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Congress examines new ideas for VA care

By: tom philpott Military Update
October 29, 2017 Updated: October 29, 2017 at 4:10 am
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tom philpott, 

Starting next October, the House Veterans Affairs Committee chairman hopes to see every veteran enrolled in VA health care, and who has used the system in the previous two years, be assigned to a VA primary care physician.

The primary care providers would become medical gatekeepers for veterans' care, responsible for their basic health care needs and empowered to refer them to specialists when required, either inside VA or to outside networks of private sector doctors, or even to other federal health systems, including the military and Public Health Service, under partnership arrangements to share available resources.

If VA doesn't have sufficient numbers of primary care physicians on staff by then, private sector providers would be contracted until VA could recruit sufficient physicians to close the gap. But importantly, VA would see its "role as the central coordinator of care for enrolled veteran patients" restored and sustained, said Rep. Phil Roe, R-Tenn., committee chair.

At a hearing Tuesday, the three largest veteran service organizations agreed with Roe and said they found no part of his draft bill to replace the controversial Choice program as being a "deal breaker."

Indeed, it is very similar but also more detailed than the "CARE" proposal for replacing Choice unveiled by Veterans Affairs two weeks ago.

Both packages reject how Choice uses arbitrary rules to establish eligibility for community care. Both would have VA clinicians, consulting with patients, to decide whether to refer patients to private care.

Roe's draft bill and VA's other proposal also include provisions that would strengthen the VA health care system while acknowledging and making permanent VA's reliance on community care to ensure that veterans get timely and quality health care. That balancing is viewed by Roe and by VA Secretary David Shulkin, who also testified, as critical to addressing fears raised by critics that permanent community care programs will be used by future Congresses and presidents as the foundation for privatizing VA health care.

"I believe it is important to state yet again that this effort is in no way, shape or form intended to create a pipeline to privatize the VA health care system," Roe said.

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To comment, write Military Update, P.O. Box 231111, Centreville, VA, 20120 or email milupdate@aol.com or twitter: Tom Philpott @Military_Update

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