Killer fish in VA waters
One of the tiresome and harmful myths of the self-promoting “job creators” is the superiority of the private sector in providing more efficient and cost effective government services. The recurring portrayal of the public sector as a bloated bureaucracy incapable of anything except wasting taxpayer money demoralizes public servants and minimizes their worth even as they build public institutions to effectively serve our nation.
A favorite tactic of the self-righteous business barons is to “starve the beast” of government by dramatically reducing budgets and then loudly complaining about the poor quality of care when services are cut. And they make sure the blame is placed on the people actually doing the work instead of the policy-makers who made the ill-advised funding decisions. The inevitable scandal is then used as leverage to propel private contractors into the mix, undercutting the public sector workforce and introducing a profit motive that serves no one well except those making money off the very misery they inspired.
We’ve seen this cynical model used extensively over the past 30 years in corrections, primarily in state prisons, but also in other public institutions such as state mental health hospitals or juvenile facilities. The for-profit sector is now gearing up for the largest target of all, the Veterans Administration.
In June, The Hill reported on new proposals from the Trump Administration designed to push more veterans into the private medical sector instead of funding their care through the Veterans Health Administration (VHA) budget. Veterans Affairs Secretary David Shulkin told Congress he wants to replace the Veterans Choice Program with a new version that would allow veterans to select any private sector physician or provider even if there is no waiting time at their local VA or they don’t have to drive more than 40 miles to a VHA facility, the criteria previously used. The veteran would have to search for a provider outside of the system but there would be no requirement for integrated care or communication with the veteran’s medical team at the VA.
There are mountains of studies showing privatization of government services is a bad idea. Susan Duerksen from In the Public Interest says, “Governments at all levels are just desperate to balance their budgets, and they’re grasping at privatization as a panacea. But there’s evidence that it often is a very bad deal with hidden costs and consequences when you turn over public service to a for-profit company.”
There’s one thing you can count on when public services are privatized. In order to generate profit, expenses need to be cut, which means workers get paid substantially less and receive fewer benefits while corporate board members and their CEOs maintain their exorbitant salaries and benefits.
Secretary Shulkin is an Obama appointee who was retained by Trump, perhaps because other potential nominees refused the enormous and risky job of “fixing” the VA. He insists that “privatization of the VA won’t happen while I’m in office” as he walks the tightrope between expanding the private sector “choice” system and strengthening the 28 VA hospitals.
So far, the non-partisan Shulkin has earned praise from both sides of the aisle as he tries to budget within funding caps and meet increasing demand, but that may change as he urges Congress to purchase a $16 billion digital health record system to better coordinate care. It’s unclear how long he can continue down both paths of strengthening the existing system while expanding private sector options.
Shulkin says his “only party is the veteran’s party,” an admirable stance for someone tasked with fixing a decades-old problem of underfunding services for our nation’s heroes. But let’s make sure he doesn’t sell out our vets to keep the private sector piranhas happy.