Hey Guys! Let’s Reinvent The Wheel! VA edition

GOP leaders, whistle-blower join in calls to privatize veterans’ care

The idea of privatization has gained steam since allegations of a wait-list at a VA facility in Phoenix were exposed last month, but the concept has been posed for years by conservative lawmakers, including Sen. John McCain, R-Ariz., in 2008 and GOP presidential nominee Mitt Romney, who both faced a backlash from such groups as the Veterans of Foreign Wars.

Last week, McCain, a Vietnam veteran, began working on a plan with GOP Sens. Richard Burr, N.C., and Tom Coburn, Okla., to allow veterans to receive health care outside the VA system.

The plan comes at the same time conservatives have suggested a program in which veterans could use vouchers to pay for treatment at private facilities

OK, this is what drives me bonkers about Washington. Politicians don’t bother looking at what existing programs they can easily modify to meet a need.

Apparently their creative instincts are only satisfied by starting from scratch with something new and complicated. Veterans over 65 can already use a “voucher” to pay for treatment at private facilities. Its called a Medicare card. What’s even more obvious and on point, the Dept of Veterans Affairs already has its own Medicare-like (but without the premiums) voucher program that pays for private treatment, its called CHAMPVA. Give every veteran a CHAMPVA card, problem solved.
CHAMPVA is a single payer system (generally paying the same rates as Medicare) for the families of severely disabled veterans. Even vets so seriously disabled their families qualify for CHAMPVA must themselves go to the nearest VA hospital for treatment, which is kind of odd really. Just today, the wife of an Air Force veteran was telling me when they lived in Alaska her husband needed surgery, the VA told him he’d have to fly to Seattle for the operation (fortunately his job had health benefits and he just had it done in Anchorage). That’s just crazy.

Like I said, give every vet a CHAMPVA card. Then after we wait a decent interval to see that the rocks won’t melt and the sea won’t burn, give every American a card.

Comments

  1. beowulf says:

    McCain is introducing the Veterans Choice Act later today. I’ll update with link once there’s more details. If it involves anything other than simply giving vets CHAMPVA cards, the plan is over-engineered.

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  3. beowulf says:

    Here’s a link to a summary of McCain’s Veterans Choice Act. As predicted, there’s some wheel reinvention going on.
    http://www.burr.senate.gov/public/_files/VeteransChoiceActsectionbysection(final).pdf

    The bill would issue Choice card (as opposed to existing CHAMPVA card) to vets on a waiting list or at least 40 miles from a facility. This of course does nothing for vets near a facility that doesn’t offer appropriate care– that Alaskan vet who would have to fly to Seattle for surgery wouldn’t qualify even though his local VA hospital offered inadequate care. Just give every vet eligible for VA care a CHAMPVA card, then waiting lists will take care of themselves, vets will vote with their feet if they want to be treated by VA or a private provider.

    The bill also has some rigmarole about Choice card coverage would pay at Medicare rates. Again, CHAMPVA already has its provider coverage issues worked out. It’s accepted by all Medicare providers and it actually is a better deal for recipients. Medicare is barred by law (score one for the pharma lobby) from negotiating drug prices, CHAMPVA and military Tricare recipients benefit from low drug prices already negotiated by VA.
    What the bill doesn’t mention (and a point I neglected to mention above) is that unlike Medicare, Medicaid, food stamps and other entitlements the VA isn’t funded by an automatic mandatory appropriation for whatever the benefit formula requires paying out. The VA’s annual appropriation sets a dollar cap that comes out of veteran care (i.e waiting lists or sub-standard care) if its exceeded. This is a benefit we’ve promised veterans, it really should be funded as an entitlement.

  4. Matt Franko says:

    ” Then after we wait a decent interval to see that the rocks won’t melt and the sea won’t burn, give every American a card.”

    You would think that the Dems would be smart enough to figure that out…

    I listened to the Pres. press conference on the Arizona debacle/Shinsecki resignation and couldnt help but feel sorry for the guy who thinks we are out of money… so all he can come up with is “hold people accountable”, etc…. but to your point on the fixed appropriations vs non-discretionary, that wont help with the current “rationing” and delays which was the main problem in Arizona (people just lied about it…)

    This would be a good way to get some stimulus going… ie a “new deal” for our veterans… put a major program together, increase the appropriations, convert to a non-discretionary, etc… but not from this Administration….

    Thanks for bringing this issue up not many are talking about it…. but after the increased military activities and deployments of the last decade, our returning vets are going to need corresponding increases in continuing healthcare…

    rsp,

  5. beowulf says:

    Right, Shinseki was fired because you can’t allow subordinates to get away with reporting false data up the chain (if Congress had known earlier how bad the facts on the ground were it might have taken action sooner).

    However the bad facts (i.e. the waiting lists) were not themselves caused by mismanagement but by sufficient appropriations– this is probably happening in programs large and small across the govt thanks to across the board spending cuts of the last few years.
    I have no doubt the govt wasted dozens of billions of dollars but that can only be zeroed out with a “base closing commission” process. Instead these across the board budget cuts treat muscle, fat and tumors equally.