A review of the first steps toward privatizing Veterans Administration medical care shows that taxpayers spent more money to deliver longer wait times to veterans through a new program called “Veterans Choice.”
The program does have some success, and was started with good intentions — allow veterans to access services through private providers, sidestepping the long waits and dysfunctional bureaucracy of the VA medical. But a review of VA claims data by the investigative websites ProPublica and Politifact show that the roughly 1.9 million former service members who received private medical care through Veterans Choice experienced average wait times that were longer than allowed for by law.
“The watchdogs also found widespread blunders, such as booking a veteran in Idaho with a doctor in New York and telling a Florida veteran to see a specialist in California. Once, the VA referred a veteran to the Choice Program to see a urologist, but instead he got an appointment with a neurologist,” according to a story about the review.
The review also found that the price tag on the poor service was more than $2 billion more than what it would have been had the same services been offered through the regular VA.
It sounds almost too bad to be true, but this program — the pilot for which started under the Obama Administration and continued under Trump — is set to expand.
We are not generally opposed to this idea. The VA has been the focus of much attention in recent years due to multiple blunders, long waits and other problems. Yet these issues spring more from bureaucratic incompetence, outdated systems and new challenges than the mere fact that it is a government institution. That same bureaucratic incompetence is on display with the privatization efforts — but this time the incompetence was shown by private companies.
That didn’t stop those companies from pocketing roughly $2 billion in fees — that’s $2 billion in taxpayer money — that amounted to about 24 percent of all program expenses. That’s a pretty good profit margin for any kind of work, much less substandard, bungled work.
The VA secretary, Robert Wilkie, admitted there were issues in testimony before Congress earlier this month.
“The department, I admit, was taken advantage of because of the hasty nature that took place when the program was put together,” Wilkie said, blaming the problems on the rapid three-month timeline required by Congress’ act establishing the Veteran’s Choice program. The issues identified by the investigation have been corrected in advance of the permanent private care program, which is established by the so-called Mission Act. That program is set to go into place in 2019, under roughly the same timeline — 90 to 120 days — as the first attempt.
Several lawmakers expressed concern over the potential for a repeat of the same issues and the expense. But others have a longer view in mind, and a pressing worry that these efforts are less about saving money and more about taking apart the VA, piece by piece.
“My ongoing concern, and this article demonstrates that, is that we are in the process of dismembering the VA — taking resources away from the VA, putting it into the private sector,” said Sen. Bernie Sanders, the Vermont independent who entered the investigation into the public record. “I fear this is nothing short of a steady march toward the privatization of the VA. … It’s going to happen piece by piece by piece until over a period of time there’s not much in the VA to provide the quality care that our veterans deserve.”
It would be one thing if Veterans Choice offered better service at a lower cost. Yet it has not. The question becomes, in a climate where the messaging is consistently that government is bad, who is going to stick up for good government? Because when it’s good, government works. Customer satisfaction at the VA is high. A majority of veterans who work with the VA are happy with the care they receive. There are definite problems with service — long wait times and poor service — that need to be corrected. The system overall is hampered by an outdated, outmoded computer system. But in spite of that, the broader system of a government health care system for veterans works. And Congress should focus on long-term support, modernization and fixes to that system rather than profiteering and piecemeal dismantling.