DawgTalkers.net Forums DawgTalk Everything Else... Donald Trump Adviser Signals Plan to Change Veterans’ Health Care

By BEN KESLING
May 12, 2016 10:42 a.m. ET

Donald Trump says the Department of Veterans Affairs’ health-care system is badly broken, and this week his campaign released some guidelines that would steer changes he would implement if he wins the presidency.

While short on details, the presumptive GOP presidential nominee would likely push VA health care toward privatization and might move for it to become more of an insurance provider like Medicare rather than an integrated hospital system, said Sam Clovis, Mr. Trump’s chief policy adviser, in an interview.

“We want quality care top to bottom,” Mr. Clovis said in an interview. “If that means we have some form of privatization or some form of Medicare, we don’t see anything wrong with that.”

Mr. Clovis, who is also Mr. Trump’s national campaign co-chair, said the candidate’s priority would be to give veterans timely health care close to home.

That could mean restructuring the system in a way to more resemble an insurance provider along the lines of the popular Tricare system used by 9.6 million members of the Department of Defense, where civilian facilities routinely augment department-run hospitals.

“We’ll certainly look at that model, we want to make it as comprehensive as possible,” said Mr. Clovis when asked about Tricare. “The VA’s a broken system now. We can’t continue down that road.”

Mr. Clovis cautioned that Mr. Trump won’t try to fix what is working.

“There are a lot of VA facilities that are being run very well,” Mr. Clovis said, adding that Mr. Trump doesn’t “want to take away the veterans hospitals and the things that are working well.”

VA officials declined to comment on Mr. Trump’s plans.

The campaign’s proposal to move toward privatization isn’t necessarily new. Mr. Trump’s website has long said the businessman wants to “ensure our veterans get the care they need wherever and whenever they need it,” but he has yet to provide specifics about how he would do that.

As with many of Mr. Trump’s policy positions, some of which he has seemed to reverse, the campaign has been reluctant to provide details. Mr. Clovis declined to lay out specifics, saying, “every time we put a detailed plan out we just get eviscerated in the media.” He added that the campaign is using broad guidelines on the matter and likely will hold back on releasing a comprehensive plan until Mr. Trump’s first 100 days in office.

He also said that Mr. Trump will crack down on fraud, waste and abuse in the system to keep the VA budget essentially flat or even bring costs down.

The Democratic front-runner, Hillary Clinton, has said multiple times in campaign appearances that while she wants to restructure the VA she opposes privatization, referring to it on her website as a “misguided ideological crusade.”

Jon Murray, veterans outreach director for Mrs. Clinton’s campaign said in a statement that the Democrat would “make much-needed reforms to the VA without forcing veterans into a private health-insurance market ill-suited to handle their specialized needs.”

Though Mr. Trump says such plans can work while keeping costs flat, the Congressional Budget Office, which does nonpartisan analysis, said in a 2014 report, the most recent available, that moving the VA toward privatization could increase costs dramatically.

Currently, 9 million of the nation’s 22 million veterans are enrolled in the VA’s health-care system, and 6 million use those benefits regularly. The CBO report noted that of those veterans who use the benefits, 70% receive most of their care outside the VA, often using coverage like private insurance or Medicare.

The CBO also estimated that services provided by the VA would cost about 20% more if obtained in the private sector and prescription drugs would likely cost about 70% more under Medicare and Medicaid.

Expanded privatization could also flood the system with veterans who don’t use the program now, the report said.

The VA’s health-care system, though it has been under fire since revelations in 2014 that employees had been falsifying wait-time records, consistently rates highly with those using the system.

“On really almost every measure, VA health care is as good and in many measures is even better than the private sector,” said Carrie Farmer, a senior policy researcher focusing on veterans’ issues at Rand Corp., a nonpartisan think tank. “Relatedly, the VA is providing, not all the time, but probably better than in the private sector, military cultural competent care.”

In other words, the VA’s doctors are trained to deal with the veteran community and the unique issues they face from post-traumatic stress disorder to traumatic brain injury, hallmarks of the most recent wars. And older veterans are more likely to be sicker and have more total illnesses and injuries than a civilian patient, which can be related to military-specific injuries such as exposure to Agent Orange, a powerful chemical mixture used to defoliate forest cover during the Vietnam War.

VA officials tout that it is the largest integrated health-care network in the U.S., where centralized systems ensure veterans’ health records can be seen by any doctor and veterans are treated holistically rather than each injury or illness in isolation.

“Cost is really only the tip of the iceberg here when you’re talking about the potential effects,” Ms. Farmer said, noting that by her estimates only about 20% of civilian doctors are properly trained and equipped to deal with veterans’ issues.

Many veterans’ organizations, including the Disabled American Veterans, have steadfastly maintained opposition to privatization of the VA, warning that as services slowly get outsourced to civilian doctors, veterans will start to lose the comprehensive care they get at the VA.

Other organizations, such as the Iraq and Afghanistan Veterans of America, agree.

“We are not for full choice,” said Elizabeth Welke, a political associate at the organization, adding that the Iraq-Afghanistan group wants the VA to remain the provider and coordinator of veterans care.

“There are specific programs that VA offers that aren’t in the private sector: poly-trauma and spinal cord injuries,” said Ms. Welke. And “when you go to the VA everyone is a vet. Doctors who are out in the community don’t necessarily understand that.”

Write to Ben Kesling at benjamin.kesling@wsj.com

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Now this is a reason to not let Trump get in. The VA has been a huge benefit to and for my family; changing that to a 'for profit' model is not something I can get behind at all.

Let's not pimp out our soldiers' healthcare, we've already pimped out their futures.

[quote]While short on details/quote]

Was anyone surprised to see these words? I honestly don't know what to think. With all the horror stories we hear coming out of the VA I've often wondered what it would be like to just give our full coverage vets a card that gets them the care they need wherever they are, no questions asked.

There's certain things I wish I could go to Cleveland Clinic for.

But the VA does still need to Be the main provider.

Because anytime somebody suggests taking power or control FROM the government, Hillary thinks it is misguided and ideological... and she just adds the "crusade" part because that has such a negative connotation and is associated with the right.

In the end, I just want vets to get good care, at least as good as what those with good insurance get if not better... and right now that isn't happening. But I'm sure more government regulations and programs will fix it.

I am not going to complain about the VA,in my case,they've done well.
But,my boy had the Tricare,man that was very good insurance.
I'm not for or against privatization,but I would really like to get on that Tricare,at a reasonable rate.

I think you're severely under rating the care at the VA

I have never been in a VA (well as a patient, I have done work in them before).. all I've heard is the horror stories. If you tell me the horror stories are exaggerated or politically motivated, I'll take your word for it.

I think the rhetoric from the politicians on both sides is exaggerated, yes.

As far as us patients go, not everybody is gonna have the same experience. I get that. Lord knows I have a few problems with the VA myself.

But if anything, the VA needs more funding or restructuring. It's not a matter of the care bring bad so much as its a problem with them Being severely understaff.

I'm really thankful for the VA clinic here in cleveland because they are amazing with regards to what they are working with. The thing with appointments for example is that there are a ton of vets who aren't just being seen for physical ailments, but a TON of mental health appt, something that some private hospitals aren't really designed for.

The clinic here is understaffed. I can't imagine a place with a huge concentration of vets, like Texas.

Just a bit more funding could go a long way.

Thank you for the explanation.

It all depends on what treatments or procedures one needs.

Add to that an atmosphere of primary care doctors or in my case a nurse practitioner who is afraid of losing her jobs if she spends too much of the SURPLUS of funds. The end result is getting my forth set of X-rays, that will tell them no more than the previous set(s), when a MRI might have found something conclusive, but she is afraid of her boss and my provider, so she will not order the MRI, because of the monitary implications.

The end result is that I'm not getting any answers. Basically I'am getting the old run around. For years!

Mean while these bosses/department heads have been receiving large bonuses for years.
Meh! ... They need it more than are vets.
God bless them. <Sarcasm

On the other hand I love VA nurses. The most of them genuinely seem to care and take pride in their jobs.

Would the real John Miller please stand up? Please show your birth certificate John.

I don't think anybody should be getting bonuses in healthcare. But that's just my personal opinion.

And I feel you. That's why I said, some of the physical procedures could absolute be done at private hospitals.

But the mental health care is a different animal, and unless the VA is way too out the way for people(which sometimes is the case) routine check ups or procedures can be done at the VA, they just need to tighten up their shot group.

I agree with that. They're always trying to get us to talk with someone. It's one of the hardest things to do for most of us.