December 10, 2018
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When Congress created the Veterans Choice Program years ago to push veterans into for-profit hospitals, they sold it as a temporary fix for a shortage of VA facilities and health care professionals. But they never made building facilities and hiring personnel to care for veterans a priority. They also keep cutting employees’ pay, benefits, and workplace rights.
As a result, the VA is struggling to fill nearly 49,000 vacancies. Now they’re using these self-inflicted problems as an excuse to send even more veterans to health care corporations, serving the agenda of private hospital CEOs and the Koch Brothers' shadow organization Concerned Veterans of America but ignoring the needs and preferences of veterans to receive the vast majority of their care from a fully-funded, fully-staffed VA health care system.
Even though VA hospitals are better and less costly than their private counterparts, a slew of new pieces of legislation have been introduced to send veterans off to health care corporations without clear eligibility criteria that are essential to preserving the VA's core capacity or ensuring veterans can still go to their first choice for care. House Committee on Veterans Affairs held a hearing on these new bills on Oct. 24. The bills have the same goal of privatizing the VA but with different approaches. Here’s how:
1. Making the “Choice” Program permanent
Draft legislation proposed by House Veterans Affairs Committee Chairman Phil Roe would make the Choice Program permanent. This would divert funding away from VA’s internal capacity and into the pockets of giant health care corporations. The bill has no provisions to strengthen the VA’s own capacity or to send veterans back to the VA when private sector care is no longer "justified." Under this bill, Choice providers would continue to receive less scrutiny than VA’s own providers. It doesn’t require the same transparency about wait times for private care as is required for VA care. It also makes it too easy for non-VA providers to receive certifications that allow them to participate in networks regardless of whether their skills and training are equivalent to those of VA’s own providers.
In short, the “Choice” program appears to be the CEOs’ choice to make money off our wounded warriors.
At the hearing, Chairman Roe himself was not sure how to fund his privatization program. The last time they tried to find savings to fund the extension of the VA Choice privatization program, the Trump administration proposed to cut $3.2 billion from a program that provides compensation to disabled veterans. They cancelled the proposal only when AFGE and veterans service organizations shone a spotlight on the proposal and condemned it.
AFGE is keeping a close watch on the Roe bill as the chairman appears close to securing broad VSO support through some revisions that still allow for Choice expansion.
2. Turning the Choice Program into an even bigger bonanza for hospital corporations
VA CARES, the legislative proposal from the White House and the Department of Veterans Affairs also represents a dangerous blueprint for privatizing the VA by getting the VA out of its main responsibility of providing care to veterans and turn the VA into a mere contract manager.
The VA’s proposal would “end” the Choice program and accelerate privatization through open-ended access to private-sector care without mandates to address understaffing at VA hospitals and deteriorating facilities. The result will be a flood of veteran patients at unprepared private hospitals. Veterans would be forced to go to health care providers who do not have the expertise or integration across medical disciplines required to take care of their complex needs.
What’s even more absurd is that this privatization program would be funded by mandatory funding while VA’s own funding would remain discretionary and therefore continue to have to close funding gaps on the backs of veterans through such proposals as Cost of Living Adjustment round-downs.
Veterans deserve the best care our country can offer. Starving VA hospitals so veterans have to go to private hospitals is not giving them more choice – it’s forcing them to get care from inferior providers.
3. Creating a “pilot program” to privatize mental health care for military sexual trauma patients
A bill has been introduced by Rep. Andy Barr of Kentucky to establish a three-year private sector pilot program for the treatment of military sexual trauma (MST) – sexual assaults or harassments that happened while veterans were in the military. Just like almost every other VA private sector pilot project, this is another back-door attempt to dismantle the VA’s comprehensive, integrated health care system. VA is a world leader in the treatment of MST and provides training and research in the area. VA requires that every veteran receive screening for MST and screening also plays a critical role in data collection on the treatment of this widespread condition. All VA mental health and primary care providers are required to complete initial and continuing MST training. MST specialists are available at every medical center and many outpatient clinics.
It’s a well-known fact that VA hospitals have consistently outperformed private-sector hospitals. VA hospitals are particularly good at providing mental health care – they continue to outperform private-sector hospitals by 30% on every single indicator of good health care. In addition, VA and Defense Department providers are significantly more likely to have cultural competence and inclination to deliver evidence-based therapy for Post-Traumatic Stress Disorder (PTSD) and depression. Only 13% of private health providers are likely to have cultural competence and use evidence-based approaches for mental health problems.
If Congress believes the VA doesn’t have enough MST specialists or other health care providers, it needs to help the agency fill the 40,000 vacancies, not dismantle the entire system and send veterans off to inferior providers in the private sector.
Our veterans deserve the highest quality of care. They deserve a fully staffed and resourced VA. Click here to find out what you can do to make a difference.
If you are a veteran or have a family member who is a veteran, join AFGE Veterans today.
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Nearly 72,000 federal employees will begin receiving higher locality payments in January.
On Dec. 6, the House and Senate passed, and President Trump signed, a short-term stopgap bill that funds the government through Dec. 21.