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VFW Magazine September 2016 : Page 6

CURRENT VETERANS ISSUES + BY TIM DYHOUSE Issues Up Front Total Privatization of VA Health Care Could Cost $450 Billion Annually VFW believes that VA health care is not only as good or better than private care but also cheaper and tailored for veterans specific needs. Affairs Commission on Care has estimated that total privatization could cost nearly $450 billion a year, a large portion of which would be passed on to veterans.” A 2014 study by the Congressional Budget Office (CBO) attempted to compare costs between VA and the private sector. While admit-ting it was difficult because of VA’s “mission, mix of enrollees and financing mechanism,” CBO did find that VA care was cheaper. The study estimated costs for private-sector providers supplying the same number and type of services as those delivered by VA. It found pitals put the lives of their patients at risk. We can’t get information from private doctors through Freedom of Information Act requests, or VA’s inspector general can’t walk into any doctor’s office and audit their practice.” He adds that because VA is a government agency, VFW and other veterans advocates can monitor its performance. “We know what VA facili-ties and VA employees have manipulated wait-time data or have neglected veter-ans,” Fuentes said. “With that data, we can hold VA accountable for correcting those issues.” Even under the limited private-care options afforded by VA’s Choice Program, Fuentes said VA must still coordi-nate that care. “Regardless of where the care is delivered, VA must be accountable for it,” he said. Fuentes added that the Choice Program, which allows certain patients who can’t get timely appoint-ments with VA to obtain private care, has not been the panacea for VA’s access prob-lems that many envisioned. “Veterans who have used the Choice Program have experienced firsthand how long wait times can be for the private sector,” he said. “VFW believes veterans have earned and deserve timely access to high quality, comprehensive and veteran-centric care. Privatizing VA would lead to veterans wait-ing in the back of the line to receive private-sector care that is not tailored to their -unique needs.” E-MAIL tdyhouse@vfw.org W hile much news about VA focuses on how long it takes for veterans to be seen by doctors, one fact often goes ignored: the care vets receive is top-notch. “The quality of care VA provides is indisputable,” said Carlos Fuentes, deputy director of VFW’s National Legislative Service. “The overwhelming majority of studies comparing VA care to private sector hospitals has found that the quality of care veterans receive from VA is equal to or better than the private sector.” It has been that way for a while, too. A 2003 New England Journal of Medicine study found that, as of 2000, VA’s quality of care had “improved dramatically in all domains studied” after a “re-engineering” in 1995. More recently, a 2015 study by Rand and the MITRE Corporation found that compared to the private sector, VA patients had a bet-ter survivability rate after surgeries, VA inpatient care was “more or as effective” as that in private hospitals and that VA outpatients got better follow-up care, among • SEPTEMBER 2016 other revelations. VFW believes that a big part of quality is specializa-tion. Fuentes said the private sector lacks the “expertise” to care for veterans with ser-vice-connected disabilities, such as conditions related to Agent Orange exposure. And it does not have the financial incentive to devel-op such expertise. He also cited a —CARLOS FUENTES, DEPUTY DIRECTOR OF VFW’S NATIONAL LEGISLATIVE SERVICE recent Rand study that found only that VA services “generally 13% of private-sector provid-cost less” than equivalent ers could supply “culturally care provided in the private competent and evidence-sector. based” mental health care. The study also noted HIGHER COSTS FOR VETS, that this was true “even TAXPAYERS though the comparison used Studies have shown that VA Medicare’s relatively low pay-care is cheaper, too. Fuentes ment rates for private-sector notes that VA patients are doctors and hospitals.” “older, sicker and higher users” of health care. In order VA MUST BE ACCOUNTABLE FOR CARE to pay for their care while Another of VFW’s major still making a profit, insur-concerns with total privati-ance companies, he said, zation is the loss of account-would have to increase cost ability and oversight that shares and limit coverage. would occur. “This would result in vet-“Medical errors are erans and taxpayers paying the third leading cause of higher subsidies and out-of-pocket costs for less coverage death in the United States,” than what is available today,” Fuentes said. “But we have no idea which private hos-Fuentes said. “The Veterans “WE HAVE NO IDEA which private hospitals put the lives of their patients at risk. 6 • VFW

Issues Up Front

Tim Dyhouse

Total Privatization of VA Health Care Could Cost $450 Billion Annually

VFW believes that VA health care is not only as good or better than private care but also cheaper and tailored for veterans specific needs.

While much news about VA focuses on how long it takes for veterans to be seen by doctors, one fact often goes ignored: the care vets receive is top-notch.

“The quality of care VA provides is indisputable,” said Carlos Fuentes, deputy director of VFW’s National Legislative Service. “The overwhelming majority of studies comparing VA care to private sector hospitals has found that the quality of care veterans receive from VA is equal to or better than the private sector.”

It has been that way for a while, too. A 2003 New England Journal of Medicine study found that, as of 2000, VA’s quality of care had “improved dramatically in all domains studied” after a “re-engineering” in 1995.

More recently, a 2015 study by Rand and the MITRE Corporation found that compared to the private sector, VA patients had a better survivability rate after surgeries, VA inpatient care was “more or as effective” as that in private hospitals and that VA outpatients got better follow-up care, among other revelations.

VFW believes that a big part of quality is specialization. Fuentes said the private sector lacks the “expertise” to care for veterans with service- connected disabilities, such as conditions related to Agent Orange exposure. And it does not have the financial incentive to develop such expertise.

He also cited a recent Rand study that found only 13% of private-sector providers could supply “culturally competent and evidencebased” mental health care.

HIGHER COSTS FOR VETS, TAXPAYERS

Studies have shown that VA care is cheaper, too. Fuentes notes that VA patients are “older, sicker and higher users” of health care. In order to pay for their care while still making a profit, insurance companies, he said, would have to increase cost shares and limit coverage.

“This would result in veterans and taxpayers paying higher subsidies and out-ofpocket costs for less coverage than what is available today,” Fuentes said. “The Veterans Affairs Commission on Care has estimated that total privatization could cost nearly $450 billion a year, a large portion of which would be passed on to veterans.”

A 2014 study by the Congressional Budget Office (CBO) attempted to compare costs between VA and the private sector. While admitting it was difficult because of VA’s “mission, mix of enrollees and financing mechanism,” CBO did find that VA care was cheaper.

The study estimated costs for private-sector providers supplying the same number and type of services as those delivered by VA. It found that VA services “generally cost less” than equivalent care provided in the private sector.

The study also noted that this was true “even though the comparison used Medicare’s relatively low payment rates for private-sector doctors and hospitals.”

VA MUST BE ACCOUNTABLE FOR CARE

Another of VFW’s major concerns with total privatization is the loss of accountability and oversight that would occur.

“Medical errors are the third leading cause of death in the United States,” Fuentes said. “But we have no idea which private hospitals put the lives of their patients at risk. We can’t get information from private doctors through Freedom of Information Act requests, or VA’s inspector general can’t walk into any doctor’s office and audit their practice.”

He adds that because VA is a government agency, VFW and other veterans advocates can monitor its performance.

“We know what VA facilities and VA employees have manipulated wait-time data or have neglected veterans,” Fuentes said. “With that data, we can hold VA accountable for correcting those issues.”

Even under the limited private-care options afforded by VA’s Choice Program, Fuentes said VA must still coordinate that care.

“Regardless of where the care is delivered, VA must be accountable for it,” he said.

Fuentes added that the Choice Program, which allows certain patients who can’t get timely appointments with VA to obtain private care, has not been the panacea for VA’s access problems that many envisioned.

“Veterans who have used the Choice Program have experienced firsthand how long wait times can be for the private sector,” he said.

“VFW believes veterans have earned and deserve timely access to high quality, comprehensive and veterancentric care. Privatizing VA would lead to veterans waiting in the back of the line to receive private-sector care that is not tailored to their unique needs.”

Read the full article at http://digitaledition.qwinc.com/article/Issues+Up+Front/2544104/324472/article.html.

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