Thursday, June 05, 2014

Paralyzed Veterans of America Statement on New ‘Veterans Choice Act’

Paralyzed Veterans of America released the following:


  June 30, 2014

Media contact:                 

Lani Poblete 202-412-1709

Washington, DC – Paralyzed Veterans of America (Paralyzed Veterans) National President Bill Lawson released the following statement regarding the “Veterans Choice Act”, introduced today by Senators John McCain, Richard Burr, Tom Coburn, and Jeff Flake.

“ While Paralyzed Veterans of America (Paralyzed Veterans) sees some merit in the proposal, particularly with regard to transparency, we believe the illusion of “choice” is being used to mask the accountability issues regarding access to care provided by the Department of Veterans Affairs (VA).  Currently, VA has the authority to contract for health care services through fee-based care, non-VA purchased care, and the Patient-Centered Coordinated Care program.  Additionally, VA is implementing more liberal application of its fee-basis care program to allow veterans who have been waiting too long for appointments to get care.  Ultimately, we believe veterans have already made a choice—14 million veterans choose not to be enrolled in the VA health care system.  Meanwhile, 8 million veterans are currently enrolled in the VA health care system and approximately 6.5 million have chosen to receive care directly through the VA system.  

Moreover, establishing a scenario whereby veterans can choose to leave the VA health care system places the entire system at risk.  Former VA Secretary Anthony Principi recently wrote in the Wall Street Journal why the concept of a veterans card (as provided for in the “Veterans Choice Act”) is not a viable long-term solution to the problems facing the VA health care system:
“Vouchers [similar to cards] are not necessary to ensure high-quality health care…While this may have value in areas with long waiting lists, it raises serious questions. The VA system is valuable because it is able to provide specialized health care for the unique medical issues that veterans face, such as prosthetic care, spinal-cord injury and mental-health care.  If there is too great a clamor for vouchers to be used in outside hospitals and clinics, the VA system will fail for lack of patients and funds, and the nation would lose a unique health-care asset.”

Paralyzed Veterans has long emphasized this point.  The broad array of specialized health care services provided by VA is simply not duplicated in the private sector.  Moreover, these services do not operate in a vacuum.  The viability of the VA health care system depends upon a fully integrated system where all of the services support each other.  Sending veterans into the private health care marketplace serves only to undermine this principle. Moreover, it has proved difficult enough to monitor care and promote consistency across the 21 Veterans Integrated Service Networks and 152 medical facilities; and 1,400 community-based providers; this task gets harder rather than easier when the health care framework consists of a fragmented system of non-VA facilities operating by their own rules. We see no guarantee that Veterans Health Administration directives, Congressional oversight, and the limited jurisdiction of the VA Office of the Inspector General will prove more effective once the responsibility for delivering care is shifted to state, nonprofit, and private non-VA facilities.

The proposed legislation leaves many questions unanswered.  How will Congress respond when reimbursements are not provided in a timely manner (as has long been the case with VA)?  What actions will Congress take when doctors choose not to accept veterans as patients because they choose not to accept the Medicare rate (a common and growing problem in the medical provider community)?  What actions will Congress take when it becomes apparent that the private sector cannot provide timely access to high-quality care as well?  What actions will Congress take when it becomes evident that the care being provided in the private sector is clearly substandard to VA’s quality of care?  Will Congress provide any additional funds to support such a program when it becomes apparent that the cost of care provided in the private sector is significantly more expensive than care provided in the VA system?  Why will Congress not commit to further expanding the capacity within the VA health care system that veterans are obviously trying to access?  Who will be responsible for ensuring the seamless transfer of health information between VA and an aggregated network of non-VA providers who are not contractually linked to VA?  

Paralyzed Veterans of America believes that VA should be held accountable for addressing the administrative failures that have compromised the integrity of the health care system.  It is the responsibility of Congress and the Administration to ensure that VA is equipped to meet health care demand and provide timely, quality care now and in the future.”

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Paralyzed Veterans of America was founded by a group of seriously injured American heroes from the “Greatest Generation” of World War II. They created a nonprofit organization to meet the challenges that they faced back in the 1940s—from a medical community not ready to treat them to an inaccessible world. For more than 68 years, Paralyzed Veterans’ national office and its 34 chapters across the nation have been making America a better place for all veterans and people with disabilities. (