The American Federation of Government Employees (AFGE), the largest labor union representing federal and District of Columbia government workers, announced Tuesday that about 40 anti-VHA privatization rallies will be held nationwide. The move comes as the VA Commission on Care, the congressionally-mandated body tasked with making recommendations about the future of Veterans Health Administration, closes in on an early July release date for a report on the agency's future.
The Veterans Council of the AFL-CIO and the Roosevelt Institute, a New York-based think tank, held a conference, "Keeping the Promise: What's Next for the VA" in Washington last week. National health-care experts, VHA officials, and the directors of five veterans service organizations (VSOs), outlined what veterans stand to lose, if the VHA is privatized, which is precisely what one group of commission members (the so-called Strawmen), who represent the hospital industry and the Koch Brothers-funded Concerned Veterans for America, has proposed.
VA Undersecretary for Health David Shulkin and top VHA research, teaching, and clinical services officials described the VHA's progress in improving access to VHA services. The VHA's Million Veteran Program, which amasses health care and genetic information on hundreds of thousands of veterans, will be making significant contributions in efforts to individualize treatments for a variety of medical problems facing Americans. The VHA is a global leader in telehealth services, which allow providers to connect with patients who live miles away from a clinic or hospital. This type of care brings much-needed services to underserved areas, particularly in the 55 percent of rural counties that lack a single psychiatrist, psychologist, or social worker, according a recent HRSA report.
Terri Tanielian, a senior social research analyst who served as director of the RAND Center for Military Health Policy Research for more than a decade, delivered a key message. She debunked the idea that private sector mental health providers can adequately care for the nation's veterans.
Tanielian explained that a recent RAND study, "Ready to Serve," found that only 13 percent of the nation's mental health providers have an understanding of military culture or an awareness of the appropriate kinds therapies for civilian patients with specific mental health concerns. If mental health providers cannot provide suitable therapy regimes for civilians, how can they care for veterans with complex, military-related problems?
The VHA's Marsden McGuire, the VA's deputy chief consultant for mental health care, explained that the agency provides "wraparound services that other health care systems cannot." In 2014, The American Journal of Public Health devoted an entire issue to VA programs like the national system of Veterans Courts that help veterans avoid or shorten jail or prison terms through housing, employment, and substance abuse programs. These measures go a long way to explain why, when surveyed, veterans overwhelmingly support the VHA, according to Joshua E. Ulibarri of Lake Research Partners Veterans.
According to Garry Augustine of the Disabled Veterans of America and other groups, veterans fear that a fragmented private-sector system will deliver inadequate care. They believe that private-sector providers have little or no understanding of their specific problems and are too often motivated by profit rather than interest in individual veterans.
Sherman G. Gillums, executive director of the Paralyzed Veterans of America and Marine Corp veteran who was paralyzed when a vehicle rolled on top of him, told The American Prospect that many of the VHA's current problems stem from congressional underfunding and inaction. "It is Congress's job to fund the VA and provide oversight of its functions," he said. "The Independent Budget [a group of VSOs that submit recommended funding levels for and policy recommendations about the VA to Congress every year] have lamented the shortfalls in VA construction, information technology, staffing budgets year after year."
Capitol Hill also came in for criticism from Kenneth W. Kizer, a former Clinton administration VA undersecretary, who warned that relentless attacks on the VHA over the past decade have exacerbated the agency's insularity. "You don't create organizational excellence by focusing on how many people you've fired, which [is] driven by Congress, and is too much of a focus of current VA leadership," he said.
Representative Tom MacArthur, a New Jersey Republican, has sponsored a bill that could eventually privatize VHA mental health; Senator John McCain, the Arizona Republican, supports a bill that would make the Choice Act permanent and eliminate its restrictions; and new legislation from Representative Cathy McMorris Rogers, a Washington state Republican, who chairs the House Republican Conference would also speed up privatization of VHA services. Twenty-six VSOs sent a letter Tuesday to McMorris Rodgers protesting her proposal.
The AFGE and veterans groups are counting on the organized protests to force Congress and the commission to reassess its positions. If efforts to privatize the VHA persist, protests will likely continue throughout the summer.
