Are Talks About Privatizing the VA Health System Premature?

on December 2, 2014  |  Permalink

Topics: Care Delivery, Access to Care, Clinical Quality, Patient Populations, Military, Veterans

Following a national scandal that highlighted reports of care delays at Veterans Affairs health care centers, experts have begun debating whether the VA health system should be privatized.

Earlier this year, President Obama signed a $16.3 billion bill (HR 3230) to overhaul VA and improve veterans' access to care, which includes $10 billion in funding to allow veterans facing long wait times or distances to seek private care outside the VA health system. The Veterans Choice Program was authorized to operate for three years or until funding runs out.

What Privatization Supporters Say: American Enterprise Institute economist Joseph Antos and Dartmouth Institute for Health Policy and Clinical Practice Senior Research Scientist William Weeks are among the experts proposing that VA be privatized. Antos said the government should give most veterans vouchers for them to purchase private coverage, with the VA narrowing its focus only to veterans with the serious, service-related medical issues. Similarly, Weeks said the Veterans Health Administration should provide premium and copayment subsidies for veterans to receive coverage from private insurers and emphasize care coordination among providers. Meanwhile, experts cited various justifications for privatization, including:

Allegedly lower quality of care at VA;

A projected decline in the number of veterans in the coming years;

VA's struggles hiring enough physicians, particularly considering physicians' high workloads and salaries that are lower than those available to private providers.

What Privatization Opponents Say: Other experts have argued against privatization or extending the Veterans Choice Program beyond three years. Lou Celli, who heads American Legion's veterans affairs and rehabilitation division, argued the VA health system provides the best "bang for your buck," citing a Congressional Budget Office report that a version of the Veterans Choice Program eventually could cost taxpayers $50 billion annually. In addition, experts opposed to privatization argued that the VA system provides:

A sense of community for veterans;

Lower prices;

Medical research breakthroughs;

More specialized care; and

Higher quality of care.

Our take: The federal government and other observers should wait to see how well the Veterans Choice Program works before deciding whether to privatize the VA health system. VCP should give federal officials measurable results to determine whether veterans are receiving more timely access to higher quality health care. Based on those results, officials can determine the best way to move forward to ensure that vets get the quality, timely care they deserve.

 by Ashley Fuoco