Jun2 27, 2014
Chairmen Bernie Sanders (I-Vt.) and Jeff Miller (R-Fla.), respective chairs of the Senate and House Veterans Affairs Committees gaveled the opening of a rare conference June 24 to discuss pending legislation that seeks to speed up access to VA care for thousands of veterans on waiting lists at VA medical facilities across the country.
Though cordial, the conferees offered competing views on how best to resolve the access problem.
Republicans, led by Senator John McCain (R-Ariz.), House Veterans Affairs (HVAC) Chairman Miller, Senate Veterans Affairs (SVAC) Ranking Member Richard Burr (R-N.C.) and others, would give veterans a ‘gold choice’ card that would allow them to get care from outside the VA system if they met certain criteria to trigger the election.
Democrats, led by Sen. Sanders and HVAC Ranking Member Mike Michaud (D-Maine), voiced preferences for expanding VA’s capacity through various measures addressed in the legislation including more effective use of existing purchased care contracts.
In his opening remarks, Sen. Burr denounced the Congressional Budget Office’s (CBO) high cost estimate to field a ‘choice,’ card. Burr said the CBO’s $35 to $40 billion price tag was ludicrous. The numbers are “grotesquely out of line” and, in his view, were actually higher than the cost of providing care to currently enrolled veterans. He said it made no sense to expect that almost 8 million veterans would drop other coverage such as TRICARE, Federal Employee Health Benefits insurance, Medicare or private insurance to get a VA choice card for the two-year pilot program set out in the Senate bill.
Democrats fretted that the focus should be on fixing the VA, not diverting resources by expanding outside referrals beyond current arrangements (The VA will spend about $5 billion this year for contracted – purchased – care from outside providers). Former SVAC Chairman Sen. Jay Rockefeller (D-W.V.) said the goal should be to “improve the VA, not tear it down.”
A number of conferees agreed that the focus should be on how to quickly resolve the backlog of wait-listed patients, change the culture within the VA and establish greater accountability at all levels.
House panel member Rep. Phil Roe, R-TN, a physician and former Army Reserve medical officer said throwing more money at the VA won’t solve the problem.
Two members endorsed seizing the moment to take a longer view on the future of VA health care. Rep. Tim Walz (D-Minn.), a former Army National Guard sergeant major and Iraq war veteran asked rhetorically why there isn’t an over-arching strategy on veterans. Rep. Dan Benishek (D-Mich.), who served veterans for 20 years as a physician at a VA facility, said the best health care minds should be brought in to compare and contrast VA performance with outside health care practices.
Along these lines, MOAA continues to endorse the establishment of a high-level, independent commission to chart the future of VA health care in the 21st century.
Sen. McCain warned that the “last shoe” had not dropped on the VA scandal. He emphasized that the situation in the VA was an “emergency” and urged his fellow conferees to lay out the parameters of what needs to be done and move forward.
The conferees are expected to hammer out a compromise after returning from the July 4 recess.