News from Frank (VT) to consider:
Congresswoman Cathy McMorris Rodgers (WA-05) is working on a bill that contains many VA healthcare restructuring proposals. She wants feedback on the 58-page discussion draft (LINK).
“With this draft legislation, my goal is for veterans to have the ability to choose what health care plan best fits their individual needs,” McMorris Rodgers said in the statement. “This proposal should serve as the starting point for putting veterans in charge of their health care.” (LINK)
One good idea is to allow vets to buy into the Federal Long Term Care Insurance Program (Section 401). But this could just be a carrot because it plays into our fears (realistic or not). Why not just separate this provision as a standalone law?
Some of the ideas are radical and seem suspicious. For example, a proposal to create a VetChoice Care Program with an open enrollment period, linked to priority groups, premiums, premium supports, health savings accounts, and other complicated ideas.
Newspaper articles make these proposals sound good but hold on…
The DAV, responding to Sen. McCain’s criticism of VSOs about resistance to some non-VA care proposals gives one pause:
“What we are against is unrealistic proposals that promise unlimited choice, which in itself is unsustainable, and in reality could force millions of veterans to lose the option to use VA health care, which could ultimately shift the financial cost of care onto every veteran.”
I’d like to see analysis from the Veteran Service Organizations on this discussion draft. I would love to see an end of the dysfunctional, wasteful system veterans endure now but I think some of these privatization ideas are not in the best interest of veterans.
Thank you for posting this information Kiedove.
At least the Congresswoman is asking for feedback–something many Representatives and Senators do not do. If she (and her staff) read all the responses and take them seriously, then so much the better.
Privatization sounds great on paper, but in reality what veterans will likely receive is typical “managed care” insurance. Instead of the VA telling you what’s allowed, it will be a group of business people whose motive is profit, telling you what’s allowed and which doctors you can see. (Vets will definitely not be able to “see any doctor they want” as some would have you believe).
One-third of Veterans Health Administration (VHA) employees are veterans, and many of the non-veteran employees like working at VA because helping veterans is very important to them. What do you think the composition of the private managed care insurance companies will be, i.e., what percentage will be veterans? What percentage genuinely care and are highly motivated to help veterans? I bet the percentages will be much lower than the VHA.
One way to look at it is to ask, Who should the middle man be? Right now it is a big government bureaucracy, albeit one that employs many veterans and those committed to helping vets. Or we could switch to privatization and the middleman will be for-profit companies.
Also keep in mind that veterans currently have the ability to influence policy and procedures directly (by contacting their Representative and Senator), and via veterans service organizations. With privatization, veterans influence will diminish because Congress has limited power with private companies, i.e., they have less influence with a diverse group of for-profit business entities than they do with a federal agency.
If you have the time, why not develop these ideas and send an article to Alex to post? Your opinions are valuable to readers here.
I will be dead and in my VA grave before there are essential changes to the VA. I get tired of this Hero crap. Most guys in Vietnam were just counting days and trying to survive the war. Hero types usually died. They in Nam just like other wars were heroic but not hero types except Audy Murphy maybe.
When the politicians use the word, they are just sycophants.
VA restructuring proposals are essentially wishes. The VA is the mother of all genies. Guess what happens next.
Well, some readers here have advanced the idea of having Medicare handle payments–which has merit. Medicare has two basic charges, “extra help” with reduced premiums for low-income seniors and regular premiums.
But throw in the VA’s priority schemes and you’ve got a mess. The priority schemes are self-defeating because they deny services to thousands of “better off” vets, vets who might have private employer insurance, which they could bill for income
Congress does not allow veterans to buy a ACA exchange policy AND be enrolled in VA. How stupid and insulting. Simplifying policies, streamlining methods, would save time and money. But no, the VA hires private contractors like Healthnet to handle the Choice program, and it’s a horror show.
The veterans’ choice reform movement is good. It needs to be expanded but I for one am very uncomfortable with the thought of turning it into a program whereby it becomes like a HMO, opting-in to have to pay premiums–unless service-connected–based on their income. I don’t see how that is going to improve the VHA’s quality of care.
We should really stay informed about what they are cooking up in DC for vets–and probably pay attention to the VSOs who are clearly wary for good reason.
Very well said Keidove. I agree with your analysis.
Here are two articles that explain some essential power dynamics related to veterans healthcare and benefits:
Iron triangle (US politics) – Wikipedia article that provides a succinct introduction to the concept. | https://en.wikipedia.org/wiki/Iron_triangle_(US_politics)
Beyond the Iron Triangle: Implications for the Veterans Health Administration in an Uncertain Policy Environment by Stephen K. Trynosky | http://www.ptsdexams.com/wp-content/uploads/2016/06/Beyond-the-Iron-Triangle.pdf
The implication for individual veterans is that to influence change, you need to persuade one or more veterans service organizations to support the changes you believe will most help veterans.
To put it more crudely, venting on message boards might feel good, but it’s unlikely to change anything.
Thanks for posting the Iron Triangle information. I will read Trynosky’s paper tonight and give it some thought.
How does change happen? When things become intolerable for masses of the “have-nots” they will eventually vent, complain, and use either violent or peaceful methods to get at least some of the things they need via the laws of their lands–or flee.
It is appalling that American women were not allowed to vote until the 19th amendment was ratified in 1920–a case of motivated individual women being too peaceful perhaps?
Sander’s trip to the Vatican to speak about a moral economy reminded me of Dorothy Day, Peter Maurin, and the Catholic Worker Movement. They didn’t ask for permission from a bishop or cardinal to feed the unemployed in the Bowery in 1933; they just did it based on their understanding of Christ’s teaching on poverty. The Torah offers a tremendous guidance on how to create a moral economy. Or Ghandi; Or Tolstoy. Mother Theresa told people to not come to Calcutta; instead, find the poor and lonely in their own backyards.
The VA is an economic system that lacks moral leadership–and yet, much good gets done anyway by individuals one-on-one. Gov. administrations don’t follow U.S. laws–for example, the Buy American Act of 1933. The VA buys foreign goods over American products even though they can easily source them here. I’m surprised that Trump and Sanders, who are so critical of our trade policies, haven’t mentioned this disaster–one so easy to enforce.
I agree completely. I have a hard time understanding their good intentions for our Vets but, yes there is always a BUT when screwing a good thing; lol! BUT, with everything they come up with always has the clause(s) that eliminate the use of the good idea. Something is wrong with a system that feels drugs are the answer for everything or the system that puts more time into setting the rules then implementing it smoothly. It sure sounds to me as though it’s a wash my hands and move you Vets on. No responsibility regarding the healthcare you receive BUT man, thanks for putting your life at stake for our Country. A quick note regarding the “Choice Program”. My husband got darn lucky in using this program, if it wasn’t for a young Vet working the program my husband never would have had the opportunity to have his surgery which has allowed him to urinate on his own again. This young Vet bypassed a small rule that made a huge medical relief for my husband who went nearly a year on meds that did nothing. He would have been left on the meds with no change until he passes. Think about that for one minute, this one young Vet made a decision on behalf of another Vet that has changed his existence, who now sees a viable reason to get up in the morning. You pass this kind of brother relationship on and I guarantee you the private medical field will in no way take care of a Vet like this.
I think you are indeed lucky because even though the VA has broad authority to apply rules and regs to help vets, they don’t often seem to. Are you still able to use the Choice program or was it just for one course of treatment?