VA secretary resigns amid push to privatize US veterans’ health care

By Kate Randall

31 May 2014

President Barack Obama accepted the resignation of Veterans Affairs (VA) Secretary Eric Shinseki at a White House press conference Friday morning. The retired general’s exit comes amidst a mounting scandal over veterans’ health care. It follows the release Wednesday of a report by the VA Office of the Inspector General (OIG) showing that VA officials falsified records to cover up the long wait times of US veterans for medical appointments.

The OIG’s interim report revealed that patients at the Phoenix Veterans’ Hospital waited an average of 114 days for an initial appointment, far greater than the averages reported by hospital officials. Many of these officials received awards and salary increases based on the falsified numbers.

Doctors at the Phoenix, Arizona hospital have charged that delays in treatment were responsible for at least 40 preventable deaths. An earlier internal VA review found that long wait times at VA hospitals in multiple states were linked to 23 deaths.

Before resigning, Shinseki announced the removal of senior leaders at the Phoenix VA hospital and the elimination of performance awards for VA leaders in 2014. These moves will do little to resolve the crisis engulfing the Veterans Health Administration (VHA).

As new exposures emerge of the deplorable treatment of veterans at VA facilities, growing numbers of congressional Democrats as well as Republicans are seizing on the crisis to ramp up calls for the privatization of veterans’ health care.

The VHA is the largest integrated health care network in the US, with 150 VA hospitals and 820 outpatient clinics as of 2013, enrolling about 9.3 million of the nation’s 22 million veterans. The system handled 84 million outpatient visits in 2012, a 23 percent increase over 2008. These numbers are expected to continue to swell as growing numbers of soldiers from the wars in Iraq and Afghanistan seek treatment, along with aging Vietnam War veterans.

Obama and members of Congress have responded to the VHA scandal with a breathtaking level of cynicism and hypocrisy, even by Washington standards. The same president who, in announcing Shinseki’s resignation, stated, “We will never stop working to do right by you and your families” only two days before in a speech at the West Point military academy vowed that the US “will use military force, unilaterally if necessary, when our core interests demand it.”

A byproduct of this acceleration of military aggression across the globe will be increasing numbers of veterans seeking treatment for brain injuries, post-traumatic stress disorder, lost limbs and other horrific injuries. The VHA is woefully understaffed, underfunded and wracked by bureaucracy and corruption. But according to many lawmakers, the answer to this crisis is not the appropriation of funds to hire new doctors and other medical professionals, but the dismantling of the government program in order to provide a profit windfall to private insurers and health industry firms. The result of this policy will be less care at greater cost to veterans.

Rep. Jeff Miller (Republican of Florida), chairman of the House Veterans Affairs Committee, stated, “We have an opportunity now to transform the way the VA does business.” His committee, which has already moved legislation through the House giving the VA secretary greater authority to fire or demote senior VA executives, says he intends to bring legislation that would allow veterans who have been waiting more than 30 days for an appointment to receive medical care through private doctors and hospitals.

Under the “Veterans Choice Plan” being promoted by Rep. Andy Harris (Republican of Maryland), veterans could either choose to continue receiving care through the VHA or go to a private provider of their choosing. In what amounts to a voucher system, the federal government would cover the cost of insurance premiums and some out-of-pocket costs, depending on a veteran’s priority ranking.

Harris, who will send his plan to the House Veterans’ Affairs Committee within the week, believes it would be “budget neutral” or might even reduce veterans’ health spending. In other words, the VHA would be deprived of funds while money is diverted directly into the pockets of the private insurers and health care industry.

House Minority Leader Nancy Pelosi (Democrat of California) voiced her support Thursday for privatizing more health care services for veterans. “I don’t have any problem with that,” she told reporters in the Capitol. Commenting on Rep. Miller’s plan, she said, “It isn’t a panacea, but I would certainly be open to that because of volume [at the VHA] and because of geography.”

Pelosi said she was not concerned that Republican proposals threatened the dismantling of the VA system in favor of the private health care sector. “I don’t think that’s how they see it,” she said, urging others in Congress to “think in a bigger way” about medical care for veterans.

These privatization plans are strikingly similar to the proposal by House Budget Committee Chairman Paul Ryan (Republican of Wisconsin) to set up a voucher system for Medicare. His plan, which would provide a stipend for individuals to purchase private insurance, is aimed at gutting and ultimately dismantling the government-run national insurance program for the elderly and disabled.

A number of veterans groups are opposed to moves to privatize veterans’ health care precisely because they threaten funding for the current VHA system and the specialized care the network of hospitals and clinics was designed to provide. Joe Violante, national legislative director for Disabled American Veterans, told Vox.com, “The more money we spend out on the private sector on veterans, the less money there is to care for those that are within the system.”

Carl Blake of Paralyzed Veterans of America told Vox.com that a typical VA patient “might have a spinal cord injury, plus an orthopedic issue, plus a mental health issue. They’re a multifaceted patient.” He added, “The VA is a system constructed to provide holistic care for the life of that patient. The private system is not constructed with those ideas in mind.”

The proposals to privatize veterans’ health care services come as the Veterans Affairs system is struggling with an acute shortage of doctors, particularly primary care doctors. According to a Friday article in the New York Times, VA doctors often work 13-hour days and nurse practitioners often treat complex cases that should be handled by doctors. Doctor pay at veterans’ centers is significantly lower than in the private sector, and hospitals and clinics suffer from high turnover rates.

The Times noted that in the past three years, primary care appointments have increased 50 percent, while the VHA staff of primary care doctors has grown by only 9 percent.

Under these dire conditions, the House last month passed an annual spending bill that included a minimal $1.5 billion increase for fiscal year 2015 to fund veterans’ programs, bringing the total to $64.7 billion. House Veterans Affairs Committee Chair Miller made clear any large infusion of cash for veterans’ health care is not in the cards, commenting, “I believe that if money would have solved the problem, it would have been fixed a long time ago.”

The moves to privatize veterans’ health care underscore the hypocrisy of the bipartisan glorification of soldiers and veterans. It also sets a precedent for privatizing Medicare and Medicaid, the federal-state health care program for the poor.

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