Tuesday, July 4, 2017

Koch Brothers' Privatization of Veterans Health Administration Jeopardizes Everyone's Health

How the Koch-Backed Effort to Privatize the Veterans Health Administration Jeopardizes Everyone's Health Care Future

Sunday, July 02, 2017 By Candice Bernd, Truthout | Report

As Senate Republicans' Affordable Care Act repeal bill threatens more than 441,300 veterans' Medicaid coverage by 2026, new proposals by the Trump administration and Department of Veterans Affairs (VA) Secretary David Shulkin also threaten the nation's largest, integrated, government-run health care system: the Veterans Health Administration (VHA).

Secretary Shulkin unveiled a proposal before the Senate Committee on Veterans Affairs on June 7 for the creation of a "Veterans Coordinated Access Rewarding Experience" program to replace the unpopular 2014 Veterans Choice Program, which will sunset in August.

The new proposal eliminates mandates that were originally required under the Choice program. Under that program, veterans could only select a private-sector doctor if they had to wait 30 days or more for care from the VA, or had to drive more than 40 miles to a VHA facility.

"Under the new proposal, veterans and VHA providers will discuss every decision about care, and decide, on a case-by-case basis, whether care at the VHA would be better than the private sector. The plan, combined with President Trump's overall VA budget, would ultimately push more veterans into the private sector as the VHA is stripped of needed resources. If the trend continues, it could eventually lead to the dismantling of the VHA system entirely," says Suzanne Gordon, author of The Battle for Veterans' Healthcare: Dispatches from the Frontlines of Policy Making and Patient Care in The Hill.

The proposal comes as legislation to overhaul the VA appeals process unanimously passed the Senate Committee on Veterans' Affairs last week and heads to the full Senate for a vote. It also comes as President Trump signed the Accountability and Whistleblower Protection Act into law in June that will make it easier for the VA to fire problematic employees and promote whistle-blowing in the aftermath of the 2014 national scandal over manipulative record keeping that obscurred lengthy amounts of time for care at VHA facilities. While veterans died while waiting for care in some places, there is no known link between the deaths and delays, according to The Washington Post.

Still, an increasing body of research shows that the VHA delivers care that is equal or superior to that provided in the private sector, with studies confirming its quality of care even after it was revealed that faulty record keeping concealed lengthy wait times at some VHA facilities in 2014.

Meanwhile, President Trump's VA budget would impose drastic cuts to much-needed resources -- sparking fierce criticism from both Sen. Bernie Sanders and Sen. Jon Tester.

"Our job is to improve to what already works reasonably well and not to dismember it," Senator Sanders said of Secretary Shulkin's Choice replacement proposal. "That is a fear that many veterans service organizations have, and it is a fear that I share."

Trump's VA budget is 6 percent larger than last year's, but the increases are funneled toward privatization. According to Senator Tester, 33 percent of the increases in the proposed VA budget go to private-sector care, while only 1.3 percent go to VA care. Trump's plans for a $186.5 billion VA budget for fiscal year 2018 include $13.2 billion in mandatory funding for outside-care programs.

"By making [private-sector care programs] mandatory, [VA officials] will be then pulling money out of other VA programs to fulfill the obligation of [private-sector care programs] being mandatory -- thus turning the VA into a slush fund for hospital executives and privatized care," said Will Fischer, a Marine Corp veteran who deployed to Iraq in 2004, and who is director of government relations for Vote Vets.

Moreover, Secretary Shulkin's plan to fund the Choice replacement program would cut disability compensation paid through the Individual Unemployability program to 208,000 severely disabled veterans, while the Trump budget proposes to scrap the Individual Unemployability program entirely.

The new plan also includes proposed pilot projects that reflect those previously offered in the 2016 "Strawman document" to the VA Commission on Care. The Strawman document's authors included members of the Koch brothers-funded Concerned Veterans for America and hospital executives who stand to profit from privatization. The document pushed for the dismantling of the VHA, using the 2014 scandals as a justification. Congress established the commission as an oversight group in the wake of the scandals to evaluate veterans' access to health care and recommend proposals for how to reshape the VHA over the next 20 years.

The proposals could spell the end of the VHA as we know it -- something veterans groups like Fischer's are pushing back against. They say single-payer advocates should be opposing these dangerous proposals more visibly.

Diane Reppun is a member of Fighting for Veterans Healthcare (FFVHC), a veteran-centered organization working to fight privatization efforts and improve the VHA. She deployed to Iraq in 2009, and has been getting her care from the VHA since 2010. She works as a supervisory program analyst in the office of education at the VA, managing graduate medical education for University of California medical residents and fellows on rotation at VHA facilities.

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