Deliberations by the Department of Veterans Affairs Commission on Care, the congressionally mandated group planning the future of the Veterans Health Administration, have, as The American Prospect has reported, become increasingly marred by controversy. When the 15-member commission met in Washington in mid-March, another furor erupted. A recently uncovered proposal to privatize the VHA set off a firestorm of protest within the veterans community.
Several members of the commission learned that seven of their colleagues had been secretly meeting to draft a proposal to totally eliminate the Veterans Health Administration by 2035 and turn its taxpayer-funded functions over to the private sector. Those commissioners dubbed the plan "The Strawman Document."
The authors of the Strawman Document insist that the VHA is so "seriously broken" that "there is no efficient path to repair it." Although the commission's work is supposed to be data-driven and done by the all the commissioners together, the faction meeting independently of the full commission has ignored many of the studies that indicated that treatment at the VHA is often better and more cost-effective than the care available in the private sector.
It is not surprising that the Strawman group has chosen to ignore this research-its members have a vested interest in dismantling the VHA. The Strawman authors include Darin S. Selnick, a part-time employee of the Koch-funded group Concerned Veterans for America, as well as Stewart M. Hickey, a former leader of Amvets, a group that broke away from a coalition of large veterans service organizations because of its support for Concerned Veterans' interest in dismantling the VHA.
The Strawman authors acknowledge that private-sector health-care systems do not provide integrated care, high-quality mental-health treatment, or many other specialized services that the VHA currently delivers. But if the VHA became an insurer-paying the bills instead of providing direct care-it could spend more money trying to "incentivize" providers to give better care in these areas.
Private hospitals would also get federal funding to run what are now VHA Centers of Excellence, which treat epilepsy, Parkinson's disease, and other conditions veterans face.
Representatives of veterans service organizations (VSOs) believe the secret meetings of the Strawman group may violate the Sunshine and Federal Advisory Committee Acts, as well as the commission's agreed-upon processes. The commission had set up working groups to consider key VHA issues. Unlike the secret Strawman meetings, the subcommittee members were well known by all members and the public. Meeting times were posted, and discussion minutes were recorded.
The Strawman faction engaged in another end run around their colleagues when they met with Republican Representative Jeff Miller, chair of the House Veterans' Affairs Committee, and Speaker Paul Ryan. One representative of a major VSO, who asked not to be identified, observes: "If the authors requested the meeting with the House leadership, that constitutes lobbying. If they were invited by the House leadership, that constitutes more interference into the commission's deliberations. Either way, this meeting, funded by the U.S. taxpayer, was totally inappropriate."
"The plan does represent a complete deflection of responsibility to subject these men and women to an alternative 'payer-only' system of care that not only is ill-equipped to absorb the demand but is also, at best, minimally equipped in terms of expertise and the ability to coordinate such complex care over a veteran's lifetime," says Sherman Gillums Jr., acting executive director of Paralyzed Veterans of America.
Before the Strawman proposal became public, Disabled American Veterans (DAV) launched Setting the Record Straight-a social media campaign against proposals that would privatize some or all of the VHA. Garry Augustine, DAV's Washington executive director told the Prospect, "Although we have voiced our views about VA health care for the future, it seems many on the commission are committed to [doing] away with the VA health-care system and turn veterans over to private health care, which we believe would result in uncoordinated and fragmented care for veterans."
The commission would do far better to consider the views of VA Undersecretary of Health David Shulkin and commission member Phillip Longman. Shulkin has argued for strengthening the VHA and giving it a more active role in directing and coordinating any care veterans receive in the private-sector system. Longman believes that the VHA should serve all veterans-not just those with service-related conditions or those who are low-income veterans.
