Bipartisan US veterans’ health deal provides $10 billion for private care

By Kate Randall
30 July 2014

US House and Senate negotiators on Monday unveiled a $17 billion emergency package in response to a scandal at the Department of Veterans Affairs (VA) that erupted earlier this year. The deal between Sen. Bernie Sanders (Independent of Vermont) and Rep. Jeff Miller (Republican of Florida), who head the Senate and House panels overseeing the VA, will allow veterans to seek care outside the system.

The bipartisan compromise was struck in the wake of revelations by VA whistle-blowers of the falsification of data and long wait times, resulting in patient deaths in the VA system. On May 30, President Obama accepted the resignation of the VA secretary, retired Gen. Eric Shinseki, who ordered a systemwide audit.

The deal struck Monday followed reportedly contentious negotiations between Sanders and Miller over funding and other issues, with Sanders pushing for as much as $25 billion while Miller called for capping funds at $10 billion. The two were agreed, however, on measures that will further shift the provision of veterans’ health care to privatization.

The package provides $10 billion to allow veterans to seek private care if they have waited more than 30 days for an appointment or if they live more than 40 miles from the nearest VA facility. The deal also includes a three-year extension to a VA pilot program to treat brain-injured veterans at private rehabilitation facilities. The assisted-living program had been set to expire in October, and the VA had already begun discharging dozens of veterans from facilities across the country.

According to a 2012 Institute of Medicine report sponsored by the Defense Department and the VA, an estimated 13 to 20 percent of veterans of the wars in Iraq and Afghanistan have post-traumatic stress disorder (PTSD) or may develop it in the future. This amounts to roughly 338,000 to 520,000 veterans who are either suffering or in danger of suffering from this debilitating condition.

An April 2012 VA inspector-general report also showed that fewer than half of those veterans seeking mental-health services received a full mental-health evaluation within the 14-day window mandated by the VA’s own guidelines.

Democrats and Republicans alike are cynically exploiting the fate of these seriously injured veterans to push, not for increased funding to the VA health care system, but to shift funding to the private sector. The Sanders-Miller deal provides $17 billion in spending for medical care, the hiring of new doctors, nurses and specialists, as well as construction projects and leases for at least 27 new facilities in more than a dozen states.

Of this $17 billion, $12 billion is new, emergency spending and $5 billion will come from unspecified spending cuts across the already cash-strapped VA system. The bulk of the new money, $10 billion, will be earmarked to help pay for medical care for veterans outside the VA system.

A column in Monday’s Wall Street Journal describes the draft bill as “a step in the right direction,” but argues, “We need a permanent program that will provide veterans with timely access to the best care.” Robert Margenthau writes that Congress should consider providing an appropriation to the Department of Health and Human Services (HHS) to fund “public-private partnerships with not-for-profit hospitals and universities” to treat injured veterans.

In what would amount to a voucher system, the Journal advocates that funds “could be used to pay for mental-health care for veterans by reimbursing not-for-profit hospitals for medical expenses, just the way an insurer does” (emphasis added).

As an example of the type of public-private partnerships the Journal supports, the article points to the Headstrong Project set up by Zach Iscol, a combat veteran. Headstrong has formed a partnership with Weill Cornell Medical College to provide mental-health care to Afghanistan veterans.

The newspaper also touts the efforts of organizations such as Welcome Back Veterans (WBV), which is currently funding PTSD programs at university hospitals in New York, Boston, Chicago, Los Angeles and other locations. On its web site, WBV is described as “a public/private partnership with the Veterans Administration, Department of Defense, Major League Baseball Charities, the McCormick Foundation, the Entertainment Industry Foundation and world renowned Centers of Excellence at University Hospitals throughout the country.”

Under such programs, the responsibility for the treatment of the hundreds of thousands of veterans maimed and mentally incapacitated as a result of the wars supported and funded by politicians of both big business parties is to be handed over to charitable foundations.

While veterans and their families have been outraged over the lack of treatment and deaths resulting from long wait-times, corruption and mismanagement at VA facilities, there is no groundswell of support from their ranks for turning over the care of veterans to the private sector.

In a statement, the advocacy group Disabled American Veterans commented, “We remain concerned that simply giving veterans plastic cards and wishing them good luck in the private sector is not a substitute for a coordinated system of care.”

The VA health care system is in desperate need of doctors, nurses and other medical professionals to provided specialized care to wounded veterans. The portion of funding in the new VA spending package targeted for hiring doctors serves at best as a Band-Aid on an already crippled system.

While the crisis at the VA calls for a massive influx of spending, the Obama administration’s proposed 2015 budget includes just $163 billion for the VA, or only a 3 percent increase over the 2014 exacted level. The US military machine, by contrast, consumes in excess of $1 trillion every year to finance its exploits worldwide, creating a steady stream of wounded veterans.

The Sanders-Miller legislation must still be approved by the full House and Senate. In an effort to boost their credentials as champions of “our wounded warriors,” congressional leaders hope to do this before heading home Friday for their five-week summer recess. White House spokesman Josh Earnest said administration officials want to examine the details of the bill, but “the early reports are positive.”

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