At one point in 2014, the Department of Veterans Affairs’ Pacific Islands Health Care System had the longest wait times in the entire VA system — about 145 days for an incoming patient to get an initial appointment with a primary care physician.
The glaring problem was spotlighted in the wake of a scandal involving patient cases in which military vets were dying while awaiting specialist treatment at the Phoenix VA Healthcare System in Arizona. Since then, officials here have maintained that wait times are shorter. (The VA is the largest and the only health care system that publicly publishes wait times for appointments).
Also, other strides have been made to better serve some 127,000 veterans living in Hawaii and throughout the Pacific basin, including assistance for homeless vets and health care provider training that addresses issues relevant to the VA’s fastest-growing group: women vets.
What’s now worrisome is an apparent push in Washington, D.C., for privatization of veterans health care and other services. While, clearly, the VA system is far from perfect, the government’s primary interest is serving veterans. There’s reason to worry that business sector issues tethered to privatization could result in an interest more focused on rosy financial pictures than health care.
Last week, President Donald Trump booted out David Shulkin as Veteran Affairs secretary — via Twitter, no less — and tapped White House physician, Navy Rear Adm. Ronny Jackson, for the top post. Shulkin, an Obama administration holdover, quickly spoke out against complete privatization.
In an interview on “PBS NewsHour” Thursday, Shulkin said: “I just don’t see privatization as a good thing for veterans.” The ongoing push in that direction, he said, appears to be anchored by Trump appointees and others who are “sticking to a political ideology or … doing this for other reasons, like financial reasons.”
Hawaii’s U.S. Sen. Mazie Hirono rightly echoed the concern in a statement that also raises an eyebrow over Jackson’s ability to lead the nation’s second-largest agency — with more than 350,000 employees and a nearly $200 billion annual budget — given a lack of management experience. Hirono frets that such an appointee could end up serving as a “rubber stamp,” rewarding select people and companies with profits, even if it undercuts care for vets.
Privatization supporters make valid points in noting that despite improvements in patient care made after Phoenix VA whistle-blowers exposed unacceptable flaws, the current system is still hampered by spikes in wait times and limited hospital choices. Given the VA’s immense scope, there will always be bureaucratic lags.
Even so, groups like the American Legion are opposed to any sort of switch. Addressing reporters at the National Press Club last month, Lou Celli, the Legion’s national veterans affairs director, said privatization could be more expensive, and thereby reduce access to a full range of care. “One of the things we’re most concerned about is an increased contracting out — when we should be able to do that on VA campuses — that will deplete the amount of money that’s available to see veterans.”
Veteran health care centers are all paid for by the government, and all workers are given set salaries. Their payments do not change based on factors like surgical procedures, diagnostic services and visit types. By comparison, under a privatized system, veterans would likely be subject to fluctuating payments based on many different criteria.
The VA’s Pacific Islands Health Care System includes some 1,000 employees — many who are veterans themselves, according to its director, Jennifer Gutowski. She has described the system as focused on providing “comprehensive patient- and family-centered care.” It’s crucial that the VA is held to that worthy mission — as it’s one that veterans need and deserve.
