the increased cost of private care will come at the expense of the VA’s own health system. Some lawmakers said the administration’s plan defies the purpose of the law they passed.
Flashback: The Battle for Veterans’ Healthcare
Suzanne Gordon’s book, The Battle for Veterans Healthcare: Dispatches from the Frontlines of Policy Making and Patient Care, captured the Capitol Hill debates that led to the VA Mission Act. Here’s an excerpt:
On March 14, 2016, Republican Congressman Jeff Miller, the House Veterans’ Affairs Committee chairman and a staunch advocate of privatizing the VHA, wrote an angry letter to Commission Chair Nancy Schlichting. In this unprecedented missive, Miller personally attacked Phillip Longman, a commission member who has advocated for not only preserving but strengthening the veterans’ healthcare agency, in part by eliminating its cumbersome eligibility requirements and expanding healthcare services to veterans’ families.
Miller accused Longman, a Washington Monthly senior editor, of personally editing a recent article by former Wall Street Journal reporter Alicia Mundy. Mundy criticized Miller for his singular focus on VHA wait times and his insistence that forty veterans had died because they were waiting for care. She also detailed the role that miller and other congressional representatives have played in the Koch brothers’ campaign to privatize veterans healthcare. Mundy warned that private sector hospital systems, which have representatives on the commission, are “circling like vultures over the idea of dividing up the VA’s multibillion-dollar budget.”
Fast forward: In 2017, former Congressman Jeff Miller joined the lobbying shop McDermott Will & Emery whose clients include health care leaders like Blue Cross Blue Shield and CVS Caremark. Both companies have a stake in veterans’ healthcare.
The Wounds of War
VHPI Senior Policy Fellow Suzanne Gordon is currently on tour for her new book on the VA. The book collects hundreds of interviews with veterans and care providers and details the Veterans Health Administration’s unique approach to care. Find it here.
Upcoming Wounds of War Book Events:
The Problems with Measuring Health Care Quality
As the VA Mission Act’s implementation proceeds, questions about quality measures mount. From The New York Times:
Problems in measuring health care quality are not confined to veterans’ hospitals. A 2015 comparison of four popular commercial systems used by private hospitals found their ratings so inconsistent that not one of the 844 hospitals examined earned a top rating from all four.
Medicare tried to institute a five-star hospital grading system, but postponedreleasing the latest results indefinitely in July after several hospitals threatened to sue, saying the grading method was inaccurate.
Veterans’ hospitals, however, do not have that option, nor can they choose among commercial rating systems.
The department says its star ratings help keep veterans informed. But Dr. David Shulkin, who was President Trump’s first secretary of veterans affairs, says the stars are not much help in gauging progress from year to year or in making comparisons with nearby civilian hospitals, because Sail grades veterans’ hospitals on a national curve.
Deep Dive: VA Quality Measures
Read VHPI’s critique and guide to solve some of the VA Mission Act’s biggest challenges on VeteransPolicy.org.
Big bills and questionable quality
Stars and Stripes reports on a GAO investigation that revealed contractors tasked with helping veterans determine their eligibility for VA benefits are falling behind in quality and timeliness. From Nikki Wentling:
The VA set standards for the outside contractors to meet, including for 92 percent of exam reports to contain no errors. In the first half of 2017, only one contractor met that target, the GAO found.
Most contractors fell into the “unsatisfactory performance” category, meaning 10 percent or more of their reports contained errors. The worst-performing contractor had errors in 38 percent of their exam reports.
…
The VA awarded contracts in 2016 to five private firms to conduct the exams, totaling up to $6.8 billion for five years. The firms are: VetFed Resources, Inc., in Alexandria, Va.; Logistics Health Inc., in La Crosse, Wisc.; Medical Support Los Angeles in Pasadena, Calif.; QTC Medical Services, Inc., in Diamond Bar, Calif., and Veterans Evaluation Services, Inc., in Houston, Texas.
Quick Clicks:
- CBS 8 Des Moines: Number of Homeless Veterans on the rise in Iowa
- How Housing Matters: Swords to Plowshares explains the challenges of veteran homelessness in urban areas
- Huffington Post: What’s holding up veterans care? Chronic understaffing.
- Spectrum News: VIDEO - Austin VA members explain outreach and care programs for aging veterans.
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