Congressman Greg Landsman, pictured on left, receives a copy of the July/August Disabled American Veterans (DAV) Magazine from DAV Department of Ohio’s Hospital Chairman John Plahovinsak, pictured on right, during one of the many Congressman’s Town Hall Meetings. The July/August Issue highlights the ramifications and consequences of the Department of Veterans Affairs’ (VA) Veterans Health Administration (VHA) being dismantled and having a Nation without Veterans Health Care. The DAV wanted chapter members to educate our Congressional Leaders on the dangers of Privatization to the VA health care system. Photograph courtesy Alexa Helwig.
The Department of Veterans Affairs (VA), composed of the Veterans Health Administration (VHA); the Veterans Benefits Administration (VBA) and the National Cemetery Administration (NCA) has one of the largest annual budgets of our federal government. Only two (2) other Departments have larger annual budgets.
Consequently, when Congress decides to add new expenditures and services, they view reducing the budgets of all Departments as opposed to increasing taxes.
Congress is hesitant to reduce the benefits already earned by veterans and there is no significant saving to be incurred in the budget of the National Cemetery Administration.
Therefore, Congress always focuses their cost-cutting perspective to the Veterans Health Administration. The VHA operates the largest health care system in the Nation, with 171 medical centers and 1,113 outpatient clinics serving 9.2 million veterans.
One way in the past, Congress has viewed cost-cutting within the VHA is by the Privatization of medical services to veterans.
Some analysts state that former President Trump’s 2018 VA MISSION Act propelled Privatization via the newly formed Veterans Community Care Program (VCCP). This was a process designed to shift patients from the VHA to the private sector.
A review of the last four (4) years indicated that VHA medical services are being rapidly replaced by private-sector care, even as several studies have indicated that non-VA care generally is of a lower quality and higher costs.
For example, between April 2019 and December of 2020, VHA’s total monthly encounters shrank by twenty-five (25%) percent. The VCCP rose to thirty-four (34%) of all care delivered to veterans at taxpayers’ expense.
The VCCP cost has been doubling over the last four (4) years, consuming nearly twenty (20%) percent of the VHA’s health care budget.
The Disabled American Veterans (DAV), in their July/August 2023 issue of the DAV Magazine, explored, in depth, the consequences/ramifications of Congress continuing the total expansion of Privatization, and thereby eliminating the critical funding of the VHA.
The initial cause of initiating the VCCP hinged on “reducing the waiting times” for veterans seeking medical services. Congress erroneously believed that the “Choice Program” would remedy the situation.
History has documented that the “Choice Program” was a total failure. The new modified version of the “Choice Program” was the VCCP and it was meant only to supplement, and work in conjunction with the VHA effort.
Several studies comparing current wait times between the VHA and private sector facilities indicate that the VHA wait times are shorter for medical services.
Some studies indicate that the wait time for community care options is typically less reliable (or even non-existent), resulting in worse options for veterans already frustrated with medical care delays.
If Privatization replaced the VHA medical system more than nine (9) million veterans would have to migrate to the private sector for their medical care. Currently, the VHA is understaffed and in certain specialties overwhelmed. This is the same situation with the private medical sector.
The Kaiser Family Foundation’s 2022 data identifies more than 8,000 locations in the private sector that have health care provider shortages, which negatively impact more than 97.8 million people. Over 156.8 million people are now affected by a provider shortage in mental health care.
The key fact in the DAV Report is that the VHA is not bound by the constraints or limitations of insurance companies and their goal of profitability. The VHA physicians can provide specialized medical care even if it is not economically viable to do so.
Providers of VHA services ask all veterans about housing, employment, food security and their transportation situation during each appointment. When a veteran indicates one of these needs, a referral is made to a VA or a community program. Privatization providers do not perform this service.
The VHA provides a holistic approach for veterans in which medical providers know how certain conditions are linked to military service. Private sector physicians may not comprehend the veteran’s military experience or unique medical needs and conditions.
My Analysis: The DAV Magazine report is thorough and contains many insights into why increased Privatization for veterans’ health care is not the answer. The overall theme is that the VHA is not bound to the constraints of the insurance companies or the profitability on the bottom line.
The VHA is also engaged in training health care professionals and is the largest provider of medical training in the United States. Nearly seventy (70%) percent of all U.S. physicians completed at least part of their training within VA facilities.
The DAV wants to communicate and educate our elected officials in Washington, D.C. to preserving and enhancing the VA health care system and other important institutions. We must work to keep our lawmakers in Congress accountable to do what is right for our disabled veterans.
Privatization is but a simplistic answer for politicians in reducing related health care costs for our veterans. But they deserve better! “A strong and viable health care system is part of keeping our promise to those who served,” said DAV National Legislative Director Joy Ilem. She is right!
BioSketch: John Plahovinsak is a 32-year Army veteran, who served from 1967 to 1999. He is the Disabled American Veterans (DAV) Department of Ohio Hospital Chairman and the Adjutant of DAV Chapter #63 (Clermont County). He can be contacted at: plahovinsak@msn.com.