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Shulkin: Privatizing the V.A. will hurt veterans

Embattled Veterans Affairs Secretary David Shulkin fired in latest White House shake-up

By David S. Cloud
Los Angeles Times, March 28, 2018

President Trump on Wednesday fired David Shulkin, the embattled head of the Department of Veterans Affairs, the latest high-profile ouster to roil the White House.

Shulkin ran afoul of some conservatives for his go-slow approach to expanding government-paid private care for military veterans outside the VA system. Shifting more veterans to private care is a top priority for the influential network of conservative groups funded by Charles and David Koch.

An effort to expand the existing Veterans Choice program, under which veterans can get government reimbursement for seeing a private doctor in certain circumstances, failed this month when Congress did not include it in the massive government spending bill that Trump signed into law.

The Koch-backed Concerned Veterans of America has pushed for the legislation, but most other major veterans organizations opposed it.

Sen. Bernie Sanders (I-Vt.) said the Senate should examine (Trump VA Secretary nominee Dr. Ronny) Jackson's views on privatization of VA care. "Every major veterans organization in this country vigorously opposes the privatization of the VA," Sanders said. "I stand with them. Our job is to strengthen the VA in order to provide high-quality care to our veterans, not dismember it."

http://www.latimes.com...

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David J. Shulkin: Privatizing the V.A. Will Hurt Veterans

By David J. Shulkin
The New York Times, March 28, 2018

During my tenure at (the Department of Veterans Affairs), we have accomplished a tremendous amount. We passed critical legislation that improved the appeals process for veterans seeking disability benefits, enacted a new G.I. Bill and helped ensure that we employ the right people to work at the department. We have expanded access to health care by reducing wait times, increasing productivity and working more closely with the private sector. We have put in place more and better mental health services for those suffering from the invisible wounds of war. We are now processing more disability claims and appeals than ever before and, for the first time, allowing veterans to see the status of their appeals by simply logging on to their accounts. Unemployment among veterans is near its lowest level in years, at 3.5 percent, and the percent of veterans who have regained trust in V.A. services has risen to 70 percent, from 46 percent four years ago.

It seems that these successes within the department have intensified the ambitions of people who want to put V.A. health care in the hands of the private sector. I believe differences in philosophy deserve robust debate, and solutions should be determined based on the merits of the arguments. The advocates within the administration for privatizing V.A. health services, however, reject this approach. They saw me as an obstacle to privatization who had to be removed. That is because I am convinced that privatization is a political issue aimed at rewarding select people and companies with profits, even if it undermines care for veterans.

Until the past few months, veteran issues were dealt with in a largely bipartisan way. (My 100-0 Senate confirmation was perhaps the best evidence that the V.A. has been the exception to Washington’s political polarization). Unfortunately, the department has become entangled in a brutal power struggle, with some political appointees choosing to promote their agendas instead of what’s best for veterans. These individuals, who seek to privatize veteran health care as an alternative to government-run V.A. care, unfortunately fail to engage in realistic plans regarding who will care for the more than 9 million veterans who rely on the department for life-sustaining care.

The private sector, already struggling to provide adequate access to care in many communities, is ill-prepared to handle the number and complexity of patients that would come from closing or downsizing V.A. hospitals and clinics, particularly when it involves the mental health needs of people scarred by the horrors of war. Working with community providers to adequately ensure that veterans’ needs are met is a good practice. But privatization leading to the dismantling of the department’s extensive health care system is a terrible idea. The department’s understanding of service-related health problems, its groundbreaking research and its special ability to work with military veterans cannot be easily replicated in the private sector.

I have fought to stand up for this great department and all that it embodies. In recent months, though, the environment in Washington has turned so toxic, chaotic, disrespectful and subversive that it became impossible for me to accomplish the important work that our veterans need and deserve. I can assure you that I will continue to speak out against those who seek to harm the V.A. by putting their personal agendas in front of the well-being of our veterans.

https://www.nytimes.com...

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Comment:

By Don McCanne, M.D.

The Koch brothers' goal is to reduce the role of government and the need to pay taxes to support it. In this instance they would move care for our veterans from the highly acclaimed V.A. Health system (acclaimed except for a couple of glitches) to the private health care delivery system. David Shulkin explains in his NYT op-ed why this would be a terrible injustice for our veterans with health care needs.

When we eventually establish a single payer Medicare for all program, it is likely that the VA Health system will continue to be supported as part of our health care delivery system because of its expertise in providing specialized services for the unique needs of our veterans. The last thing we should be doing now is allowing anti-government ideologues to wreak havoc on our health care delivery system.

When the private wealth class is failing us, it's time for us to elect government stewards who care for and will act on behalf of all of us, including our veterans, and not just on behalf of their wealthy friends.

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