VA touts private health care for vets but cost issues linger

FILE - In this Aug. 4, 2017, file photo, Secretary of Veterans Affairs David Shulkin speaks during a visit to the Veterans Administration Medical Center in, Manchester, N.H. Shulkin is touting an overhaul plan to give veterans even wider access to outside doctors than under its troubled Veterans Choice health care program. He is stressing stronger ties with the private sector, even while acknowledging key questions of cost and sharing of medical records were still unresolved. Shulkin on Oct. 24, acknowledged the program would run out of money sooner than expected and urged Congress to provide new stopgap funding by year’s end. (AP Photo/Charles Krupa, File)

WASHINGTON — Veterans Affairs Secretary David Shulkin touted an overhaul plan Tuesday to give veterans even wider access to outside doctors than under its troubled Choice health care program, stressing ties with the private sector even while acknowledging key questions of rising cost and sharing of medical records were still unresolved.

 

Testifying at a House hearing, Shulkin provided new details on the VA’s plan to permanently replace the Veterans Choice program. Acknowledging the program would run out of money sooner than expected, he urged Congress to act by year’s end to provide stopgap funding and loosen restrictions to ensure timely, quality treatment for veterans when unavailable at VA medical centers.

Veterans should get “more choice in the say of their care,” Shulkin told the House Veterans Affairs Committee. “Nobody should feel trapped in the VA system.”

Still, faced with repeated questioning from lawmakers, Shulkin conceded that an upgraded VA information technology system needed to reduce delays and ensure a smooth sharing of medical records with outside doctors was still seven to eight years away and that the White House budget office also had yet to approve the costs of its proposal. Major veterans’ organizations generally oppose paying for Choice by reducing veterans’ disability benefits or with cuts to core VA health programs.

His remarks underscored significant change underway at the VA, drawing both praise and consternation after a 2014 wait-time scandal at the Phoenix VA medical center and big campaign promises from President Donald Trump to expand “choice” for veterans.

“Veterans’ health care should not be subjected to offsets or pay-fors, and the full burden of providing care for service-disabled veterans needs to be borne by the federal government,” said Roscoe Butler, a deputy director for The American Legion, the nation’s largest veterans group. He called the initial proposals a “great start” that needed adjustments to protect against erosion of VA medical centers.

Dubbed Veterans CARE, the VA proposal would eliminate Choice’s current restrictions that veterans can go outside the VA network only in cases where they had to wait more than 30 days for an appointment or drive more than 40 miles to a facility.

Veterans would get outside referrals based on “clinical need,” consulting with VA health providers about their medical problem. The health provider and patient would then jointly decide whether it was best to receive care within the VA or with a private doctor. A veteran could take into account the length of time waiting for a VA appointment, poor performance at the local VA hospital based on department ratings, or if the VA can’t provide the service.

Veterans also would be able to access walk-in clinics, such as MinuteClinics.

 

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