Saturday, July 2, 2016

The VA privatization debate is coming to a head



By Jim Emerson, staff writer
The week will be make or break time for the Department of Veterans Affairs (VA) as it may be decided whether or not to privatize medical care for veterans. Congress created the Commission on Care to overhaul the VA and it is expected that this panel will release its final recommendations on whether to provide the option for private care for veterans enrolled in the VA’s system of hospitals and clinics.
Efforts to privatize health care have caused blowback from national veteran’s groups. Fearful of losing their jobs, unionized VA employees have been staging opposition rallies. They are concerned that privatization may be used to close poor VA medical centers. VA facilities will have to compete against the civilian sector or close. They will essentially become a not-for-profit corporation.
The American Federation of Government Employees Union is worried that expanding the use of private care to treat veterans could lead to the closure of VA health care facilities due to a lack of need. The VA and its employees will have to treat Veterans professionally or lose their job. They will have to compete against the local community or shutdown. The Commission on Care (CoC) panel was created in the wake of the nationwide VA wait-time scandal. A recommendation of privatization should be a wake-up call for VA management as their jobs will be no longer be secure.
Veteran’s groups, including the American Legion and the Veterans of Foreign Wars, criticized the plan to privatize medical care and warned they would reject any final recommendations to do so. They are concerned that the CoC panel is focused on condemning the current Veterans Health Administration by promoting privatization. The Commission is part of the 2014 Veterans Access, Choice and Accountability Act. These groups believe that the quality of VA health care continues to outperform the private sector.  Unfortunately, the groups overlook the possibility that privatization would benefit veterans who live great distances from VA centers.
Privatization provides VA doctors and patients more flexibility, given that they may choose private health care as well as in-house treatment. Because all VA Medical centers are not capable of providing a full spectrum of medical care in a timely manner, the option of choosing a private hospital can be very important.  Doctors must decide what is in the patient’s best interest and the VA leadership should do the right thing.
VA doctors and hospitals have singular expertise in the treatment of post-traumatic stress disorder (PTSD). Soldiers have returned from warzones in Iraq and Afghanistan with PTSD, traumatic brain injury and limb amputations. The VA has experience in these cases that few civilian primary care physicians and specialists can match. Without the VA, veterans facing these problems would have difficulty getting first rate care.
Even so, the VA needs serious reform or it must go out of existence. Veteran’s lives and mental health are far more important than job security and bonuses for VA employees. If a VA facility can perform as well as or better than an equivalent civilian facility, it should stay open.  Those that are unable to measure up must be closed down. It’s long past time for them to compete.

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