By John D. Rockefeller IV
May 31, 2016
Next month, the congressionally established Commission on Care will release its final recommendations on how to best reorganize the Veterans Health Administration (VHA). Expect the report to call for “bold” reforms and to lay out a new plan to “improve” health care for veterans. Whatever the language, it will be critical to see this for what it is: a call to privatize the VHA.
It is important to understand how the Commission arrived at this conclusion. Following the wait-time problems at the Phoenix VA, a bipartisan group of 28 Congressional representatives, myself included, passed a compromise bill to triage the immediate needs of veterans waiting for care and to begin to address the systemic issues at the Department of Veterans Affairs (VA) and VHA. That legislation also established the Commission on Care, which was tasked with “examining veterans’ access to Department of Veterans Affairs healthcare.” Over the last two years, the Commission has held its meetings and heard testimony largely out of the public eye. As a result, without anyone noticing, a group of for-profit hospital executives and representatives of a Tea Party veterans group aligned with the Koch donor network has quietly attempted to lead the Commission to a point where its final recommendation is the privatization of the VA’s healthcare system. Put another way, the commissioners who stand to benefit the most from privatization are the ones leading the charge to dismantle the VHA.
Let’s be perfectly clear: privatizing the VHA will neither improve access to care nor reduce total costs. Instead, it will turn public revenue into private profits while shifting the financial burden onto taxpayers and veterans, whose total cost of care may not be fully covered by any new voucher program. It will also likely to reduce, not improve, access to care. One of the strengths of the VHA is that it can provide a variety of services in one location, limiting the need for travel to multiple doctors’ offices. Eliminating that convenience will only increase the burden on our veterans, particularly those in rural areas. Most importantly, privatization would ignore the wishes of the men and women this system is meant to serve: a survey conducted for the Vet Voice Foundation found that 64% of veterans oppose privatization.
To be sure, the VHA faces a number of systemic issues, but it is important to remember that this is a system that treats millions of veterans every year, and it treats them exceptionally well. It is not, as the commissioners supporting privatization would like you to believe, “seriously broken.” When tested, the VHA has proven that it is up to the challenge of caring for today’s injured servicemen and women. Independent research by MITRE, RAND and Grant Thornton/McKinsey found that the VHA performed the same or better than non-VA providers on 12 of 14 inpatient care effectiveness measures. The VHA also did the same or better on 16 outpatient effectiveness measures, compared with commercial health maintenance organizations.
If the Commission on Care would like to see serious improvements at the VHA, it should use this opportunity to recommend legitimate funding increases for the agency. Today, the VHA faces mounting pressure to deal with injuries, including cases of traumatic brain injury and traumatic stress disorder, at a rate its people have never before experienced. For years, Republicans in Congress have deliberately underfunded the VA and VHA, leaving the agency unable to hire the doctors, nurses, and administrative staff it needs to care for our returning servicemen and women. No other agency is asked to do so much with so little, and we have recently seen the tragic consequences of continued underinvestment. Only by providing the VHA with the resources it needs — while continuing to ensure that they are used correctly — can we give our veterans the care they deserve.
We must not be swayed by the misleading claims of a group that is only interested in its bottom line. The VHA is and should continue to be an example of what good government can do. Congress should ignore the calls of the healthcare industry and instead give the VHA the tools, resources and time it needs to provide our veterans with the care they have earned. It is my hope that the Commission will take this opportunity to truly try and improve healthcare for our veterans.
By John D. Rockefeller IV // The author, a former U.S. Senator from West Virginia, was a member of the Senate Committee on Veterans’ Affairs for 30 years and served twice as its chairman. He is now a distinguished fellow at the Council on Foreign Relations.
May 31, 2016