Columnist John Paradis: New VA secretary will not privatize agency

  • Veterans Affairs Secretary David Shulkin speaks Feb. 14 in Washington.  AP FILE PHOTO

Thursday, March 09, 2017

Lost last month in the day-after-day political rancor in Washington, D.C., was the unanimous confirmation of Dr. David J. Shulkin as the ninth secretary of Veterans Affairs.

Shulkin’s approval on Feb. 13 didn’t make the front page. With the announcement that same day that Michael Flynn was resigning as national security adviser, the new VA secretary’s confirmation hardly registered more than a blip during that day’s news cycle.

But the bipartisan sign of support for Shulkin was widely hailed as a great development within the veterans community in continuing to move the needle for VA improvements and is seen as a strong vote of confidence for our VA, the largest integrated health care system in our nation.

The VA, which operates a medical center in Northampton and five outpatient clinics as part of the VA Central Western Massachusetts Healthcare System, is one of the largest employers in our region and cares for nearly nine million patients nationwide with more than 1,700 sites of care.

Shulkin, a board-certified internist, was the undersecretary for health for VA in the Obama administration and he still sees VA patients as a practicing physician. Although he is not a veteran himself, his father was an Army psychiatrist. During Shulkin’s confirmation, he received major endorsements from our nation’s major veterans service organizations.

Serving under the previous VA Secretary, Robert McDonald, the former Procter & Gamble Co. president and CEO, Shulkin was brought on to lead change at a time when VA had come under fire after media reports that dozens of military veterans had died while waiting for care at the VA’s facilities in Phoenix . Before coming to the VA, Shulkin was the senior administrator for several large health care systems, including Beth Israel Hospital in New York.

As an outreach specialist in the community for the U.S. Department of Veterans Affairs, I get questions all the time from health care workers, veterans and the public about VA health care.

During the election campaign last year, the issue of privatizing veterans care, in particular, would often come up. What do you think will happen with how veterans get care, I would get asked, and will the VA be privatized?

The VA, the largest network of hospitals and clinics in our country, has long been a target of some in Washington who don’t want a government-operated, single-payer system, what some have derided as “socialized medicine.”

But veterans, by and large, don’t want their care turned over to the private sector and to for-profit hospitals.

Privatizing the VA would be a disaster and nearly all the veterans I listen to and talk with agree.

First is the VA’s research arm. The VA spends $1.8 billion on research and trains more than 70 percent of the doctors in our country. The VA invented the first cardiac pacemaker and the first nicotine patch and pioneered our nation’s first electronic medical records. The VA in New England, in particular, spends more of its budget on state-of-the-art equipment and research than any other health care provider.

The VA leads all health care sectors in the treatment of post-traumatic stress and has singular expertise in caring for veterans off the battlefield. On a daily basis, it cares for veterans with what is known as poly-trauma – PTSD plus traumatic brain injuries plus limb amputations. No one has more experience in the complex needs of injured combat veterans.

Second, on a single day the VA cares for more than 230,000 veterans. Given the serious shortage of primary-care providers in our country, many veterans would have difficulty getting care outside the VA.

By many measures, including the Rand Corp., the New England Journal of Medicine, and others, VA hospitals and clinics are the best in the country.

Indeed, the greatest number of complaints I receive among veterans is not about the care they receive from the VA but the difficulty in getting seen. And like private health care, the VA also has challenges in filling vacancies for frontline nurses and doctors.

The ease of getting appointments will be a priority with the new secretary, who also has a New England connection as a Hampshire College graduate with Yale School of Medicine and VA West Haven Medical Center experience. In his two years leading the Veterans Health Administration, he saw wait times for appointments improve to an average of five days for primary care, six days for specialty care and 2½ to three days for a mental health appointment.

But in a town hall with veterans last month, he emphasized that more work needs to be done and improvements must be made. In his testimony before the Senate Veterans’ Affairs Committee, Shulkin said he was committed to greater accountability, with expediting the time it takes for the VA to review appeals for denied benefit claims, and with improving access to health care for veterans. That would include more care in the community when it makes sense.

And, he told the Senate Veterans’ Affairs Committee that “the Department of Veterans Affairs will not be privatized under my watch.”

And, that, for all of us who serve and support veterans, is a very good thing.

John Paradis, a retired U.S. Air Force lieutenant colonel, lives in Florence and writes a column published the second Friday of the month. He is a veterans’ outreach coordinator for VA New England Health Care System.