Topics: Veterans Affairs

Rep. Andy Harris: Congress should offer veterans a private option for health care

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In the 1980s as a medical student intern at The Johns Hopkins Hospital, I did some of my medical training at the Loch Raven Veterans Health Administration center in Baltimore.

Then, as is still the case today, the physicians, nurses, and staff who provide care directly to patients are, as a whole, very dedicated professionals who are passionate about caring for our veterans. They are good public servants put into an overwhelmed, bureaucratic system doomed to failure.

The actions by Veterans Affairs employees in Phoenix, Ariz.; Albuquerque, N.M.; Charleston, W.Va.; and a couple-dozen other cities -- where records were criminally falsified to cover up long wait times -- are a stain on our nation. While care at any hospital can always be better, the fact that veterans are dying while waiting for medical care in our country is unconscionable.

Saying “I'm mad as hell,” considering firing a few higher-ups, and getting the inspector general to investigate is just a Band-Aid. It does not solve the fundamental flaws within the foundation of the VHA system. There have already been 23 veteran deaths directly linked to delays in VHA care, and delays in treatment have been a factor in more than 100 deaths at VHA centers since 2001.

Late last year, I listened to testimony from VHA officials on the epidemic of prescription pain medication abuse among VHA patients, as part of a House Veterans' Affairs Health Subcommittee hearing. Veterans had lost jobs, destroyed their families, and committed suicide because their pain was not managed properly and because many had become addicted to their prescriptions. The gist of the hearing was that people in the VHA want to fix the problem, but they don't have the right tools to do so.

In one facility, the manager of the "pain department" had no formal training in pain management and was not even a physician. During that hearing, VHA officials stated that the entire VHA system employs 115 pain specialists — one specialist for every 50,000 veterans experiencing pain.

In another facility, physicians were not even aware of pain management devices like spinal cord stimulators, which have been used for years. Thankfully, one veteran's family did its own research, found out about this device, and drove multiple hours to a separate VHA facility that actually knew about the device and could give it to the patient. That patient is now doing well.

During the same hearing, physicians employed by the VHA testified that they felt pressured by their superiors to prescribe highly addictive opioid pain medication even though it was against their medical judgment. These drugs are often less expensive then treating the root causes of the pain.

In rural parts of the country, like the Eastern Shore of Maryland, which is in my district, veterans often have no choice but to drive several hours to a VHA facility to see a specialist physician or go to a full-service VHA-run hospital. This is in stark contrast to all other Americans with health insurance who can go to physicians and hospitals just up the street or in the next town over.

What we see with the VHA is a system that unfortunately provides second-class care too often to those men and women to whom our nation owes so much. The system is clearly broken.

Congress and the president can continue to try to patch what is a failed system, or they can give veterans a choice. Veterans who want to continue to get all their care through the VHA should be able to do so; however, a new option should be available. Veterans should be given a set amount of money -- enough to cover a decent insurance plan -- to buy insurance in the private marketplace. This would allow them to see any doctor they want, go to hospitals that are close to their homes, and receive care from the top professionals in the field.

For the average of what the VHA spent on medical care for the 5.6 million veterans in the program in 2012, we could pay the entire premium for veterans to get a private insurance plan through the Federal Employee Health Benefit Program. Veterans should have an option of receiving at least as good care as the employees taking care of them at the VHA -- they are obviously not getting that now.

Transitioning to this new option will not be easy, but elected officials have an obligation to our veterans and their families to find a way to work together to get this fixed.

Federal employees have a great health care plan that actually works. Don't our veterans who put their lives on the line for our nation deserve the same?

Rep. Andy Harris, R-Md., is a physician who received medical training at a Veterans Affairs center and served as a medical officer in the Navy Reserve, caring for active-duty troops at Bethesda Naval Hospital during Operation Desert Storm. He has spent more than 28 years on the faculty at The Johns Hopkins Hospital in Baltimore.
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