The official in charge of the Department of Veterans Affairs healthcare reform planning is being reassigned, a move that's raising more fears about the VA health system's future under reform.
Elwood Headley, M.D., acting deputy undersecretary for health, will be leaving to become chief of staff at the VA's hospital in Jamaica Plain, Mass., effective May 1, 1995, the VA said last week. The move has veterans advocates concerned that the VA will lack adequate leadership as it moves into health reform. The position of undersecretary of health has been vacant since late last year and has been filled on an interim basis by John Farrar, M.D. The undersecretary oversees the entire VA health system of 171 hospitals and numerous clinics.
"It certainly isn't moving along the way we would like it to," said Rep. Roy Rowland (D-Ga.), chairman of the House Veterans Affairs hospitals and healthcare subcommittee. "The committee is concerned there will be a void at the top."
A spokesman for the VA said Dr. Headley's transfer was being made at his request, and officials would begin the search for his replacement immediately. The VA has told at least one veterans group that it will include non-physician candidates in the search. Past attempts to fill leadership positions within the VA health system with non-physicians have been opposed by physician groups, including the American Medical Association.
At a hearing of the full House Veterans Affairs Committee last week, Dr. Headley was attacked by Republicans, who contended the Clinton administration's reform plan, known legislatively as the Health Security Act, would hurt, rather than help, the VA.
Rep. Steve Buyer (R-Ind.) predicted that "if we take the path of the Health Security Act, it is the beginning of the end for the VA healthcare system."
The Clinton plan would make the VA, for the first time, compete with private healthcare providers. The VA would be offered as one of many options to veterans who would then choose the VA or a private plan. For veterans now eligible for the VA, all co-payments and deductibles would be waived if the veteran chooses the VA system. Critics argue that the VA, after years of budget shortfalls, is unprepared to compete with private providers.
"The Clinton plan will sow the seeds of destruction for the VA system; it is not a fair fight," said Rep. Michael Bilirakis (R-Fla.).
In other action, the full VA Committee passed unanimously a bill allowing the VA to implement many of the Clinton administration's healthcare reforms on a test basis in as many as five states.
The committee also passed a measure that would exempt the VA health system from staff cuts proposed in the administration's 1995 budget, which calls for more than 5,300 personnel cuts throughout the VA system, 3,700 of those among the medical staff.