VA seeks to re­di­rect bil­lions of dol­lars into pri­vate care

The Herald (Rock Hill) - - Front Page - BY JEN­NIFER STEINHAUER AND DAVE PHILIPPS

The Depart­ment of Veter­ans Af­fairs is pre­par­ing to shift bil­lions of dol­lars from gov­ern­ment-run veter­ans’ hos­pi­tals to pri­vate health care providers, set­ting the stage for the big­gest trans­for­ma­tion of the veter­ans’ med­i­cal sys­tem in a gen­er­a­tion.

Un­der pro­posed guide­lines, it would be eas­ier for veter­ans to re­ceive care in pri­vately run hos­pi­tals and have the gov­ern­ment pay for it. Veter­ans would also be al­lowed ac­cess to a sys­tem of pro­posed walkin clin­ics, which would re­quire co­pays for treat­ment.

Veter­ans’ hos­pi­tals, which treat 7 mil­lion pa­tients an­nu­ally, have strug­gled to see pa­tients on time in re­cent years, hit by a dou­ble crush of re­turn­ing Iraq and Afghanistan veter­ans and ag­ing Viet­nam veter­ans. A scan­dal over hid­den wait­ing lists in 2014 sent Con­gress search­ing for fixes, and in the years since, Repub­li­cans have pushed to send veter­ans to the pri­vate sec­tor, while

Democrats have fa­vored in­creas­ing the num­ber of doc­tors in the VA.

If put into ef­fect, the pro­posed rules — which re­main un­der ne­go­ti­a­tion within the Trump ad­min­is­tra­tion — would be a win for the once-ob­scure Con­cerned Veter­ans for Amer­ica, an ad­vo­cacy group funded by bil­lion­aire in­dus­tri­al­ists Charles and David Koch and their net­work of donors, which has long cham­pi­oned in­creas­ing the use of pri­vate sec­tor health care for veter­ans.

For in­di­vid­ual veter­ans, pri­vate care could mean shorter waits, more choices and fewer re­quire­ments for co­pays — and could prove pop­u­lar. But some health care ex­perts and veter­ans’ groups say the change, which has no sep­a­rate source of fund­ing, would re­di­rect money that the cur­rent veter­ans’ health care sys­tem — the largest in the na­tion — uses to pro­vide spe­cialty care.

Crit­ics have also warned that switch­ing vast num­bers of veter­ans to pri­vate hos­pi­tals would strain care in the pri­vate sec­tor and that costs for tax­pay­ers could sky­rocket. In ad­di­tion, they say it could threaten the fu­ture of tra­di­tional veter­ans’ hos­pi­tals, some of which are al­ready un­der re­view for pos­si­ble con­sol­i­da­tion or clos­ing.

Pres­i­dent Don­ald Trump, who made re­form­ing veter­ans’ health care a ma­jor point of his cam­paign, may re­veal de­tails of the plan in his State of the Union ad­dress this month.

The pro­posed changes have grown out of health care leg­is­la­tion, known as the Mis­sion Act, that was passed by the last Con­gress. Sup­port­ers, who have been in­flu­en­tial in ad­min­is­tra­tion pol­icy, ar­gue that the new rules would stream­line care avail­able to veter­ans, whose health prob­lems are many but whose num­bers are shrink-

THE PRO­POSED CHANGES HAVE GROWN OUT OF HEALTH CARE LEG­IS­LA­TION, KNOWN AS THE MIS­SION ACT.

ing, and also prod the veter­ans’ hos­pi­tal sys­tem to com­pete for pa­tients, mak­ing it more ef­fi­cient.

“Most veter­ans chose to serve their coun­try, so they should have the choice to ac­cess care in the com­mu­nity with their VA ben­e­fits — es­pe­cially if the VA can’t serve them in a timely and con­ve­nient man­ner,” said Dan Cald­well, ex­ec­u­tive di­rec­tor of Con­cerned Veter­ans for Amer­ica.

Crit­ics, which in­clude nearly all of the ma­jor veter­ans’ or­ga­ni­za­tions, say that pay­ing for care in the pri­vate sec­tor would starve the 153-year-old veter­ans’ health care sys­tem, caus­ing many hos­pi­tals to close.

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