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Roe, Koch brothers fall flat on outsourcing the VA

Judy Garland • Apr 22, 2018 at 8:15 AM

Marion Grover’s cogent letter to the Forum about privatizing the VA (4/7) took me back to the day CNN announced missiles had been launched into Iraq by the Bush Administration, starting what may be the costliest mistake in American history. I recall wondering if anyone in charge had bothered to consider the likely astronomical cost of collateral damages, now estimated to come to around $9 trillion in borrowed dollars, if it ever ends.

Grover is correct to place the blame directly on Congress for the VA’s inability to accommodate the damage that arrived in the form of thousands of injured bodies and minds caused by Bush‘s ill-thought and clumsy response to 9/11. That’s not to say there wasn’t evident wrongdoing on the part of many individual VA administrative employees who definitely knew they were distorting data, and in some districts vets suffered for it. But had the hospitals been better prepared, funded and staffed, most of the 2014 scandal likely wouldn’t have developed. I agree that Republicans locked on to it as their long-desired door to privatization.

Rep. Phil Roe is trying to position himself for the upcoming election as a defender against privatization, but I think evidence is clear that he cannot be trusted. I, too, receive Roe’s newsletters which track a commitment to an increasingly privatized VA, up until his last issue. The 10/8/17 edition provided a link to background on his Care in the Community Act, which lauded some 30 percent of veteran care already diverted to the private sector. No reason whatsoever to credit his latest manifestation, which to me smells of false pandering.

Fortunately for our vets, the Koch-inspired privatization dream has fallen flat. They’ve made some inroads around the edges, but their target for demolition happens to be a treasured public-run service for 8.9 million men and women, and their families who pay good attention to how it all works. (Like with Medicare and Social Security.)

They stacked the deck by formally legitimizing their strategy, even to see that blow up in their faces. I highly recommend a 1/3/17 article in the Business Insider titled “Why privatizing the VA won’t do much to help veterans.” One of the many takeaways is that the VA under Bob McDonald (the permanent director who followed Shinseki in 2014) had already acted to reform the system and culture of the agency so that waiting periods are way down, nearly all facilities can provide quick access to care and outperform the private sector in almost every measure.

Most Democrats and Republicans agree that in some situations sensible and monitored private options should be available. As of now, if the local VA hospital is more than 40 miles away or wait time is over 30 days, as in a pilot program of the reform bill, veterans can use a Choice Card at a private facility. That roll-out, though, has been rocky because the 90-day deadline for implementing changes allowed too little time to vet the private contractors, some of whom had records of botching healthcare management. It created another waiting list because some private care is difficult to access. There were numerous instances of billing errors, eligibility questions, duplications, and sub-standard care. Critics were of course quick to further blame the VA, but public/private hybrids will expectedly be initially troublesome to navigate.

Some conservatives hold the absurd notion that if the VA were allowed to be challenged by the private sector, it might soon fade out of existence. Not happening. Frankly, what our vets have in the VA looks like a dream to many of us, one they’ll probably fight to protect. It looks like what we all should have, kind of like Medicare-for-All.

Republicans tried to prove their case in 2014 by mandating a bipartisan 15-member Commission on Care for redesigning the VA. They stacked the deck by imbedding three healthcare CEOs (who’d benefit from privatization) and two tied to the rabidly pro-privatization Koch Brothers. Funny, though, their final report didn’t much endorse privatization. They recommended highly credentialed community provider networks to expand capacity, integrated with the VA’s electronic records system, but their polling of veterans and 30 veteran organizations garnered near-unanimous opposition to outsourcing treatment. VA facilities can specialize in care unique to some of the veterans’ needs, as few others can. Another huge caution are studies showing privatization could double the cost of the current VA.

It’s no surprise that Trump plays the expert here, as usual, with his talk about a public-private option where vets can choose “either/or or all private.” But his thumb is on the scale, so be alert and carefully track our representatives. The firing of Director David Shulkin on made-up grounds didn’t happen in a vacuum. Shulkin’s cautious approach to outsourcing frustrated two of the Trump political appointees on his staff. They jumped on the mere whiff of ethics violation, exaggerating it to implicate Shulkin, who it turns out had done nothing wrong.

If there seems little individually and close to home we can do about all of this, I’m willing to suggest we could begin by imagining a whole different congressperson.

Judy Garland of Johnson City is a community health care activist.

Editor’s note: The opinions expressed by all Community Voices columnists are their own and do not necessary reflect those of the Johnson City Press.

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