Some veterans groups vehemently oppose President-elect Donald Trump's plan to allow military veterans to seek care from private doctors instead of Veterans Affairs' healthcare facilities. Others welcome the idea of more choice.
Trump this week met with private-sector healthcare executives, including a contender for the next VA secretary, Cleveland Clinic CEO Toby Cosgrove, to talk about reforming veterans' healthcare. One option is allowing veterans to choose care from private-sector providers, an unnamed transition team official told media outlets on Wednesday.
The official offered no details on how such a system would work. But some view the announcement as a step toward privatizing veteran's healthcare.
“The VFW is against privatizing the VA, but we also acknowledge that contracted, private-sector care has its place,” said Joe Davis, director of communications for the Veterans of Foreign Wars of the U.S. Still, while private care can complement the VA system, it can't fully replace it, he said.
“We will ask the same of any plan for the VA: Who will oversee the quality of health care and ensure accountability; and what will replace ... protection for our most vulnerable veterans?” Sherman Gillums Jr., executive director of the Paralyzed Veterans of America, said in a statement. Another question for the group is, “What will become of VA specialized services as demand for tertiary care diminishes?”
Gillums believes privatizing healthcare would lead to less fragmented and coordinated care and that allowing veterans to opt out of care provided by the VA puts the entire system at risk.
The American Legion and Vietnam Veterans of America have also said they would oppose privatizing veterans' healthcare.
Meanwhile, Mark Lucas, executive director of the Concerned Veterans of America, a conservative group funded by the Koch brothers, said that “the veteran community is encouraged to see the President-Elect Trump embracing solutions that would allow veterans to seek care outside of the VA.” He added that offering more choice is not the same as “privatization.”
Trump initially proposed allowing veterans to choose a private healthcare provider during his presidential campaign, when he laid out his 10-point plan to reform the VA. He said the move would cut down on wait times for care.
The proposal is similar to the Veterans Choice program, which was part of the 2014 VA overhaul. The $10 billion, three-year program funded by Congress is meant to improve access to healthcare and reduce wait times for veterans who typically seek care from VA facilities.
Under the Veterans Choice program, veterans who have waited at least 30 days for an appointment at a VA facility or have to travel more than 40 miles for VA care are able to get federally funded treatment at local, non-VA doctors.
Some Republicans have advocated for making that choice open to all veterans.
The VA has long been criticized for making veterans sometimes wait months to see a doctor. Advocates say patients have died while waiting for appointments.
While those delays have improved, a July report by the Commission on Care said the VA still has “profound deficiencies” in delivering healthcare to millions of veterans.
The report also said the “the design and execution of the Choice Program are flawed.”
“Implementing the Choice Program has posed challenges, including difficulties arising from overlapping, but fundamentally different, care-purchasing authorities. Veterans, VHA staff, and community providers have been confused because of conflicting requirements and processes in eligibility rules, referrals and authorizations, provider credentialing and network development, care coordination, and claims management.”
Instead, the Commission said the VA must establish high-performing and integrated healthcare networks.
Previous studies have found that delivering VA healthcare services would cost more through private-sector providers.
A 2014 report by the Congressional Budget Office points out that it is difficult to compare costs of healthcare provided by the VA with services delivered by private healthcare providers because it is unknown how the VHA would build contracts with the private sector in a public-private system.
Moreover, veterans typically receive most of their healthcare outside of the VA. Many veterans are enrolled in Medicare or Medicaid, or have insurance through a private plan, the CBO noted.
In 2015, the VA spent about $65.6 million on medical care for the 22 million living U.S. veterans, according to the Veterans Affairs Department's National Center for Veterans Analysis and Statistics.
