STATEMENT BY

BOBBY L. HARNAGE, SR.
NATIONAL PRESIDENT
AMERICAN FEDERATION OF GOVERNMENT EMPLOYEES, AFL-CIO

FOR

THE COMMITTEE ON VETERANS' AFFAIRS
U.S. HOUSE OF REPRESENTATIVES

REGARDING

THE DVA'S ABILITY TO RESPOND TO DEPARTMENT OF DEFENSE CONTINGENCIES AND NATIONAL EMERGENCIES

OCTOBER 15, 2001

Mr. Chairman and Members of the Committee, on behalf of the more than 600,000 federal and District of Columbia employees represented by the American Federation of Government Employees, AFL-CIO (AFGE), I want to thank you for the opportunity to express our views and concerns today on the public health mission of the Department of Veterans Affairs. AFGE represents 135,000 Department of Veterans Affairs (DVA) workers across the nation, or about 75% of the rank and file employees in the agency.

After September 11th, we must reassess the role of government and the best way to defend our country from terrorism. In light of this, we must also reconsider our approach to the public health system in this country. We must acknowledge that the private sector does not always provide the answer to public problems. It provides excellent care to privately insured patients, but ignores millions who are uninsured. It encourages efficiency in health care management, but it also cuts back so-called "excess capacity." When we as a nation need to respond to events which may affect vast numbers of our citizens simultaneously, the lean, mean private sector will be incapable of responding to our nation's needs. For years, we have neglected public investment in health care assuming either that the private sector health care system would fulfill public needs, or assuming that national security threats would never translate into national threats to public health. Today, we know better and must do everything possible to reinvigorate this system.

The Federal Response Plan needs a public health care system to succeed. However, this system must have different values than a private business. The first concern of a private company is profit. That cannot be the only aim of a nation at war. We must focus first on our nation's safety and our citizens' health.

Unfortunately, in recent years DVA has embraced a private sector model of management. I come here to say that this is a mistake. Many DVA medical centers have reduced staff and supplies simply to reduce costs. As a result, they have little surge capacity to meet the demands of either war, terrorist attacks or epidemic illnesses. This short-sighted, bottom-line approach has decimated the DVA, and left our nation's public health system in a vulnerable position. The DVA's use of private contractors and reliance on private hospitals will not be adequate in a time of crisis. The DVA must maintain a higher level of capacity to respond to a crisis, even if it is "inefficient" in terms of how a business operates. Indeed, this capacity is a central part of the unique public health function of the DVA and military medical systems. They maintain capacity that would not be profitable for a private sector health care provider to maintain.

The DVA would play an important role in responding to any public health crisis. The keystone to this response is surge capacity. The DVA medical centers can address some of the need for space and supplies. The Veterans Health Administration offers an existing network of medical facilities in every state. It provides health care to veterans with approximately 173 medical centers and other facilities throughout the country. This is an invaluable resource as we prepare to respond to mass casualties. It provides an extant network to which surge capacity can and must be added.

The Drive to Privatize and Dismantle the DVA

There have been constant calls either to close DVA medical centers, merge DVA facilities with private hospitals or to contract out and/or privatize the services that they provide. DVA claims to have closed more than 52% of all its hospital beds, since 1994. AFGE estimates that DVA cut 1 in 6 of its nursing staff since the mid-1990s based upon an analysis of the agency's budget. DVA is seriously considering closing “excess” facilities as part of its capital assets management.

Through the "Federal Activities Inventory Reform Act" (the FAIR Act), the Office of Management and Budget developed regulations for agencies to use when implementing the law. The Bush Administration directed that five percent of all jobs listed on the FAIR Act inventory must be given to contractors or subjected to public-private competitions.

Late last month, the DVA issued its FAIR Act lists. It has categorized 161,065 Veterans Health Administration jobs as commercial, effectively putting that number of federal employees at the risk of losing their jobs to privatization. Additionally, 28% of DVA employees are veterans, according to the Office of Personnel Management's "Demographic Profile of the Federal Workforce." Few of these veterans will even the opportunity to compete in defense of their jobs. The Bush Administration will require the agency to compete or privatize a minimum of 9,300 of these workers. Many of these employees perform work that would be essential in the case of a massive public health crisis.

DVA considers all of its nursing staff, roughly 50,000 Registered Nurses, Licensed Practical Nurses, and Nursing Assistants, as performing work that could be turned over to the private sector. There are also 11,496 employees, mostly physicians, performing medical services for the DVA that can be privatized without even the opportunity to compete in defense of their jobs. The DVA has another 5,068 surgical service employees who could be privatized. Among psychiatry services personnel, the number is 5,470. Pathology and laboratory medicine services workers at DVA medical centers numbering 6,787 are on the block. These DVA employees provide clinical disease management and examine the development of a diseased condition. Other DVA specialties subject to arbitrary privatization without competition include, but are not limited to, the following: anesthesiology services, audiology and speech pathology services, biomedical engineering services, blind rehabilitation services, chaplain services, clinical ambulatory care services, dental services, dermatology services, diagnostic radiology services, dialysis services, domiciliary services, fire protection unit, medical and patient library services, medical media services, neurology services, nuclear medicine services, nursing services, optometry services, orthotics laboratories, pharmacy services, physical medicine and rehabilitation services, podiatry services, psychology services, radiation therapy services, readjustment counseling services, security services, social work services, and spinal cord injury services.

The DVA has a key role in mass care of civilians during emergencies. However, it is not capable of fulfilling this responsibility today. The path of privatization guarantees that the DVA will not be able to provide the needed surge capacity.

In an emergency, the DVA also plans to offer shelter and food preparation for masses affected by a medical or other disaster. However, the DVA lacks the resources to perform this work today. For example, it is reducing its infrastructure for food production by introducing the quick chill method. When quick chill is in place at a medical center, the facility no longer has the capacity to produce food unless it is in a particular microwavable form.

Similarly, DVA's privatization of the work performed by DVA engineers and computer specialists has undermined its capacity to fulfill its support functions in these areas under the Federal Response Plan.

DVA facilities provide ideal locations to stockpile pharmaceutical and medical supplies. DVA medical centers exist throughout the country. In many less populated areas, the DVA could serve as an excellent resource to provide pharmaceuticals and medical supplies if needed. In September the DVA announced that many of these jobs will be subject to privatization again without even offering the employees an opportunity to compete to keep their jobs.

There is a demand for better laboratory capacity. The National Laboratory System (NLS) is an attempt to respond to threats to public health posed by bioterrorist attacks, infectious diseases, and other health problems. The DVA should join this attempt to improve the public health system. Because community facilities may be the front line for the detection of biological threats, the DVA should lead the efforts to coordinate the identification, monitoring, and cure of these threats to public health. Using the DVA would increase the number of clinical laboratories associated with public health departments around the country.

The Veteran Population

In the 1990s, most policy makers assumed that this nation would not need an infrastructure to care for aged veterans in the future. They believed that the passing of veterans from World War II and Vietnam would also end an era of large number of Americans who served in the armed forces. However, in a war on terrorism we will create new veterans and may continue to have civilians who are injured on the front lines of terrorist attacks. The future of the DVA and all its capital assets should be reevaluated in light of this change in outlook.

Conclusion

The DVA can play a critical role in responding to terrorist attacks or medical disasters, however, to do so it must abandon the HMO model and embrace the public health system ideal. As a corollary to this, the agency should create favorable working conditions for its staff. The DVA cannot retain a cadre of capable employees to meet today's new demands if these workers are constantly at risk of losing their jobs. In short, the agency must treat its staff with respect and dignity.

In closing, I ask you this: How will turning over nine thousand DVA jobs to private sector contractors, without any competition, increase our nation's ability to respond to a medical emergency? How will this increase surge capacity? Will this save lives? Or will it sacrifice them to the mindless allure of privatization?

Thank you for considering AFGE's views.

Return to Congressional Testimony

Do you see a mistake or inaccuracy in this page? Please report it.