As a vet I have already experienced the so-called private sector care offered from the VA and it was horrible! The doctor was far less caring and his diagnosis was inaccurate. Thankfully, I was able to contact my VA doctor and get proper care. As an older vet I get far superior care from the VA than any local doctor can provide because they understand our needs.
3
It's all from the same VA pot.
So they're going to bleed the VAs, making care depend on even fewer resources and making care worse, while splitting this with for-profit care that will have comparatively little experience with veteran's issues, will be inundated with the largest group of these new patients at the start, and eventually close the VAs, so that profit can be made off of these veterans.
First supplement--now supplant. Inconsistency and lack of detail.
Unsurprising.
Appalling.
2
Apparently the folks who are in favor of this have never tried to get an appointment in the private sector if a new patient to a practice. A month is not uncommon.....for specialties, even longer. And our family has good insurance....
1
I personally can attest, that this is creating even more delays and the private care, doesn't have the respect and dedication to the veterans. In Huntington, WVA, VA, they dont have a cancer doctor or kidney doctor and the cardiologists care is awful, the wait for these, was longer then the VA care, much longer!
5
How about making disabled veterans eligible for Medicare and simply plug them into the existing system? No new bureaucracy needed.
3
I live in a somewhat rural area of northern California. We have dedicated medical personnel locally, but they sometimes run against the tide of poor service amd greedy exploitation of patients. As a Vietnam veteran, I moved here in the ‘70’s for the rural lfestyle and never considered the VA. That all changed when a local out-patient VA clinic was established. This clinic and the Fort Miley VA hospital in San Francisco literally saved my life.
The VA health care system may be flawed, but I have received excellent care from a system actively interested in my continued good health. I love ‘em. Always smiley at Ft. Miley. The VA system provides a template for national health care for everybody that I vote for every chance I get.
Dear Supreme Leader, the Koch brothers, and their zillionaire allies want nothing less than total power in a satanic alliance of government and the super-rich. Isn’t that fascism? Why else would the super-wealthy get tax breaks adding over a trillion dollars to our budget deficit?
No, no, NO to Trump and his Republcan allies who want to destroy the VA, the Post Office, and apparently this great Nation of nations which so many have sacrificed so much to protect and advance.
11
You don’t need a graduate degree to come to terms with neoliberalism. It’s the privatization and monetization of things that should not be for sale. Reagan and Thatcher started were the inaugural torch bearers, and both parties have been selling out the commons to profiteers and capitalist pigs ever since.
4
This kind of policy will be reversed with new administration
1
Who is behind this, people are asking? Whose administration is in charge—This is the work of D.J. Trump, if not directly, than through the individuals he has appointed to his Cabinet, and the GOP Senate that has approved them.
As the Navy veteran daughter of a 100% disabled WW II Marine combat veteran, I can speak both from my own and my father’s experience and say that the VA should not be defunded and supplanted by private care on the outside. The VA provided my dad excellent care through the end of his days, as it does to veterans throughout the country.
Veterans across the country, and those who support us—we need to unite and do our best to keep our VA medical care. We should not stand idly by while it is taken from us.
9
Here’s a one quiz question:
When you remove burdensome treatment costs, provide comprehensive medical and dental care, constantly measure patient and doctor satisfaction, eliminate medical incentives / procedures to negate the bottom line and profits, and provide a first rate academic training and research to residents (not just science but exposure to empathy, sympathy and real need) which system is it? It’s the VAMC.
It’s not without its problems but the system is a model for patient care. Privatization is the not the solution. For profits health systems see the large budget allocated to the VA and want a piece of the pie. Unfortunately, it’s that simple.
13
Veterans voted 2 to 1 for Trump over Clinton in 2016. can't be a crybaby about it, it was obvious what the GOP planned to do.
14
The Republicans have been working hard to dismantle the VA Health system and now seem close to making a killing blow. This move to "outsource" Veterans healthcare is nothing more than a transfer of money to for profit healthcare systems. I am a Vietnam Era veteran and I am enrolled in the VA system. Veterans want and need their own Healthcare system.
13
Yuuup. The "Free" Market cures all. Red State-istan led by the Koch (Choke) Bros., needs to be made to understand that the Market fails at the Common Good and our Common Risks. Health Care, Public Ed., Retirement Security, Food Safety, Clean Air and Water, Environmental Concerns, Worker Safety, etc. All these areas and others can not be trusted to Profit and Greed of the Holy "Market".
11
I have worked in both the VA system and private health systems. The VA has tailored programs the meed the vets needs. No private system has the outreach and support services provide by the VA
And has anyone tried making an appointment with a primary care provider, much less a specialist, in the private sector? The waits are months long.
Sending vets to private providers is another ill-conceived idea that does nothing to address the problem. Very emblematic of this administration.
17
As long as there is profit to be made by treating our veterans as a way to make money, that is the way they will be treated.
7
These libertarian types, like the Koch brothers, love to funnel our tax dollars through the government and into their pockets all in the name of les government. PIs the VA underfunded? Yes, but for the most part it is an efficient system, subject to transparancy and public oversight. The last thing our vets need is to see the promise we made to care for them in exchange for the sacrifice they make to protect us and defend our country raided by the for profit healthcare system we have here that prices millions out of health care and bilks our government out of billions and leaves us ranked at the bottom in health outcomes for industrialized countries. If we had single payer, publicly provided, government funded healthcare for ALL Americans this whole issue would be a mute point....we would all get the healthcare we need when we need it.
9
To correct one misleading statement: The VA does not require a 30 day wait before activating the Tri West community care option. In some areas where the required treatment is unavailable at a VA facility, the option kicks in immediately, particularly for female care.
People also need to be informed that for conditions other than service-connected disabilities/illnesses, veterans must qualify under an income threshold in order to enroll in a VA Medical Center.
If care is privatized, there will still be a VA administering its own health plan coordination to assure that cost-free medical treatments are available to low/moderate income veterans and that all service connected injuries are forever free to the veteran. Non-service connected illness and treatment usually require a modest co-pay, depending upon the veteran's income level.
I do not know at this time whether veterans with income above $39K are able to enroll in the VA system; they may be required to use TriCare. There was a period of time when high-income veterans were refused enrollment; info for 2019 would be useful to know.
3
This profit driven capitalist society we live in is not sustainable. The government's solution cannot be to simply just "Privatize" everything. We already know how much of a disaster our privatized "healthcare" system is. Other countries that tax higher rates to provide government sponsored healthcare and other benefits often do it far better than our way of "privatize it to save money" method. Our method in turn passes the cost of these services directly on to the consumer to try to make a profit (this is the direct goal of privatizing and capitalism). Maybe we should take a hint from most, if not all other, first world countries and elect a government that will bring us into the 21st century when it comes to government provided services.
6
This indicates that we should have a single payer system for all Americans. This would eliminate the duplication of systems and services we currently have and reduce the variety of insurance forms that medical businesses fill out for their customers. It would also unify our medical records so that we could easily identify pill mills and oversubscribing of medications. We could change jobs or move anywhere and any medical care facility would have access to our records.
9
From Lucas Waldron, writer for ProPublica:
Since 2014, the VA’s Veterans Choice Program has spent $10.3 billion. Most of that money went to private contractors.
Contractors spent $1.9 billion — or 24 percent — of that money on overhead. That’s about double the private-industry standard rate and three times as much as the military’s health insurance program.
According to the agency’s inspector general, the VA was paying the contractors at least $295 every time it authorized private care for a veteran. The fee was so high because the VA hurriedly launched the Choice Program as a short-term response to a crisis. Four years later, the fee never subsided — it went up to as much as $318 per referral.
“This is what happens when people try and privatize the VA,” Sen. Jon Tester of Montana, the ranking Democrat on the Senate veterans committee, said in a statement responding to these findings. “The VA has an obligation to taxpayers to spend its limited resources on caring for veterans, not paying excessive fees to a government contractor. When VA does need the help of a middleman, it needs to do a better job of holding contractors accountable for missing the mark.”
The Affordable Care Act prohibits large group insurance plans from spending more than 15 percent of their revenue on administration, including marketing and profit.
14
Turn all the veterans' hospitals into local hospitals, and give the veterans an ID card that entitles them to the same healthcare benefits that our senators get -- at any hospital near them.
Some of those VA hospitals are hours away from wherever these vets live. My old uncle had to travel two hours to get to his. My father simply opted out.
It's a shame. Men and women who risked their lives and sometimes lost their limbs, their eyesight, their faces -- and we won't give them medical care where it's convenient for them.
3
If Trump is behind it, you know it's probably good for profiteers. He put billionaires in key positions of his administration to serve the little guy because he doesn't trust normal people to do as good a job of running thins, but "making America great again", means making it's institutions great again and keeping them great
6
I believe the VA is the canary in the coal mine. It cannot be adequately staffed due to a doctor shortage. As the population ages and enters Medicare, many of the VA problems will be experienced in civilian medicine.
5
This is a terrible idea.
As a seventy year old veteran I have had more than enough experience with hospitals, run by the VA and several public and private hospitals. The VA hospitals are far superior.
At the VA facilities I am valued, treated with loving attention as a treasured family member. At the public and private hospitals I spend long hours ignored by the staff who see me as just another old man.
11
Just fix the VA!
6
The private sector hospitals are of course doing so well! when it comes to making money that is. Patient care? That is another discussion.
6
A good friend of mine had his legs paralyzed in a fall. He's been treated for more than three years at the James Peters VA Hospital in the Bronx, NY. He's received excellent care, been outfitted with a special wheelchair, and the VA has outfitted his home and van so he can enter them. I doubt any private insurer would do all that. This proposal is just another attempt to siphon off money into private coffers. It reeks, just as George W. Bush's proposal to privatize Social Security.
14
Interesting that the VA health care is probably the best example of socialism in the USA, closest thing we have to the British NHS, and is, although not perfect, extremely popular.
14
Healthcare is not a normal consumer transaction. Consumer patients mostly have no choice but to enter into these contracts, and no knowledge of or power to negotiate price. That is why medical bills are skyrocketing in the private sector; it is a market especially vulnerable to taking advantage and price-gouging. On average, non-V.A. hospitals charge four times Medicare rates; that's 400% of cost. That is the trade-off: a government-run V.A. system that protects veterans from unregulated price-gouging, or throwing them to the financial wolves.
5
If you go the Orthopedic and Prosthetics unit at Ft. Miley in San Francisco, you will understand in a minute why we have VA hospitals. I just go there for compression gear, but those that need the other services will never find their like anywhere in the Bay Area.
The Concerned Veterans sounds like a well oiled machine, like ALEC intent on implementing the Koch bros agenda and in the process destroying something that works for a huge majority of us. I didn't realize that Shulkin and Selnik "clashed" but that helps explains why he got the boot. Koch's alligators are everywhere in the Trump Swamp. Look at what they've done to the ACA, we're going to get the short end of that stick too, thanks to David and Charles!
13
This has scam and fraud written all over it. Get ready for the reports of financial abuse over the coming years. Stay on it NY Times!
11
As a former DoD provider and now seeing Veterans for comp & pension benefit exams, I can say that not ALL care in a VA is good. In my particular field, it's pretty bad, this from hearing from Service Members (who returned to AD) and those Veterans I'm seeing now, plus reviewing the VA medical records of these Vets (those are inconsistent -- some depts. writing/reporting is clear, others woefully lacking).
Why do I hear from some "they didn't tell me that", "I had no choice", "he didn't seem to care", "that's what they told me", "you just go in there and wait, you don't get the same person [who knows you/your case]", and on and on.
In my field, I am happy that some may choose to go private, but it does seem like it's hospital (big bidness) or clinic, and not necessarily private practice. So may not be a help after all.
As I told the Service Members I saw (in the DoD) who had TBI & co-morbid psychological conditions: "There are more of us (good providers) out there, you just have to look/find them. May not be the first one you get to, but there's more of us out there." Of course, that's true for all of us, eh?
2
I work directly with these claims, and I would disagree with some of your assessments. Many of the exams I see from private contractors are insufficient, contradictory, or do not rise to level of evidence necessary for adjudication. I am hearing stories of medical contractors hiring PA’s, conducting appointments in empty storefronts and using subjective symptoms to complete objective sections of exams. In addition, many of these exams are purposely done incorrectly, as contractors are charging $700 for every exam uploaded into the system. They are simply regurgitating new and unnecessary exams for the same vet. V.A. exams are almost always thorough and adequate for rating purposes.
8
brought to you by Koch Industries.
7
If VA hospitals will now be run by private health care providers, and BILLIONS of dollars are at stake, then I fear these much needed services and VA hospitals will end up like our prison system - ineffective, poorly run and maintained while profits go to private health care providers rather than towards exceptional care for our beloved veterans.
My brother is a patient at a fantastic and wonderfully run VA hospital in Milwaukee. Every single doctor, nurse, administrative person, janitor, valet parking attendants AND other patients are sincerely kind, compassionate, helpful and respectful towards my brother as well as myself and my husband, He also receives incredible care. I shudder to think how badly this scenario will go sideways once the private sector pushes in and takes over. Presently, he is receiving excellent care from his VA doctors. I worry if this will change and how it will effect his present condition of colon cancer.
This is just another example of Trump helping out his rich friends to get even richer and this time, it will be straddled on the backs of our vets.
For crying out loud, why can't this man just leave SOME semblance of order in place instead of destroying everything that he believes he can control and ruin. If he were a vet, I wonder if he would feel differently about the private sector taking such a huge role (financially as well as directly).
13
Of course. Trump will Pay for protection
1
Because the private sector has really been doing great things for healthcare. Keeping costs as high as possible, denying claims and putting folks into bankruptcy.
9
When I see it's something the Koch brothers support, I think it can't be good for the average (GI) Joe.
11
Sounds like another version of the school voucher scam
7
I do not want non-VA care. Private sector providers want to Do All The Things. So do VA doctors, but they understand that their patients are functioning adults capable of making their own informed decisions. When a doctor, any doctor, misses the hints I give about my understanding of things medical and scientific, that's it. It's over. There is no more conversation. I don't like private sector doctors. My experience with them has been far from satisfactory.
My experience with VA doctors has been mediocre at worst. Some of my experiences have even been good. I'd rather wait for a VA appointment than deal with private sector providers. I can't say it often enough or loudly enough: I want VA care, not private sector care. And if private sector care is all that's available, I'll go without even if it means pain, suffering or death. Don't mess with my VA care.
8
This a privatization push for profits by the health industry.
The Government is designed to provide public services. Corporations are profit driven. A move like this will mean more expensive care for fewer services and less quality, stuffing the pockets of the ruling Healthcare Juntas. Wouldn't the public like to see a cost study comparison before implementing such a drastic change? Alaska wanted to outsource their Pioneer House system. It was determined that the private companies bids couldn't compete with the comprehensive services provided by the Pioneer Homes. That the spokesman for DVA wouldn't give specifics is a telling red flag.
9
Precisely. It's all about the money. The Republicans will push privatization as quickly as possible because they suspect their guy in the White House won't be living there much longer. We'll see what next they want to devour before dt changes his address.
They've wanted to privatize the Postal service for years. They've already got control over the military budget. Privatize the IRS? The Mint. Social Security? Medicare? We know they want those two entities. The FAA, DOT, FDA, EPA?
The VA provides excellent medical care. Don't let them fool you. In this environment of misinformation, they exaggerate the flaws in order to plant the seeds of a failing agency, so they can swoop in to "save" the day.
8
Alternatively:
it would be good for regular Americans to have the opportunity to see the end result of their country's perpetual military actions and the price paid by our veterans by having a conversation with a disfigured veteran while they wait with their children in the waiting room.
Anyone want a piece of candy?
"Avoid foreign entanglements" — George Washington
8
I was a young nurse when the mental hospitals were closed and the patients shifted to “community care”. Now we know the prison system is the largest caregiver for the mentally ill. The rest are homeless with no care at all. What will really happen to our veterans?
11
Trump & the Kochs want to defund the VA. It may be unChristian, but I really despise these people.
10
NO! How can we stop this?
6
Bring the same level of care as the VA to outside facilities that are lacking in reliable medical care!
4
If corporations are making "record profits" maybe they should be paying "record taxes" instead of even more schemes to defraud the taxpayer.
9
This is nonsense, both the active duty military and VA have out sourced veteran care for quite a while.
Of six surgeries related to one of the "service-connected" conditions resulting from military service:
2: Landstuhl Army Regional Medical Center (LARMC), Landstuhl, Germany, prior to discharge
1: Outsourced to foreign medical facility in foreign country, Homburg University, Homburg, Germany
1: VA Medical Hospital, Portland, OR
2: Outsourced to private surgeon, Las Vegas, Nevada
The American people are being gamed by the system, but they don't seem to mind bcz it's not happening to them. Yet.
Ah, but ain't that America?
6
Nice Mellencamp nod.
2
@Phyliss Dalmatian
Thank You, Phyliss!
You've been wonderful!
See you next year!
I can see Rick Scott already in his new Senate office putting together a plan to embezzle millions from the VA. He got away with it with Medicare after all.
5
Taking care of vets quickly and effectively is paramount. Public money (any money) going to private healthcare has a large component that is wasted that is just inherent in for profit insurance and hospitals. If the the VA takes money from existing VA services that will make them less able to serve vets. Which then feeds the meme of ineffective government run services. What they leave out is the private services are far more expensive and if the VA and other government run services were funded at the same levels the private services are, they would be better than the private services.
The efficiency of privatization is pure fantasy.
6
@Trebor
Correct, the privatized US health care system is the most expensive in the world AND doesn’t even cover all of its citizens.
1
American oligarchs like the Kochs never privatize to make better; they privatize to make money.
8
The Koch Brothers invented Concerned Veterans. It's a false flag operation. Like Trump, they never ever were veterans, and they (both athletes) grew up in the era of universal male service. I wonder if they also had Miracle Vanishing Bone Spurs. The article says we don't have a lot of the details of Trump's ordering billions and billions of dollars appropriated for the care of veterans to go to the private sector. That is to be expected. After all, the goal is obscenely large profits, not care for veterans, so details must be concealed.
9
Several years ago when I was in Washington I had a discussion with Edward Powell who was either Undersecretary of the VA or acting Secretary under Clinton and I was in private practice. I stated that they should privatize the VA. A little under three years ago when I was back in Washington I made it a point to meet up with “Ned”. In the interim I had left private practice and worked at the local VA for more than 10 years. I had to tell him how wrong I was. The National electronic medical records and coordinated care of a patient population which was different from what I had in private practice made the VA a better place for them.
The overload is the result of the perfect storm of low retirement financial returns caused many elderly Veterans to drop part B Medicare supplements and come into the system at the same time Obamacare led many to come in to avoid penalties for not having insurance. All new enrolling patients get an intake exam with labs. In Florida and South Georgia and US VI and Puerto Rico we enrolled over 500,000 new patients in the first six months of Obamacare.
8
@James, MD You raise an excellent point. The VA electronic medical records system is superb, especially for patients. I can go to any VA facility anywhere in the country and they can pull up my entire medical record, including medications, vaccines, labs and medical history. No private sector system can claim the same.
I can pull up those same records from any computer with internet access. It's extremely useful.
4
I am a Vietnam Vet this is a huge mistake! Follow the money to trump's big money buddies!
7
One more giant rip off of the American public--and veterans in particular--by corporate America. Privatization always means profiteering, and why should anyone profit from the treatment of our veterans?
6
Healthcare in Jersey has been stretched to the limit in skyrocketing costs, minimal effectiveness, and serious lack of both convenience and accessibility. The Republican agenda to privatize veteran’s healthcare would dump millions of more patients into a system that is already one of the lowest ranking on the planet. It should be obvious that a quantum jump in patients-per-doctor will only magnify the pathetically long waits of weeks to see specialists or a PCP. As usual, the medical profession is silent on what should be done to fix America’s serious health care situation, and seems content with making millionaires out of bureaucratic specialists who are being gobbled up by monster corporations and ever-expaning hospitals intent on smothering private practices. A nation-wide impact survey needs to be mounted before taking any votes on this issue.
4
@redward
Republicans are oblivious and obviously don't care bcz it will have zero impact on them where they receive their taxpayer provided care.
4
I think it's so heartwarming that the Koch bothers are concerned about veterans. Said the spider to the fly. There is only one reason why the Trump Administration is trying to do this and it has nothing to do with better care for veterans. It has to do with the only thing this administration has any interest in: private sector profits for themselves and their friends. The fact that veteran groups are so opposed to it, and the fact that the Trump Administration has refused to give any details, tells you all you need to know.
10
What could possibly go wrong here?
5
where is the evidence that this will provide better service at lower government cost?
8
Way, way overdue! Over 400,000 V.A. Employees who need to be downsized drastically. I’m a DAV who is lucky to have private medical insurance, and use it because I can choose my doctors and hospitals which are near me. Not so in “the good enough for Government work” Veterans Affairs gulags...
4
We need to nationalize health care in America, not privatize it.
The privatization of health care for veterans, or anyone else, is movement in the wrong direction.
On a per capita basis, we are paying twice as much for health care as the citizens of any other country.
If we need more facilities to serve the needs of veterans, build them, staff them, and maintain governmental control of them.
We have been sold on this swindle way too many times already.
“Privatizing services” = increased costs and increased profits. The GOP and their corporate allies love the idea.
The hard-working taxpayer loses every time.
5
@Tom W
Tom W 2020!
2
I’m a vet, and very pleased with the care I receive at my local VA hospital. I fear that this is a first step toward 100% privatization of veteran health care, freezing benefits while costs rise dramatically. After years of non-stop military engagement, Republicans are trying to reduce veteran benefits. They have no shame, or conscience.
9
I had tricare and now have full healthcare coverage. Tricare is funded by a large pool of healthy beneficiaries. va is all sick and old patients. Medicare for all is going to include healthy payers so it is solvent. their taxes will go up because taxing the rich is not enough. the Green New Deal requires revenue. healthcare is the moral imperative. sorry about the rising and heating oceans.
1
This article is confusing and inadequately discusses the debate about public v private. More concerning perhaps is the lack of Congressional oversight on veteran needs cited by the article. Does it exist in any detail? What have Congressional hearings et al investigations determined about the benefits of either side?
During this government shutdown, where Trump's wall seems not adequately vetted (if at all) by Congress--how would we know? journalists don't talk about it--the tendency of professional journalism to act as if whatever side has the stronger political voice is the one deserving to decide is chilling for our democracy. If Congressional oversight has meaning, it should be done and cited as primary proof of whether a particular policy has merit or not.
Both Congress and the media need to do their jobs better if we're to have government by merit, not by pure politics.
2
One. Public. Medical system. For everybody. Not just vets. Everybody. Campaign finance and ethics reform is the starting point.
10
@Chris But if we want the kind of consensus that democracy thrives upon, then we need to have public--ie Congressional--investigations of the different options (and there are many for public health care) so that we don't just install a system that hasn't been properly vetted, but one established by brute political force. (See my comment above.)
As a disabled veteran who receives my healthcare from the VA (Martinsburg VA Medical Center) and a retired medical researcher and hospital administrator I feel qualified to attest to the high quality of that care. I can count on one hand the number of times I've waited more than 10 minutes beyond my appointment time to be seen and my physicians are as good as any I've seen or worked with in the private sector. Most problems at the VA could be fixed, IMHO, if the system were properly supported. The Koch-funded outfit driving this push for privatization is out for the money - if they succeed in hollowing out the VA, veterans' care will surely suffer. In fact if I were designing a national healthcare system I would look to the VA as an example to emulate.
10
The article fails to mention other major pitfalls of such a mixed system: the administrative costs, coordination challenges, and the difficulty ensuring quality care, i.e. clinical oversight as the VA would retain responsibility for adequacy and sufficiency of care. These costs and additional layers of clinical and administrative responsibility have the potential to ensure that this plan is a great example of what one author titled an "Ultra Solution": solves the problem and ensures failure. For historical reference, see Veteran's Choice program and history of VA referrals outside the system.
3
Out here in rural America veterans must travel very long distances to each a VA facility. It might be more convenient for them to have the ability to receive medical care locally.
6
In other words, we the civilians will be competing with millions of vets for medical service. Not good for either.
5
It looks like an invitation to corruption. The idea that the private sector can do things better than the public sector, is always an interesting proposition.
However, this idea falsely rests on the assumption that the government always overcharges for parts and services.
There is some truth to this, especially in the military, where they often have huge budgets.
However, in this case, it appears that Trump is trying to use another hodgepodge scheme to address an issue, he becomes aware of, rather than craft an actual fiscal policy.
I don’t remember a Republican who has spent more on nonsense than he has.
3
This is yet another money grab by the most corrupt administration and party this country has ever seen.Would love to know if Eric Prince is slicing up some of this pie for himself.Who has the contract to pay for the tent cities Trump has erected to house kidnapped and caged immigrants?.It's time for a civil uprising..we have a Russian asset in the WH for God's sake.
6
Big mistake on every level. Next thing to go is Social Security and Medicare. Call your appropriate reps and tell them "NO".
9
There is one way to remove the problems of the VA hospitals: fully fund them. Handing them over to for profit institutions only serves to help for profit institutions. Let's restructure the tax plan and pay for what matters.
7
I am not writing as a veteran. But I do think veterans need to think clearly about what it means to put their care in the hands of people who believe that privatization, with its relentless capitalist drive to direct resources toward maximum profits, will result in anything except lack of care for those too expensive to treat profitably. Privatized VA benefits is really a message to the sickest of our veterans: “Hurry up and die.”
7
if you want single payer government run insurance.... this disaster is your template
2
Republicans privatize government for personal profit. Example being private prisons. Privately operated prisons are not more economically efficient as compared to public run institutions but they do make money for the owners.
Private insurance is failing the American health care system.
How will privatizing the V.A. help improve care for veterans as compared to hiring more high-quality doctors and nurses for V.A. facilities? This move by the GOP is intended primarily to make money for lobbyists and investors in that industry, who in turn kick back money to GOP Congressional representatives who created or will protect that legislative effort.
The MIC has mutated into the Prison-Industrial-Complex and now the GOP wants to make it the Veteran-Care-Industrial-Complex. The real solution is to stop "making" injured military veterans. Sadly it's Republicans who start wars and conflicts that generate more veterans.
2
I defer to the opinions of the veterans on this issue, but a quick review of the redponses indicate this is same old same old rant for privatization "to provide better services," which it would not do. I hope the new congress puts an immediate quash on this bad idea.
4
This should help keep the costs down.
1
another in a fifty year campaign by the Kochs and their Republican cronies to move public goods into private pockets.
5
Fundamental rule: whenever you hear or see the word “reform,” from right-wingers, check a) to see if your war hero uncle’s respirator is still plugged in, and b) your wallet
5
Another win for the healthcare industrial complex. Waiting at the end of life to empty our pockets and rob us of all our assets is no longer enough. Now they are going after the tax dollars meant for veterans' healthcare. What a sweet honey pot it must look to them!
9
If they can do this for veterans, what's the problem with Medicare for all?
3
All due respect to veterans, shouldn't the ultimate goal be Quality Healthcare for ALL Americans?
4
Republicans want VA money for private sector profits. This is standard operating procedure. The Government will end up spending more money for less service. The "more money" could be used to expand VA capacity instead.
4
It's the same tactic being used by charter "schools." Suck and siphon off enough resources and money for these private-enterprise schemes to KILL PUBLIC schools and veteran's care. And in the case of the VA, isn't it actually some cronies of Trump's at Mar-a-Lago who are making decisions for the VA?
Republican's are intent on destroying all the institutions that benefit US and instead pour our tax money into schemes that enrich the 0.01% and further penurize the rest.
8
And then when VA costs skyrocket because they’re using for-profit healthcare, the Republicans can argue for cutting VA funding.
4
My third post on this story, crony capitalism at its worst.
I was so angry I spent this A.M. giving the following Congress Persons a piece of my mind:
Senators Boozman, Cotton, Isakson and Tester; Congressmen Takano and Westerman.
Three of these, Boozman, Cotton and Westerman represent my home state or district but all are involved with veterans' affairs. Isakson, Boozman and Tester in the senate and Takano in the house sit on or chair veterans' affairs committees.
Don't just read these comments and ad your gripes or opinions, or worse, do nothing constructive (merely ranting is not constructive). Contact these folks or your goombahs and demand that they put a stop to what is going on at the VA until those committees can hold public hearings.
7
Fine tune the existing Veterans Health Administration. If those in the private sector clamoring for a big slice of the VHA want to help a veteran so badly, then join the Marines and cover the six of a grunt on the firing line...Meanwhile, keep your filthy, greedy hands to yourself.
2
I'm a disabled Vietnam veteran and when I hear
"Trump & the Koch Brothers have a plan to help Veterans" , I respond the same way I did when I heard someone shout "In coming!" in Nam.
You don't think about it, you just get under cover fast because you know something not nice is about to happen.
128
Just another stripping of benefits from soldiers who rely on our Veteran's Administration network for cost-free care. The solution is more funding for the VA, more doctors, and more facilities, not privatization. We've already seen what privatized health care looks like, and it's not pretty--rising costs, out-of-control drug prices, and people dying because they cannot afford their medications. This is just a way to add to the already-existing crisis.
10
It is hard enough getting treatment for PTSD for veterans, much less us having to translate our experiences to civilian doctors who are not going to have a clue, so the patient becomes the caregiver? I don't get it?
5
Having been privileged to care for many Veterans in a VA hospital --I will always believe vets should receive the best of care, with a large dose of respect and gratitude.
That said, the best heart hospital in my state is not the VA. And the best joint replacement hospital is not the VA.
However, the best PTSD clinic, and the best vet friendly diabetes outpatient clinic IS the VA.
What I would like to see is big ramp up of outpatient services/gathering places that are Veteran oriented ( housing support, job training, family counseling, addiction medicine, etc) under the VA umbrella-- but farm out the inpatient stuff to the best academic/community hospitals.
7
@Doc Whiskey
I completely agree with you. I lived across the street from the Menlo Park VA till the 1st. Close to Stanford Hospital and closely affiliated. It makes sense to send complex, specialized care to the best hospital. But the VA is so much more. I just talked to a guy in the volunteer section. I had some good quality furniture to give away. He was delighted. He had 2 wounded vets they had just found housing for that needed good furniture. I wanted to cry. I couldn't have found a better home for my son's room furniture since he moved abroad for University.
I also rented a room short term for years and had 3 different guests come to intern there. PTSD is tough, reintegrating at home overwhelming. As non-profit hospitals, the VA can give vets the community care they need. The VA provides essential services that this plan will deny. The folks who work at the VA are devoted to our vets and this plan doesn't have that.
This Koch plan is inhumane. It's terrible and will just take money from vets.
5
Turning the VA into a for profit entity responsible more to shareholders and investors would destroy a semi-functional medical institution. Improvements are needed, particular in record keeping, information technology, and overall efficiency, but anyone who believes the Koch brothers want to do well for a government entity should take a break from their medical marijuana.
They ultimately want veterans and everyone else off the dole and responsible for their own health using their own dollars in an unregulated market. At best they might support an underfunded healthcare pension for veterans forced to buy care on the open market. A market that all evidence shows has done little to advance healthcare in America.
One way or the other the VA should be folded into universal healthcare that is more affordable, more evidence based, and not profit driven but cost conscious. A good start might be folding it into Medicare to limit administrative costs and facilitate cooperation with non VA providers as needed.
The Koch brothers should stick to operating their polluting petrochemical industries. Or better yet, how to limit their carbon pollution and toxins ruining the environment.
8
@Michael Tyndall Absolutely - 1 health care plan for everyone - with housing, PTSD treatment, and other clear needs of active duty and vets provided through full funding of a non medical care VA.Roll US citizens'health into universal system -Medicare, VA, Medicaid, Private Insurance, Public health clinics, School clinics, etc. Stop wasting our time and money on useless meetings and incompetent administrators.
3
Privatizing would be great. Government run healthcare has the efficiency of the Post Office with the compassion of the IRS. That and many union government employees have bad attitudes and believe they are untouchable. I've been in the system since 1980.
3
History has shown that when government programs are thrown into the arena of the private sector, costs go up, services go down and abuse often becomes rampant.
Our government shutdown is now withholding payments to 25,000 veterans. How is that benefiting the men and women who have served or are serving to protect our country?
Where is the oversight? Who is ultimately responsible? If it falls to Trump and his administration, one might as well declare a national emergency.
6
A huge republican pork barrel.
10
Oh joy - coming soon to a veteran near you: Kushner Care Clinics!
10
Oh, New York Times. Check your facts. Don’t misinterpret VA trying to provide access to Veterans far removed from care by distance or time as privatization. The MISSION Act and the nationwide community care network are meant to augment VA infrastructure. Not detract from it. Thanks for stirring the pot though. Keeps things interesting.
4
@Chris If you'd read the article, you would understand that this means monies for privatized care would come out of the current Veteran's Administration budget, reducing funds for VA Hospitals. A better solution would be allowing veterans access to active-duty military hospital and opening more regional clinics so that veterans don't have to travel as far or wait as long for care, but any time the government takes money out of care for the soldier and transfers it to the private sector, costs escalate and the level of care (and funding) degenerates. Be careful for what you wish for--you will regret it.
3
I cannot believe how many commenters are so blinded by animus that they would deny veterans better care. Shame on them. This is precisely why they cannot be trusted with policy decisions.
4
@AACNY What I cannot believe how many commenters want to get rid of VA & shunt all veterans to private providers. We need to take care of our veterans, NOT enrich insurance companies and "not for profit" hospitals even more.
3
Having used the VA system as advocate for my father for the past 10 years and with knowledge of his care in the prior 20+ years of VA care I can attest to the excellence of that care. While the bureaucratic processes were cumbersome and unwieldy at times, once you waded through all went well.
What didn't go well was when we tried the Choice program, essentially a private sector health care provider as is stated in this article. I spoke with workers and supervisors and managers of that program and none seemed to know, let alone understand, what they were doing. They refused care that was authorized by the VA. They lost mounds of records and paperwork. It was total incompetence. I switched Dad back to the VA and he was then cared for with all the excellence he had previously experienced. I preferred driving him the 60 miles to and from appointments rather than deal with the idiots in the Choice program.
What I see with this administration's move is to slough off the costs and eventually the whole VA healthcare system, onto the private sector, completely renigging on the United States's promise to care for all those who serve their country in times of war and peace.
This must not be allowed to happen. It is our obligation and duty to those who choose to serve our country to take care of them. I find it shameful and disgusting that this administration would try to shirk their duty to these brave people.
10
There are some capitalist that simply can not put America, and American Veterans before themselves getting extra profit. The Veterans that protect America. They are being used as a profit material. No reason to think these type of people would not start armed conflict to make another dollar. Below is an investigative report from ProPublica that leaves me a bit stunned and madder than sad.
https://www.propublica.org/article/va-private-care-program-gave-companies-billions-and-vets-longer-waits
3
WHY? Is it always black or white; this or that? That's a sign of ignorance and this country is one big racist/lack of diversity MESS! Let's review the facts!
VA is overwhelmed!
Veterans live far away.
Veterans have to wait months for treatment.
Most Veterans do not have battle related issues.
Rural hospitals are closing leaving people stranded!
WAKE UP!
2
@HoldYourBreath
So why not address these problems---solve them? Why starve the VA system?
Hire enough doctors and staff to meet the expanding needs of veterans.
The administration is starving the system in order to privatize it, and that is bad news for veterans.
2
@kraig peck
There have been 2 significant Acts passed, one included $16 billion for improvements. The VA did not meet a significant goal: 2/3 of specialty care sites were not meeting the 30-day requirement for care, according to NPR.
No one is starving the VA. It's time to acknowledge that the the problem isn't the GOP, the Kochs, etc., but the VA itself.
2
@HoldYourBreath I thought there ALREADY WAS the option for veterans to get care closer to home through non-VA providers. For all the reasons you mentioned. It's obvious you're NOT a veteran.
1
The VA facility pictured at the start of the essay looks like the interior of a gothic cathedral. Is this the new Denver VA hospital that took years and billions in cost overruns to finish?
1
Are the Koch's the members of Mar-A-Lago who came
up with this privatization of the VA plan while hanging
out waiting for comrade trump to arrive for some golf?
2
Another great idea. I think not. Just more greed at work screwing the little guy again.
6
It will mean more money for the for profits, nothing more. I wish the times wouldn’t buy into the privatization hype.
3
Oh, so veterans should get the same substandard, expensive care as the rest of Americans? And hospitals can rip them off too?
Who profits? so obvious.
4
@michael You are very naive to think that the government owned and run hospitals aren't influenced by the same forces as private run hospitals. The employees and administrators of the government facilities protect their source of patients and their collection of dollars just like private institutions with the added negative of believing they have not fear of being fired or replaced with a better performing group or system.
1
I could have, probably should have, had a medical deferment, but volunteered for two tours in Vietnam. There, I had an epiphany that my real enemy was not the Viet Cong, who were resisting our foreign invasion of their country, but the military industrial complex Ike had warned us about.
The Kochs and their ilk, including the Bonespur Brigade, are enemies of the American people. This disgusting, brazen (is brazen even relevant anymore?) maneuver to get a cut everytime a vet is treated, is an attack on the entire country through the VA portal.
9
The best and really only good thing about living in my husbands home state of West Virginia besides the picture postcard landscape is the Clarksburg VA hospital. As you pull up into the parking lot you find Valet parking which includes valets who bring you a wheel chair if needed. You go inside and first thing you notice is the baseball caps worn by proud Veterans who want you to remember that they served and when and where. Local medical coverage in WV is sketchy at best. Allot of my medical coverage takes place on line as I communicate with my doctor via the web. That is not available with local doctors. So the GOP is out to put a price tag on VA medical benefits so their donors can make money??? If you want to thank me for my service leave my VA hospital benefit alone!!!
7
Yet another way to steal public money.
Republicans never stop with that tired, sad act, do they?
6
Why not bring veterans into the medicare system?
2
@Al
The VA is much more than just physical hospital care. It's a community devoted to the special needs of vets. It's personalized care vs. impersonal care.
1
Let’s be clear. It’s not “the VA” that wants to gut its services by sending billions to the private sector, it’s the Koch brothers and other right wingers who can’t stand having a single payer healthcare system that works.
8
Bannon may be gone, but the insidious “deconstruction of the administrative state” continues apace under our corrupt president, with the apparent blessing of the GOP.
4
Great idea, throw billions of additional taxpayer money to the most inefficient healthcare system in the world. Shorter waits? A meaningless sound bite inserted by the lobbysts. Privatizing just brings an additional hugely expensive middleman.
5
Very understandable. Just think of all that lovely money sat around helping veterans when it could be in shareholders pockets! Those poor, poor shareholders.
6
The VA is where people with no health insurance should go. And Federal employees and Congress. And vets should be allowed to go anywhere they wish. This way, no subsidies are needed and those without insurance will be given the best care the US has available. After all, the VA was invented by Congress. It’s a shining example of government health care!
3
@Hoobert Herver What you are missing is that appropriate funding by Congress is an oxymoron. Do you really expect 535 horsetrading lawyers to appropriately fund and resource anything? Its not about government health care inasmuch as clinging to an 18th Century government architecture that no efficient organization would use as a way of conducting its business. Love your $30,000 prescriptions.
1
The whole issue displays the gross misunderstanding of the purpose of the VA health care system.
First and I can not stress this enough, there are two types of veterans: those with service connected injuries and those without service connected injuries. Why is this important?
Congress in its mad rush for votes has turned the VA into a medicare for all system. It was primarily for service connected veterans. The system was never meant to provide health care for ALL veterans.
Now Congress has put those of us with service connected injuries into the same queue as veterans who simply need health care.
This is a one way street to a disaster. Why? There are nearly 20 million veterans but the VA only serves 7 million by turning it into medicare for all it will destroy the current funding of the system because current studies show that private care is anywhere two to three times more expensive than VA care.
What is the solution? Turn back the clock. Make the VA only for service connected veterans. I hate to shock people but just because we served in the military it does not give us health care for life.
If the VA insists on this suicide run, then make sure all "pay go" requirements are removed. This means when we run out of budget, which we will, we are not asked to offset with cuts as currently happens.
There is also another solution. For veterans over 65, let us use our medicare--regardless of service connection--with VA secondary.
7
@william church Privatizing would be great in my book. Government run healthcare has the efficiency of the Post Office with the compassion of the IRS. That and many union government employees have bad attitudes and believe they are untouchable. The government won't be paying full price just as insurance companies don't pay full price. It's negotiated. And with the large pool of veterans they'll get an even bigger discount I've been in the system since 1980 and have worked in insurance healthcare for 20+ years. And don't believe the lies about non VA doctors not knowing how to care for military. Doctors are trained and educated the same. Most VA doctors were doctors in civilian live at one time. Many other VA doctors can work anywhere else because of their advanced age or other disqualifications. Something else the GOV doesn't disclose.
@william church Although I haven't studied how VA gives veterans health care, I suspect you are right. Indeed, why should veterans without service connected illness be entitled to lifetime health care?
@Josh Ya First you missed oned of the biggest points. And lets stick to documented facts if possilbe. A recent report of the Community Care VA program (private care) shows the cost was two or three times higher.
The point you fail to underestand is the pay go concept. Please study that. If we use our budget at a faster rate then we run out of budget. Congress in the past has demanded we cut another program to pay for this. They do not just give us more money. Do you get that?
As doctors, you obviously are not a vet. The VA pioneers care with brain damage, artificial limbs and and many of these are not seen in civilian care.
Bluntly I would love private care if Congress suspends the pay go rules.
Even though I'm open minded to this idea as long as costs don't exceed current costs, I'm pretty sure they've figured out how to commit fraud on the taxpayers very easily or the ability to do so will be written into the regulations. Look at medicare fraud.
Anyone laboring under the delusion that America's private health care providers will be able to offer quicker, better medical care to our Veterans, has probably not called to schedule a non-VA new patient primary care appointment within the past 20 years or so. The magical belief that there is a functional, non-VA American health care system that is ready and able to absorb the care of our Veterans would be laughable, except for the sobering truth that Veteran's health and safety are at stake. Not to mention that this scheme will reduce overall access to health care for non-Veterans, as the non-VA health care system struggles to absorb an influx of Veterans, who will no longer even have the option of choosing VA medical care. America's health care system is already completely overwhelmed, this is why we rank so low compared to other countries, and one of the reasons why our life expectancy is declining...Please don't be fooled by pie-in-the-sky promises: this will be a catastrophic (and completely unnecessary) step backwards.
12
Where I live non-critical appointments can take anywhere from 1 week to months to get. We have few specialists and they are hard to get into see. Also, if you are a Medicare patient many providers will hand you your records as soon as you qualify. Many providers won't even see you if you have Medicare. ( I know this sounds goofy but it is true. I needed gynecological surgery and was turned away by every gynecologist in Anchorage. I was finally able to get in with a surgical oncologist after much searching and waiting. I did not have cancer but I believe she took pity on me.) This is the way it is if you live in the last frontier and are a retiree.
If the many veterans here are added to the system it could collapse. Then no one gets help. I know many people up here who work for or are patents of the VA. Yes, there can be delays but at least they can't be turned away.
Our health care system needs massive reorganizing for everyone. This idea only seems to benefit Trump's cronies not veterans or the American public at large.
u
1
As the widow of a disabled veteran, I have seen VA health care in action for more than 30 years. Throughout that time, he received excellent care.
Toward the end of his life, he was diagnosed with stage four lung cancer due to Agent Orange exposure. Thanks to his team, he enjoyed an unexpected three years with friends and family. The VA provided cutting edge immunotherapies and, in the end, access to top-flight hospice care. Equally important to him, his illness did not leave his survivors staggering under a pile of medical bills.
There are areas of the country where veterans struggle with access to health care services, but they are areas where all of the residents have poor health care options. The solution is not to starve one of the few working health care systems in the country but provide better care for everyone in these underserved areas.
As for Concerned Veterans for America, call them what they are: a Koch-funded operation, wrapped up in patriotic cover to rip-off of the American people.
Samuel Johnson got it right when he said patriotism is the last refuge of a scoundrel.
14
@varine...As The Times jurinalist noted, Concerned Veterans for America is an advocacy group. It is NOT a Congressionally chartered veterans group like the VFW, the American Legion, Disabled Veterans of America and so on. In short, it is a bogus social media scam that advocates for the Koch Brothers. It is scandalous that The New York Times insists on legitimizing it by referencing it sometimes to the exclusion of legitimate veterans' organizations. Note how the Times buried the VFW in this article. Did I mention scandalous?
3
@varine Maybe the physicians and their facilities don't want to live in many rural areas? Can't say that I blame them. However, our system should provide access. Similarly in the last election it was revealed many counties in GA did not have physicians nor pediatricians. Something is wrong here.
2
We'll see about that - I don't exactly trust "sub-contracting" government agencies. Low bidders are low bidders for a reason.
5
As always, follow the money. Nothing more, nothing less.
It COULD this and it COULD that....but it won't. We've all seen this never ending movie.
6
I'm not a veteran but have gone to see those that were admitted to the VA hospital, Most tell me they are pleased. the people I run into at the VA are very polite and helpful. I don't have an opinion if this is good or bad, My question would be is the private provider a not for profit provider or a for profit provider. I think this info needs to be told to to Vets.
2
Doctors and medical residents should be offered zero-interest loans for their med-school bills if they spend two years in the VA.
3
@JAM consider a similar approach of the US Public Health Service. Commit to working for us on graduation from med school, for every year of med school, you work for us for two, as a commissioned captain, and at captain’s pay. Would alleviate the VAs critical current shortage of PCPs, which in too many cases are too often being filled by lesser qualified PAs and NPs.
Impossible to imagine that this improves our Vet's care. And what of the cost? That would be the thing to compare here. What's it cost a Vet today with the current system, and what would the cost be under this new proposed system? I'd bet the moon that it costs the Vets more, the taxpayers more... The layers of corruption attached to this Trump administration just makes it impossible to trust anything they do.
2
BIG question: Who, in Trump's corrupt realm, stands to profit from privatization of VA funds and services?
As has so often happened in the past, one or more of Trump's Cabal of "insiders" has been intimately involved in shady Federal dealings that would reap huge profits for him/her. Mnuchin stands to gain from financial privatization, Ross from manufacturing and trade inside knowledge, etc., etc. Who is watching these corrupt Trumplicans? Who is watching the corrupt "Republican" legislators who blindly support The Dotard, and who will check them as they profit illegally?
6
If they try to privatize the VA, I will help lead the Resistance.
3
Most physicians in the United States spent some part of their training in VA rotations. And most would argue that VAs are the bloated, inefficient, poorly run institutions that only veterans (and unfortunately also their waiting family members) could tolerate. VAs take the military adage "standby to standby" to another level in all functional aspects. Cost overruns, poor care, ridiculous service (we were always done with appointments by noon) are par for the course. I would shutter the entire VA system tomorrow if I could.
3
Up front, not a veteran.
I spent about a year doing a chaplaincy internship in the Denver VA hospital, about 1999. If I ever heard a complaint about the care, it wasn't anything you wouldn't hear in any medical setting.
Twice a year a memorial service was held for the families of the deceased. Literally, every single family member who spoke praised the hospital staff.
Maybe things have changed, I don't know.
As to the backing of the privatization plans by the Koch brothers, that's good enough reason to run the other way. Or, howz this? The VA surely knows it's cost for every procedure. Let selected clinics or private hospitals provide the same service for the same price. I'm sure the silence will be overwhelming. To say nothing of the VA negotiated drug prices!
Wars, past, present, and planning for future ones consumes about 65% of the discretionary federal budget. And we are supposed to add $100B...B...Billion to that?
3
It means we will get less care and more bills. Not surprised that the corrupt Trump administration going to pick apart our VA care and toss us to "private care", which means we will have to incur more costs and get denied coverage more--while money goes to the Koch Brothers--who like Trump have an aversion to the military overall, so figures they would be the ones profiting from us while decimating us--talk about an "enemy."
4
America, when it comes to the rest of the world, especially when it has to do with healthcare, you are moving further and further into the wilderness and you wonder why Ocasio-Cortez and other progressives(and their policies) are gaining the publicity and popularity they have in such a short time?
2
If we start from the days of Ronald Reagan, it has always been the agenda of Republicans to "starve the beast", keep cutting funding to various departments and then when people start complaining about the quality of various government services, they will point out the obvious that "government is not working" so it would be better to privatize it". Of course, Republicans were the ones that created the problems in the first place!
What amazes me even more so, is by continuing to vote Republican, how so many Americans bought in to this decades old scam.
4
When I lost my job and health benefits in 2015, I found out about ChampVA for families of 100 percent disabled veterans, and enrolled. I have another job and health insurance, but I still use the VA hospital in Albany NY and the Outpatient VA Clinic in Catskill, NY because the care is actually better than I was receiving by my former doctors. They were obviously squeezed by managed care. Using these facilities is quite a drive for me, especially from there to my job, but so far worth the price of the gas. My husband, a major skeptic of the VA system, quickly switched to VA doctors as well. Everything is paid for him, including dental work, because he is an Agent Orange victim and contracted a chronic and fatal illness. My take on the system is that more outpatient clinics are needed, and they need to be better staffed, so that people would not have to use the VA hospitals and drive longer trips. However, there are vans from VA service centers for patients, which my husband uses whenever he can, and trip reimbursements if he has to drive. My husband used Veterans Preference once and was disappointed in the physician. He gets much better care from the VA hospital in Albany, even for non-service related issues. The hospital is slowly being updated in some of its wings, and just updated the elevators. Using its services can sometimes be a pain, but it is no different than the pain of seeing a private practice doctor. I, too, am suspicious of privatization initiatives.
83
@K.R. Cook The two companies running the community care, switch over to private care, should be investigated, I suspect billions are being stolen!
4
My senators, Johnny Isakson, has long been an advicate for imptovements to the VA system, so this is clearly not a problem that arise during the Trump administration.
What I don't understand and is not explained, is why the existing VA system can't be made to perform at a level that is responsive and reliable for the patients.
Is there some anticipation that the current issues are statistically a bump and the need will decrease over a certain period? Or is this an ongoing situation that nobody can figure out how to address properly and if so is this plan going to have the desired effect.
If someone potentially earns a little more profit from treating vets, should that preclude their use if the benefit to the vets is demonstrated as greater that in a VA facility?
Too many questions.
1
Healthcare is complex, and different patient populations have distinct needs. A doctor who has never served in the military, much less seen war, spends 10 minutes assessing a patient, asking questions without looking up from his computer screen as he types the patient's responses. He skimps on patient history, or like my provider, skips it entirely. How can he read body language if he doesn't make eye contact? How can he understand the mental health challenges of surviving conflict that took the lives of your comrades if he never experienced anything similar? I don't see how this can improve veterans' health.
7
@Mary M You are referring to two separate problems. When I worked in the VA system in late 1990's early 2000s, the VA was already computerized. No dictations, you had to type own notes, whether you could type or not. I left after begging for help for more staff for over a year, and had been there for several years, long enough that there was a 6 mth wait for follow up appts (foregoing any time off) and still seeing new people daily. Then was told administration agreed we needed more help, but Congress would not approve budget. VA paid by executive order monthly as no budget approval/appropriation for current year. And no one would drive on ongoing basis to rural clinic we were at for staff due to distance, serving mental health needs of 5 counties of vets with one doc, one nurse and one social worker therapist. This was before telemed. Requirements for documentation were limited, but flexible. Fast forward 20 years, now CMS is in charge of what must be documented, draconian in nature,required EHR, must see as many pts as possible as CMS pay rates are so low to keep doors open per admin, so shorter and shorter times with patients and patients and docs both miserable. Patients and docs are not in control of process anymore....
1
Medicare for all would solve this problem and provide veterans with choice about where to receive health services. Most likely veterans would choose the VA for primary care services and services where the VA provides specific post-combat care such as mental health. For complex, sub-specialty veterans could could (and likely would) elect for services from medical centers with greater expertise. This would allow them access and flexibility for conditions such as cancer or transplant that are not related to military service.
6
As a former physician, one aspect here is the payment rates likely to be offered by the VA. Several years ago, I was approached by the VA to care for VA patients locally. Unfortunately, the payment rate offered was LESS than usual and customary Medicare rates, making the compensation likely not worth the hassle of dealing with another arm of the government and numerous, needless forms and documentation. I declined.
8
I know someone that works as a nurse in the private system, which is mostly managed care.
She recently did an internship at a VA provider while working on her nurse practitioner degree.
She was amazed at the professionalism and superior care given at the VA over private providers.
Vets, don't believe the hype. Privatization is a way to take your healthcare and turn it into private profits for shareholders.
22
@McGloin We know, but people think of the VA in a stereotypical manner. But, who is our advocate? Nobody. The only advocate is for the Koch Brothers, so how do we fight that?
2
This could be part of a larger effort to privatize much of the federal government . This article from February 13,2017 in The Nation spelled out the concern. It calls it the Overthrow Project.
"In addition, the Overthrow Project aims to privatize as many governmental activities as possible. Left for government is the maintenance of the remaining public infrastructure that enables private enterprise to operate efficiently and safely, as well as the assurance of public safety through ever-higher funding of the military, the homeland-security apparatus, the police, and other forces of so called law and order."
Whatever the stated goal of the Shut Down is, one side effect is certainly to weaken/cripple Federal agencies, at least temporarily. Perhaps some people connected to the current administration see this as a desirable effect.
25
@A reader,
This isn't anything new.
Have a look at the privatization of America's prison systems sometime.
Mandatory minimum sentencing makes a lot more sense when a private business enterprise is full to capacity with non violent offenders are doing long stretches.
2
I am a physician who has like many, spent some training time at the VA. I also consider myself progressive and am hardly a fan of the president or the Kochs.
That said, I have always been struck by the existence of a parallel system of care that seems inefficient, wildly expensive and in the end, not a good model for most Veterans.
The typical VA patient is not there due to conditions flowing from their service. They are ill individuals. Some with acute issues and some with chronic conditions. The private sector is perfectly capable of caring for such individuals with competence and closer to home. A fee schedule like Medicare can easily be applied. I don't know what the current fee arrangements are for private care paid by the VA.
The VA can and should consider several regional centers of excellence for treatment and research relating to combat PTSD, TBI (traumatic brain injury) and limb loss. But the vast majority of conditions are equivalent to those experienced by non-Veterans.
Comments extolling the benefits of their VA care are sincere and personally well-informed. But we have read much about the problems of the VA. Likewise the private sector is far from perfect but on balance does a fine job and can do a better job for Veterans than many currently receive, likely at a reduced cost due to the billions it costs to maintain the VHA. Those skilled professionals in VA facilities that reduce or close will be more than welcome elsewhere.
7
@Seeking Truth
100% TRUE. There should be small, focused regional system that focuses on military-related issues. Many countries with single-payer systems have this type of setup for chronic care patients with spinal cord injuries, kidney failure, etc. There is no need for full scope VA hospitals spread nationwide.
6
@Seeking Truth
The VA is the second largest Federal bureaucracy, with some 350,000 employees. As with any large organization, public or private, you’ll find superstars, and candidates for the many “man bites dog” stories in the press.
As a 100% disabled vet, I’ve experienced this spectrum from excellence to incompetence in the VA.
Unfortunately, unlike the private sector, if the VA provider is under qualified, we VA clients are not allowed outside the system.
But let’s not throw out the baby with the bath water:
1) beef up the primary care physician staff. 1400 patients per PCP is an exercise in futility, when my recently retired PCP started with the VA with a load of 650.
2) eliminate the mediocrity, as the press has accurately reported in their recent man bites dog stories.
(Thanks, Dr. Shulkin for efforts on these)
3) maintain and build on unique specialties expertise in which are essentially nonexistent in the private sector — prosthetics, PTSD psychiatric counseling, and addiction services.
4) for specialty requirements where the VA has no qualified capability, or no nearby capability at all, allow us to seek services in the private sector.
(Keep on truckin’, Koch brothers, on this item.)
Both these instances required the vet to research his alternatives in what I term that triple oxymoron, the American “health care system”. But aggressively pursuing rational reforms, without the histrionics, require our best.
Looks like Trump's three cronies at Mar-a-Lago are looking to privatize the VA health care system. If this project takes off, it will probably lead to raids on the US Treasury by private medical corporations, much in the same way that for-profit colleges functioned until most were proven to be scams. The tip-off: this scheme is the brainchild of the Koch brothers, who, ii should be said, do not have the public good first in their hearts. The worst thing: the current VA system, while it needs improvements, basically works pretty well, and doesn't need the private sector coming in to give vets short shrift in service of the bottom line. I would be interested in what other veterans who use the VA health care system (I don't) think of this proposal.
16
@James I am an RN and a veteran, and I HATE this idea.
20 odd years ago, I broke every bone in my left foot and ankle. I was no longer in the service, had excellent insurance and used the private sector for my care. I was in pain, often debilitating, every day thereafter. Physical therapists told me I'd just have to live with it, as there was nothing else to be done; it was depressing and disheartening.
Eventually, it sent me to a shrink who recommended that I try the physical therapy department at the VA. Yeah, I had to wait a few weeks to be seen, but as someone who'd been living with the problem for 20 years, I was the definition of 'non emergent'. I went for hourly appointments three times a week for about six weeks, then twice a week, then once a week. I also attended a yoga class aimed at older vets like myself at the same time. The results were dramatic: most days I walk without a limp and am never in debilitating pain. The VA outperformed the private sector by light years.
The VA saved my sanity, and I now go there for all of my care, since I can always be seen quickly by my primary care doctor - who I trust completely. I now have social ties to a large group of people of all ages who understand one another in ways which those who haven't served cannot. Real veterans, unlike those paid by the Koch brothers to pretend they are vets, know that the private sector can never provide these ties.
10
I’m not a veteran, but if you think you’ll be seen faster on the open market, that hasn’t been my experience.
Why do you think the big chain pharmacies are opening medical clinics staffed with nurse practitioners? And, incidentally, charging the same co-pay as a traditional doctor’s office visit.
Good luck to us all. We’re going to need it.
24
The article seems to date the Republicans' push for privatizing the VA to 2014, but their efforts go back much farther – probably decades.
The Reagan Administration triggered massive, and successful, efforts to outsource government functions. The VA is only one example.
Today, many governmental functions are contracted out, and/or are performed by on-site private contractors. Talk of a "blended workforce" (part civil servant, part contract) has become commonplace, as though it were the normal state of affairs.
"Service" contractors have their own lobbying group, the Professional Services Council, whose leaders pass through a revolving door to head up a key federal personnel organization.
To paraphrase Calvin Coolidge: The business of government is, increasingly, business.
9
This wouldn't be an issue if we had a real national heath care plan. Fracturing the system into smaller parts is not the answer consolidation of all the moving pieces would save time and money in the long run.
14
Mike, I have no idea if you are a veteran or not. The VA exists because many of us have service connected injuries that require special care. We go to the VA because our health regime is abnormal. Let me give you an example please. I have Agent Orange cancer issues that require hyper screening that a civilian hospital would not recommend.
I have specific injuries from toxic exposure to jet fuels that a normal health care system does not see. I have malaria exposure that a hospital in the USA has never seen.
The reall problem is that the VA has been turned into medicare for all.
We need to turn back the clock and let the VA be only for service connected veterans to receive specialized treatment.
3
Republicans have wanted to privatize the VA for years.
8
If the Koch brothers are behind this, it's very, very bad. They do not care a whit about veterans. The only thing these two old billionaire buzzards care about is money. They hate, loath and despise government in all its forms, and paying taxes. This would be nothing more than a scheme for them to repatriate the tax dollars from themselves and others in the billionaire buzzard club back into their pockets.
A must, must read:
https://www.ineteconomics.org/perspectives/blog/meet-the-economist-behind-the-one-percents-stealth-takeover-of-america
Hat tip for the link from another commenter (thank you!), and posted by Socrates as well.
Our democracy and way of life is about to become road kill if we don't stop them now.
22
I sustained a sniper ak47 round in Vietnam partially severing my sciatic nerve!
Shut down the VA is fine by me. I am unable to communicate with the local VA Clinic! Their attitude is authoritarian and not open to change. I have requested changing my VA clinic doctor but have been refused! I no longer go to the VA. It’s a shame and outrageous!
12
@Rodney Simon Right on Brother!!!!!I know where you're coming from!
2
@Rodney Simon:Yours is the general VA story. To be fair, my VA does a bit of good but you had better know how to get it. Where do all these peoplen gert thgeir great views of the VA from? Almost all of the VA cheer leaders are 3rd party.
2
@Rodney Simon
It is a shame and outrageous! Good luck to you.
2
It's very clear. The goal is to starve the VA of funds and place veterans where GOP special interest predators can leech onto them.
22
@Bill Adkins: Right! The private vuktures are better @ leeching.
1
When you say Koch, you've said it all.
How much more shameless can you get than to loot the very people who put their lives on the line to defend us?!
13
“People will naturally gravitate toward the better deal, that’s economics”
That’s not economics, that’s highly reductive and specious reasoning.
The VA needs to be overhauled, not unlike much of our national infrastructure. Privatizing the healthcare of veterans is a disgustingly greedy betrayal.
15
This is just another right-wing effort to take the VA away from us.
Is it being done by those who never served??
10
@George Kamburoff If the traitor's name has anything to do with it, then YES!
1
"Under proposed guidelines, it would be easier for veterans to receive care in privately run hospitals and have the government pay for it. Veterans would also be allowed access to a system of proposed walk-in clinics, which would serve as a bridge between V.A. emergency rooms and private providers, and would require co-pays for treatment."
Hmm... that doesn't sound so bad. Oh but wait, but the devil, as always, is hiding in the details.
In the present situation, who do we have to fix veterans' health care? The chief executive in this case is a pathetic, incompetent, incurious, uninformed, simple-minded, boorish buffoon whose only agenda is himself. And what subordinates did he pick for making veterans' healthcare great again? As @Socrates said:
"...Meanwhile, the Mar-a-Lago Trump troika -- Bruce Moskowitz, a Palm Beach doctor who helps wealthy people obtain high-service “concierge” medical care, Ike Perlmutter, the reclusive chairman of Marvel Entertainment, and a lawyer named Marc Sherman -- has been running VA policy from Palm Beach for the last two Trump years..."
FDR 1936 quoting the GOP party line about social programs: "Just turn them over to us. We will do all of them—we will do more of them, we will do them better; and, most important of all, the doing of them will not cost anybody anything..."
and went on to say:
"...The Republican leadership today is not against the way we have done the job. The Republican leadership is against the job’s being done."
11
What people need to remember is that once you move into the private sector then profit comes into play. While I understand that efficiency is important to keep costs down, I also know that we will now have one more thing to factor in and that is profit. Private industry is not a charity; it exists solely to make a profit. What must we give up in order to ensure that profit? My guess... the well being of the patient.
13
This is a transparent attempt to privatize, to financially profit from providing medical assistance to America's military vets. It is an affront to the VA and to the veterans.
Vets who need care and who live in areas where access to a VA clinic or hospital is impractical due to distance or the disability itself already have access to non-VA care for which the VA pays.
https://www.va.gov/COMMUNITYCARE/programs/veterans/index.asp
The Koch brothers do not have the interests of veterans at heart but do covet the money they can realize with this blatant attempt to privatize veterans' medical care.
8
This is a scam, pure and simple. It perpetuates the myth that private entities can deliver healthcare services better and more cheaply than government entities. The overwhelming evidence is that's simply not true.
How about we finally as a country decide that ALL of our citizens have a right to healthcare and transition to a single-payer system like the rest of the civilized world?
11
Let them go to the VA. You, too!
My VA is working far better than private health care did.
7
Right, because it worked so well with pensions, public schools, utilities, etc.
4
$100 billion in projected costs means someone stands to make $100 billion. The private sector cannot absorb these numbers. This is just a back-door to bleeding the VA and ultimately closing facilities. Veterans are a pawn and that's a shame.
13
Privatization involves the displacement of one set of managers entrusted by the shareholders—the citizens—with another set of managers, those tasked with maximizing profits, who answer to a very different set of shareholders.
Privatization of the V.A. will be effective only if private managers have incentives to act in the PUBLIC INTEREST which includes, but is not limited to, efficiency.
In the last 30 years or so the private business sector has shown that their ONLY interest is profits, with little regard for the welfare of it's employees and/or the general public (wages, pharmaceuticals, insurance, banking, consumer protection, environment, profiteering, political & business corruption, etc. etc.........this list is endless)
Based on the recent historical evidence, the motive to privatize the V.A. is individual profit, and has little or nothing to do with with providing better care.
This MUST be stopped!
12
The title of this article should be “Republicans accomplish starving The VA enough that they can now make the case to open taxpayer coffers to their buddies in private healthcare.” Once the American people started opening their tax dollars for private pillaging, they will never be able to change that. Don’t let it happen. That DOD budget is the biggest in the world. We are one of the wealthiest nations in the world. If we can’t take care of our vets the right way (which isn’t through private means!) then we deserve the kind of dumpster fire government Trump is.
8
This is probably another idea of Jared Kushner. Where is he funneling the money to this time?
7
Are you happy with how your private health insurer covered when you most needed it? If you weren't, then veterans probably won't be happy either.
3
For years the news media published lurid tales of the failure of va hospitals. Now they’re great and beloved by vets (though now at risk according to the reporting). When did this all change exactly?
2
@Andy Deckman
The VA functioned well until the increased caseloads could not be met by sufficient funding and medical personnel.
The House controlled that funding. And we know who controlled the House.
5
@Jerry Engelbach
You mean increased caseloads that still average 1/3 to 1/2 of the normal private practice office! Every medical student and resident knows VA appointments often end at midday, that is why VAs are great rotations!
1
I'm not yet seeing any reference to the fact that VA policy is now being determined not by Mr Wilkie but by three cronies of Trump's, whose only qualification for administrative involvement is that they are members of the Mar-a-Lago Rich People's Club. Reportedly, the head of the VA administration takes his marching orders from this triumvirate, actually travels to Florida to meet with them to find out what they want. As one of this troika is a physician, it's far from unlikely that a subtext of this reorganization is a scheme to get more money in non-VA doctors' pockets.
9
The problems (scandals) in the VA health care system have been well documented. Significant measures have already been taken to address them; yet problems remain.
Obama's Veterans Access, Choice and Accountability Act of 2014 (Choice Act) provided over $16 billion to improve health care delivery. In 2017, the "Department of Veterans Affairs Accountability and Whistleblower Protection Act" was passed making it possible to fire poorly performing VA employees.
How much more can realistically be done and how much more money should be spent to address problems in an Agency that cannot manage to consistently provide quality care? It's time to allow veterans to access quality care where it is most accessible.
1
The VA Is where people with no health insurance should go. For free. End subsidies to insurance companies.
The critics are wrong.
There is room for both private and VA hospital care for veterans and over time every veteran will figure out what works best for him or her. Let's give them credit for at least that much intelligence in addition to their patriotism and willingness to fight for the nation.
It's natural for VA administrators to fear the private sector since they know how relatively efficient they are. But yet, it's obvious they would want to grow their empires and maintain their bloated bureaucracies and inefficient systems. If they can compete with the 'real' world, they deserve to survive and prosper, if not let them do what they do best and let for-profit institutions fill in the gaps. Those gaps have been growing for years and there's been tremendous growth in managed care and private clinics with resultant increases in efficiency. Let the best systems be in place and let our veterans have options and be the winners. After all, they are the ones needing care and they should be the ones deciding what they want, not some bureaucrats in Washington. If the
Vivan I would support your views if you can convince Congress not to enforce "pay-go" rules on the VA budget. Today, when we go over the budget at the VA we must cut another program. Many times Congress has used this to cut disability payments or other care. Privitatization has proved to cost two to three times the cost of VA internal services.
Not to remove "pay go" policy will cause a disaster at the VA and accomplish the GOP goal of cutting the VA budget in terms of real benefits.
2
@Vivian
Private health care is run for profit, not for the best interests of the patients.
I use the Choice program and go to private hospitals as do many of my peers. I had a prescription sent to the VA from my renal specialist and they refused to fill it. As a result, I was taken to the hospital the next day just before Christmas. When I was discharged Christmas Eve, I had them send the prescription to a Walmart pharmacy and paid cash for it. $25.00. So, instead of paying $25, the VA will be billed for an ambulance and 3 days of emergency care in the hospital. The VA thinks its job is to regulate instead of giving medical care. This was the 4th time they almost killed me last year.
2
@websmith
State and federal medical practice and pharmacy laws, not the VA caused your problem.
Has anyone considered what this would mean for Graduate Medical Education? If the VA system collapses becasue of this, then it will have a wide-ranging impact on medical training in the US overall, not just for the VA.
3
Forgive my cynicism, but this sounds no different than the "school choice" campaign, with the same ulterior motive: a public service isn't working; its intended recipients aren't getting the service they ought to; the private sector can provide this service better and more efficiently; spinning off part of this service by using some of this service's public funds to pay private providers will force the public sector to do better to compete for customers -- when the actual plan is, defund a public service (there, public schools; here, the VA), watch the public service falter, and then argue for privatizing the lot.
The GOP dogma that the private sector can always provide service better and more efficiently is just that: a dogma. It's an unsupported article of faith, insincerely held, the real purpose of which is to serve as justification for transferring taxpayer funds into the hands of the GOP's wealthy donors, reward the rich and punish the sick, the poor, and the disadvantaged (who don't deserve the benefit in question anyway).
8
It seems that the VA system has never recovered from the scandal of denial and delay of 2013/14. The Veteran Choice program initiated under the Obama administration never helped alleviate delays and/or just wasted the funds. The VA system is a highly hierarchical top down system where chain of command is the only rule that counts. The rule makers are incompetent. This essay should only reinforce the fact that our entire healthcare system is totally broken.
3
This is so simple, and yet people are always fooled. Private health care, like any private sector system, requires generating a profit and therefore will always cost more. That cost is always passed on to the "consumer", that is, the taxpayer. It would cost far less in additional taxes to adequately fund and staff the VA so it could provide the quality care our veterans have earned. Yet, the flag wavers in the GOP would rather support their wealthy donors. It really is that simple.
10
The same thing is happening with Medicaid and Medicare. All for improved profit margins of the private healthcare insurance companies on the backs of taxpayers. Part of the GOP assault on public programs. To add the word choice to this process is laughable at best.
2
As a Vietnam Veteran with 100% disability, this proposal to shift my medical services to the private sector is both alarming and quite disturbing. Having experienced both systems, I can state categorically the VA healthcare system far exceeds that of the private sector. The reasons far exceed the space allowed for an appropriate and detailed reponse. Trump, a draft-dodger ,avoided the honor of serving his country, while many of us fought and over 58,000 died, now wants to destroy the very institution that is really focused on our well-being. If Americans really care about we veterans, this is the time to show the “Thank you for your service” inernest. Don’t use my lifeline to the VA as a political football!
8
You can continue at the VA. They are giving you a choice.
There is only one principle that can be consistently attributed to the Republican party and it is the only one they have stuck to absolutely. It is this. If there is a cash flow anywhere then a slice of it must be diverted to an entity friendly to the party. Now it is the VA they are going after.
4
The phrase "have government pay for it" must be replaced with "have the taxpayer pay for it."
Financially, we ARE the government.
And this is a transparent ruse to divert huge amounts of taxpayer money through third parties who will profit wildly, while veteran's care continues to suffer.
Ask yourself a question: we have a grotesquely outsized military budget, but veterans cannot get adequate care. Why is that? Could it be that the military-industrial complex is mostly concerned with giant, ineffective weapons systems we don't need, while revolving door officials make off with the money?
Wake up, folks.
1
Having worked in several VA hospitals, it is clear that they need competition. A monopoly mentality permeates every aspect of their function. The original purpose was to care for veterans who could not be served in the private sector. That time has passed, but the VA has not acknowledged the change. When asked if I was just passing through or was going to be permanent I said that I was long term unless I got fired. She laughed, "Honey, they can't fire you at the VA."
2
@W. Ogilvie
So true! Many "tired" personnel in SW Connecticut end up working at the VA in West Haven because the pace is slow and the chance of layoffs is zero. If you can take the boredom, your check still clears the same.
If we want to see what will happen by diverting money from the VA system to private medical providers we have two salient examples, public education and health insurance. In the case of public education we have near daily stories of fraud, failure, re-segregation, and the failure to serve special student needs. In the case of health insurance, when you compare the cost increases of Medicare to private health insurance, there is no equality. Medicare cost have risen at a much slower rate, and would rise even slower if Congress would allow Medicare to negotiate prescription drug purchases. Big Pharma has been fighting this successfully for 50 years.
6
The Republican solution to “improve” government services is generally privatize and/or add consultants. The problems created include the fact that as services are diversified to multiple providers typically accountability declines. Whom do I register my complaint with if I feel the service was inadequate. Where does that oversight come into play. I have been fortunate that although a Vietnam Veteran my employer has always provided healthcare coverage. I have numerous friends and relatives that have routinely used the VA system and are generally satisfied. We all both those using the VA and a private system have a common complaint that is the wait time to get an appointment to see a doctor. Few If any complain about the quality of service. The distance to a service center may be a timing and geographic problem. If a problem exists and I am sure there are some, the fix or solution needs to address the actual problem not just offer some alleged corrective action. Draining money from the VA Administration to enable access to private providers may sound like a good solution. The questions are what problems are being addressed and ultimately who is receiving the higher benefit, the veterans or the private sector?
3
Any idle VA hospitals that result from this could be used for care of widows ages 55 and above who are too young to qualify for medicare and who fall through the gaps of health coverage. The service could be funded with a national sales tax.
My husband gets his health care through the VA; while I get mine through private insurance that is supposed to be excellent. He has shorter waits to see a doctor and better overall care.
I believe that this is another "privatization" boondoggle that will worsen the care of the vast majority of veterans.
23
As a physician who partly trained in the VA. I have first hand knowledge of the system, so my opinion is important.
The cost of war includes caring for the veterans who survive. There should be no whining about funding medical care for the veterans.
Some of the very best care for multiple trauma, PTSD, and other service related injuries is found at the VA, and should be continued and improved. Most of the veterans treated at the VA have problems indirectly connected with service, such as the long-term effects of smoking, drugs, and alcohol abuse. Since these have both psychiatric as well as medical causes, it is possible that the VA is a good place to treat these problems also.
Some medical/surgical problems are beyond the expertise and ability of the VA; veterans should be transferred to the best places to care for these problems, and they should be payed for with VA funds.
Service members families should be cared for because their pay is so low. It is an outrage that these families are on food stamps and other welfare. If you want to fight wars, you have to pay for them, and that includes the families.
27
VA healthcare is good. I strongly believe our service men and women should be allowed to seek either private or VA healthcare whenever needed. The private company I work for accepts medicaid, but not Tricare. Boggle$ my mind!
The problems at the VA are also an opportunity for those in office who favor some sort of single payer system.
To those like minded folk - FUND and FIX the VA until it is the envy of non-veterans. Prove that a Government run single payer system can deliver better care at a better price. And then with proof in hand, implement Single Payer for the rest of us. Try as they might - the GOP would have a hard time explaining why they do not support great health care for our Veterans. (Sure - they would try to sell the privatization as great health care - but adding profit skimming to the system isn't going to convince everyone.)
14
VA care in my community is great, from general health to ER to surgery to rehab to cancer care, vision care, mental health services, is excellent.
Anyone who wants to mess with privatizing veterans health services is either utterly unfamiliar with what is offered, simply delusional, or fabulously wealthy.
President BoneSpurs meets all 3 of those criteria. He and his henchmen couldn’t care less about veterans or their needs.
Their scheduling and admin systems need real improvement but the care, the actual care protocols and providers, are the best. In an environment that honors and respects vets.
4
@William Smith
That is not the point though.
The great leveler works in a way that after it passes society has a more balanced income and wealth distribution.
Best measure for it is the Gini coefficient (goes from 0 to 1 with one being the most unequal, that everything goes to one person versus zero where the distribution is perfectly equal for all get the same size of slice from the pie).
The Great Depression and the WWII lowered the Gini. The fact that the second helped get rid of the first is not of consequence here.
Sorry for sounding academic but it is the easiest way to explain.
Read Walter Schiedel’s book called The Great Leveler. You will like it.
1
Thanks, informative post. Trump supporter and Midwest conservative but will check out the book.
If you just change the words, the article sounds very much like the debate about charter schools and public school system. The latter reportedly is failing the students and therefore, charter school is the answer to give the students a choice. Even if there are good charter schools, the end result is that you are diverting funds from the public school system, thereby making the situation even worse. Diagnosing the problems within the public school system OR the VA system appears to be an impossible task which I don't understand. Or even if the problems are diagnosed, the solutions appear to be insurmountable. Private care is not the solution because private does not always equal better. In addition, the cost will bankrupt the VA system.
22
@Sadie
Best to remember that both changes were initiated because of poor performance. Just because some public schools are good doesn't mean everyone is benefiting in the same way. Ditto for VA health care.
also the private system does not have the capacity to absorb the new patients nor the needed specialized services. Private does not equal cheaper. Raise salaries to attract needed prifessionals.
As a vet? I had the option to use the local health care system when there was a delay in the VA. The wait time was even longer outside the VA. I am not sure where anyone considering the policy is getting the idea that the US health care system consists of a bunch of spare doctors sitting around doing nothing?
Put simply, my experience with the VA has been much better than it was with two decades of the US Military's health system ... and no one is considering turning that system over to the private sector.
Whatever is driving this, it has absolutely nothing to do with the needs or desires of our veterans.
26
As a spouse of a VA Healthcare recipient, I understand why *in theory* this might appear to make sense. In reality, however, with the increase in outpatient clinics - and the current ability to go to private providers if the local facility can't schedule you in a timely manner - this seems unnecessary.
Also, I fear funds given to this new initiative will take from current VA facilities and services that are working well.
Fix what is broke, in short. Don't do a 180 turn. Men and women that have given the most will be caught in the middle.
I won't even mention the veteran healthcare research & longterm studies that are conducted that can't feasibly be carried out in a private care environment.
12
@Eric G I agree this is a deal to feed the greed that is this administration, I have had some of the best care within the VA once you are within their system you have no problems getting appointments nor receiving treatment.
2
@Eric G
Wait time is shorter in the VA because that is where the "spare" doctors are sitting around. A VA physician is salaried, so in no rush to move to the next appointment or next surgery. In the VA, a cancelled surgery is one less that has to be done that day. Ever look into how limited some VA hospitals are in scope of care? The less care able to be delivered at a location, the less work every day going forward! It is like socialist Venezuela in slow motion!
How do you not mention that Concerned Veterans of America is a Koch front group?
30
@Bryan Ketter
I don't know if there was an update, but the article does say that the CVA is "an advocacy group funded by the network founded by the billionaire industrialists Charles G. and David H. Koch".
3
The devil is in the details. And with this administration there is no care for details. All I keep thinking is what’s in it for the Koch’s?
20
As a100% Service Connected Disabled Veteran who is very happy with the care from VA facilities, I feel we will now see the possible decline in care from the VA while the Trump Administration diverts dollars from the VA to their chosen supporters profits. If Congress really supports healthcare for veterans they must find a way to stop this stupid decision.
21
Is this the product of trump's cronies who run the VA from Mar a Lago?
12
Privatize the VA??
Consider—
1) Veterans are against it (the deserving people whose care will be impacted).
2) The Koch brothers are for it (the greedy people who will profit from it).
Whose side are you on?
41
More corporate welfare from the military industrial cesspool, is what this is-- and caring for vets has nothing to do with this kind of profiteering.
11
I am a veteran who has been calling on VA Hospitals for years. The VA Hospital in Minneapolis is IMHO providing care equivalent to the best hospitals in the USA - Mayo Clinic for example. Now compare that to the VA Hospital in Milwaukee. While waiting for an appointment - I finally quit calling on this hospital - they were a real PITA. I started talking to veteran of WWII - the 10th Mountain Division and a skier myself we had plenty to talk about. This veteran was being left in a hallway with his bedpan not having been cleaned in a long time.
VA Hospitals are the source of lots illegal drugs as the veterans being treated sell their meds to fund their illegal drugs. One of my neighbors in my small S IN town lots his legs and told me his experience with VA Hospitals was this - he would not let those VA Hospitals treat his pet dogs.
Now overlay these problems with our POTUS, I am not confident that we will see a resolution to this mess.
BTW I am 77 YO and just had a small endoscopy procedure which cost me a grand total of $75 - the cost without Medicare would have been over $9K. There are awful hospitals in the private sector also. Grady Hospital here in Atlanta is overwhelmed with all manner severe trauma patients. My neighbors lost their daughter because they could not afford the pain meds and she became hooked on Heroin which eventually killed her. Bayer aspirin owns the heroin trade mark.
2
I'll believe it when I see it
@Pajaritomt
Koch Brothers are in their last legs. They will die despite of all their money and rot like all other organic matter if not cremated before.
I will rejoice that day. Evil rotting away gives one hope even though it may be just be an ephemera.
I dream of a Rawlsian Society every night. One in which there are no Koch Brothers and Mercer Père at Filles.
Believe me. I cringe when I see the name of David Koch in front of the Metropolitan Museum or the Met at Lincoln Center. How hypocritical for them to rob the country out of decency and fund the arts. Disgusting!
7
@Blunt
Yes they do die and rot away as do we all, but their money will likely keep on supporting libertarian groups. That has been the situation with many wealthy families. Dark Money by Jane Mayer really lays it out. It i disturbing reading about how wealthy individuals have deliberately, often deceitfully but successfully worked to warp our governments to their own benefit.
This is so clearly a ‘privatization scam’ by the Disguised Global Capitalist Empire (and its UHNWIs, and their private corporations) to loot money from all of the universal programs that our pubic, democratic Republic and tax-based programs provide to ‘we the people’.
This scam was beta-tested with Medicare Rx (under naive dubya Bush), which lightly loots but heavily feeds money to big Pharma by blocking Medicare from any disciplining of drug prices with “an ingredient discovered in the jellyfish” Congress.
Next came the massive ‘front-loaded’ looting scheme of Medicare Advantage, which unlocks the pubic Medicare ‘non-locked-box’ by allowing the private medical insurance thieves to take money out at an accelerated “capitation rate” — which will leave the fund empty far earlier, and then throw half of ‘we the people’ back on regular Medicare (or the streets) when Medicare looting is finished and the private insurance companies refuse to cover the higher ‘end of life’ vast majority of all medical costs — just like the big banks refused to cover the costs of their own ‘negative externality costs’ in the 2008 crash.
“When you see the name Koch on the scheme, you know we’re going to get creamed”.
“But wait, there’s more, behind the ETF door”.
11
They are doing this exactly backward. The usual stupid privatization scheme, which will increase prices, never cap them, and pour taxpayer money into the pockets of rich corporations. When are Americans going to put a stop to this and start insisting that we fund our NON-PROFIT government institutions properly? Come on, people. We are being hoodwinked by Libertarians, who don't give a darn about you or your family - they just want to not pay taxes!
12
I extend my heartiest welcome to our dear Veterans into our wonderful fantastic world class private healthcare system. You know, Gummint care is lousy because there is no choice but here in our free market you will definitely attain nirvana. Please do come, step across the threshold, see Capitalism at work, see markets at work! Every time you are healed and return home, please do not forget to thank our modern founding fathers Charles and David Koch. If only all legislation in this country was written by ALEC which the Koch brothers have so kindly gifted to the undeserving people of America then we would have the magic of free markets and choice and heavenly joy coursing through every nook and cranny of this great nation. Welcome Veterans! God Bless America! Thank you for your service!
9
VA care in my community is great, from general health to ER to surgery to rehab to cancer care, vision care, mental health services, is excellent. My dad, brother, and husband are all vets who love the VA.
Anyone who wants to mess with privatizing veterans health services is either utterly unfamiliar with what is offered, simply delusional, or fabulously wealthy. Or wants to funnel billions of taxpayer dollars into corporate “heath care” industry pockets. And eliminate the care our service people deserve.
President BoneSpurs meets all 4 of the above criteria. He and his henchmen never served and couldn’t care less about veterans or their needs.
The VA scheduling and admin systems need real improvement but the care, the actual care protocols and providers, are the best. In an environment that honors and respects vets.
absolutely not! these men are part of trump's clan at Mara A Loco, yes, Loco.... they will do anything to get ahold of that money
9
Another conservative sick joke —- first the “private” education graft - stealing education funds —- now another “easy” victim — steal money from veterans...
Greed and political theft have no end or limit.
Can the Wall Tax on the homeless be coming soon?
12
Typical GOP attempt to redirect public money to private (grifters) sector. We owe these men our freedom and security. W and dick had no concern for them before stepping into a war with false intel and fever dreams of victory parades by a thankful people. Those dreams and this "privatization" were then and are now a con.
7
Warning! Stop Trump's Republicans from stealing and giving your money away to private enterprise!
12
As a retiree and a service-connected disabled veteran, I have experienced excellent VA care from a clinic that is only 18 miles away in Georgetown, Delaware. Within the last two years, this clinic was expanded to a new larger building with more doctors and assistants. The VA hospital in Wilmington is 107 miles from my home. VA already does have a policy of providing private care if the veteran lives more than 40 miles from a VA facility. It would be interesting to hear from veterans who have benefitted from this policy.
4
@LWK I hope it stays like that for you. My healthcare is better on the Choice program.
I am just assuming that anyone with bone spurs gets immediate 100% coverage?
6
@Christopher Hopefully, you will ge good care. The VA has stepped in the middle of this and is regulating it like they did the Choice program so, who knows?
Veterans do not want to be separated from the VA Health Care! They paid, dearly, already. Their care must be funded through support of the VA Health Care Administration.
5
@Jan The VA almost killed me 4 times just last year. I am alive because I have been able to seek private care through the Choice program.
1
You seriously need to change your headline. It should say "Trump moves forward with plans to PRIVATIZE veteran health care." This is not a redirection - this is another safety net being dropped into the pockets of the 1%. Period.
9
@Shainzona Several decades ago, the Feds created the REA, now the RUS, which resulted in the establishment of hundreds of private companies providing our unmatched telecom and power capabilities at great prices nationwide while adding value to our economy. Trump is a successful business man and hopefully this result in the same thing for healthcare.
@websmith
How much do you profit from the telecom and power industries benefiting from the trump policies? Your handle of "websmith" says it all.
Another terrible move along with the EPA, consumer protection, climate change, all our allies, the shutdown for God’s sake. All Trump administration moves get worse and worse faster daily. Can’t everyone Sedona like a runaway train?
2
@John Levy Everything is better for everyone. It will only get better as we eliminate illegal immigration. We will get a wall the easy way or the hard way. There is no reason not to have one.
That really worked for the prison system. Good luck with that.
7
@Thom You have a successful business man who knows what he's doing running things now for free. The better he makes things, the more money he will make.
@websmith
Well, websmith, your last phrase tells all. It is all about money for the dumpster and his supporters, and is never about improvement of services or betterment for the country.
The GOP privatize everything and insulate the corporations from any liability represents the looting of America by the 1%, for the 1%. Trump presides over the most corrupt, shameful, and traitorous regimes in the history of this nation.
7
@Rodger Parsons As privae facilities compete for healthcare for millions of VETs, the prices will go down and the quality of service will go up as the taxpayers save money. That's the way it works.
@websmith
Sure, that's the way it has worked for the rest of us, saddled with fee for service private health care providers and insurers. If you believe that, "Bridges for sale, bridges for sale!"
Good grief!
Easy solution: Take the $1,500 BILLION (1.5 Trillion over 10 years) Congress recently gave to the rich as tax cuts, and direct as much as needed to make the VA whole. Wake up, America-you collectively do not understand the math!
8
@Marcus
The problem is that that money really isn't the government's to give. It first has to take from those who earn it.
@Marcus The rich invest their money in the economy and the tax cut has resulted in highest employment for whites and all minorities. Far from being rich, It saved me $5,000 and got me a new truck which, by the way, also contributed to the economy. As i cruise around in my Ford F150 XLT, I see that everyone is happier and better. That's the math.
@Marcus
The math is that the $1.5 trillion is being overspent already each year in accumulated debt. Each year, we are about $1 trillion in the hole, with something like $18 trillion in overall debt. Let's pay that back before giving out a single cent more to the VA paper pushers.
Thanks for this first step in fixing the VA, President Trump. Negligence and malpractice at the VA have claimed too many lives of the veterans who willingly defend our nation's interests. About time we have a president that puts Americans first. God bless you and your family and God curse those who curse you.
1
@Joshua Ditto. I am alive only because of changes the President has made to the VA so far.
As our wars in Iraq and Afghan escalated, the VA asked Congress to fund 25 new VA hospitals in order to treat the additional vets who would need care. The price tag was about $30 billion. The GOP Congress wouldn’t do it. Instead of blaming the VA for its need for more beds and staff, blame the representatives who control the $budget.
2
@Joshua
It's shocking how many just ignore the problems plaguing the VA to indulge their animus towards the GOP, Kochs and Trump.
How many of these "private care" facilities are GOP donars? Follow the money.
6
@Ken Hanig My private care facility is owned and operated by the Catholic church which also operates free food banks nation wide that many VETs go to. Im not Catholic and neither am I Republican. I just recognize a good thing when it exists.
They have to know by now this doesn’t work — which means they’re just a bunch of robbers - from us.
4
"THEY" know, it's We who don't seem to learn. Now that they've pretty much stolen the electoral process, the hill has become that much steeper.
@Thom More jobs and lower unemployment rates for everyone. Whats not working?
By all objective measures of cost and results and as compared with other developed countries, US private health care is a failure. The Trump administration seems to manage by doing more of what's not working, less of what is. But they sure talk a good game to their base of fools.
6
@Jeff Atkinson As VETs are driven into private care to get better health care, the cost will come down and quality of cars will go up as more facilities are created and they compete. Its economics 101.
Ah, the Republican Party emerges again.
The purpose of the Republicans is to channel money to their rich supporters. Both medical care and education are huge parts of any governmental budget. That's why Republicans are constantly wanting to "privatize them". That's how they get their hands on to that huge wad of cash.
Tax cuts for the rich evidently weren't enough.
American continue to vote these money-grabbers into office, against their own personal best interests. That's the power of propaganda. Look! There goes a caravan of Muslims over there!
7
@Matthew O'Brien Healthcare ane education are not listed in Articel 1, Section 8 as federal duties nor powers making government involvement illegal. When the government established the REA (now RUS), hundreds of private companies responding to customer needs were established proving us with unmatched telecom and energy services at low prices as they contribute to our economy. This will be the same.
Last year, Pro Publica reported in detail how three of Trump's business cronies — including Marvel Entertainment chairman Isaac Perlmutter (!) — have been setting VA policy. Pro Publica also reported on how disgraced hedge fund mogul Stephen Cohen was trying to get the government to pick of the tab for the $275 million he spent building (on spec) 10 free mental health clinics for veterans. One shudders to think about the other unsavory and unqualified characters who would flock to and exploit a fully-privatized healthcare system for veterans.
5
@John Caulfield Most of the VA employees spend their time regulating instead of providing health care resulting in a bureaucracy that is genocidal and monstrously huge. It will take a long time to fix. Changes over the last couple years are the only reason I'm alive.
Hmmm, something "stinks" here. I trust the current "Administration" and it's supporting politicians about as far as I can throw the WRJ Va facility... which by the way is doing a very good job delivering care to us veterans. Is the system perfect? Nope, but what Trump and his minions want will not be a better option.
2
@Chris R The VA has been killing VETs for decades but, the changes made have saved my life and its only getting better. The faster the government gets out of illegally managing healthcare, the better.
@websmith
I'm confused... they, the VA, saved you but they are Killing others??? Further, are you saying we should terminate Medicare,Medicaid and the Va healthcare system?? They are all government programs.
Trump and Republican big skim accelerates. Add America's Vets to the list:
- coal miners
- farmers
- healthcare users
- taxpayers
5
@cbindc Things are getting better for everyone. Coal mners are back to work and farmers no longer have to pay tariffs making it easier for them to compete. I qam alive only because od changes to VA healthcare.
1
a bad bad idea....most private clinics are not staff by
people trained to deal with veterans health issues..
most private clinics are staffed by quack PA's...nurses
pretending to be doctors..all VA clinics I see are staffed by REAL doctors..who know our problems because all the patients they treat have similar issues...same goes with emergency staff at private hospitals..some of them have real bad service and many are rude to patients......the VA is not medicare and veterans should have the top notch care...not what the republican party is wanting to do..the veterans organizations need to step up and stop this action...appears the Koch bros are sticking their noses into Americans and veterans business which they have no business of interfering with thier lives..they should be charged and arrested for intrusive medical care that could result in harm to veterans
1
@chill Switching to private care through the Choice program saved my life. VA doctors are good but the adolescent staffs they use obstruct health care and laugh about it. They almost killed me 4 times last year.
BEWARE! trump Mar a Lago pals have had the keys to the VA wallet since trump rolled in. This is privatization with our tax dollars as the purse. The Koch brothers could care less about veterans or anyone else for that matter. This is the same angle as privatizing the war in Afghanistan so Betsey DeVos's brother can cash in. Much like Putin, trump pals are in for the pot of gold. The money will disappear, more oligarchs will be made, we lose.. DON'T BELIEVE A WORD COMING FROM THIS ADMINISTRATION. You have been warned!!
5
@lulu roche Tax dollars are not legally suppose to be spent providing healthcare. I am alive only because I could seek private care on the Choice program.
You say "For individual veterans, private care could mean shorter waits, more choices and fewer requirements for co-pays — and could prove popular." So I Googled "VA care vs private doctors wait time" One of the top hits is "Vets May Wait Longer to See Private Doctor Than a VA Provider." https://www.military.com/daily-news/2018/06/05/vets-may-wait-longer-see-private-doctor-va-provider-report.html
3
@harrync I get private care through the choice program and besdews having no wait times, it has saved my life. You can shop around for the best care privately.
This is probably another idea from Trump "Maralago administration". Fat cats who know nothing about healthcare except to make money off of it somewhere. Our poor veterans.
4
@Edgar The REA (now RUS) resulted in the establishment of hundreds or companies across the U.S. providing us with unmatched telecom and energy as the contribute to our economy. The VA knows nothing about healthcare and almost killed me 4 times just last year alone. Before they have taken my weight to 140 from 187 in two weeks and given me a stroke. Its way past time for a change.
@websmith My father was a Korean vet. He received immediate appointments, excellent care,and follow up from the Tucson Veterans hospital. I really believe that it all depends on the hospital administration. A lot needs to be cleaned up...but a lot of them are doing right. Sorry your experiences went wrong.
1
Could it be made more clear that these men, who themselves are not veterans, have no concern for combat injured men and women? If they were simply pencil pushers who scouted the expense sheet with the narrow eyes of saving money it would be one thing but reallocating our tax dollars to private hands is quite another.
This Administration will stop at nothing when it comes to siphoning government funds into private hands and yet we the sheeple willingly allow them to fleece us.
We sure are slow learners.
4
@Ian MacFarlane The federal government cannot legally provide healthcare and I am alive only because I could seek private care through the Choice program after the VA almost killed me 4 times last year alone.
@websmith
So long as the private care comes at no cost I concur. In fact healthcare for all "socialized medicine" as most civilized nations provide is what we could use.
VA healthcare? I'm sorry we have veterans or the need for them. But we are here and we deserve care. The VA, like most government funded bureaucracies, has good parts and bad parts. It is a regional service and some regions use the money they receive to provide the best care they can. Others use the money to employ. I currently live on the fringes of practicality for care. My clinic is 37 miles away through heavy traffic. My hospital is over 60 miles away in the opposite direction. A sick call visit is a circus. Way too many patients for the availability of care. "Bend over, next," is the care given. It is free and I see many poor vets waiting and waiting. Some medical services are not available, period. So death becomes an option for lack of proper care. Yet I appreciate that the care is available. The system needs an overhaul. Some form of privatization is likely a cure, while certain parts should stay.
@Mark Lindsey After the VA almost killed me 4 times last year and driving 100 miles to the hospital, I was able to see a private clinic less than a mile away on the Choice program and walk into their emergency care facility anytime. That's why I am alive now.
This is a disaster in the making. And will increase violence as well
Correction: Veterans do not get "military" care.
1
The article’s headline is misleading. It’s not the VA that “seeks to redirect billions of dollars into private care.” It’s the Trump administration, taking direction from those selfless crusaders for the public good, the Koch brothers.
3
@bergfan Regardless, everything is better for everyone. As private companies compete for our business, hings always get better abd cheaper so they can get our money. That's the way it works.
Anyone who thinks the Koch brothers and Trump care about veterans is a fool. This is all about privatizing government whatever the costs, in lives or dollars.
But the silver lining is that veterans voted for Trump and are about to get what they voted for. So don't ask for sympathy.
3
@Garak The VA almost killed me 4 times just last year. I am only alive because I could seek private care on the Choice program.
The Dillinger question. Why did you rob banks? Cause that’s where they keep the money.
With this bunch of jackals, Do I need to explain more?
3
I see the Republicans have found another trough of public funds to snarf up. Belly up, boys!
4
I am a DAV. I have Medicare A & B as well as insurance from my prior employer. I have never used the VA health system as I feel I can survive without it. I am very pleased in my dealings with the VA telephonically and via mail. Never had any problems. They are professional and courteous. As I have never dealt with the med side of the system I really can't comment with authority. Unless you are a vet dealing with the system then the decision should be left with the people who deal with it on a frequent basis.
3
Roosevelt said government by organized money is just as dangerous as as Government by organized mob. Trump surrounds himself with mobsters, some of whom will soon serve hard time as he may do. We should never allow oligarchs to divide or demean us.
3
The current system is a substandard medical system that exists only because it supplies federal jobs to so many congressional districts. Vouchering veteran care to private and civilian public hospitals would be the best care for the lowest price. Anyone who says otherwise is defending a fat, ineffective bureaucracy. And I am a liberal saying this.
2
Medicare for All !
Perfect.
2
The Department of Veterans Affairs is a monument to corrupt crony capitalist corporate plutocrat oligarchy.
The real casualties of the rapacious gluttony of the military-industrial complex are American veterans. Like defense veterans affairs should be too basic and critical to our government to be left to private capitalist commercial business interests.
Ever since Donald Trump's cowardly dishonorable unpatriotic German grandfather fled to America to avoid criminal prosecution for dodging the military draft no member of the Trump has ever worn the military uniform of any American armed force.
Since 9/11/01 a mere 0.75% of Americans have volunteered to wear the military uniform of any American armed force. And they have been ground to emotional, mental and physical dust by repeated deployments in ethnic sectarian foreign civil wars that have no military solution.
While most Americans pretend to be brave honorable patriots by rising to sing the national anthem and salute the flag at sporting events.
5
The public should run the other way from billionaire libertarians who want to privatize the VA or otherwise starve it of funds. Running healthcare like a factory or turning it into a ‘free market paradise’ is a fools errand even if meant to be a proof of concept. There’s no place on earth where this model provides inexpensive universal care of reasonable quality. More likely, these efforts are another shakedown of taxpayers by political donors.
Medicare is the best nationwide analog we have, which explains why the pubic wants the US to move to universal healthcare along those lines. The VA could be folded into this system with an emphasis on special services tailored to veteran needs. Community services could supplement the VA based on convenience and necessity. Conversely, we should consider letting the public utilize VA services where they are the best or most convenient local provider.
Without other reforms we’d still have a system that’s too expensive and not efficient enough. Kaiser Permanente in California compared favorably to the British NHS in an academic study some years ago*. It provided better access and high quality care at a comparable cost. Kaiser operates as a non-profit but its performance was partly shaped by a very competitive marketplace among healthcare providers.
*https://www.ncbi.nlm.nih.gov/pmc/articles/PMC64512/
1
While many VA Doctors are high quality there are two many that find a "home" with the VA because of the lack of Doctors. Just two instances I know of (1) some years ago a WWll vet was told he needed to have his larynx removed due to cancer after seeing a VA doctor because of a persistent sore and raspy throat problem. He then went for a second opinion to a civilian doctor who diagnosed it as severe strep throat, treated him for that and problem solved. (2) Recently a vet friend of mine asked a VA doctor why he practiced there and not privately, the doctor told him at the VA he does not have to worry about malpractice suits or insurance!!!
2
1. So that inaccurate diagnosis would never be made at a non-VA hospital?
2. Trump’s VA is being run by three of his rich cronies who are members of Mar A Lago. Does that sound like the right folks to have in charge of the VA?
2
Finally! Instead of providing $60b to $100b for Tricare, Trump can flip flop on this decision and use that money for The Wall. Moreover, next year he these exact same funds to build The Canuck Wall with Canada!
1
Moving billions into a private health system. This is what the swamp looks like.
4
This is what Republicans do. Capture public, tax payer's money for private sector profit margins. As time goes on, costs go up, and service goes down.
4
We all know the private healthcare system is a joke so this is just to make money off veterans health. It is sickening to watch.
4
Short term solutions by elected and appointed officials who lack the courage to put their shoulder to the door. Your taxes, and your poor decisions when casting a votes (mine too) enable these self-serving weaklings to run our once great nation. Thanks to The NYT for reminding us of this reality, daily.
3
Hmm, I wonder which Republican donors this will benefit.
2
The VA Administration, their hospitals, healthcare are deplorable. Veterans deserve the same standard of healthcare as the general population. Here in California is Kaiser Permanente. They have their act together, better than any other in the state, hands down. I'd like to see California veterans have their quality of health care, not the VA with hospitals that have interns and research physicians that come and go quarterly. The system is disgusting. One washcloth and one towel per week at their hospitals. Can you imagine patients having to use a smelly, filthy washcloth by the end of days?
I'd like for veterans to have the health care paid for without a copay. Absolutely free paid for by us taxpayers.
4
@sandcanyongal
The question is whether one wants the veterans' care to improve more than one wants to indulge in ideology, which requires opposition to all measures.
More profit for private corps...the mantra of the Kochs.
2
I have found the Veteran out patient Clinics to be a Gods send.
They are courteous & efficient , why fix what isn’t broken.
2
Privitization = For Profit minus Public Service.
3
This is excellent. Veterans should get the same health plan that all fed workers and Congress gets, and the wretched VA system should be entirely shut down.
1
Put the vets on Medicare.
2
This shutdown is part of Putin's plan to destroy the United States. We have a Trojan horse in our Presidency!! What better way than to destroy our veteran's health care system in the process? The VA took care of my dad until his death at 90. I am also retired military and they take care of me already in the private sector. There is no need to change anything other than to bleed the VA of money for billionaires.
5
No "commander in chief" who falsified medical tests to evade military service, no six time bankruptee who sued thousands of small businesses to get out of paying them for their labor, running many out of business, and no hack who defrauded thousands of their tuition money to go to his fake university - should be allowed to change medical care delivery for our bravest men and women at a time when they need care the most.
VA privatization has been a goal of GOP-parasite, government services-nihilist Koch Brothers for ages.
Clearly they've found their willing stooge.
5
As a prominent Veteran’s Leader, I’ve been trying to make this a reality for YEARS!! It’s about time the VA used my Tricare idea. I’ve only been saying it publicly since 2014 when the waitlists scandals broke which BTW I was instrumental in breaking. The way this will work is instead of cutting off Tricare, you get to keep Tricare or move over to the Champ VA side (which is still Tricare) upon separation. You go to the Tricare site for your region & find the doctors listed as accepting Tricare. Research your choice of doctors then call their office for the appointment. The doctor’s office handles calling Tricare back for verification & services covered. If the vet is rated @50 or more, copays & deductibles should be waived. In other words, 100% covered by VA. Tricare already covers meds but you also get the option to order your meds from VA’s pharmacy. I personally use a pharmacy out in town. I do have a very small copay for certain meds, but I can afford 6$. If I can afford my Starbucks addiction, I can afford my copay IJS lol This is a HUGE W for veterans and no I’m not saying it for political reasons. (I’m not a DT fan) I tried the VA system first. It was absolutely horrendous. I couldn’t believe what I faced. I also knew that I wasn’t the only one facing that atrocity. Some vets don’t know any better. Other veteran organizations have certain incentives for not changing. If you want QUALITY of life; take VA up on it’s offer & go to the private doctor.
2
I am suspicious Concerned Veterans for America is funded by the Koch brothers. I believe they have their own selfish interests to advance (privatization of all medical care that is currently government run, including Medicare)that have nothing to do with the best interests of veterans.
3
VOUCHER SYSTEM = CUTS IN CARE. Plenty of Veterans groups that warn of this. Get to your grass roots Veteran's group and talk with them one on one. Once they untie the LAWS and REGULATIONS, they will cut cut cut, at first, where you dont see it, later, in a year or two, all over the place-- by then it will be too late. The 10 scariest words in the English Language. "I'm from the Republican party, and I'll help you" with your entitlements.
5
"For individual veterans, private care could mean shorter waits, more choices and fewer requirements for co-pays — and could prove popular. " Or Not!
The war mongering Republican Party sends our troops to wars based on lies, then wants to use the large influx of wounded to gut the VA system for private profit. This is yet another example of Republicans using the disasters they cause, for profit, as an excuse to create new disasters for profit.
The VA healthcare system gets much higher satisfaction ratings than the corporate healthcare system. There is no reason to believe that having shareholders take money out of healthcare and put it in their bank accounts will result in better care for veterans.
The war in Iraq destabilized Syria, created ISIS and resulted in in waves of immigrants fleeing to Europe and the U.S., so they use that disaster to make more attacks, demand walls that don't work, and now to steal from the VA.
The same people that are pushing this scam use European healthcare as a boogeyman to discredit universal health care, counting on Americans to be too lazy to check the actual statistics. The reality is that universal healthcare systems all have better outcomes than the U.S. (unless you are a billionaire that can afford luxury care that most Americans cannot) for far less money!
The most expensive system in Europe spends 60% of what we pay, per citizen, and gets far better results.
Corporate healthcare doesn't work! Check the numbers.
Reject this scam!
3
Anything private is for profit period. Let them go private but send the bill ti the V.A. Just like my doctor sends the bill to Medicare. Will the Koch brothers agree to that?
2
It sounds like the end of health care for veterans and some really nice beach front properties for ?
4
Visitors to the United States quickly become aware of two things. Firstly, that the narrative about respect for the military and for veterans is up-front and everywhere; secondly, that there are destitute veterans begging on the streets of American cities.
On a recent trip to Chicago, I was approached by a man, clearly unwell, distressed and confused, who showed me his military identification papers. Assuming that I was an American citizen, he didn’t ask me for money: he asked me for help. I did the only thing my other commitments at the time allowed and fed him.
This man’s wretched vulnerability and his simple refrain, “I served my country; please help me,” stayed with me. Veterans need more from the richest country in the world than rounds of applause. If America genuinely respects those who have served in its military, if it truly wants to thank them for their service, then they will be fed, sheltered, and provided with the medical care they need. Anything less is rank hypocrisy.
5
A cabinet of deregulators
drips their poison in our waters
sowing spite in pitchy darks
selling out our national parks
defunding the public schools we share
privatizing the public square
De-taxing our greatest private wealth
in hopes of cutting public health
de-taxing our biggest private incomes
in hopes of gutting public pensions
Driving on, the Business Right
who lost the anti-New-Deal fight
rise again against Socialism
to christianize CapÍtalism
To find more goods to monetize
and if they’re public, privatize
To find more costs to externalize
and charge to taxpayers they despise
Never failing at all occasions
to find a way to demonize
Workers’ attempts at self-protection
Citizens trying to organize
Would-be voters in state elections
Conquering by dividing us
Into our ethnicities
genders, sexes, orientations
origins and occupations
Without ever taking off their hoods
They privatize our public goods
—Sgt W. Everdell, USMC 1966-68
6
Introducing a for-profit middleman into a system that seems to be working rather well...how is that a good idea?
4
Follow the Money!
American Corporations own the major hospitals in the country. Talk about Corporate Welfare... VA Funding being "given" to fund American Corporate CEOs. Who funds the Veterans Administration? Everybody pays their fair share of taxes in the United States. The American working class citizen. The USA Corporation CEOs and Board Members who are astute financial wizards when it comes to the art of the deal on paying their fair share. Rocky Mountain Low!
1
Please don’t mess around with a medical system that works. The VA has treated me very well and care has always been excellent and timely. I live in fear that politicians want to fool around with an excellent system. Please keep the private medical lobby’s sticky fingers to themselves.we have seen the mess they have made of the private medical industry.
4
Can you spell P R I V A T I Z A T I O N? This has nothing to do with helping veterans. Improving the VA's admin systems would do that for far cheaper. This is about putting billions of taxpayer dollars into the pockets of medical industry's CEOs and investors, simultaneously "starving the beast." Grover Norquist's is quivering at the thought.
4
Even if this might be a good way to serve more veterans, I don’t trust the Trump administration.
Healthcare costs should be free for veterans and active service no matter where they get their healthcare. Private contractors must offer a fair market price and quality care in an open-bidding process. Do you really trust the Trump Administration to oversee such a process without kickbacks and no-bid contracts. Look at the horrific response to hurricanes in PR and CA wildfires, both from the President and the government.
Trump is a criminal. That’s how he runs his government. He will fleece our vets and bankrupt the VA because that is what he does with EVERYTHING.
2
Privatization of veterans health care is a way to diminish the effective power lobby of the Veteran Administration in Washington, DC and replace it with corporate health care run by friends of Mr. Trump. Any veteran who believes this takeover is a good idea probably thinks that the Mexicans will pay for a border wall along the Rio Grande River.
2
Almost always missing from reporting on timeliness of care within the VA is timeliness of care in the private sector. Where can anyone get a new patient appointment for either primary or specialty care in the private sector in under 30 days? Your reporting - and that of almost all news outlets - penalizes the VA for actually collecting the data.
3
Roosevelt said government by organized money is no is just as dangerous as government by organized mob, and Trump surrounds himself with mobsters, some of whom will soon serve hard time in prison. We should never allow oligarchs to divide and demean us.
2
I can only speak for the two VA hospitals I’ve worked at - in Louisiana and Texas. They are FAR from being “starved of resources.” Quite the opposite. Other hospitals could be run entirely off the excess and waste of VA resources.
1
Privatization is just what happened with prisons and public education. The Koch brothers? Inconsistencies? No details on the plan? Unprepared to present the details?
At some point this country should give veterans the respect and help they need. My mother worked at the VA. She took great care of her patients.
What Trump promised the Veterans--a 24/7 hour hotline from the White House and if the caller's problem could not be resolved, he would take the call himself. There is no hotline. He implied that returning Veterans with PTSD were weak.
And then Mr. Bone Spurs told Howard Stern that his sexual encounters were his Vietnam because of STDs. He actually said this.
2
"[T] the proposed rules... would be a win for the once-obscure Concerned Veterans for America, an advocacy group funded by the network founded by the billionaire industrialists Charles G. and David H. Koch."
The key to understanding that sentence is to replace the word 'America' with 'the Koch brothers'.
2
I have received all my health care at the VA for 18 years and fully support the VA system, although I acknowledge that it could benefit from some fine-tuning.
Opening up private care to veterans opens the VA up to more private provider fraud. There is already a system of care in which vets go outside the VA when specialists do not exist within the VA. I had to go to one of those specialists. As a routine part of that system, the VA authorized 12 visits to that specialist from the outset--without a first visit or preliminary diagnosis. Therefore, the private specialist was motivated to use 12 visits, because he knew the VA would pay him for 12. As a result, this particular unscrupulous specialist invented reasons for me to keep returning to his practice, including an infection which did not exist. When I reported this provider to the VA, the business office and my primary VA doctor acknowledged previous problems with the outside provider. Therefore, the VA discontinued all interactions with that specialist. I can only imagine how much money he had fleeced the VA of before he was reported. Moreover, he is just one of many providers motivated to accept VA patients that will be paid for by the VA--no questions asked.
I believe the VA is a basically good system that needs more doctors and a more-highly-scrutinized referral system. I do not believe that more referrals under the current system would be cost effective from the VA's (i.e., taxpayers') point of view.
78
@GiGi Painting broad scope on private care. Most run efficiently. My private doctor is invested in my healthcare. A personal and financial connection.
In 1964, a goose laid a giant golden egg for doctors in the form of Medicare. This proposal would be another and even greater since the cost controls of Medicare would not apply, it would all be free and most certainly destroy the VA Healthcare system. It's the never ending Republican goal to privatize everything without control. Even as we speak, I'm sure private urgent care clinics and other providers are lining up to be the VA's contractee..full payment for services without limits, deductibles or copays. Speaking of Fee For Service Nirvanah.
1
Don't you wonder why the people in favor of privatizing the VA are involved either in private insurance companies or other for profit entities?
4
What's really happening here: A greedy fight for private sector to gain market share of a public sector-provided good, all so they can corner it and raise the prices for profit.
2
Excellent move. Our veterans deserve the same level of care as everyone else and, unfortunately, haven't been receiving it. I hope this isn't resisted for the sake of opposing Trump.
@AACNY
Maybe you haven't noticed that everyone else is not very happy with the system we have, and can't afford.
2
Don't do this. There is one reason to chose this option rich people will get richer, veterans will lose. VA care in St. Louis is first rate, better than private care. I have medicare and VA, I only use VA care and wish my wife could too. I get appointments faster than my wife or friends who use private insurance. I have met no person in VA care who want this, none.
Trump wants this for his rich friends not to help veterans. I know of no veterans group that support this type of care.
1
My father receives 13 hours a week of home health aid benefit from the VA. He has Parkinson’s. The first “private” care agency they contracted couldn’t find anyone willing to work for only 2 -3 hours per day for 10/ per hour mandated by the VA. After 3 months they finally passed to another “private agency. Meanwhile my Dad did not receive any of the care that he was “entitled” too. The 2nd agency found someone who sat on her phone while my Dad fell and ended up in the hospital with a brain bleed. The rules placed on VA contractors- hour limitations and below market rate they pay severely limits quality of service. This “benefit” has done nothing to benefit my Dad who served.
1
@Debbie I'm sorry this happened to him. What do you think the situation would have been in private care? Not better, I can assure you. And some have made the point that lifetime care for all vets, with non-service related problems is not realistic. Parkinsons is probably not service related. What healthcare system then would be the next stop for such people? Medicare? Private health insurance?
2
@lou. Great questions and appreciate your thoughts. You are correct his care is not better under privatization. He was provided the service by the V.A. through a contracted private care company. He does have service related health problems- so the V.A has offered the care but can’t fulfill their commitment because they have obviously not budgeted enough to appropriately utilize a private entity. I have nothing but frustration with the system and a personal story that I believe is relevant to this discussion. I must add that the individuals we have encountered who work in the V.A. are diligently and compassionaly doing the best they can within the constraints of the system. Hoping for a better healthcare system for all the Vets!
2
I have been treated by VA facilites for the past 65 years and have been treated with excetpional care. These facilities ranged from the Adironeacks to Westchester County and now in Maine. I can understand having a problem in one area, but having spent considerable time in three areas, the treatment has not varied and appointments were of a normal wait time.
The VA has upgraded it's online services and Veterans may make appointments, refill meds and have email communication with his or her physician...and recieve a prompt response.
I personally know a physiciian who recently was employed by the VA and his experience is definitely positive, after being in private practice for 20 years.
The VA provides excellent care, has up to date medical facilites and you are constantly reminded of your service to your country.
Rural hospitals are having their own problems and to change the VA system to privatization, would be of no benefit to our veterans
3
I’m sure there can be improvements to the veterans healthcare system just as there can be improvements in healthcare overall. Of course we owe the very best to the citizens who choose to serve in the military.
If the Koch brothers are involved in anyway this only sounds like one more way they can achieve their overreaching goal to privatize every aspect of our government to enrich corporations.
Public anything is a dirty word that they want to undermine.
I wonder what all the other countries that have low cost or free public healthcare do to fullfill their medical obligations to service members? Maybe we give that a try?
1
@m shaw If the Kochs are for it, I am against it.
2
The VA system has failed our veterans for decades. It has proven to be a costly, inefficient and largely ineffective means of delivering health care. For far too many it has also proven inaccessible. For decades those now arguing against a competing system have promised reform but have failed miserably to deliver on the promise. Contrast that with the private healthcare sector which has expanded dramatically since the passage of Obamacare. In NJ at least new hospitals are being built, existing facilities are expanding and there are mediclinics on every corner. Why shouldn’t resources be directed to a more efficient and effective system?
The answer is simple really. By eliminating a federal anachronism the power of the sows populating Washington DC would be diminished. It would also eliminate a cudgel wielded by recalcitrant politicians who would rather “shut down” the government and suspend what can only loosely be described as a service. Instead of arguing the “immorality” of building a "wall" that encourages migrants to flood our borders and consume resources that should be directed to our veterans, one would hope they address the real immorality that they have imposed on our veterans with equal vigor.
1
@tim k
You are in the minority here, pal. This is not what i am hearing from vets comments. The real problem has been that the VA funding and facilities were not funded adequately to have forever wars. Too many vets, not enough facilities. That is why there is a waiting list. Doesn't take a genius to understand it. Whether the promise should be made for life time care is another problem. My brother in law was never injured or served in combat positions, but he was promised care even for prostate cancer, heart bypass, other expensive non-service issues. He chose instead to go with Medicare benefits. This left him with something to pay afterwards. If our healthcare system was a good for everyone as the VA is for veterans, then we would have something worthwhile.
3
This effort to privatize VA health care is the agenda of the Koch Brothers and their well funded campaign.
So let's cut to the chase: Why do the Koch Brothers want this? What is in it for them? Why were they not interviewed for this article if in fact they are the driving force behind the change?
Is the Trump administration 'working' on this or just waiting for their orders regarding the specifics from the Kochs? Are there any other plans proposed for helping the VA system out there? Or has everyone just capitulated already to the Billionaire Koch Brothers who seem to be ruling America with well funded but hidden agenda?
The Koch Brothers didn't want Nashville to expand their public transportation system and launched a very well funded campaign which resulted in No votes. Why are Americans constantly being undermined by these brothers? Why won't anyone stand up to them? Or is there support for the turning of America into an oligarchy by the 1%?
3
This reallocation of money (and it is a lot of money) to private care is the underlying reason for the recent change in management at the top of the VA by President Trump. There is no other.
2
Why am I suspicious? Because this is what Republicans always do: Turn critical public services over to private profit-making corporations with little to no oversight, and no tools to keep them from gouging the government and exploiting those they are supposed to care for.
And since the VA is being run by 3 unappointed, unvetted billionaire members of Trump's private Mar-a-Lago club, it's no wonder THEIR plan to "fix" the VA involves privatizing it!
Republicans have already privatized prisons and much of the military, both with disastrous consequences, part of Medicare, and tried to privatize Social Security--which would have given hundreds of billions to the same Wall Street investment houses that crashed the economy in 2007 and 2008!
Problems with the VA go back many years, but got far, far worse under the 2nd Bush regime. Obama TRIED to fix them but was stymied (as usual) by Republicans in Congress.
Now the ReTrumplicans are going back to the same, failed "solution"--privatize.
1
This is bait and switch. The goal is to eliminate the VA and then cut services. PLEASE look at the pattern of the Koch brothers activities and stated goals. Care might improve for the short term but AFTER the VA is greatly diminished and the VA can't be rebuilt- then they drop the hammer on care. Standard operating procedure for capitalists wanting to cut the size of the federal government and their tax bill- BY ANY MEANS NECESSARY. Don't fall for it they want to buy you breakfast and lunch this week and then drop you into the middle of a desert next week. Bait and switch. You'll notice that THEIR children aren't veterans needing care.
2
If the Kochs are behind privatizing the VA the be assured it is not about service but profits.
2
as a 100% Service Connected disabled veteran I can tell you this is a bad plan for veterans and the taxpayers.
It's using a machete when a scalpel is needed.
The VA's problems stem from decades of Congressional poor choices and a lack of oversight. Government allowed itself to hide its bad acts and then deny they existed.
The problems and infrastructure of the VA can be fixed at a far cheaper rate than giving free private healthcare to millions of very ill veterans.
keep in mind that private sector healthcare is out to make a profit and as so many civilians have experienced making that profit is often done at the cost of the patients health.
Then look at what Republicans want to do to all Social Safety nets. When the VA Medical Complex collapses there will be nothing but the safety nets and no firewall that prevents veterans from being shortchanged along with civilians.
3
From what I've been reading we have a doctor and nurse shortage in this country in the private sector already. How is this going to help?
1
So services can be improved by redirecting a big chunk of the funding into corporate profits?
“Finding efficiencies” generally means reducing services and paying people less.
Of course, this kind of “logic” is a foundational belief of free-market corporate conservatism, which is callously indifferent to the real needs of its captive clientele as long as quarterly profits and company value is maximized.
This is why Republicans are sticking with Trump. With Trump, the door to privatizing government services so they can be sold back to taxpayers at a guaranteed profit has long been a right wing dream.
1
As a Navy veteran who did not serve in combat, but who had the privilege to be a volunteer patient-transport van driver at a veterans hospital for those who did; I would like to know if either of the Koch Brothers also served in the military, or are they just chronic profiteers who once again want to privatize and ultimately diminish, the critical medical services given to our heroic warriors. My experiences driving these sometimes horribly disfigured men and woman, taught me that VA hospitals not only afforded them first rate medical care, but also provide a culture of camaraderie, acceptance and most of all, "respect" unique to these dedicated medical facilities. Indeed, VA hospitals also provide treatment by physicians/medical/support-staff who have the unique training and experience to deal with such injures as IED, post-traumatic stress, amputations , etc., tailored to those who have so bravely fought and/or served our country. Yes, greater efficiency, convenience, modernization of our VA hospitals should always be a goal; but the imperative should always be genuine concern for the veteran - lest we throw the baby out with the bathwater.
110
@logic
"Chronic profiteers." Love it. Should be part of the liberal dictionary to describe the Republicans.
12
Large numbers of VA / Medicare eligible veterans buy zero premium, no drug-coverage Medicare Advantage plans, which are pitched to veterans. These veterans are opting for private alternatives. Cost to the Federal Government is greater -- Feds fund the VA and fund the Advantage plan for these veterans. Why not just put all VA eligibles into Medicare with added coverage for specific military related claims or obligations.
2
I am 74 year old Vietnam veteran and use the VA hospital in Indianapolis. It is the only place I have visited, since I left Vietnam that has provided the respect one would expect for someone who'd done service in a war chosen and financed by the American people. I love going there.
Privatization of VA services is just another effort to remove a valuable and honorable government service for the sake of tax cut for the rich in the name of a debunked economic theory embodied in a second rate novel. Sad, indeed.
7
Nothing in this article addresses the quality of care and patient safety directly. It is true that bureaucratic malfeasance causes delays in patient care that can often lead to harmful delays in diagnosis and treatment.
The quality and safety of care can be measured by outcomes analysis. Another important parameter, as shown by two independent groups of researchers is the past litigation history of the individual doctors caring for the patients. Doctors with a history of large and/or frequent payouts were much more likely to harm patients again and again.
Costs are greatly affected by the quality of care to the tune of 300 billion dollars a year in one estimate that demonstrated the waste caused by unnecessary and improperly administered care notwithstanding the human costs.
Quality is an important variable in the health care equation and since it affects patients and costs, a good argument can be made that it is the most important and yet nothing appears in this article addressing quality.
2
In the mid-1970's I worked for an Alaska legislative committee investigating the high cost of medical malpractice insurance for specialists. Every health care expert who testified, regardless of political or ideological orientation, started from the base, self-evident understanding that health care provided by non-profits was superior. It was obvious: for-profits didn't enter the picture.
"A fortiori" four decades later when corporate culture demands a laser focus on the board's "responsibility to shareholders" to generate profits. I find this kind of public discourse on health care issues like the VA infuriating. We can more readily fix the VA by improving management and providing adequate funding than creating a boondoggle turning the care of our vets over to private corporations who will always put profit ahead of the needs of those who served their country.
11
As a veteran and a longtime VA physician and medical school faculty member I continue be terrified by the plans for the VA.There are several reasons, but to worry;
First, the privatizing folks don’t seem to know that there are massive shortages of primary care, pediatric,and psychiatric providers. [Partly because training dollars were cut years ago to control costs!]
Second, current government rules around Medicare and Medicaid have made money for insurance companies, but discourage providers to accept government funding programs.
As long as our education system costs students huge amounts of money and reimbursement system squeeze it will not be entirely reasonable to become a healthcare provider. (One of many reasons that we are importing more and more doctors.)
If we want to save money and improve healthcare, those going into nursing, medicine, osteopathy, physical therapy should be salaried as students so that they didn’t spend 20 years trying to pay down their student debt.
13
All the initiatives that the GOP and Trump are pushing are beginning to seem like Bannon's dream come true: thorough dismantling and defunding of government agencies under the guise of reform. Except for military or quasi-military ( Homeland Security) services.
1
@chery
we went to private prison , increased cost and was a total failure. Obama was in the process of closing them, then came Sessions. I always said we should have done a deep dig on his finances.
You are right they want corporate control.
then where will we be?
1
If care is needed outside the VA system, wouldn't it make sense to allow veterans below Medicare age to join Medicare? Wouldn't that be a much less costly option than private insurance?
My dad, who is 85, manages his healthcare jointly between the VA and Medicare. He's had prostate cancer for 25 years and would not be alive now without his VA care.
18
So the idea is to move veteran care from a system where there is cost control into the private sector where cost is hidden and seems to be the last consideration?
21
@Tom Miller
Yup.
To me it looks like the student loan racket which has led to the ballooning of prices for higher ed. Or Federal guaranteeing of bad mortgages.
Just awful.
1
I had eye surgery, colonoscopy, checkups, all paid for with travel pay. Health care based on how close I am to private health clinics would mean I can't receive healthcare. No one is less qualified to chose a DR and hospital. The VA limits the number of eye glasses each year and requires an annual check up to maintain my status. The VA installed kiosks to speed up checking in and to receive travel pay. Taking money away from the VA is taking healthcare away from me.
16
This plan will be in the best interest of veterans as long as the money is redirected to non-profit health care organizations.
After many years of working for the VHA, I truly believe system is broken (and corrupt) beyond repair. The recent attempts at accountability have only made a bad situation worse. It's unfortunate, because the majority of VA employees are doing their best under difficult circumstances.
8
As a VA recipient spouse, I understand why, in theory, this might appear to make sense. in reality, however, with the increase in outpatient clinics - and the current ability to go to private providers if the local facility can't schedule you in a timely manner - I don't get this.
Also, I fear funds given to this new initiative will take from current VA facilities and services that are working well.
Fix what is broke, in short. Don't do a 180 turn. Men and women, that have given the most, will be caught in the middle.
3
Did I miss something or did either of the Koch brothers who are funding this push to privatize the VA ever actually serve? Since when do rich oligarchs get to tell vets where they should get healthcare? The reality is that veterans are a specialty group of medicine and need the respect, understanding, and empathy that only the VA can provide. It is an honor to serve these veterans and most employees at the VA genuinely care about them. Not all private hospitals can match that and certainly not all private hospitals are better than a VA hospital.
21
Pensions to Wall Street 401k's; then privatize Social Security. Public education to charter schools; then starve public schools. VA care 'supplemented' by private; then close VA and get more expensive private care. All this they sell us as freedom.
The same conservative move to take basic human services from public to private with less equality of access and more money in the pockets of corporations.
Will it never end? Not till more people wake up. And soon or it's too late. It's far easier to tear down than build up.
34
The Koch brothers are always behind privatization of our public resources. They’ve also infiltrated our Statehouses & own legislators across the country. Ask yourself why?
3
The Trump administration is looking to privatize as much of the $4 TRILLION annual budget as possible.
Standard Federal cost plus fee contracting includes a profit margin in the range of 3%.
Do the math: If you get a 3% profit margin on $4 Trillion, that is a mere $120 BILLION in PROFIT very year. (Yeah, I know; pocket change, right?)
What do you have to do to get that 3%? Be the prime contractor, subcontract everything out to anybody you can, do very little of the real work, and take your cut, year after year after year.
If you actually do the work, the profit margin can be much higher.
The only catch is that to GET THE CONTRACT, you need to be plugged in to the people choosing the contractor.
9
Too many veterans are getting free lifetime health care for non service related disabilities. I don’t understand why the vets aren’t just put into Medicare like everyone else. Not every vet was in combat and suffered wounds. I’m all for lifetime care for service connected disabilities, but the federal government is just not capable of delivering unlimited high quality retail level medical care. We have an enormous private health care system in the US. I think moving the vets to that system is long overdue. The only VA medical infrastructure that should be left in place is one dedicated to serious service connected care, like limb amputations, TBI, etc. There are civilians who were in war zones, and civilian federal law enforcement who faced dangers far worse that the vets who were “in the rear with the gear.” We don’t give them lifetime care. if you weren’t in a combat arms unit, I don’t think you should get lifetime VA care at all.
4
Or on the other foot. You could be someone like me:
I have a service connected disability. I do not use any VA facility. I have Medicare and a secondary insurance plan. I figure that me not using any VA care leaves a space open for another Vet who needs that space more than I do.
1
@John Smith
What planet do you reside on??
We do have an enormous Healthcare system in the U S -- with enormous waits to get appointments, enormous shortages of primary care physicians, extremely inflated costs. Dump millions of new patients into it and break it permanently for everyone and then leave the vets with nothing.
And their private docs have NO specialized training AND NO OVERSIGHT.
Trump and VA to vets -- head on out to the big world of general medicine in the U S and you got problems?? Don't call us suckers!
2
I have always thought that it would be more cost effective and better care for veterans if they simply have an insurance card to go anywhere. The US Gov. does NOT need to be in the hospital business.
8
@mike from Toledo
Americans have a tenuous relationship with health care reality. They tend to extrapolate from their own experiences, so if their heath care is good, they'll claim the system "works" for the entire country. Under Obamacare, if their premiums went down, they claimed it was "working" despite the fact that everyone over the subsidy and Medicaid eligibility levels saw their costs skyrocket.
They also tend to idealize the systems of other countries, morphing them into one perfect system, despite the fact that there are myriad models (often containing private components) and often use rationing to control costs.
It's a conundrum.
5
I am a veteran with both private medical insurances and VA health care, because of my service connected injuries, I am free to use either. Time after time I choose to go to the VA hospital over using my private insurance because the VA has fast and thorough service, offers a variety health services from telehealth to in-patient care, its employees genuinly care for and respect the patient, and it provides the sense of togetherness, i.e., brothers in arms, that is a part of all veteran's lives.
The VA, however, does not provide all medical services, such as dental (unless required surgery) care or VHA doesn't seem to have alergists. In cases such, I can see how a supplemental would aid some vets and I can see how that may divert funds from others.
How about society does whatever it takes to do the right thing instead of arguing over money for everything? Nah, society would rather play by it's self made game of life than do what everyone knows is moral. Stupid money #manmadeproblems
Apart from my preference for the VA over private health insurance, don't retired soldiers already receive Tri Care (private health insurance) as part of retirement?
63
@AACNY I can only speak from my experience. My experience with private care is wonderful. Responsive. Timely. Efficient. Professional but personal. So my comments reflect my experience.
As with so much else, this is a for-profit power grab by the current regime. It's not about care at all. It's about lining the pockets of private companies with tax dollars and shifting increasing costs onto patients - in this case, veterans.
Public schools are failing. Instead of supporting the communities and fixing them, privatize them. Separate and not equal. Funnel tax dollars to private companies.
Prisons are too crowded. Instead of reforms and community support to prevent crime, privatize them. Funnel tax dollars to private companies.
Veterans aren't getting the care they need. Instead of expanding the VA system to care for the large numbers of vets who need help, privatize it. The country shouldn't be burdened with taking care of those who have given, literally, pieces of themselves to defend us. Push that off to for-profits that have not got a clue, not a flipping clue what vets may have gone through. Instead of being able to walk into a VA hospital where there are other vets and people who have served, who can understand what they may have gone through (because they went through it too), push them out to some private and more expensive place.
We should be supporting the men and women who defended us. Not defunding the VA to give more tax dollars to support private greed.
14
All I see is that it yet another way to channel money into already filthy rich insurance companies. Even if closing the VA hospital centers I still don't believe it is going to deliver what Republicans are promising. The majority of PCPs are already full and not accepting new patients. That means the vets will then go to urgent clinics for care and that is a huge expense when compared with PCP signup. When a different doctor or physician's assistant attend a patient every time the patient goes in there is a real lack of continuity of care provided. It's not only because the healthcare system is already congested but it is probably more of person to person problem. A patient is less likely to discuss anything slightly embarrassing with a care giver that haven't gotten to know well. As for the caregivers, they are less likely to ask questions that are out of the humdrum of standard care when meeting a patient who they haven't dealt with before.
The problem is that in the USA healthcare is a thriving industry. From Pharmaceuticals all the way to home care and to colleges to medical schools, it is all about soaking up profit. This is why the VA has a Republican made problem. As far as Republican politicians are concerned any thing that is not making a profit should be privatized. We know how well that works already with the Health Care System that is currently in place.
8
Another example of the neo-liberal playbook: underfund, undermine, create disfunction and customer dissatisfaction then turn over to to the private-for-profit sector who will rapidly increase prices and profits. They will say it’s designed to improve the service for patients but it’s really designed to provide profits for the shareholders. Vets will suffer, but the GOP will keep on flying the flag and repeating their lies about respect for Veterans, many of whom are working class sons and daughters. The sons and daughters of the shareholders have bone spurs and University careers instead.
8
I’d like to see a study that examines the idea of replacing the V.A. with Medicare (at 100% instead of 80%.)
4
While I also fear the private sector has the potential to make matters worse as the well known outrageous abuses in the prison systems, I do not see much success in any are run by government systems. Medicare funds have been misused and will undoubtedly be unavailable to those who contributed, our educational institutions rank well below those of other countries, our infrastructure is disintegrating, and most decisions are made by wealthy senators and congress members who are happy to have their own health cate and pensions provided by taxpayers. The answer to the problem escapes me, especially when our politicians have polluted our citizenry with half truths and outright lies to gain re-election. We seem not to realize that these politicians DO NOT CARE. Let the nation see a proposal on veteran health care presented by a third party without an agenda, then let us vote on what the facts tell us. We must stop allowing politics into our heads and demand integrity.
2
@Sharon Glassman This requires that voters are educated about what they are voting on. It requires some effort on their part. Otherwise, we end up with what we have now. And it seems very few of those people responsible for putting them in office will ever acknowledge it was the wrong choice. People who won't try to learn anything about the candidates, and won't admit they were ever wrong about anything. Seems that applies to a very large number of people.
This reform is long overdue!
Thank you to everyone of our veterans and they deserve the very best care and they deserve it when they need it!
No doubt better by far the most important factor, and no doubt more convenient this is a good solution
4
@Tod L
They will be just like the rest of us suckers out here in private medicine - - shortages of docs, wait forever for appts, NO recourse if you have a problem.
And when they want to go back to the VA even with it's problems-- it will be gone.
1
To the GOP reform means gut the VA, Medicaid, Medicare, and Social Security. Then we can afford more tax cuts for the upper 1% and corporations. Redistribution of wealth back to the wealthy were the Koch brothers think it belongs.
5
Who profits, who gains when public services are privatized ?Like they sat, follow the money.
5
My view of health care going forward is the elimination of all the programs out there and just have one program for everyone. Eliminate Medicare, Medicaid, the VA, 50 state programs for workers compensation and whatever else is out there. In eliminating all these programs we would also be eliminating often conflicting bureaucracies along with their advocacy groups, lobbyists, etc. One program for everyone makes sense. Remove the built-in unpleasantness in the present system and leave health care out of the national dialogue.
5
@mikeyh
Agreed- as long as you also eliminate private-for-profit insurance companies as well!
This type of move is an old standard in the Republican playbook and it is exactly what you expect. Shrink a government agency, push the money into the private sector and say that it is really about improving the system.
As a veteran I oppose this and expect that the usual results will follow with hollowed out care, exploding costs and another useful public service sacrificed to greed.
We all know who the real owners of the Republican party are and they are not ordinary working Americans. But as long as the Koch brothers are happy I imagine that this is what will Republicans will do, which is sad.
7
Not a good idea. Those VA funded vouchers will disappear into our profit-fueled health care system and veterans will be left without care.
6
This is in essence privatization of veteran's programs. Let me illustrate what privatization does: In Northern California, a ride to the ER in an ambulance has increased. 2 years ago it cost $250 to take my mother in law to the ER. This year it cost a friend of mine over $2,500. No discernible difference in service other than that privatized ambulance companies seem to make lots of mistakes. For example, taking my mother in law miles away to a different hospital when the one she was insured for was 5 blocks away.
Beware of privatization. Better to spend $ to increase effectiveness. Better that is for the people, not the profiteers.
7
The power of confirmation bias never disappoints. The comments are stark proof of the phenomenon. Perhaps a discussion of our differences instead of an all out assault would produce a better result for all American's
3
When the Trump maladministration and Koch brothers conspire to pump more money into the private sector you can be sure it’s to benefit them, not veterans.
3
Take the money from the military's budget. They're the ones who caused the devastating injuries.
1
Is this another good argument for universal health care in the US? Seems like every time a problem is uncovered a new problem is created with the solution. The grand fix is to provide equal health care for every citizen of the US. In the end the American people are going to save a truck-load of money and everyone will be able to go see a doctor or go to the hospital without fear of having to mortgage the house to do it.
The VA in the US has been a huge bureaucracy since for ever and handing over money to private for-profit agencies will not solve that. If you need proof just look at the mess that your heath care system is in now. The for-profit companies that decide who gets treated have helped create the mess that your health care system is now; giving them billions more dollars will not make anything better. All you will achieve is to make Steve Mnuchin's and Wilbur Ross' friends richer.
President Trump has shown himself to be incapable of either caring about or understanding any aspect of public policy so do not listen to anything he says on the issue. What you really need to do is call your member of the House of Representatives or your Senator and make sure that you tell them in no uncertain terms how you feel and what you want. Be clear and don't just say "somebody gotta do something," that doesn't cut it.
Good luck, your health depends on your efforts.
3
There are some pretty good ideas put forth in the article worthy of reasonable debate. There is obviously no simple fix. But can this Administration, with its reputation for competent management, and its ultra rich and rightist-libertarian amen chorus, develop a program that can garner bipartisan support? Or, as is his wont, will Trump leave out the experts AND the vets, and throw something on the wall to see if it sticks?
1
If the free enterprise medical insurance and care system is good enough for civilians, it is good enough for the military vets. Or socialized medicine for all. Full ride for some and nothing for others is overdue for change.
2
This proposed overhaul completely invalidates the promise to the applicable Veterans’ population, established in contract, of free healthcare for life.
The Pro Publica article references by many of the commenters is a must read. I am a 30 year veteran and I don't trust this administration in anything.
4
You can be sure certain that preferred parties with the right political connections are going to make out like bandits when the VA collapses - and the taxpayers get stuck with an inflated bill for services and drug costs.
Doesn't take a rocket scientist to figure out that the fix is in...
1
Privatizing government service to benefit the donors. If the Koch brothers want to determine policy they should run for office. Anyone who thinks private sector insurance is any better is delusional. The focus should be on improving VA service not privatizing vets healthcare. Who stands to profit from this? Follow the money.
2
Sort of like private prisons, but even higher stakes.
Republicans are always scrutinizing the use of taxpayer funds (see: any school board meeting). So how can they be OK with sending billions to private, for-profit companies with little oversight?
3
Today it's the VA healthcare system. Tomorrow Trump will try to privatize Medicare and Social Security. There's a lot of money to be made and guess who's going to pay. The looting of the United States continues. While our attention is diverted by the phony emergency at the southern border and the Trump government shutdown, right wing forces behind the scenes continue to pick our pockets.
3
@Peter Cee Actually, they have already tried to privatize Medicare. That's what those medicare advantage plans are. More and more complexity, less and less care. How many times do they need to show in studies that our current private healthcare system costs more and has worse results? Now hospital systems are buying up doctor practices, so a facility fee is added and the cost will increase. The hospital in my city that costs the most does not produce the best results.
Though there can be some good from limited privatization where that would benefit veterans with more timeliness and accessibility, anything that has the stamp of the Koch brothers and Trump's shadow-VA kitchen cabinet cogitating at Mar-A-Lago should be examined very closely for the stench of the kleptocracy and looting inherent in our healthcare system, which is currently a rentier's dream and a fraudster's paradise.
Who would benefit financially from this? The claims processing industry? The insurance industry? Claim scammers? All of the above? Funny how it's often the same ideological sector that rails at "big government spending" that is so adroit at skimming off the top from it... maybe that's the point of their agitation?
3
Just what we don't need. The VA is doing a good job for us Vets. Let me tell you, it was the VA that solved my breathing issues, not the private sector. And as soon as I am done with this comment, I will order my medications through the VA website. No questions asked; delivery within in a week.
1
Integrate the VHA (and the Military Health System (MHS)) into a local community health system. Many VHA resources are underutilized and duplicative to what may be needed by local taxpayers requiring similar services. Aside from PTSD and TBI, most of Veterans ills are identical to those of fellow citizens. Taxpayer maintenance of two (three?) unique health systems is wasteful and inefficient. Develop a single, national Electronic Health Care Record, with Veteran/Active unique fields, as needed.
2
Why not give veterans the option of Medicare? Some veterans have access to fantastic care at great VA medical centers, while other may feel they receive substandard care. Let each veteran who has served us so valiantly choose what is best for herself/himself.
We have Medicare but only if you apply for & are approved for SSDI. Tricare is already in place & 90% of private drs already take Tricare. With Medicare you have to pay huge deductibles & premiums. With Tricare, you don’t. Tricare is the better system & deal for veterans.
As long as they do it at the same price and with the same quality try it. My concern, we have seen this numerous times in the past. People will see this as a license to scam the government. I think to be prudent the VA should decide if a patient qualifies to use non VA services and who they can see and what hospitals they can use in a local area. We have waste and fraud in medicare, medicaid and not the VA. This can be prevented with prudent oversight and software to spot outlier professionals and hospitals.
“'The belief is as costs grow, resources are going to shift from V.A. to the private sector,' David Shulkin said. 'If that happens on a large scale, it will be extremely difficult to maintain a V.A. system.'”
That's the ultimate goal, no? "I don't want to abolish government. I simply want to reduce it to the size where I can drag it into the bathroom and drown it in the bathtub." - Grover Norquist
"Prior to the November 2012 election, the [Norquist 'Taxpayer Protection'] pledge was signed by 95% of all Republican members of Congress and all but one of the candidates running for the 2012 Republican presidential nomination." - Americans for Tax Reform
I get my health care from the VA. It's ALREADY happening, and the care I've received via the VA system is FAR superior to the care I received in the private sector.
p.s. I joined the VA system, as the government mandated travesty would have bankrupted our household.
1
As a combat-disabled, decorated Vietnam veteran, I have nothing but good to say about VA Healthcare. I have experienced the care and compassion of VA workers, and their respect for America's veterans for decades.
The idea that any VA care should be privatized is just another example of plutocratic, corporate greed. Corporations are attacking and attempting to destroy American democracy just so they can pass on the spoils of the class war they intiated to the top 10%. A pox on all of them.
Save VA Healthcare for the Americans we claim to honor --Veterans.
3
Merging the VA with medicare makes the most sense but won't happen because the Koch Brothers (who are behind this) want to see both systems fail and become privatized. Once the government limits it's role to writing checks, they can start making those checks smaller and smaller. "Make government small enough to drown in the bathtub"
I’m a disabled vet and I have received VA care for five years. First, the V.A. provides awesome care. I’ve used three facilities in three different states. 99% of the staff are conscientious and caring. Any press you see to the contrary is anecdotal and fake news. Second, the V.A. has been outsourcing to private care at least as long as I’ve been in the system. This is not new news. Easliy 70% of my care has been provided outside the VA but supervised by the V.A.
4
By keeping the VA public, our politicians get to more fully own their decisions for growing and employing our military globally, and there is nothing wrong with that.
1
This country keeps playing whack-a-mole with health care expenses rather than tackle the problem. Unmanaged health care costs more and frequently delivers less. We need to bite the bullet and centralize as ALL the other industrialized nations have or go broke, both personally and as a nation. Will middle management in insurance companies lose some jobs? Will wealthy CEOs lose their astronomical salaries? Yes and Yes. But the alternatives are far worse. Medicare for all.
1
@Djr Let's not put all the blame on the greedy rich people. Look who put the power in the hands of politicians that get their marching orders from the greedy rich. This did not happen without the willing help of nearly half of the U.S. voters.
Any privatization in any field leads to increased administrative cost, poor service to the client, and massive amount of profit for few connected individuals. In healthcare today the insurance companies are laughing all the way to the banks while the patients are denied services despite paying massive premiums and deductibles. No wonder 65 percent of the physicians prefer single payer system now. Privatizing the V.A. proves only one thing that the government is incompetent in managing its own affairs. Twitting “alternate facts” does not lead to better services.
2
Privatizing is a means to evade accountability. This profit-driven administration is not the one to hand out the plums to wealthy cronies.
American veterans deserve the best. From my experience working as a (now retired) state RN for many years in secure units for mentally ill
convicts in State prisons, it is clear that adequate health care for victims of war and society's disorders will never be profitable.
Costs must be shared by the citizens. Care must not be diminished to allow the rich to become richer,
as is currently the case in our profit-driven health care system..
1
The private sector cannot manage what they have now. Increasing the number of patients will overload the system. That may work out in urban areas near large hospitals, but what will happen in places where there aren't enough providers now? Also if we are privatizing the VA system, I have a few questions: If you are shifting the problems in the VA system to the private sector, hoping that will "fix" them, what if it does not? And if you flood the private sector with many new patients, do you think anyone currently in that system will be negatively affected? Obamacare demanded everyone participate AND that preexisting conditions be covered. What will happen to the many veterans with not just preexisting conditions, but complicated and expensive problems? What will happen to all the veterans with chronic mental health and substance abuse problems? Medicaid pays for that now. And Republicans want to get rid of Medicaid. In short Republicans want to get out of caring for those no one else wants to cover, the patients who drag down profit. The bottom line here is if it sounds too good to be true, it must be. Perhaps it is time for open, Congressional hearings to try to shine some light on this. But , of course, Trump does not want anyone to see there is a huge downside to this.
1
Seems to me the perfect moment to rethink the entire medical system in the US, start implementing Medicare for All.
As always, the issue for Republicans is how to get the private sector nose into the trough without actually appropriating any more money;All the rhetoric about "access" is what in my day (when I wore a uniform) was called "eyewash". No additional dollars have been asked for.
I may be excessively cynical; I am a Veteran, and had emergency bypass surgery last August. I received excellent care in the local (Civilian) Hospital, and the VA didn't say a word about the costs.* BUT, the (VA Contractor) wanted me to make a forty five minute drive to the next county for my Cardiac rehab. I hung in limbo for six weeks awaiting the word that rehabilitation would be paid for by the VA at my (local) civilian facility, it was WHERE the contractor could get the "best" deal. Never mind that I had no reliable transportation to reach the next county.
* I was doing "Public Service Announcements" about how I followed the VA protocol, "If you Are having a medical emergency, call 911" First time in my life I called 911. Closest hospital with my chest pains...
I receive excellent care from my VA primary care physician, but there is an enormous difference making that trip (45 minuses to an hour, depending on traffic) Once or twice a year, and basically the same trip three times a week when you are not even supposed to be driving, a basic restriction for thirty days after the surgery.
It is REPUBLICAN failure to put enough money into the VA system that has caused the problems.
2
I think anyone who went to a US medical school that has a VA hospital on campus, as many academic medical centers do, understood what was common knowledge. That the care in the VA was not supervised as well nor was there much accountability if things did not go well and that is where you went if you were doing you first few cases as a surgeon. I think one of the problems that the internet and social media has created is allows everyone to shout out there opinion on something that they may not be that familiar with. The VA has needed fixing for 30 years, the Vets are not treated like private patients, they are not even treated like active duty military. If there was an article about the Boeing 777 and engine reliability with Rolls Royce I would not throw out my opinion as I don't feel I know enough about it to justify public commentary...but here goes....Boeing 777's give more turbulence especially with those new rolls royce turbofans.....I'm happy now.
3
i'm the widow of a decorated combat wounded veteran as the va calls it. THIS IS A TERRIBLE IDEA!! its all about making a buck off veterans. i've been reading more than one article about how this stuff is being dreamed up by some of trumps buddies at mar lago. look if there are wait times at the local va the answer is to GIVE THE VA MORE MONEY so they can hire more personnel and bldg new facilities.. well, duh, if u run wars for 17 yrs straight u get more demand for va services.
our experience at the va here in miami was excellent. my husband used the va and university of miami health system doctors. in many instances they were the same dr.s in both systems. but there was a special feeling at the va. it was a very comfortable, like a family feeling.
even the people who are advocating for this change can only cite studies that say the wait time for service is too long. the surverys say that once veterans are seen the service is excellent. ITS JUST ANOTHER ATTEMPT TO RIP US OFF. but why be surprised--the current administration is all about making a buck not serving the country.
1
History has taught us that crucial services like medical, including VA, SS, military, even some IT should be more regulated by the gov't than not.
Otherwise it will result in something like the de facto criminal health care system that we have today.
Gov't facilities that are not crucial like parks, golf courses etc. should be franchised out to private corporations but subject to some price control by govt.
Other corporation which includes the majority should be in private hands with the least gov't regulation.
History has shown us over and over again this is the best way to go.
2
The VA can negotiate drug prices, the private providers cannot. Guess what money is behind this move.
1
It's just another pot of money that the Kochs and their ilk want for themselves. They'll say and do (or pay others to say and do) whatever is necessary to make that happen.
The VA is providing excellent care and had improved significantly under Shulkin. They ousted him because he actually cared about the veterans and was protecting them from the Kochs.
2
When I was in the army during the mid-2000's, I still remember visiting a local private doctor nearby Fort Ord, where the doctor tried to diagnose me with sleep apnea even though I clearly stated that I didn't have any breathing problems when I'm asleep. Yet, he kept pushing me to take the diagnosis just so that he can provide a case to get more "free" money from the government. Mind you, this doctor is an allergist, not one that specializes in sleeping disorders...which I find really strange. I'm not saying that all doctors will do things like this, but they're out there...many ready to reap a lot of government benefits by exploiting service members' ailments.
I would question whether the private sector can absorb this large group. I would question how well non-military personnel would understand not only the physical needs of the Vets, but the psychological needs. I would question whether the government will back this up with enough money. Part of the current problem is also allocation and amount of funds.
If we stop and look behind this we will find the usual failed aspects that private can do better than government. This is asking for profit to take of not for profit. It is historically a failure. More than likely a power grab by individuals ready to defraud the government and the Vets. It is just part of the Republican Playbook. Government cannot work and I will prove it, every Republican running for or in office.
1
I already have a private doctor. He understands me very well. Oh & I’m 100% disabled service connected- Marine Corps. I refuse to step foot into a VAMC. VA healthcare is atrocious... hence why I have a private doctor.
This is what the media is too often missing while it covers the chaos of the Executive Branch. Profiteers and special interests are using their influence to divert government resources and repeal regulations in order to increase their bottom line...even if is at the cost of the public good.
2
Interested to know exactly who is behind this plan...qualified, knowledgeable career V.A. minds? OrTrump cronies from Mir-A-Lago who might (or not ) be more interested in "private" than "health care".
I believe that with proper, educated and experienced leadership who isn't politically beholden to this (or any other) administration, the same result can be had in improving servicing the Veterans. More doctors, more staff = more money. And just who has had their hands on the purse strings?
I don't believe this administration has any more compassion for our vets than they do for children of families on food-stamps or refugees from war-torn and cartel dominated countries. While Trump plays his grab-the-headlines game, this taking of the VA toward the slippery slope of privatizing government programs (a long-held GOP dream) is just another one of those news stories that isn't being regarded with the panic we should feel as our country is slowly being taken over in a coup by the 1% and corporate interests. AFTER there is one foot on the precipice, it will establish a precedent. Look what happened when we started using warriors for hire in Iraq. And how prison populations exploded, based not on justice, but profit instead, when prisons were privatized.
Is this a democracy? A government? Or just a profit driven organization that has a broad and powerful reach?
Think long and hard, my friends, when you next enter the polling booth.
1
This will be the end of veteran healthcare. People who support it either don't know what they are talking about, or they stand to gain a lot of money in their overseas bank accounts.
3
One point lost in the discussion is costs for veterans' health care have already been incurred. The only question is who will ultimately bear those costs: the public that was only too happy to send our sons and daughters "to fight them there so we don't have to fight them here" or those same sons and daughters who returned from the fight with battle scars, visible or invisible. I've personally opposed these splendid little wars of aggression because they are immoral, but also because our current defense budgets ignore the unseen costs we impose on those who volunteer. "Thank you for your service" doesn't come close to repaying the debt owed by those who, like Dick Cheney, "had other priorities".
2
The VA, despite its problems (and private healthcare is hardly problem-free), is the best healthcare system we have in the US. Because it is driven by care, not profit, the focus is on serving as many Veterans as possible with the best possible care. This necessarily requires that every individual will not get what they want, exactly when they want it. That’s what happens when the benefits of serving all, take priority over the wishes of one. In the private sector, assuming one has the wealth, they can get what they want, when they want it. That doesn’t make it better. That definitely makes it more expensive and it leads to disparate care for the haves and have-nots (see “US healthcare”). The VA system as a whole provides better quality care that is focused more on prevention and wholistic care (because it is serving a population) and therefore, as a whole, is more cost efficient. For example, the VA offers a broad array of evidence-based (EB) psychotherapies that are more effective than many medications currently used alone in the private sector. Try finding combined medications and EB psychotherapy in your community. Pills are faster (15 minute doctor visit), offer the patient the fantasy of immediate relief (“ask your doctor if X drug is right for you,” See also “opioid epidemic”), and better reimbursed by insurance companies, and fuel pharma profits. But at the VA it is not about making money, it’s about serving our Veterans.
2
When a Republican says “choice”, it’s code for redirecting public tax dollars to for-profit, private entities. We all know where the money goes in the private sector.
2
I am a veteran and work in a licensed healthcare profession and a few facts need to be brought front and center:
1- a significant portion of the care provided at VA hospitals is not any different from what is provided in the private sector. Bypass surgery is no different on a 70 year old Vietnam vet than a 70 year old draft dodger other than who is paying for it.
2- much of the specialized conditions treated by the VA is not significantly different from what is already available in the private sector. PTSD cares not if it came from a school shooting or a patrol in Afghanistan.
3- the VA facilities are often located far from the communities where eligible veterans reside and getting there is many times a burden. Transferring a patient from a private sector hospital to a distant VA facility just because the VA is paying for it is wasteful of time and money.
The simple truth is that the money wasted operating a VA hospital and clinic system would be better spent paying for care in existing non-VA hospitals. Give them a Medicare card and shutter the DVA healthcare system.
2
I have a very good friend who is a veteran and who loved in my house for years. He and I would compare notes on how long it took us to get appointments. He always was able to get his much more quickly than I can get mine in the private sector. For instance about a month ago I tried to get one to see my doctor. February 5 was the earliest I could get. He got his within a week at the VA.
Our medical schools do not turn out enough doctors to satisfy our annual needs for new doctors. Absent our poaching doctors from third world nations, our medical system would collapse. If you doubt what I say, visit a few friends who are hospitalized there you will see doctors from India or Taiwan and nurses from the Philippines or India. Our investment in medical education needs to be upgraded.
4
They haven’t been able to steal Social Security so they’re stealing the VA. It’s just the same, corrupt Republican playbook; slam an agency or government service, turn it into a culture war, lie about the inefficiencies and exaggerate the benefits all at the behest of the real parties interest, the corporate medical industrial complex.
1
As with all proposals from the Trump administration, we can count on this one to be poorly researched and poorly thought out. Republicans, of course, do not fund programs that don't support the defense industry and erroneously think private industry is always better and more efficient. What would happen is the VA system would get starved, and the ability to serve veterans would decline, leading to a death spiral. Costs would then skyrocket.
Let's remember that terrific "better and cheaper" healthcare plan republicans came up with after working on it for a decade.
1
I am astounded that a little known, not quite mainstream, "veterans organization" has the clout to engineer a feat that many real veteran's organizations abhor, along with many veterans.
I am beneficiary of VA care, care that I have nothing but positive experiences with. I have no need to go "shopping" for specialists when advised-my care provider takes care of this in my behalf. The wait times are quite tolerable and in some cases shorter than when I was a beneficiary of Tricare Prime.
And speaking Tricare Prime, it is a good system-to a point. The beneficiary needs to find that contract provider, needs to get preauthorization, and hope all of the associated activity is completed. That in itself is time consuming and may result in longer wait times.
Sadly, many will side with Trump and his toady in the VA, and believe everything the Kochs and their sham veterans organization will tell them. Those who support this initiative may pay the price in time with care that is less than they receive now.
Privatizing any aspect of the VA is a fool's errand as those successful bidders will only be concerned for one thing-the profit-rather than our care.
So, beware of those bearing false promises.
2
Government run single payer has been a failure to our veterans who deserve better access and better care, even the routine. That beacon of Leftists light Sweden privatized all their socialized health providers years ago, the result is better, competitive access.
The government fails at employing healthcare providers, and the VA ground zero.
1
As a taxpayer, I am suspicious. Fix the VA and provide care within their massive organization. Bringing private health care providers into the service delivery chain seems like one more opportunity to defraud the taxpayers .
1
The sole purpose of privatization is to make someone rich using public dollars.
1
Would I really trust this administration with its mendacity and corporate payouts to privatize the VA? Hmmm. Seriously?
1
Medicare for all. Then everybody gets medical care where they are.
1
My father, who served in WWII, loved the VA hospital and doctors who cared for him throughout his 2 year battle with lung cancer. Dad had not used the VA prior to getting gravely ill, but living in a rural area of Louisiana it was the best option for treatment of such a serious illness and he knew he'd get excellent care there (and he did).
Veterans deserve the very best care and services. By dismantling the VA health system Republicans show us yet again their hypocrisy (they pretend to care about the men and women they send into battle); their greed (this will put money in the coffers of the wealthiest whose greed motivates them to always and only want more); their selfishness and arrogance.
It could backfire on them. Many if not most people join the military because it provides a career with good benefits. Take away the.benefits (ie affordable, socialized health care among others) and why on Earth would they sign up?
1
My husband receives health care from the VA and it is the best health care system i have ever seen . I receive mine locally and it is beyond dismal . I wish I had access to a wonderful system like the VA. They want to ruin all that is good . They are drowning the government in the bathtub . Witness the shutdown . On and on . Trump has to go and his cronies running everything into the ground .
1
Let's take a closer look. If this is done to dismantle the VA, shame. If it can be a precursor to Medicare for All and negotiating Medicare drug pricing, it might work. The devil is in the details.
2
This is beyond insulting to people who serve this country . America is great for marketing but implementation is poorly done. Now we are doing anther financial give away to Trumps cronies. Privatization is further in your face cover up corruption by this administration. No changes should happen till we get all the facts on trump and Russia. The role his inner circle namely his family is involved in.
1
Isn’t this exactly how the oligarchs were created in Russia? Privatize state assets and hand them over to cronies who make billions in profits while prices and services creep up out of the reach of lesser citizens?
2
if it ain't broke, don't fix it. If it needs adjusting, tweet it.
This is essentially the charter-/home-schooling of the VA system.
Before of sapping the VA by drawing off resources, fix and improve it first.
1
Private? Public? Both uses of public funds can be done well if done competently. I touch one part of the VA elephant very day, their private healthcare pay part, and, that part is stunningly incompetent, opaque, impervious, whatever. It makes every government institution you've ever dealt with look like an Amazon distribution facility. I suggest the left and right, gov lovers and haters, hold hands and try first to make government competent by giving leadership the same authority over its employees as Jeff Bezos has. The haters would have to stop just wanting to kill the beast, but, the tougher task is for the lovers because they would have to decide whether they serve gov employees or the People.
Just another attempt to slash and burn, confuse and redirect attention to rob veterans benefits. This money will be stolen and aid to aging vets and those maimed in foreign wars will suffer. Privatize is code and thievery is old. Time to kick the monsters out.
1
Another welfare corporate program pay by the taxpayers. No wonder there is no money to improve the services provide by the public veterans hospitals.
1
Watch out middle-class taxpayers, your pockets are once again going to get picked as the GOP hands government services off to the private sector. Just like with the military contractors, there will be no monitoring, no oversight & plenty of campaign contributions to the GOP. Guess who's going to get fleeced?
1
This article doesn’t answer a key question. Since we can assume that the Koch brothers aren’t backing the Concerned Veterans of America “astroturf” (fake grass roots) lobbying organization out of the goodness of their hearts, what is their financial motivation for encouraging greater use of private healthcare by veterans, which the veterans themselves apparently don’t want? Do the Koch brothers own private hospital systems or other care organizations? Medical device companies? Drug companies? That would be useful information to have and shouldn’t be hard for the reporters who wrote this article to track down.
1
It is clear large government run systems, managed by bureaucrats, are inefficient, uncaring, and have worse outcomes than private profit based competitive practice. Why the persistence of the one payer type system lovers continues is bewildering. Bigger is almost always worst.
If the issue is advanced by the Reublicans, and if it was supported by funding from one of the Kochs' foundations, and if it involves privatization of a service previously provided by the government, then it is going to mean government money being funnelled to large corporations. This system will probably be a nightmare for Doctors and patients alike, but you can be sure some "investors" will wind up pocketing billions of taxpayer dollars.
2
"Concerned Veterans for America" was an early indicator of why this is such an important issue for conservatives. Although promoting free enterprise is the mantra, the real issue is far darker. The pharmaceutical industry and the health care system itself are also behind this initiative.
What they care about is not veterans, but their continue ability extract 17% of the country's GDP, essentially double what most countries with universal healthcare AND increased longevity pay.
Many years ago I stumbled on a study run by a think tank for the FDA (I found it on the FDA website) that showed what prescription drugs cost in various distribution models. It modeled the actual charges for a $50 list price drug if purchased by the patient (could be over $50), to prescription drug plans, HMOs, and even Medicare (each of these channels ended up paying from $34-$37) for the prescription. But, then there was one column that showed a much different result, $24. Although the column title wasn't very clear, research showed the purchaser was... the VA.
The long game here, for the Koch's as well as the medical industrial complex generally, is to remove any US example of a comprehensive single payer program, before someone starts using it as a benchmark for what might be possible in the country.
The VA has to die, so the pharmaceutical industry and the rest of the costliest, most inefficient healthcare system in history can live.
5
@John,
Very good illustration of what's really happening here: A greedy fight for private sector market share of a public sector-provided good, all so they can corner it and raise the prices for profit.
3
The arguments here are nearly identical to the public vs. charter school arguments, and a balanced system may have many advantages. However, in order for it to work, the worst performers in both categories need to be eliminated. Too many players results in conditions where marketing, advertising and competition for bodies becomes more important than the actual services.
Well, I’m confused. The Mission Act ‘sailed through Congress’ with bipartisan support, and the support of the service organizations. It was sold as supplemental to the VA system. But no additional funding was, or will be provided.
Now the proposed regulations are opposed by those service organizations. What does the legislation actually say- supplement or replace? What was proposed for funding at the time of this great bipartisan support?
After two years of trying to privatize, opportunize every government agency, action, I’m supposed to believe that all these veteran organizations, all the Dems, trusted this administration to...,supplement VA care? And now realize, suddenly, that 60 billion might be needed for implementation?
And you still wonder why traditional Democrats, loving compromise at every opportunity, are....being criticized?
4
I'm a physician in a little community hospital in Queens. I don't much like seeing vets; the VA goes through all kinds of maneuvers not to pay you for seeing their patients. Not enough to just submit a claim like every other insurance co. They want to see every note from the entire hospitalization accompanying your bill. And then they never answer any calls if you want to contact them.
2
Every veteran I've ever dealt with in my line if work prefers their VA medical option--hands down--to any privatized medical treatment choices. Vets scoff at switching to privatized medical care, describing better health care at better prices through the VA. The VA system works! This is just another shot legislators are taking to toss billions of your tax dollars to their own, their friends' or their political donors' money interests and dismantle a government program that works through funding deprivation and bad press. Don't be fooled--these efforts to dismantle a government funded program that works is not to favor veterans in any way.
154
As a Vet, I have had mixed experiences with VA facilities. Mostly good. They are incredibly crowded though. I was once sent to a private opthalmologist. Good experience. I don't agree we should have to pay a copay though. We earned this benefit through our service. Adequate funding would fix most of the problems. When I hear the Koch brothers are involved, it makes me think of Reagan's phrase, modified to fit industry, "We're with Corporate America and we're here to help."
10
@Me "We earned this benefit through our service."
I have a problem with that. There are plenty of jobs, plenty of ways, in which people can selflessly render important service to the country. Most members of the military never go into harm's way. I personally am tired of treating each and every person who ever wore a military uniform as if they were Rambo and Mother Teresa rolled into one.
1
The VA is sized in part to provide excess capacity to support major wars. It can rapidly expand, especially for trauma care and follow up.
Well, we've been at war now for 17 years. This is it, the needs of war. The VA needs to accommodate the actual needs of the actual wars, not some hypothetical needs of potential wars.
I've seen private care used to supplement the VA in the TRICARE program. It worked well. Of course it could be done badly, anything can be bungled. But it could and once did work rather well. It is a way to expand the VA to fill specific needs.
If that expansion is then underfunded, then it is bungled. Most things can be ruined by under funding. Our veterans deserve better, and many of our politicians at least say they understand that.
5
@Mark Thomason
you are incorrect. The VA Medical Complex was never intended or designed to "provide excess capacity to support major wars."
The VA does not send doctors into war zones or even to support base hospitals.
There is a rare and I do mean rare crossover where active duty service members with very particular conditions, such as missing limbs and TBI injuries, are detailed to a VA center with specific skills or research in those areas.
Those that can return to duty do so and then use base hospitals for continued care, otherwise they are discharged and become veterans with that statutory right to use VA facilities.
The VA is NOT the Tricare program and no private services supplement the VA in the way you claim. The closest to your claim is that a veteran with private insurances uses an alternative provider for some of their care.
What you don't know or just don't say is that in those circumstances if a veteran uses the private provider for some specific treatment, the VA will NOT also provide that treatment or anything involved with it beyond pharmacy support and their private insurance will be billed for that.
Like congress and certainly Trump, you demonstrate you know nothing about how the VA works but insist on spewing an opinion.
Shame on you, you are part of the problem.
1
I am a physician in a rural area with many vets. Many go to the VA to get some services and came to me as well. My interaction with the VA has always been positive. A few years ago there were "blockbuster" stories about veterans not getting care or timely care, but in my experience, they was overblown. Nevertheless, the blockbuster news expose, got the VA chief fired and and a promised of better performance.
My other experience about the private medical system (I call the Medical Industrial Complex) is that it is 98% about profits.
I practiced medicine for 40 years after taking that quaint "Hippocratic Oath". There is no oaths today, just profits. So the VA will walk into the lions den (with the Koch's who are certainly not all about profit right?) ready to dole out money for big profits for someone. Guys, keep your pens warm, there will be plenty of blockbuster reports about wasted money to come. Gravy train.
32
Back in the 1990s, my father who was a WWII veteran lived with us and received his medical care from the VA. We used to have to drive 1-1/2 hours one way to get him to the facility and then wait all day for him to see the staff. I wrote several times that, for minor problems or examinations (he had cancer) that he should be given a VA card that would allow him to see local doctors where a determination could be made about more extensive treatment. Of course, no one listened.
Glad to see some common sense enter the system. But it should be private care for lesser problems and VA care for longer-term hospitalization and care.
7
Having worked in academic, private practice, and in VA settings, suboptimal delivery of care within the VA are not related to the expertise or capabilities of physicians and allied healthcare staff caring for Veterans. Limited resources resulting in poor upkeep of the physical facilities, the glacial pace of planning physical facility updates or processes needed to define health care delivery, and ineffectual managerial processes are the most significant and frustrating obstacles to practicing and providing care within the VA.
In rural areas, where private care is limited to nonexistent but the cost of living is much more manageable, the VA health care system in the form of full service acute care and rehab facilities serves a valuable function and should be strengthened. In urban and suburban areas, the existing VA inpatient facilities should be converted to outpatient centers for primary care, mental heath care, and social support/resource assistance. Streamlined electronic healthcare record availability and access to local acute care facilities should be the gold standard for these areas.
Regarding VA tort claims, for every legitimate malpractice claim I've seen, there are 5 to 7 fold more frivolous claims lodged. Tort claims handled in the VA are resolved within months NOT years, as compared to the private world. Additionally, claims settled by the VA are not uncommon and have been fair.
11
@Terri - too much common sense and not enough red meat for partisans on both sides.
Your framework is obvious and makes sense to anyone who think about it without ideological filters. We face this dilemma on just about every issue. The truth is nuanced and invariably borrows from what has been proven to work regardless of ideology.
2
As usual, no one mentions why we can’t have a hybrid system. For the normal illnesses that veterans have (like most folks), it would seem private care would suffice. But clearly there are times when the VA can provide more appropriate care than can private practice. Why is it always all or nothing? Where is the common sense we used to have?
9
other than the fact this is now apparently under active consideration and planning inside the Trump organization, this story is hardly,news. Republicans always want to bleed already appropriated funds from governmemt services add give them, instead to the private sector. it's part of an ocerall drown governmemt jn the bathtub campaign,,and it has been going on for years in relatively plain sight. we know Republicans are basically vampires, so where's the twist?
I'm a Vietnam Era Vet and have been using VA health care since 1995 when I found out I was qualified for care. Now at 75 I find it harder to drive 72 miles round trip to the VA hospital for specialty care. The last time I was there I had a 15 minute appointment with a Urologist. Until last year I was going to the Tampa for Macular Degeneration shots in the eye (104 miles RT) now I get those shots locally (8 miles RT) through the Community Care Program. I have benefited from both. I don't want the VA privatized for many reasons, including use of the local VA clinics an the excellent care I've gotten over these 23 years from the VA.
10
"Tricare automatically allows patients to see a private doctor if they have to travel more than 30 minutes for an appointment".
I live in NYC. My primary physician is less than 2 miles away. It typically takes me 30 minutes or more to get to his office. Why should this be so onerous for anyone.
8
A Google search of "TriCare Prime enrollment driving times and distances" provides more information.
Having identified the Koch brothers as supporters of the proposed policy change, the article should have explained how it will benefit them. Because it's safe to assume that that some how it will.
54
@LSL The Koch Brothers engagement is not for them financially (directly), it's for them politically. They play the long tame. A federal bureaucracy with more than 370,000 govt employees is threatening to the Koch Brothers. They want the government to be cutting checks to the private sector, and employing fewer (unionized) workers. The idea is that those in the private sector will be more sensitive to over-regulation (ready "any regulation) and more likely to support lower taxes. I dont think they have the veterans interests in mind here.
The benefits to the Koch bros are that they can see more of their corporate politics and values run our government. Their vision for conservatism enacted without themselves being elected to any office. Their profits influence the direction the ship of state steers towards when we in effect have no one at the helm. Conservative fifth column mindset.
@LSL
It's also safe to assume viewpoints based on animus are skewed.
As someone who once interned in a VA hospital, this move to privatization is troubling. The VA provides excellent care and is often at the forefront in innovative treatment of issues that impact on veterans (e.g. PTSD, prosthetics). But politicians (mostly Republicans) want to shrink government and shift services to the profit-making area. Think of private charter schools, military contractors, and private prisons which have not served us well. The response to the increase in demand caused by wars in the Middle East should have been greater appropriations for training and recruiting medical professionals and more hospitals.
59
I am proud to work for the VA as a physician. The vets HAVE spoken, through VSOs, and their views are in complete contrast to Concerned Veterans for America, a VSO NOT run by veterans. Isn't that enough said?
I've seen patients in my practice who were very poorly served by private treatment in the community through the Mission Act. Fix the VA; don't parasitize it through this attempt to privitize it.
70
Healthcare costs in the USA keep rising as they have for the past several decades. Due to a combination of: third party payment which avoids direct consideration of the cost by the consumer (patient), profit seeking on the part of the private sector which is run like any buisness and excessive testing due to malpractice defense and further encouragement of over testing and overtreating by those who stand to make money on overtesting (radiology, cardiology).
A single system such as the VA or Medicare has a better chance at controlling these issues. VA should be run efficiently. Maybe open up the VA as an available insurance plan to general public and let the VA compete in that way If u just dump all vets into the private sector then government (we the tax payers) will just be paying more and more to a out of control profit addicted black hole.
Private sector is not always the best way to control costs because it assumes a price point that not all can afford. The price of goods is not set to include everyone and the system assumes that not everyone will afford the product. So if vets can’t afford it then government will be paying whichbis not a free market anyway.
Make the VA more efficient and competitive and open the VA to the public as a alternative ( Kaiser) to private insurance/ hospital systems. Make Va stronger not weaker.
32
Privatization, while always billed as favoring consumers, NEVER WORKS (especially when there is more than making money at issue, as with public utilities or healthcare). Ask England about its rail system (or, more recently, France) or California about energy or any American about healthcare. Believing in privatization is a conviction of religious libertarians, not a rational choice about quality or efficiency. We should separate church from state.
44
@Ruth Blader
I couldn't agree more-well said!
As usual, with any and every single clear improvement President Trump's first term has offered to benefit the lives of Americans, nit-picking panic over a handful of things that might happen if something else might happen make for negative coverage.
If indeed, as this article clearly states, the Mission Act will in effect resemble TriCare's efficacy, then this is a godsend for veterans and their families alike.
TriCare's services only improved on-base medical care for service families - my family knows this for a fact, not speculation - by alleviating overcrowded waiting rooms at service hospitals and infirmaries. The same benefit will play out for the Mission Act.
6
There already are policies that us veterans can sue but they are slower than the Veteran's Hospitals. It can take up to 4 weeks to get an appointment, I know because I have used them. We would better off expanding the VA system with more clinics nearer to ones home for more follow up after initial surgeries or in the case of shots such as hormone shots.
14
@William Carlson Actually it would be far better to give veterans the same healthcare plan that members of Congress get, not expanding the wretched VA system.
So hey - who are you planning on hiring? VA already can’t hire enough doctors or nurses. Nobody wants to be @ the VA. Literally no one. Plus VA doesn’t pay nearly enough to be competitive. Most of the doctors & nurses have to repay student loans.... just curious, but why are you scared of private doctors? They’re far superior to any VA doctor. They actually paid attention in medical school & private doctors aren’t bound by the Feres Doctorine. In other words, they already know if they don’t treat you right you can sue them unlike VA. You literally risk your life every single time you walk into a VAMC. Isn’t the whole point of going to the doctor to get better not stay the same or get worse?
The discontinuity of care my mother experienced in the private healthcare system killed her. Full stop. It just did. The wraparound care my father, now 90-years old and a Korean War veteran, receives through the VA system in West Haven, CT has saved his life many times over. I have no doubt he would not be alive today if it were not for the exceptional services he has received through the VA. This kind of comprehensive coordinate care is simply not available outside the VA network.
As a family member and caregiver, I can say that every person I have met at the VA facility tries to help, from giving directions to diagnosing a condition to ensuring that we understand how to transition my father back to his home, where he lives happily and independently.
It pains me to see the VA system and healthcare providers maligned routinely in public discourse, and we should be highly suspicious of proposals to privatize the best example we have of government-run healthcare in this country. I know not all VA systems work as well as West Haven’s, but many do. We should work to improve care across the board in the existing networks, rather than dump veterans into a private system we all know is failing.
53
IMO, the first step to any change in the VA would be to include it in the DoD, which is budgeted for $600B. Is there anyone--anyone at all--tracking how that money is being spent?
10
This reminds me of the increased privatization of the country's public schools, through charter school initiatives and laws allowing parents to escape failing schools or schools not providing services for their disabled children. Individual students may benefit, but public schools are deprived of needed resources and more importantly of the parents who are the best advocates for reform. Veterans deserve to have the best service, which similarly requires continued active support for the nation's veterans hospitals serving millions from those groups most affected.
43
I had, on several occasions, driven my father-in-law to VA facilities in Northport, NY and Palm Beach, FL. On every occasion he was treated almost immediately with practically no wait, even as he was shuttled between specialists and x-rays.
On the other hand I have accompanied others, my mom, and my kids come to mind, to emergency rooms at various hospitals where typically the wait was about 6 hours while the prospective patients were parked on a bed in a hallway.
Given those circumstances, I'll take the VA.
68
@MIKEinNYC thanks for these excellent anecdotes, I have had similar experiences, as I'm sure many Americans have.
11
@MIKEinNYC
The VA health care system problems are well documented. The VA's Inspector General and Government
Accountable Office were pushing for years for it to improve its appointment sheduling and records keeping. (Remember the secret list of veterans waiting for appointments?)
While a law had passed requiring that veterans receive an appointment within 30 days, many years later only 1/3 of specialty care clinics were actually complying. Clearly only some veterans were receiving timely treatment. You were both the lucky ones.
There is an opportunity to rethink and redesign the provision of heath care for veterans. Veterans deserve a transparent, less cumbersome service . Rural vets need routine services, physicals, hearing tests, various therapies, chronic non service related diseases and injuries close to home. The current system can send a patient 350 round trip miles, paying expenses for the patient and driver/caregiver, when the same service is available near home. This costs the taxpayer and the vet.
Why can’t there be a finite number of Veterans Clinics and hospitals designed for Reearch and care for service related maladies. A solution should not start with what we now have, but what we want.
3
I've been in the VA system, it was an inconvenient centralized mess with red tape accountability to the government without accountability to patients. Not sure what has changed now, but hopefully it is better.
But still...the government does fine at writing checks, they should stick to that whenever possible and not try to run a massive parrallel health care system when there already exists a better one which Medicare uses that actually provides people health care in their own community. There might be reason to fund new hospitals in neglected areas or if the local health care system is failing, but those facilities and systems should be for everyone, not just discount shops for retirees, dependents and survivors.
6
Follow the money to see who financially benefits from this arrangement to determine it’s merits. I’m betting their is a big connection between profit gains for large political donorsand corporate lobbying groups.
65
Three rich guys in Mar-A-Largo among others will be the ones benefiting. These three tech guys who know nothing about this issue were the ones who convinced Trump with this idea.
1
@DMurphy Exactly! Excellent observation.
1
1) Healthcare for all would include veterans.
2) Every privatization I have seen means massive increases in resources withdrawn as "profit," in a system that increases inequality, and which (no coincidence) produces large Republican donors, and donations, from those "profits."
57
One thing not mentioned is can/will the new model set fees for reimbursement equal to Medicare or less? It would seem that the government can mandate these fees be accepted at any facility to keep costs in line. Private facilities that are closer to the veteran’s home should be allowed to provide care making it easier for Vets. Isn’t providing best care options for the veterans is everyone’s responsibility?
1
How can the government force a private doctor to take a fee lower than Medicare? Doctors have the right to decide who to take and not work for charity.
14
I work in three settings: a community health center, an academic medical system, and the VA. The private health care sector will not be a panacea of service provision for veterans, especially at the level of primary care "gateway" services. The private sector will be ill-equipped to provide services for an influx of veterans. The private sector also will not have the knowledge or experience of treating the unique health care needs of many veterans, especially those who combat-related conditions.
62
What's the future for if not to meet challenges? Get out of the way!
I regularly see patients who split care between the VA and Not-for- Profit health systems. Typically they access the VA for lower drug costs, but want to maintain providers outside of the VA for better access acute care. and Specialists. When an individual receives care in two different health systems errors are more prone to happen: electronic health records don't communicate, medications are changed based on the VA formulary, accountability for laboratory monitoring is muddy. Care today, particularly for chronic conditions, is typically team based. Its harder to rely on two disconnected care teams. If Veteran's benefits were portable, my gut is that many would get more of their care in the Non-Profit or Private health care systems due to greater convenience and the desire to consolidate rather than fragment their health care.
8
The veteran goes to the Va in order to access the medicine that that UNAFFORDABLE outside the VA. The VA provides a medicine from the same class from its formulary but you criticize this success in getting treatment for the patient. Would you rather that the veteran get nothing? This in fact is a success of the VA. Many civilians who cant afford the medicine go without. The non VA providers would help their patients if they explored the affordable alternatives and didnt prescribe the highest priced med from every class if the patient cannot afford it. The VA outperforms the commercial world in this regard and in fact is the reason many veterans go to the VA-access to expensive drugs.
There is something else that people should know about the VA. Most of the doctors I encounter at the VA also operate a private care office across the street or nearby. If the VA is near a university, the doctors may also work there, as well as in clinics or hospitals associated with the university. You would be surprised where these VA employees show up. And they are not always employees. Many are contractors. And that’s the big difference between VA care and private care. If a doctor working in the VA makes a mistake, rising to the level of medical malpractice let’s say, like cutting off the wrong leg in surgery (it’s happened) the veteran cannot sue the doctor in a court of law like a private citizen can do when going to private care. The veteran patient must use the FTCA, Federal Torts Claim Act, and the Justice Department provides paid legal defense for the VA employee. Veterans get no free legal help. It’s a terrible setup for veterans injured in the VA system, a setup that guarantees the VA wins and the veteran loses. If a VA patient is harmed by a doctor operating as a contractor, the FTCA does not apply to contractors, so the veteran can’t recover any damages. None. Healthcare might be better at the VA, but ironically, the veteran’s constitutional rights to due process are useless because the VA is a government agency protected by sovereign immunity. Fix the VA by making it a private non-profit funded by government and return veterans constitutional rights.
7
Let the veterans make an informed choice then by clearly informing them of the issue. Not every medical interaction at the VA ends up in a tort, therefore the venue to correct that tort shouldn’t wholly drive the move to private care. There is a great deal of money at stake here which is what is creating the political drive to open the VA’s funding to private medical interest. Let us be balanced not a wholesale shift and driven by the veteran. We should be cautious.
32
@Christopher Finley If this is something being pushed by the Koch brothers, it should be avoided. Their only motivation for anything is profit. It certainly won't be care for the people it is supposed to serve.
When, if ever, the US gets a health care system that actually prioritizes patient care as its primary objective, that will be the time to switch. This will never happen under the private sector. Any move to the private sector by definition says that profits must and always will come first. How does this improve care for Veterans or anyone else.
The people who have put their lives on the line need to have their bargain with the American people upheld.
I would only hope that we as a nation will ensure that we will have fewer injured and distressed veterans by avoiding constant warfare, especially wars of choice.
48
As we have already seen with the Corrupt Trump administration, the drive to privatize veterans health care is nothing but a scheme to make some of Trump's buddies richer; look at what has happened with the other parts of government he has already corrupted.
The analysis is incomplete because it doesn't address and quantify normal health care needs from needs resulting from injuries in service (on duty or off duty coverage) and it doesn't compare and contrast the needs of long term military personnel with short term. Are we talking about treating those with serious injuries from combat, ex soldiers who hurt their knee doing something else, or seniors who happen to be veterans? What about pregnancy and birth care for veterans?
Does the military pay into the social security system? Does DOD pay into the workman's compensation system?
8
@Kay A simple point of clarification, no one who has served in the U.S. Military "happens" to be a veteran. Whether the status is the result of a roll of the dice by the government or an individual decision let me assure you that it is a status that is earned.
Private or not, the key is transparency, accountability and availability.
If private care can give the vets proper care with the best bang for the buck on a timely basis, everyone should support it. However, if it is another treasure trove to be raided, it will just be pouring salt on open wounds!
After a long stretch of war - this Bush instigated war has actually exceeded the Vietnam involvement - plus the greying of America has overtaxed healthcare in general and VA in particular. Offloading some capability constraint to the private sector is fine but the key is to make healthcare affordable to everyone, veterans or not
14
@Bos : It was an al-Qa'ida instigated war. It would not have happened if the Towers were not hit. Period.
@Bos
The VA has already demonstrated that it cannot be trusted to report honestly.
I see the value of the current VA system comes down to services given by caregivers knowledgeable in patient needs whereas the private sector does not have that asset available. That should be the end of the discussion for private care.
23
Doing nothing as the prior administration managed the VA is not an option. Providing our Veterans quality health care is of utmost importance. If shortening wait times to see a quality medical health professional in the private sector, then why not. Note for most Veterans who live in rural areas, they do not live close to a Veterans facility or Hospital, thus many will do without care, because previously they could not see a health practitioner who was not contracted by the Veterans Administration. Just as most Medicare recipients in the past 15 years have opted to equivalent to PPO private providers who make it more convenient to see a Dr in-network and just pay a small co-pay - affordable with out the complex forms to fill to get payment refunds. If we strengthen the private insures then one day we could conceivably get medicaid onto this platform to then implement universal health care with several strong private insurers competing for clients. Priority is to care for the Vets - why fight this unless your not a Vet?
2
@Realist Healthcare for profit puts the veteran or anyone else a the bottom of the priority list. Would you go to a carpenter or taxi driver for your healthcare needs if they charged less than a medical professional? No? Then stop trying to shift us vets back into the private sector where we'll pay more for care and any necessary drugs.
here we go..."the prior administration"...wasnt it under said "prior administration" that the VA started the Veterans Choice Program, showedvdecreased rates of suicide for those enrolled in VA and was the leader in cutting edge TBI research
From investigation and reports it appears the V.A. has a bad history of serving veterans. This may be a result of the V.A. having a monopoly on treating veterans. The V.A. should be limited to treating those with battlefield injuries, etc. Their other medical needs are no different from those that did not serve. If the objective is to provide those veterans with medical care it can be done through Tri-Care or a similar plan. Under Tri-Care the veteran can go to any provider who accepts that insurance.
2
@clayton: In the past 5 years, I've received VA health care in California and Pennsylvania. It has been FAR superior to that which I received in the private sector prior to that.
3
@clayton That's easy for the non-volunteer to say, pal! Just because a guy didn't lose a leg to a landmine doesn't mean he wasn't injured in battle and keep in mind that when the veteran volunteered this healthcare was PROMISED to him as part of the deal for defending the 90+% of Americans who do absolutely nothing for their country.
1
As a veteran who qualifies for free care, I think this change is much needed and long-overdue!. I don’t know why people think that the Best way to care for the veteran population was for the government to create a parallel hospital system.
VA hospitals are clogged with people who don’t need to be there and could be getting treatment through the private sector or, as the article mentions, through a VA or private sector health clinic.
While some see evil motives (e.g., sending government money to the private sector with no oversight) the reality is the veterans administration has taken on the behavior of other government entities which resort to captive populations, bureaucratic tricks, and Requests for budget increases in order to retain or increase their influence with little evidence that increasing the budget or not allowing veterans to see care elsewhere is in the veterans best interest
5
Many of us question the motive behind the change: it isn't to improve care, it's to channel more public funds to the private sector, while appearing to make reforms. That is the direction of this administration, and of the GOP behind it.
They fail to provide public information regarding expected consequences. It is outrageous that the Administration could launch a plan that makes for massive changes affecting millions of people, without having to have a complete public
"discovery" process and hearings.
If the goal was to increase access to specific forms of care, it could be done without major changes to the entire system. Supplementing, not supplanting.
The VA did have deadwood which needed paring. Like the military, it is not rigorous in eliminating those who are incompetent at high levels - it just moves them around. That is a question of REFORM.
The VA would also like to shut down large facilities. And SELL the properties -- a potential one-off revenue source.
In rural areas, VA funding might be channeled to local hospitals and clinics - a potential benefit - but will there be expertise in handling all veteran needs?
As far as stimulating VA hospitals to compete against one another, has this been a great thing in the "private" and NFP sectors?
Needed: public input. Trump and his band of elephants have never had reason to use VA services. How about input from those who have?
31
@cheryl
There are many concerns. Thanks for contributing. The lack of health care resources in rural areas does need to be addressed. However, many, perhaps Most of those areas don’t have enough resources for the private sector either!! Our system has eliminated health care access for So Many under the Consolidation (elimination) of services which continues forward to enhance Profits.
12
Pay attention to what Trump and Devos have done in education.
I say yes. Dismantle the VA system and put every citizen into Socialized Health Care. And Veterans who are impacted by there service will have the best medical care available. Government can do it and it must do it. For Profit medicine has to go.
16
@Abingdon. That's what the VA already is, exactly what it is already. You have no idea what you're talking about.
@Ruth Kenrick LICSW
So sorry....I think you misunderstood me Ruth. I think we should all be covered without the burden of the Private Sector trying to turn a profit.......... Vet or non Vet
As a service disabled vet, I'd like to point out the following. The doctors, nurse's, therapists, and ancillary professionals are paid way less than their counterparts in the for profit system. A majority are also Veterans, which is a big plus for most of us - they speak our language.
Coming back from combat, we are all different than before we went. We have unique problems and unique needs. If it wasn't for a very special LCSW, I would be another suicide statistic.
Personally, I can see both sides of the issue. Yes, faster access to care is a good thing as long as its not at the cost of what makes the VA special - the caregivers. Yes, we have in place a method to access care in the private sector. A thity day wait though is a bit much - if it relates to a service connected condition. For routine care however, I don't see an issue.
Congress should NOT force the VA to carve out additional funding for private care, if that's the direction they intend. Funding for private care should be ancillary.
29
"Someone is wrong in the state of Denmark!"
I feel that this is a very, very bad idea and there may be more behind this "transfer" than just supposedly taking care of the veterans. If this does occur, then huge markups for the costs of equipment, disposables, doctors, procedures, and care of the veterans will most definitely happen. When this will happen, and it most certainly will, the veterans will not be given ,the same care as the costs will skyrocket out of the hands of the Department of Veterans Affairs. Care of the Vets will become secondary, and profit motivation will be first and foremost.
I would like the NYTimes to do a series on investigating this "plan", and find out who knows who, and what the connections are between those in the trump administration, and those private health care "providers".
This plan is more about finance than the care of those most in need-the veterans!
33
@Majortrout
A quick answer to your questions: the once-obscure Concerned Veterans for America, an advocacy group funded by Charles and David Koch is pushing for this "plan". You can bet that there is huuuge money to be made.
3
@Jeanne Prine
Thanks - that should have been noted, or included in a foot note.
This will add to the profits of insurance companies and break the VA. Eventually veterans will be adding their voices to demand single payer.
31
Well, shifts to the private sector as a well to completely end government sponsored or run healthcare is the ultimate GOP goal. The Trump administration is also encouraging seniors to shift from traditional Medicare or Medicare Advantage. In the short run it may seem great (some Advantage plans offer things like dental and health club participation, which Traditional Medicare plans do not). However, it is not hard to imagine the GOP moving to end Traditional Medicare as more seniors shift to Advantage plans. Then they begin to move to vouchers for the Advantage plans, then the vouchers become a smaller and smaller % of the cost of Advantage plans.
The VA system could very well go the same way. Shift more folks to private care & starve the traditional VA system. Then shut the latter down. Then freeze the amount the VA will pay for private care so that over time it pays less and less of the bill...
30
Most Vets I've known and spoken with, like the VA, want to continue with it and have its services improved therein, and do not want it privatized.
Other than private political and self-aggrandizement motives, there doesn't seem to really be any altruistic purpose to derail it.
53
@Quandry: Agreed. I receive VA health care, and in PA, the system is ALREADY sending vets into the community for care. The VA has taken better care of me that the private sector EVER did.
@Quandry
Clearly the quality of VA health care varies across the country. It's only fair to those in poorly performing VA hospitals, etc., to receive the same level of care you receive in New York.
Like many here, I too am a veteran. In principle, I agree with the proposal to increase the availability of private sector healthcare to vets. I believe the veterans hospitals should focus on injuries and other conditions unique to the battlefield and its research should also focus on this. My biggest concern though, would be VA doctor reimbursements. Like Medicare of Medicaid, sooner rather than later, Congress will attempt to cut or otherwise limit reimbursements to doctors and again like Medicare and Medicaid, fewer and fewer doctors would participate in the VA program.
37
Very good point.
I'm retired with 23 years of military service. I was not wounded or inured during my service. I do not have any service related disabilities. I am therefore no different than any other citizen of this nation. I should not get socialized medicine through the VA that my fellow citizens do not get.
Those wounded or disabled in service are of a different category. I believe we should limit VA to those veterans only. They have specialized needs that the civilian medical system is inadequately prepared to serve. Having said that, I also believe all Americans deserve high quality health care they can afford. I think a single payer system would work best. As someone who participated in the defense on the nation, I now want my fellow citizens health care needs meet. It is a measure of a decent and functional society.
53
@Some Dude. The VA is very specific on who can or cannot receive medical benefits. Unless you have a military related disability or fit into some other category such as a former POW, a Medal of Honor recipient, or at a minimum a Viet Nam Service medal, you would be placed very very low on the priority list that would make any VA care unlikely. Those that are not eligible under the current rules can still qualify should they fall below certain income levels. If you are retired after 23 years of military service (and thank you), you already have military medical benefits, either through TriCare for life or some previous medical plan. You would not need VA care.
1
@inhk
Just so! I am somewhat suspicious of @SomeDude's reasons of why just "combat veterans" should get VA care and all other Veterans should be banned. It sounds like he is a tad jealous.
As a veteran, I have grown to cherish the va hospital system. They have always treated me well, and I'm worried all be put into a privatized healthcare system where there's a constant revolving door feeling. Appointment times might be a little farther out, but they serve thousands of vets in my area with quality care. they make sure you get the time you deserve when you do come in for your appointment.
I haven't seen anyone talk about the employees at the VA hospitals either. Many of these healthcare workers forgo bigger pay checks in the private for profit healthcare system, to serve a very special population of people. Lots of these workers are veterans as well!
I volunteered at my local veterans hospital to help my fellow veterans and earn application points to apply to a local nursing school. I found the experience to be eye opening in how involved they are in the local veterans community, and how big a part of it they are as well. Many veterans knew each other on a first name bases here, and shared in stories of their time in the service. It's a hub for our veterans community, and they offer many other services besides just health care to us.
I hope when I Finnish my nursing school I can work in an establishment as fine as this, that is this dedicated to its patients.
61
@Garrett I totally agree. As the wife, sister, and daughter of vets, I love the VA. The medical staff at VAs are just amazing. The administrative systems sorely need to be improved, for sure. Those improvements could happen for a fraction of the cost of privatization. Privatization only transfers billions of taxpayer dollars into the medical industry's pockets, reduces accountability, and effectively shrinks the VA system down to nothing.
43
Did I like driving 45 minutes everyday for two plus weeks to visit my husband at the VA hospital? No.
Did I appreciate that they weren't in it for profit, and were more worried that he wouldn't be coming back for the same thing a month later? Yes.
I have worked overseeing services that were farmed out to the private sector to 'save money'. Trust me. The only way they can do it cheaper is by cutting somewhere that can't be easily seen. And leaving us taxpayers to clean up their messes once they'd gouged all the profit they could and 'sold' themselves so it could start all over again. Or canceled their contracts leaving us scrambling to rebuild the resources to take over the job again.
67
I’m not a vet, but I see the same pattern at work here as in “public” charter schools taking public money from public schools for private benefit. Or privatizing the post office, or NOAA, or NASA. If there’s public money available then private business should get it for their benefit.
31
@John Grove I agree that this trend is echoed in the charter/public schools arena, as well as some others. It is a horrifying trend, to use hard-earned public tax dollars for private benefit and profit. We need to give more support for public areas that benefit the particular area of the public involved; Vote more $$ for the VA and more VA hospitals and doctors. The private sector of medicine is [too]well-served by insurance companies with high rates, and the service, I have personally found, is no better and less caring. The other alternative, of course, would be to downsize the military, make Congress responsible for foreign military involvement, rather than license to a president, and have a much smaller military/industrial involvement and use that money to take care of our Vets.
37
@Mike J-Agree with your concerns just look at private prisons and the outsource of military and supply operations to private companies and mercenaries.
20
@John Grove
These changes arose because those systems were performing poorly.
I work at both a private-academic Hospital and VA Hospital as a resident physician (soon to be a VA Physician) and I can say this shift of funds is going to hurt veterans. VA hospitals, while not perfect, have shown to have better outcomes at a lower cost. They really make do with a lot less, and is a prime example of socialized medicine done well (though no one wants to talk about it). This is no different than the starvation and degradation of public schools and public sector services.
The private sector has one motive, and that's to make money. For a lot of the private sector hospitals, even at academic hospitals, it's about getting patients in and out as quickly as possible while getting as much money from the insurance company, even at teaching hospitals. For a lot of VA doctors, they work at the VA because they believe in the mission of taking care of those who served. They often work at a lower salaried position.
I see so many veterans that are in poverty, barely living pay check to paycheck with a lot of chronic issues and the VA is a form of a safety net. We provide them housing, mental health services, and a lot of multidisciplinary geriatric care. Should this system go away, a lot of them will suffer.
Yes there are problems at the VA Hospital but let me tell you, there are a lot more problems in the private sector.
192
@Allen. Exactly so. I am a VA mental health provider. Wait times are often longer and care fragmented in the for profit private sector. This privatization of the VA will hurt veterans and result in fewer providers inclined or able to work at VA. It's a boon to private health corporations which will pick over the skeletal remains of the veterans' healthcare system. There also by design are few if any accountability or outcome tracking measures to burden the private sector, while VA is awash in them--the result will be the perpetuation of the illusion that VA is "bad" and private care better.
15
@Allen
Rationing is one reason for the lower costs. Often the wait time is longer. It is one of the most widely used methods of cost containment.
1
@Allen
Thank You, hitting the nail on the head. The VA has been my "provider" for twenty years now, they do very well with no complaints from me.
My biggest issue is the (Patient) chuckleheads sitting around the waiting areas at the local VA watching FAUX news in their MAGA hats; They refuse to understand that the VA is what a successful socialized medical experience is like.
4
Private hospitals don't have the type of specialized care that many Veteran's who have sustained physical and emotional help need, taking money away from the VA System will only weaken the Veteran's Hospital System, not improve it.
This is a disgusting example of total mismanagement and breach of what the Veteran's have expected to get for their service.
81
Not all veterans get or are qualified to get care from the VA. Only service related injuries and disability are qualified for care in most cases and most of the care rendered is not significantly different from what is available in the civilian system.
DVA healthcare is a dinosaur that has outlived its usefulness.
2
@David Gregory
As a vet,your information is not accurate. I am not disabled or have service related injuries and I have been in VA care for 18 years.
It is progressive and vital for me and other veterans.
52
@David Gregory Congress could remedy the qualifications needed and the expense to Vets for their service. Many vets have all their medical needs taken care of by the VA, and gratefully so, not just service-related. This was the bargain/contract made with these young naive, shave-tails when they signed up, and should be honored, reverently.The care rendered, in those applicable prosthetic and PTSD cases especially, is significantly different from out in the civilian medical areas, and , rightfully so. It may need lots of improvement; that is where the thrust of our improvements and financial efforts should go, not to making some private hospital chain and their doctors richer on the public tax dollar, especially for no better-often worse- service.. The VA is most certainly NOT a dinosaur, quite the opposite-more so it the general US Healthcare system!!!
2
Let me guess. Republicans’ corrupt offshore shell companies with no knowledge of health care own these private companies taking over the VA. Or maybe they’re the same companies that own the private prison.
62
@Diamond
You could have looked it up. Here:
https://www.propublica.org/article/ike-perlmutter-bruce-moskowitz-marc-sherman-shadow-rulers-of-the-va
9
@Susan Anderson thanks for posting.
1
There is good and bad to this change. One of the under-recognized negatives is that civilian providers rarely receive formal training in veterans' cultural awareness and they do not know how to take a proper military health history. These are not included in most medical school curriculum or continuing medical education. Even worse, many providers are not interested in learning these skills even when given the opportunity to do so.
20
There are so many services that Veterans will not have in the private sector that they now get in the VA clinics. I am a physician who worked in the private sector for over 30 years and am now working in the VA. I can now have Mental Health see a Veteran within minutes, as opposed to the weeks or even months it takes on the outside. I can order and have a CT report available within 20 minutes; it can take over an hour on the outside just getting prior authorization from the insurance company. In house social work, homeless programs, Veterans Justice programs, etc. are all in house with same day access. As one of my conservative Republican friends said, 'whoever thought the VA would be a model for single payer health care.' It's here now.
80
@PutneyS - you sir are the exception, as is the VA center you work for. At our local VA, It takes 20 minutes just to get routed to the proper agent when I'd call on behalf of my elderly father, a WWII Vet, to schedule his annual physical exams or have a question. Dad went to the VA his whole adult life after his service, but when he reached his 90's, he elected to stop going on a regular basis, so the VA wrote him off the books and wouldn't reassign a physician. He's been to the VA ER a few times after that, and treated for minor injuries from falls, so it seems the VA works best under those circumstances. We recently celebrated his 99th birthday.
I don't think this should be legal, these are tax payers funds, which are budgeted for the VA, a Federal Agency in charge of administering the Veteran's Hospital, taking money away will hurt and destroy the system and care.
I think all Veteran's Organizations should file law suits to prevent this practice which on the surface looks like a good thing, but it will destroy a system that has worked well since it's inception, but needs to be tweaked and improved, not look for ways to destroy it.
This seems to be the modus operandi for anything Trump does, destroy the Federal Government Agencies that have long help and supported the American People in ever phase of their lives.
33
So, the Republicans are trying to take away our health care while they reinforce it for their warriors. Do I really have to spell it out?
12
@PATRICK Pretty clear, right? And they are "reinforcing" it by lining the pockets of their major donors in the private medical/hospital industry with our taxpayer dollars.
@PATRICK Almost, but not quite!! The GOP is trying to take any/all public monies, and channel them-legally or not- to their privileged private sectors, and of course, meanwhile, cut their own taxes, If this means cuttlng healthcare fro the 99%, so what; if it means channeling VA dollars to said private sectors, so what, even if good caring medical helpfor all GIs is thrown out in the bargain.
As someone who has worked medically in both private sector and VA, I can report that VA care is superior. My private sector colleagues will never believe this, however. It is true that the VA care could be even better-- it is deliberately underfunded. Funding is the main thing standing in the way however-- given the many deleterious features for providers in contemporary private medicine, it is never hard to fill empty VA slots with excellent providers. I know-- I have done it.
The veterans themselves rather overwhelmingly prefer to have a place of their own as revealed by numerous surveys. They are great to treat. The main problem working for the VA isn't medical-- it is administrative. Regional and Central Office work in arbitrary and capricious ways and too often do not comprehend the need to spend funds to fill provider slots even when they have the money.
Even with present drawbacks in VA care, veterans would be most unhappy in the private sector, would be my guess. The private sector could learn a lot from the VA but it never will-- its prejudices are too strong.
72
The problem is, the private sector medical facilities and physicians cannot absorb the veterans. There will be even more people without timely access to care. Not a solution.
30
I recently transitioned to the VA from the private sector and find the VA excellent by comparison. Instead of talking about privitizing the VA, the discussion should be about a single payer system modeled on the VA. Europeans pay about half of what we pay for health care. Everyone is covered, they live longer, have a lower infant mortality rate and overall they are healthier. Why do we continue to buy the falsehood peddled by the Kochs that anything run by the government is inefficient and should be replaced by profit motivated private corporations? Can’t people see that they’re picking our pockets?
112
@Dewey
It's not for lack of trying. The Veterans Choice and Accountability Act of 2014 was passed to address problems and provided billions of dollars. Problems persisted. It's taken years for the realization to sink in that the VA would never be able to provide quality care for all its patients.
Most young veterans are suffering from PTSD returning from gulf and Afghanistan ! They are used to to be pampered in VA system with unlimited time spent to their satisfaction during encounters by VAMC health care providers.
Private practitioners will be only seeing them by the number they are used to like a mill and would not have the courtesy and time needed to adequately sit with them and listen to these agitated veterans under stress .
These Veterans will surely suffer as a large number of VA centers will be closed to divert funds into private care to benefit the self centered private enterprise .
This is the issue that Dr Shulkin had in mind but some one with personal agenda is prevailing with President Trump’s blessing and it will be too late to reverse the irreparable damage being planned against the wishes of most veterans organizations who understand the long term damage .
When the Veterans with multiple complex medical and personality disorders will be selectively rejected from appointments in private clinics as being not cost effective patients ,there will be no recourse left for them except increasing the already high incidence of suicides.
Capitalists are playing their dirty game as usual against those who have given almost every thing for their country and Koch brothers are shamelessly capitalists without mercy and have billions of dollars to spend in political lobbying .
How many home less Veterans have they helped with their ill gotten wealth ?
48
@Anokhaladka
Koch Brothers are not going to live much longer. If they are believers they should be fearing the consequences of their evil deeds that affect more people in this country than Gengis Khan and Hitler affected in their Times catastrophically.
And given their MIT educations, they should be aware of Pascal’s wager and act accordingly. Which they are not.
13
Is this plan courtesy of the Mar-a-Lago trio of fat cats who have never served a day in their collective lives? Do we know what their financial involvement is?
63
@Sandra Lee Easy to guess, right?
We are on our way to a complete meltdown of a civil and democratic society that FDR tried to construct after the great levelers of the Great Depression and World War 2 took their toll in the US. Thanks to Reagan and the other brainless or spineless (or both) presidents and congressional traitors to the idea of a just society, we kept losing ground.
The Veterans Administration is one of the few remaining institutions in this country which operates on principles of a just society. We privatize that and we might as well put our mothers on sale next (or privatize them!)
Enough. Wake up and vote for Warren and or Sanders despite of everything the Times tell you. Please.
44
@Blunt World War 2 brought the US out of the Great Depression
@William Smith
That is not the point though.
The great leveler works in a way that after it passes society has a more balanced income and wealth distribution.
Best measure for it is the Gini coefficient (goes from 0 to 1 with one being the most unequal, that everything goes to one person versus zero where the distribution is perfectly equal for all get the same size of slice from the pie).
The Great Depression and the WWII lowered the Gini. The fact that the second helped get rid of the first is not of consequence here.
Sorry for sounding academic but it is the easiest way to explain.
Read Walter Schiedel’s book called The Great Leveler. You will like it.
1
I do not have much in depth knowledge about the V.A.
After reading many of the comments, I see this as another Koch brothers attempt to send public money to private coffers.
If the Koch brothers are for it, it is bad for Veterans.
58
Correction.
All "public money" was first earned in the private economy, until that money was made "public" via taxes.
There is no special selflessness in the public sector. Those folks are out for their own personal benefit too.
Government employee unions and their enablers in Congress and state legislatures have awarded themselves paychecks, benefits and pensions that exist nowhere in the private sector. Millions of government employees are virtually impossible to fire, regardless of their job performance.
All of the above are paid for by taxes on the prviate sector.
Veterans deserve excellent health care. No matter if that health care is delivered by the VA or private providers, it will be paid for by taxes, without which there is no "public" money.
3
@Fred Rick
However, there are no "owners" or shareholders extracting profit in the public sector. We the people are government employees, and we are paying ourselves the paychecks benefits and pensions that all workers deserve.
5
@Fred Rick
You are totally wrong about the employees. Most medical practitioners lose salary when they move to the VA. Look at the tens of thousands of vacancies that the VA cannot fill and you will see that it is not about the money. Also, what's with the race to the bottom mentality here? The private sector merely squeezes the workers to fatten the execs at the top. Remember the middle class? It existed because there were living wages for everyone and execs that didn't take everything. Your starting beliefs are wrong.
1
Privatization is another word for the one tenth of one percenters gorging themselves on your tax dollars.
51
First the tax cut. Now Trump is diverting billions of tax dollars to private businesses at the expense of the VA. This is nothing more than another one of his smash and grab heists from the federal treasury.
34
Here we go .. now that will ruin the VA too ... literally sickening ... I have never met a vet yet, including my father who did not prefer the VA over all other care. This country just keeps going in the wrong direction every where you look. Esp with health care.
38
The VA is a complete waste of money. Can we take profit out of healthcare? Wake up Americia, you are asleep behind the lobby wheel.
2
@Michael. Is your assessment based on empirical data? Are you a beneficiary of VA healthcare? If not, then you are quite uninformed.
31
@Michael
Japan has taken the profit out of health insurance companies. So yes it can be done. How is the startup on matching private care providers with vets going?
1
VA medical facilities are chronically understaffed. Open jobs go unfilled because the salaries are too low to compete with equivalent private sector opportunities. Too few doctors + many patients = long waits. Republicans say starve the VA further and throw the patients into private care that is less efficient. I say give the VA the resources needed to hire and retain staff. A well-funded VA will serve as a model for quality single-payer universal healthcare.
61
@WP
The VA was given $16 billion to fix its problems in 2014.
@WP
All true !
COMMUTING IS AN ISSUE. EMERGENCY services required near home. TRUE most Vets have ordinary, run-of-the-Mill illnesses. Let's have both!
It is clear to me that billionaires like the Koch brothers are strange creatures devoid of conscience if they think making money off the people who have fought to preserve their property rights and who now deserve the best of care is a moral action.
I wonder if these billionaires have found that their billions make them immune from attacks of conscience such as ordinary humans suffer. It seems as if it does.
Very sad if it is true.
23
@Pajaritomt
Koch Brothers are I their last legs. They will die despite of all their money and rot like all other organic matter if not cremated before.
I will rejoice that day. Evil rotting away gives one hope even though it may be just be an ephemera.
I dream of a Rawlsian Society every night. One in which there are no Koch Brothers and Mercer Père at Filles.
Believe me. I cringe when I see the name of David Koch in front of the Metropolitan Museum or the Met at Lincoln Center. How hypocritical for them to rob the country out of decency and fund the arts!
Step One is to p]ay providers Market Rates. Doctors, Nurses, Therapists, technicians, etc. With market rates the level of service can be significantly increased within the VA system.
Some specialties may well be best supplemented by the private system, especially where more advanced technology (like the Di Vinci Robot) is available. I use the VA for basic medicine, but all surgeries have bee by private doctors, paying with Medicare and Supplemental.
If there will private care available to Vets the money needs to be raised to pay for it. Instead of looking to cut existing VA Medical Funds or other medical program it will probably be necessary to increase the top tax rate for individuals plus increasing the basic rate for corporations to 25% - 27%.
8
Trouble with this is, it's another kitty for the private sector to loot. I see it has Kochtopus fingerprints. Here's some more (ProPublica is some of the best and most reliable in-depth reporting in the world.) https://www.propublica.org/article/ike-perlmutter-bruce-moskowitz-marc-sherman-shadow-rulers-of-the-va
"The Shadow Rulers of the VA: How Marvel Entertainment chairman Ike Perlmutter and two other Mar-a-Lago cronies are secretly shaping the Trump administration’s veterans policies."
It begins thusly:
"hundreds of documents obtained through the Freedom of Information Act and interviews with former administration officials tell a different story — of a previously unknown triumvirate that hovered over public servants without any transparency, accountability or oversight. The Mar-a-Lago Crowd spoke with VA officials daily, the documents show, reviewing all manner of policy and personnel decisions. They prodded the VA to start new programs, and officials travelled to Mar-a-Lago at taxpayer expense to hear their views. “Everyone has to go down and kiss the ring,” a former administration official said."
"Trump and Perlmutter regularly talk on the phone and dine together when the president visits Mar-a-Lago. “On any veterans issue, the first person the president calls is Ike” ... Former administration officials say that VA leaders who were at odds with the Mar-A-Lago Crowd were pushed out or passed over."
Trumpistan has worked hard to remove knowledge from public services.
20
I am a 73 year old veteran who was drafted and one of the "benefits" of my service was supposed to be free medical care for life. I never left the states-as did 25% or so of the "greatest generation". I have great insurance between medicare and medigap and no deductible but I still use the VA to cover the cost of insulin which is ridiculous given there is no generic to reduce costs.
I have a unique, probably controversial suggestion. The draft ended in 1973. Let's sunshine the VA medical system when all who entered military service prior to the end of the draft. All who entered the service after that would be covered by Tricare when the left the service only if they had a verifiable service connected disability via a thorough physical. The cost would be greatly reduced because there would be no coverage for lifestyle choices resulting in need for medicare not related to military service.
3
First privatize the Va, then do the same to Medicare and Medicaid.
See this month's National geographic, there is a nice graphic showing the US spending the most money per capita on health care, and the life expectancy declining.
The Trump Administration, and the GOP, have to make those tax cuts look like they are actually paying for themselves. What better way is to push veterans into our woefully broken, for profit, greedy health care system.
The next thing the Va will do is institute life time caps and not cover pre-existing conditions. Go shot up in Iraq, Afghanistan, Vietnam, etc; guess what you have a pre-exsting condition; no coverage.
It is very bad that our government who sent our men and women into harm's way no longer want to treat those who were harmed.
Rest assured, Trump, his staff, and Congress, will still get platinum health care. But, not those who put their live son the line for this ountry. Disgusting.
28
The modern medical-industrial complex is looking for more government dollars and the VA is the ideal sucker since the greedy republicans in Congress are listening to them. Let us see if these medicine people can get the American health care statistics up to those of Canada before we give for corporate welfare away.
13
Which one of Trump's friends or donors is going to benefit from this? Will the new admittance forms be printed in Russian?
The Russians are the king of Medicaid/Medicare fraud. Talk about letting the fox guard the hen house.
17
One of my uncles had a hernia operation at a VA hospital in FL. During recovery, he suffered a massive stroke, which staff somehow failed to notice. he was discharged, without them realizing he could no longer walk, speak, or leave the bed. Forgive me if I applaud the idea of veterans getting care *anywhere* else.
7
@Renee
I feel sorry for your uncle and you, but to suggest that any change would be good, is the opposite of being helpful.
One reason for example the taking over of Federal prisons by privately run prisons, have you ever checked out how disastrous that turned out.
Healthcare became invisible and unavailable, guards without any type of suited education and no idea to do their job correctly, probably the most horrific and unhealthy food in the United States only comparable to Russia, Turkey, Syria, Egypt, China.
See any trend there, they are all dictatorships.
American corporate power is only interested in making money at all cost.
Remember Trump talking in Mar Lago with three non elected individuals all Republican Corporate thieves, who came up with this horrible idea of privatizing VA care.
What do you think their goal was, to improve VA healthcare or to steal a large section of the allotted VA money for themselves and their buddies.
Next time think before you put up a comment.
19
What’s the incidence of stroke after hernia surgery for a person of your uncle’s age and health at VA versus non-VA facilities? That number is greater than zero at both types of facilities.
12
@Renee
So the presumption is that a private hospital would have been better? Any surgery has the risk of complications regardless of where it is. As a nurse for over a decade I have to tell you no one gets discharged with the symptoms you are describing unless it was a same day surgery which many hernia repairs are.
9
When I worked for the state Division of Vocational Rehabilitation and the state started doing privatization trials in different parts of Florida, many, many people were unable to get services because the private providers weren't able to access/utilize the states vendor database.... And of course the For-Profit companies didn't want to pay for services anyway! Privatization only benefits the 1% of the population! I saw the same corruption happen when the state privatized Medicaid (I was working as an audiologist at a non-profit clinic) and also the Department of Children & Family services.....Florida has suffered since the mid 1990`s because of this mindset!
21
The process of turning the V.A. health care system in to a money machine will, in the process eat up the veterans whom we the people (99%ers) have promised free and good health care in return for their service to the country.
This is another route for the 1%ers to control the country and get wealthier at the same time.
30
The culture of corruption GOP ideology is only for the rich and less government. Trump was lying on the campaign trail about how the CHOICE programs will help the vets . The doctors have been leaving in big numbers because the GOP don't want to pay them. I am a disabled vet and I support the DAV/American legion . They know what is right for the vets care not some out of touch GOP in a office. The Koch brothers want less government also and really need to be investigated . I bet they aren't paying taxes and have off shore Russian money coming daily like Trump and his family. Lock them up don't take our VA health care away and hospitals.
20
This veteran says NO to these plans. “Concerned Veterans for America, an advocacy group funded by the billionaire industrialists Charles G. and David H. Koch” does not speak for me or for all veterans. I’ve gotten great care at our local Veterans Administration Medical Center. I don’t want VAMCs to be gutted financially to push veterans to for-profit private care. Private non-VA care could be an option in some circumstances, but not the only option. The VA is equipped to care for vets in a holistic way. Use funds to fix problems and staff up in VAMCs. Listen to veterans and their genuine service organizations, not wolves in sheep’s clothing like Concerned Veterans for America.
37
A lot of Republican donors will be enjoying massive profits from this grift. In the end a lot of suffering veterans and their families will pay in suffering for those dollars of profit.
The Republicans and conservatives have no morals, no values, no ethics and no souls.
30
They tried private care - it did not work! Once more this administration, this congress shames this country, themselves, all of the veterans, and their families! We, we need to work harder, do better! Where is the so called friends of our men and women who serve? Why getting ready to sell them down the road! So the money will go to the rich and our service men will be caught up in more red tape with a new system like all the rest of the destruction these GOP and Trumpsters have brought down on us. As usual we all ask, when do the rich have enough? When is enough- enough? What will the veterans do when doctors refuse treatments because the medical bills don’t get paid, or they just don’t want to treat service people.
16
The rapacious avarice of the GOP and their 1% overlords is now going after my disabled cousin who served in Vietnam and is suffering from Parkinson’s Disease. He is a lover of and firm believer in his local VA hospital/clinic support system and is completely against handing his benefits over to the greedy, anti-American private sector. The GOP is sick, sick, sick and I’m so tired of this. Most of the GOP and ESPECIALLY Trump skipped out on their service to their country while my two cousins served their time and deserve their government services. When will this nightmare end?!
And thanks a lot, Stein supporters. You own this too and it’s affecting my family.
29
@left coast finch
More realistically: Blame the people who didn't vote. Blame the news media who gave Trump trash-talk lavish 24/7 coverage.
9
VA doc here. This is going to be a disaster. Vets are, on average, a very sick population with a lot of comorbities and subspecialist involvement- the more of these appointments that occur outside the VA system, the more difficult we make the jobs of VA primary care physicians who are expected to coordinate this care.
In addition, private docs can’t access the VA medical records and often have little idea what medical problems a patient has or what medications they’re taking when they show up. This exponentially increases the risk of adverse reactions and medical errors.
And that doesn’t even get into the $$... as we’ve learned from Choice, there is little incentive for private physicians to control costs and/or ensure they aren’t duplicating care with the VA when they’re getting a blank check from the government.
57
I question whether those participating in Tricare are younger and healthier than the general population. Younger, perhaps. Healthier?
Combat veterans from Iraq and Afghanistan have staggering rates of PTSD. Depression? check. For those who were injured, lots of amputees and those suffering from post-concussion syndromes from traumatic brain injuries. And that PTSD often involves substance abuse. When veterans who were in the thick of combat get together to drink, they're not drinking booze to reminisce, but rather to forget.
Did I mention the staggering suicide rates of our veterans who fought our ill-conceived "war on terror?" (We've yet to win a war on any of the nouns we've battled, the war on poverty was achieving success until the GOP decided they didn't really want to win that one.)
Then again, America's general population is generally in poor health. Epidemic rates of obesity with attendant diagnoses like type 2 diabetes, hypertension, arthritic joint pain because they're bearing too much weight. Our longevity statistics regressed for the first time in ages, probably since the influenza epidemic of a century ago. More Americans died last year from overdosing on opiates than soldiers killed during the entirety of the Vietnam War.
Rest assured, this is all about enriching certain folks who contribute to GOP politicians. The GOP loves large Pentagon budgets, stupid wars, wearing the flag on their lapels, talking how much they support our vets. All smoke and mirrors.
22
@drdeanster
Your last paragraph hits the nail on the head, though you should add the other nail: Huge payoffs to the very rich in the form of tax subsidies ("tax reform", they called it) and outright out-sourcing of governmental functions, not excluding soldiering.
10
Vets with illnesses & injuries that are considered to be “service connected” (eg PTSD, amputees, TBI) are generally able to be directly treated in the VA system (at the very least) for those health problems that are service connected whether they have other health insurance (private, Tricare, etc. ) or not.
I believe this is true based on the experiences of numerous family members including Iraq vets.
BTW, TRICARE covers not just active duty & post-discharge vets but their coverage-eligible family members. Thus for younger vets with spouses & kids, the Tricare population as a whole is going to likely skew not only younger but healthier.
4
To get a good look at how the GOP/Trump are privatizing functions of government, read "The Fifth Risk" by Michael Lewis." No federal government department is too important (DOE, NOAA data analytics, veterans healthcare, scientific expertise) that it cannot be sold to the highest for-profit bidder. Why is America concerned about Chinese competition and scientific prowess when Trump is abandoning taxpayer-paid expertise that already exists in the U.S. scientific community in federal agencies.
28
Shouldn't Congress have a say in this? No one ever voted for the Koch brothers! (Or Trump's Mar-a-Lago friends who are secretly running the V.A.)
Vote Democratic in 2020 and beyond to return this country to the people and restore our democracy.
23
@L: Congress is on a very lkong educational cruise: The subject is --How to hide corrupot cash payments.
3
As usual in the healthcare debate no mention of price controls. Pay the private Dr.'s what the VA pays for care and they may think more than twice about accepting aging and sick patients.
13
I'm back for good after having been frustrated by rejection of my comments, but now, I will write prolifically as time grows short in democracy and I will only hope you heed all my writing, published or not. The gravity of the coming military coup is far more important than my displeasure.
I have my ear to the rail.
2
It's an even greater effort to entrench fascism in our nation.
8
The outcomes from the privatization of Non-VA health care over the past 30 years (In short a total disaster unless you are health industry investor or CEO) provide veterans a perfect view of their future care in the for profit medical system.
They will join the rest of the country in having care decisions made based on what maximizes the private health care corporation's profits.
Good luck with that - all the non vets in American already know where private health care leads.
21
It’s par for the GOP to put profits over people. I suspect the only reason the GOP still exist is to ensure that money can be made for their masters.
We obviously foresee a time when VA health services are denied to a patient because other patients are more profitable. The horror stories will pile up, hidden from public view by those same corporate masters, then the few independent news agencies discover it, blow the lid off, then some Democrat comes around to fix it.
It’s possible the only reason trump is interested is so Ivanka and Jared can go invest in some health care firm.
13
Sounds an awful lot like school privatization ideas to me. Is Betsy DeVos one of the investors?
20
In Australia, there used to be a network of specialist Veterans ("Repatriation") hospitals - but this was seen as duplicative and difficult to access for folk in regional areas.
Now Australian veterans are issued with a card that covers all of their medical expenses. They go where they want to treatment - get whatever they need/want done - and the government that sent them to war pays.
https://www.dva.gov.au/providers/dva-health-cards
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@Erasmus
Are there cost controls or a schedule of reimbursements?
What is the provision for non-veteran health care? In other words, does Australia follow the American model (private health care), or some form of "socialized" medicine?
1
@Maeve
Well of course there is universal public health care (similar to US Medicare, but for everybody) - and obviously there is limits with that (again like US Medicare).
But the Veterans card goes beyond the scope of that care (check the link provided). It also covers all transport costs (most often taxis).
There are public hospitals in Australia (everything free of charge fro everybody - but waiting list for non-urgent procedures) but most medical practitioners are in private practice (allowing no waiting list + choice of doctor). They can charge what they like but there is a government set limit as to what insurance companies can reimburse for each procedure. So doctors set their fees accordingly - most don't charge pensioners and Vets above the reimbursement ceiling but often charge more to others.
Insurance (optional) is subsidised (up to 30% of premium cost) for poorer and older folk on sliding scale. No subsidy for wealthy. Vets with the card don't need insurance (effectively the Vet card is a 100% subsidy on a gold plated policy with zero deductible, except for medicines - $6 a script up to about a $300 annual ceiling, then all free).
3
@Erasmus
And you fail to mention the key point there which is that Australia has socialized healthcare so it was no big deal to switch them over. All we have is for-profit healthcare for the lucky ones who have insurance.
Recent study in the Annals of Internal Medicine showed VA outcomes were the same or better than civilian hospitals, despite how underfunded they are. This is a testimony to the dedication of VA staff. Please support the VA and stop denigrating it. If you haven’t been to one as a patient, you have no right to say anything negative.
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@Mindful A quote from the article: "However, VHA and non-VHA hospitals may report data differently to Hospital Compare. We found that several of the VHA's aggregate mortality and patient safety results were markedly better than those for non-VHA hospitals. Alternatively, analyses that use patient-level data have found these measures to be similar to those that we found in non-VHA hospitals, particularly for acute myocardial infarction and heart failure mortality (3, 5). These findings support the possibility of differential reporting. If so, we believe that the VHA and Centers for Medicare & Medicaid Services should take steps to ensure that the methods they use to calculate Hospital Compare data present fair comparisons to end users who are trying to make informed health care decisions."
1
Which Trump cronies stand to make millions off of this boneheaded move?
22
The government broke 'em. The government owns 'em. Have they no shame?
14
This might be good for those who have severe PTSD and brain trauma and must travel hundreds of miles for treatment in a VA facility as they MIGHT get the treatment they need closer to home. But I am not so sure this move is a complete solution to a complicated problem.
7
@old sarge
The V.A. does an incredible amount of clinical research on the treatment of PTSD and associated conditions. As more and more funds are directed to the private sector, the V.A. will loose their ability to continue that research. Ultimately the veterans will be on the loosing end of this privatization scheme.
15
Corporate fascism strikes again!
12
Crony care is what this will become.
Thanks, Trump-for nothing.
11
If Trump wants it, it's fascism. The Republican military is making itself a God to be worshiped, even more now.
This will change the ethos of medicine care to warfare.
Now all Americans will worship fascism as it becomes a part of every city, town and village in America.
People talk. This is but another preparatory move by the Republicans and I anticipate a violent overthrow of our nation by force.
I warned you as it is my duty to the people.
7
@PATRICK
And on the other side of the fence we have progressive socialism with open borders and eventually a borderless world with a single leader who will demand worship, the murder of the unborn, where belief in the One True G-d and His Son is considered hatred, and the list goes on.
1
@old sarge
Do you really believe that?
Soldiers kill adults and their succeeding generations.
Almost everyone believes in God, most definitely me.
Progressives care about everyone including you who actually deny yourself health care.
I'm for everyone, including you, a misguided soul who will be saved.
Please, let’s keep the religious fundamentalism out of this.....
I’m sorry but we need more facts, not religiously motivated beliefs....and no, just because you & others think the Bible is true, doesn’t mean it is. Notice that many other religions believe totally different things about Gods, etc.
You obviously can’t all be correct & thus its far more likely that you all are wrong.
The Koch brothers only have their interests at heart. Read Dark Money and Democracy In Chains.
18
Government should manage health care better. Contracting out to private companies will never be cost effective. The VA has a massive infrastructure all it needs is adequate health care professionals to run it.
23
The VA is lacking in many areas of care. It needs help. However, our private system is a horror. The Choice program was meant to reduce veterans waiting times. It does not. Waiting times for private Drs exceed, sometimes by a lot, 30 days. The medical-industrial complex is shafting all of us. Like the grave; all they want is more. Our spineless, venal Congress gives them whatever they wish. Time to stop this largest theft ever.
24
Competition is not competence.
Capitalism is not health care.
If we were smart, we’d have the VA for everyone.
I’m a service connected disabled veteran and get much better care at the VA than I ever got in the private system.
33
A veteran's healthcare system already starved for resources will be wrecked by these private vendors. Their only motive is money; growing their bottom line. They will oversell and over perform their programs for a few years, short the V.A. system, and once it is broken, privateers will own veterans care in America. This is a bad plan, hurts the vets long term, and will add to the system's problems.
20
I tried to post a long, thoughtful comment based on my experiences with care at the VA, but the Times has too short a limit on comments. So I will summarize it. The VA doesn't need to be privatized or to have a lot of it turned over to private providers. The VA has a lot of problems and it needs to be fixed. Same with the VA Choice program that already sends people to private providers. Sometimes it takes longer to get to see a Choice provider than to wait for more than 30 days at the VA. The main problem at the VA in my experience is that it doesn't have enough doctors and staff. Also, the care is good, but not great. For example, where I go in Loma Linda, CA, the eye clinic is booking nine or ten months in advance and has been without a clinic manager for about a year. Also, at the orthopedics clinic there I often see a physician assistant or resident instead of a staff doctor. When you do see specialist doctors it's usually not the same one, but one that is available at your appointment time. I've gone outside the VA for care under Medicare and paid the 20 percent that Medicare doesn't pay out of my own pocket because I didn't want to wait on the VA, including for an MRI last September for a new knee injury. I got it in a day instead of 28 days I would have had to wait at the VA. Focus on improving the VA and the existing Choice program, not on shifting much of the VA to private enterprise, which seems to be a scam by conservatives.
18
VA tried choice and Veterans weren't happy with it, the care wasn't any more timely and the quality wasn't better (VA and service organization studies) This isn't about Veterans. This is about funneling money dedicated to Veteran care to for profit healthcare providers. It is shameful. Concerned Veterans of America are a Koch brother funded organization not a veteran service organization.
26
trump said he might consider retired veterans non-essential personnel, therefore their monthly retirement checks will stop in the short-term. In that case I guarantee we will rise up and be in full smack-down mode. Wanna bet?
13
Are you kidding? Something like that happened to WWI veterans...that turned out nasty.
4
@A Aycock...yes, I'm joking but would you put it past him? Look at our poor vets now who rely on the Post-911 GI Bill: they aren't getting paid due to computer issues. Shame shame shame. Those payments literally saved my life when I was using them.
4
I work at a Veteran's hospital and am a Veteran myself. Most vets I speak with tell me, unsolicited, that they are happy with the care they receive at the VA. Now, I have no problem with the Choice program. If someone feels like the private sector will see them faster (they won't) and treat them better, then feel free.
What I honestly don't like is coming back to the VA for ancillary services like lab work and pharmacy. We cannot do business and survive like that. If you choose the private sector, then go on get your radiology services etc out there also.
18
Yeah, so they can bill the government 10x the usual amount for a non-urgent but same-day MRI for your convenience? Only if there are price controls.....
The VA negotiates drug costs directly unlike Medicare. If it’s an expensive but not urgent medication then the VA should be able mail it to you.
1
I am a PA in primary care at a VA. A patient we had sent to the private sector for neck surgery was told by that surgeon to come back to see me for post op. Me, a non- surgeon. I was incredulous. After all the $$$ the VA paid him to care for this veteran, they won't even see him in follow up? This is but a very small example of the fleecing the taxpayer and the veteran are in for if even more care is privatized.
1
To improve our help and caring for veterans,we should fully support the U.S. Department of Veterans Affairs. The V.A. is the largest hospital and healthcare system in the nation, and is the closest working model to a national single payer health insurance system in this country.
The V.A. is the only system that negotiates directly with pharmaceutical companies over drug prices, and is a comprehensive resource for veterans seeking all types of care: mental health, physical health issues,physicians/medicine/ nursing, social services, social work, clinical social work and clinical psychology. The VA is a great example of the public sector working by providing quality care for the people that use it, and it saves lives.
A 2016 RAND Corporation analysis found that the VA provides good quality care compared with other health systems, usually in a timely manner. The Veterans Administration cares for some of our sickest patients with the best results at the lowest cost with the highest patient satisfaction.The key to maintaining and improving V.A. healthcare and social services is to fully support, fund and staff the VA.
While the private wealth class continues to fail us, we need government stewards who care for and will act on behalf of us in the 99%, including our veterans, and not just on behalf of the Koch bros and other 1% wealthy friends.
37
@F.Douglas Stephenson, LCSW, BCD
Thank you for the reminder that VA directly negotiates drug prices. Perhaps this ia another motivation for privatizing VA medicine.
2
Wouldn't this shift carry the clear potential to overwhelm hospitals, doctors and health care providers in certain areas and regions of the country? For example, here are many doctors in my region who don't accept new patients because they are already handling as many as they can manage.
12
Sounds like a lose/lose for vets & the rest of us. It'll probably be implemented.
17
We could see this coming. Cut the VA funding, make care providers less available and then force the veterans into the private healthcare system. No consistent policies, no quality control. Stop playing with the health of veterans.
27
This is not a deal that the majority of veteran support , The time has come for totally free healthcare for all and to seize private hospitals and force doctors to charge nothing for services or quite being doctors .
4
The Koch brothers and their brethren don't support big government but they love to feed at the government trough. In this case privatization means private companies get federal funds for doing what the VA has been doing. Wonder how often they will have to raise their rates to pay those corporate CEOs who just got a big tax cut. Making America Great Again.
23