The Veterans Affairs Healthcare System: Politics and the Privatization Debate

Contributed by Paige Barnett. 

The largest healthcare system in the U.S., the Veterans Health Administration (VHA) System, provides a wide range of services to those who have served in the military. As a taxpayer-funded endeavor, it is often subject to scrutiny by the media as well as political fodder for either party or agenda. Due to its size, complexity and needs of patients, the VA health care network has its own unique set of challenges. Republicans have called for privatization of the system, but whether this would serve the best interests and needs of the patients is open to debate.  

Frequent stories in the media are often quick to point to failings and little about successes of the VHA. For example, in 2014, CNN ran an investigative expose, “A Fatal Wait: Veterans Languish and Die on a VA Hospital’s Secret Wait List.” which uncovered a long wait list of veterans at the Phoenix VA hospital. Undoubtedly, it was a situation that needed to be addressed and remedied. This story does not speak for all who experience the VHA care, however. “If you’ve ever been to a VA (Veterans Affairs) hospital, then you’ve only ever been to one VA hospital,”  said Dr. Roy Feldman, retired Chief, Dental Service of the VHA Hospital in Philadelphia.

That is to say, not all VA hospitals are created equal; some are competently operated, while others lack competent leadership.  In fact, the consumer surveys of veteran end users show very favorable ratings in terms of delivery of care, with the VHA ranking better or best.  In addition, there is a “Choice” program, whereby if a veteran is unable to receive services through the local VHA, the VA will pay for an outside service.  In the treatment of PTSD and spinal cord injuries, the VHA ranks the best. Further, the doctors and nurses of the VHA are aligned with the mission to serve the veterans to the best of their abilities.    

Political agendas are fueled by questions about whether the level of care delivered is an appropriate use of taxpayer dollars. A report by the VA Inspector General issued earlier this year which cited examples of financial waste and actions detrimental to patient safety at the Washington, DC hospital, served to heighten demands by the Republican administration to privatize the VHA system. It was also one of the factors leading to the ouster of VA Secretary, David Shulkin, who opposed privatization. Trump subsequently failed in his attempt to replace Shulkin his own personal doctor, Ronny L. Jackson, ultimately naming Robert Wilkie to the position in May 2018.

Those with experience working within the VHA believe that the two most pressing problems are appropriating money without a succinct plan, and policy making that does not address the needs of the patients. To be sure, the size and scope of the VHA can slow down necessary changes, which is again, an oft-cited reason by the Republicans to privatize the system. But it’s that very size, complexity and unique needs of the patients that may be the saving grace of the VHA.

Would it be wise to  privatize the second largest governmental budget? As Dr. Feldman aptly said, “You can’t get more politically correct than to support veterans.”  

And never, ever mess with what is rightfully due to our veterans.

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