SENATORS KILL PLAN TO RESHAPE SPRAWLING VA HEALTH CARE SYSTEM
Lawmakers say they will not confirm panel nominees
After years of inaction, lawmakers and advocates in 2018 rallied around an ambitious plan to modernize the sprawling, government-run health care system for veterans, which still treats many patients in hospital wards built before World War II.
A commission, mandated that year by Congress, was tasked with weighing recommendations from the Department of Veterans Affairs for each of its 1,200 hospitals and clinics across the country and holding hearings in affected communities. The southward migration of veterans from the Northeast and Midwest, the shift from costly inpatient to outpatient care and the age of each building would factor into whether facilities would be urged to close, reduce service or shift patients into private care. The VA would finally catch up to modern private hospitals, saving billions of dollars it spends each year to shore up its aging healthcare facilities, proponents of the plan argued.
But a long-sought realignment of the country’s largest health care system was killed this week by bipartisan political resistance through a short news release from 12 senators who said they would not approve the nine nominees up for confirmation to establish the Asset and Infrastructure Review (AIR) Commission. And a costly four-year effort to reposition the VA in an increasingly competitive health care market
fell victim to the principle that, just as all politics is local, so, apparently, is any decision to shift services for a constituency as crucial as veterans.
The lawmakers indicated that the politically explosive recommendations the VA made in March made moving forward impractical.
“We share a commitment to expanding and strengthening modern VA infrastructure in a way that upholds our obligations to America’s veterans,” the senators, led by Senate Veterans’ Affairs Committee Chairman Jon Tester, D-Mont., wrote in their release Monday. “We believe the recommendations put forth to the AIR Commission are not reflective of that goal, and would put veterans in both rural and urban areas at a disadvantage.” The release said lawmakers were committed to a “continued push” to help the VA invest in “21st century (health care) facilities” for veterans.
Lawmakers in both parties had expressed misgivings about a process they felt was flawed from the start. The data the VA relied on to assess the hospitals was several
years old and collected before the coronavirus pandemic, potentially skewing the number of patients and physicians in a community to appear lower than they really were.
The White House also was slow to nominate the ninemember commission, with the final member announced only last week. That left a tootight window to complete its work by an early 2023 deadline, lawmakers argued, as well as uncertainty about whether a nominee would face pressure to weigh in on the recommendations in order to be confirmed.
But by halting the commission and the sweeping plan released by VA Secretary Denis McDonough with recommendations to build about 80 new clinics, hospitals and nursing homes of varying sizes and close a net of three major hospitals and dozens of clinics with unused inpatient beds, the lawmakers left the agency with no blueprint to modernize its aging system, current and former officials said.
It’s unclear if lawmakers who still support the commission have any options.