12 Mar 2015 Fixing Veterans Health Care

About two weeks ago Concerned Veterans for America released a report on how to reform veterans health care.

The title of the report doesn’t exactly inspire confidence: “Fixing Veterans Health Care: A Bipartisan Policy Taskforce.”  Bipartisan is too often a euphemism for liberal.

The members of the taskforce include Dr. William Frist, Rep. Jim Marshall, Dr. Michael Kussman, Darin Selnick, Pete Hegseth and Avik Roy.  Roy appears to be the only free-market oriented member of the group.

However, some of the report’s recommendations are quite good.  For example, one of the Principles for Veterans’ Health Care Reform is: “The veteran must come first, not the VA. The institutional priorities of the VHA weigh too heavily in current planning, funding and care delivery decisions. We believe the interests of veterans should be paramount.”  Another is: “Veterans should be able to choose where to get their health care. Based on eligibility, veterans should have the option to take their earned health care funds and use them to access care at the VA or in the voluntary (civilian) health care system. Because private health care is somewhat costlier than VHA [Veterans Health Administration]-based care, most veterans who choose this option will be expected to share in some of the costs of such care, through co-pays and deductibles.”

So, Veterans can take the money they get from the VHA and use it to buy private health insurance.  That’s a very good start.

But here is where it begins to get worrisome: “Those veterans who choose to use VHA facilities should receive timely and quality care. In order to achieve this goal, the VHA should be restructured—as an independent, efficient, and modern organization—that can compete with private providers.” (Italics added.)

In the VHA’s new, independent role, the Veterans Health Insurance Program would administer the insurance and premium supports.  The Veterans Accountable Care Organization (VACO) would actually provide the care and would be the one competing with the private sector.  But if it competes, will VACO be allowed to go out of business should it fail just like other competitors in the private sector would?  If not, then the playing field is titled at a 45 degree angle, with the VACO’ endzone at the top and everyone else’s at the bottom.

I’ve emailed Avik Roy about this.  Will let you know when he gets back to me.