FINDING RIGHT MIX OF VA, PRIVATE CARE FOR VETS

When then-President Barack Obama wound up with egg on his face after several dozen veterans died while awaiting treatment at veterans hospitals in 2014, he was all too happy to sign the Veterans Access, Choice and Accountability Act of 2014.

Since one of the tenets of that bill allowed more veterans to use private facilities for their care, it had to be galling for the president. After all, he’d staked his reputation only four years earlier trying to convince the country a government-run health care system — rather than private care — was the way to go.

One year later, along came Donald Trump, making the veterans hospital scandal an issue in the 2016 presidential race.

“We’re going to take care of our veterans like they’ve never been taken care of before,” he said, effecting his usual hyperbole.

The way to do that, Trump has decided, is to put even more money into private care. Proposed guidelines would make it easier for veterans to receive treatment in privately run hospitals and to have access to a system of proposed walk-in clinics. Such clinics, it is felt, would be a bridge between the Veterans Administration hospitals and privately run facilities.

The goals, of course, are shorter waits, more options and fewer requirements for co-pays. Administration sources have said details of the plan could be revealed in the president’s State of the Union address later this month.

The bipartisan Veterans Administration Mission Act of 2018 was the genesis of the proposed plans. The legislation addressed the conditions under which care is required to to be furnished through non-Veterans Administration providers and conditions under which care can be authorized to be furnished by non-VA providers.

Its supporters believe the legislation can streamline care and, in effect, nudge the veterans hospital system to compete for patients, ideally making it more efficient.

Former U.S. Rep. Zach Wamp says any move toward more comprehensive care for veterans, any way to move away from the antiquated model currently in place, is a good idea. However, his experience in creating a pilot program between the Veterans Administration and Erlanger hospital between 2000 and 2002 did not work out as planned.

The idea, he said, was to circumvent any potential transportation accident between here and Murfreesboro (the location of the closest VA hospital), eliminate the time of the drive to Middle Tennessee, and allow family members to see their loved one during treatment.

“The VA opposed it at every turn,” Wamp said. Its attitude was “our way or the highway.”

During the 21 months of the partnership, according to Times Free Press archives, just 61 patients were referred to Erlanger.

“It was not fully utilized,” Wamp said. “It didn’t lead to anything permanent, but we need it much more now.”

So, he said, even though there is much he finds distasteful about the Trump administration, “anyone looking at logic can see we’ve got to do a better job of using our money [for veterans].”

“I like the idea [of putting more money into private care],” said retired Army Reserves Maj. Gen. Bill Raines, now chairman of the Charles H. Coolidge National Medal of Honor Heritage Center. Too often, “by the time you get [scheduled for treatment], you’re dead.”

“We’re so quick to send [soldiers] to war,” he said. “But we don’t think of the aftermath. If we gave it all the attention we give up front,” we’d be better off. “There’s got to be a better solution.”

Noah Long, a retired Navy rear admiral and now vice president of construction for the National Medal of Honor Heritage Center, said Veterans Administration care has improved — with the likes of assigning a specific physician to individual cases — but still could benefit from allowing veterans more access to private care.

“In my mind,” he said, “I’d do away with the VA and go with TriCare,” the health care program for uniformed service members, retirees and their families around the world. TriCare, he said, offers a variety of options, allows patients to choose their needs and, in his experience, is run efficiently.

As former President Obama reluctantly had to admit by signing the Veterans Access, Choice and Accountability Act of 2014, government health care is not always a panacea. While there are cases where veterans hospitals would be more likely to better handle patient care — such as with Vietnam soldiers exposed to the chemical Agent Orange — private medical care usually offers less waiting time, more specialty treatment and more options for the patient.

We’re inclined to believe that President Trump is on the right track by opening up more private care. As with any system, outcomes need to be monitored to determine if, in fact, offering such care will be cost effective. With the Veterans Administration system and certainly with the Affordable Care Act, we’ve seen examples of the downside of government care. Somewhere in between veterans hospitals, which have specific knowledge about certain treatments, and the impossibility of making all veterans care private, we believe there’s a happy medium.

We hope the administration is concentrating on finding just the right mix.