Amid VA shakeup, advocates fear privatization of health care

The ouster of Veterans Affairs Secretary David Shulkin has fanned concerns that the federal agency may privatize more of its medical services, which opponents say would endanger its core mission by draining precious resources.

Shulkin, who was fired by President Donald Trump in a March 28 tweet, blamed unnamed privatization advocates “within the administration” for his ouster. In an op-ed penned hours after his dismissal, Shulkin said any dismantling of the VA’s existing health care system would be “a terrible idea.”

Talk of turning over VA services to private medical providers began unnerving veterans advocates in 2016, when then-candidate Donald Trump sharply criticized the VA as corrupt and inefficient during a July campaign rally in Virginia Beach, Virginia.

“Veterans should be guaranteed the right to choose their doctor and clinics, whether at a VA facility or at a private medical center,” Trump said. “We must extend this right to all veterans.” Since then, national veterans organizations have expressed concern that Washington may be looking toward privatization as a way of avoiding the expensive task of maintaining the nation’s 170 VA medical centers and 1,063 outpatient clinics.

These concerns are particularly significant for the Northport VA Medical Center.

Northport’s nearly 90-year-old collection of aging buildings is estimated to need more than $250 million in renovation funding to fix outdated surgical facilities, failing ventilation systems, leaking roofs, flooding pedestrian tunnels, inadequate parking and other infrastructure challenges.

National veterans organizations have voiced strong opposition to wholesale privatization.

Carlos Fuentes, legislative director for the Veterans of Foreign Wars, said allowing veterans to use federal dollars for private medical care even when VA facilities are available would effectively convert the VA into an insurance agency, one whose subscribers would be disproportionately older and sicker than the general population.

“That will result in higher costs, lower coverage and lower quality of care,” Fuentes said.

Fuentes said a privatized VA would result in the health care equivalent of Amtrak, the federally subsidized rail system that has been criticized for its geographically limited service and money-losing ways. The Northport VA has experienced repeated infrastructure emergencies during the past three years, which has forced the closure of hospital operating rooms, left some walls covered with mold, and in January shuttered the facility’s veterans homeless shelter because a furnace stopped working.

Local veterans say they worry that the push for privatization could make it harder to win support for fixing Northport’s problems.

“You see it on social media and hear it in conversation — people are concerned,” said Bob Santo, past commander of American Legion Post 1244 in Greenlawn.

Even as powerful voices have come out in support of wholesale privatization, officials at VA headquarters in Washington have dismissed any notion that greater privatization of the federal government’s second-largest agency — one whose budget has more than doubled since 2009 to nearly $200 billion per year — is being actively considered.

They point out that the VA’s Choice Program already allows the use of private doctors in limited situations, as a convenience to veterans facing long wait times for appointments, or who live far from VA facilities.

“There is no effort underway to privatize VA and to suggest otherwise is completely false and a red herring designed to distract and avoid honest debate on the real issues surrounding Veterans’ health care,” VA spokesman Curt Cashour said Wednesday in an email. Cashour was also the agency’s spokesman under Shulkin.

But comments Trump made at a March 29 rally in Ohio — as they did during his Virginia Beach speech — appear to echo proposals made by an increasingly influential lobbying organization affiliated with billionaires Charles and David Koch.

“We want them to have choice so that they can run to a private doctor and take care of it,” the president said in Ohio, one day after Shulkin’s firing. “And it’s going to get done.”

The Koch-affiliated organization, Concerned Veterans for America, has pushed to convert the VA into a nonprofit corporation that could close VA medical centers it deems inefficient, and pay for veterans care at private health facilities.

“The dollars needed for veterans’ service-connected health care should follow veterans wherever they choose to seek care,” Concerned Veterans for America wrote in a 2015 VA restructuring proposal it called “Fixing Veterans Health Care.”

Under the CVA plan, veterans would have the absolute choice of seeking health care at the organization’s VA medical facilities, or to use VA-provided health insurance at private health providers.

The privatization plan also recommended allowing the president to appoint an independent nine-member panel that could close VA medical centers it deemed inefficient unless Congress acted within 45 days.

Aspects of the CVA proposal are reflected in the Veterans Empowerment Act, introduced in Congress in November by Rep. Doug Lamborn (R-Colo.). The bill would allow veterans to bypass the Veterans Affairs and receive treatment from private-sector doctors with taxpayer money.

The legislation drew swift opposition from legacy veterans organizations.

“We hope that it has absolutely no chance of becoming law,” said the VFW’s Fuentes.

Shulkin’s op-ed said privatizing VA medical care would push many of the 9 million veterans using VA hospitals and clinics into a private sector he said is less capable of addressing military service-related ailments and mental health traumas.

“Working with community providers to adequately ensure that veterans’ needs are met is a good practice,” Shulkin wrote. “But privatization leading to the dismantling of the department’s extensive health care system is a terrible idea.” Both of Long Island’s Republican members of Congress have expressed support for some level of privatization.

“I believe a veteran should be able to take their VA benefit to any provider that they wish,” Rep. Lee Zeldin (R-Shirley) told Newsday Friday. “While some veterans would want to go to a private provider with that option, other veterans love the services they receive at the VA.”

Rep. Peter King (R-Seaford) said he was cautiously open to the idea of using private providers to treat veterans.

“If areas of the VA can be partially privatized that should be looked at very carefully and that should be the exception and not the rule,” King said in an emailed statement.

Both of New York’s senators — Democrats Kirsten Gillibrand and Chuck Schumer — have voiced misgivings.

“At its root, privatization of the VA would inevitably pit profits over the critical care our vets receive and we cannot sit back and let that happen,” said Schumer, the Senate minority leader.

Rep. Thomas Suozzi (D-Glen Cove) also voiced strong opposition, saying privatization could result in the loss of a system that has a history of addressing service-connected medical needs.

“Veterans care is a specific area of expertise, with people with an understanding of what veterans have been through,” Suozzi said. “So if you were ever to privatize this thing and lose that expertise, and risk the idea of the VA failing, after it’s privatized you can’t go back. So there are a lot of downsides to this idea of privatization.”