My Latest Update on VA HEALTHCARE Initiatives and Proposed VA Secretary Actions.


Politics 101 – An Article Written for the Veterans Reporter News – Dr. Tom Waters – VA and VA Healthcare – 2017

News is just breaking about a secret plan by the VA Secretary to combine VA Choice and TRICARE. News of this will evict strong responses from the military and veteran groups (ALL WILL BE NEGATIVE). Of course I, and many veterans, believe that the real intent of this is to privatize the VA and this action will allow the DOD to jettison healthcare responsibilities for military retirees.

It is my hope that every veteran and family member of veterans will continue to watch what our entire Congressional Delegation, Governor Sandoval, and Dr. Shulkin are doing to “Fix the VA” and to improve the Healthcare System for our nation’s veterans.

As a military retiree who was promised “Free Healthcare for Life” when I first enlisted, I know that I need to stay focused on the many changes that have occurred over the years that cause me to question the promises of my government officials. I saw us move from CHAMPUS to TriCare and from No Pay to Co-Pay. I now have TriCare for Life (TFL) and, as long as I can get a space at a military facility, there is no cost. However, where a military facility is not available and the VA cannot be used, the costs are continually going UP to retain healthcare for my family.

So, why do I bring this up in a discussion about VA Healthcare? I mention it because there are MASSIVE changes coming out on January 1, 2018 affecting TriCare with the rationale that “Free healthcare for the Active Military and the Retired force is unsustainable.” While that may be a financially true statement, it is a change from the PROMISE made to many of us.

Recently, my wife and I listened to a TriCare presentation from the medical folks at Nellis AFB about the changes that are coming to TriCare on January 1, 2018. Some of the changes and the impacts are still unknown at this time but all TriCare recipients are warned to ‘stay alert’ to the website because these changes will be announced there first.

There is an article by an Associated Press reporter (Hope Yen) dated November 17, 2017 titled “VA’s quiet plan to widen private care with TriCare stirs ire” that is “eye opening” and scary.

Here are parts of her article (used with her permission) that I thought you might find interesting. I also want you to find it ‘disturbing enough’ to contact our Congressional delegation (Senators and Representatives) to ensure they don’t agree to something that is detrimental to our VA Healthcare system.

Here are Hope Yen’s (AP) statements:

{As part of its effort to expand private health care, the Department of Veterans Affairs is exploring the possibility of merging its health system with the Pentagon’s, a cost-saving measure that veterans groups say could threaten the viability of VA hospitals and clinics.

VA spokesman Curt Cashour called the plan a potential “game-changer” that would “provide better care for veterans at a lower cost to taxpayers,” but he provided no specific details.

Griffin Anderson, a spokesman for the Democrats on the House Veterans Affairs Committee, said the proposal – developed without input from Congress – would amount to a merger of the VA’s Choice and the military’s TRICARE private health care programs. Committee Democrats independently confirmed the discussions involved TRICARE.

News of the plan stirred alarm from veterans groups, who said they had not been consulted, and sharp criticism from congressional Democrats who pledged to oppose any VA privatization effort that forces veterans “to pay out of pocket for the benefits they have earned with their heroism.” VA is seeking a long-term legislative fix for Choice by year’s end.

“Today, we see evidence that the Trump administration is quietly planning to dismantle veterans’ health care,” said House Minority Leader Nancy Pelosi, D-Calif. “House Democrats will fight tooth and nail against any efforts to diminish or destroy VA’s irreplaceable role as the chief coordinator, advocate and manager of care for veterans.”

Health care experts also expressed surprise that VA would consider a TRICARE merger to provide private care for millions of active-duty troops, military retirees and veterans. The two departments generally serve very different patient groups – older, sicker veterans treated by VA and generally healthier service members, retirees and their families covered by TRICARE.

TRICARE is insurance that is paid by the government, but uses private doctors and hospitals. The VA provides most of its care via medical centers and clinics owned and run by the federal government, though veterans can also see private doctors through VA’s Choice program with referrals by VA if appointments aren’t readily available.

“My overarching concern is these are very dramatic changes in the way health care is delivered to veterans,” said Carrie Farmer, a senior policy researcher on military care at Rand Corp., who has conducted wide-ranging research for VA. “There haven’t been studies on what the consequences are in terms of both costs and quality of care.”

Navy Commander Sarah Higgins, a Pentagon spokeswoman, confirmed it was exploring with VA “many possible opportunities to strengthen and streamline the health of our service members and veterans.” She declined to comment on specifics “unless and until there is something to announce.”

In its statement to The Associated Press, VA spokesman Curt Cashour explained that VA Secretary David Shulkin was working with the White House and the Pentagon to explore “the general concept” of integrating VA and Pentagon health care, building upon an already planned merger of electronic health care records between VA and the Pentagon. Because Shulkin has said an overhaul of VA’s electronic medical records won’t be completed for another seven to eight years, an effort such as a TRICARE merger likely couldn’t happen before then.

“This is part of the president’s efforts to transform how government works and is precisely the type of businesslike, commonsense approach that rarely exists in Washington,” Cashour said.

At least four of the nation’s largest veterans’ organizations – The American Legion, Veterans of Foreign Wars, AMVETS, and Disabled American Veterans – called a TRICARE merger a likely “non-starter” if it sought to transform VA care into an insurance plan.

“VA is a health care provider and the VFW would oppose any effort to erode the system specifically created to serve the health care needs of our nation’s veterans by reducing VA’s role to a payer of care for veterans,” said Bob Wallace, executive director of VFW’s Washington office.

Louis Celli, director of veterans’ affairs and rehabilitation for The American Legion, said any attempts to outsource services away from VA medical centers and clinics would be financially unsustainable and likely shift costs unfairly onto veterans with service-connected disabilities.

He noted something similar occurred with TRICARE – military retirees were promised free care from military base hospitals. But then TRICARE began offering insurance to use private-sector care, and TRICARE beneficiary co-pays are now rising. “The precedent the TRICARE model sets is not something we would accept on the VA side,” Celli said.

During the 2016 campaign, President Donald Trump pledged to fix VA by expanding access to private doctors. In July, he promised to triple the number of veterans “seeing the doctor of their choice.” More than 30 percent of VA appointments are made in the private sector.

Some groups have drawn political battle lines, with the left-leaning VoteVets and the American Federation of Government Employees warning of privatization, and Concerned Veterans for America, backed by the billionaire conservative Koch brothers, pledging a well-funded campaign to give veterans wide freedom to see private doctors.

Representative Tim Walz of Minnesota, the top Democrat on the House Veterans Affairs Committee, called for an immediate public explanation “without delay” for the quiet discussions to integrate TRICARE with VA’s Choice.

“The fact that the Trump administration has been having these secret conversations behind the backs of Congress and our nation’s veterans is absolutely unacceptable,” said Walz, the highest-ranking enlisted service member to serve in Congress.

A spokeswoman for Representative Phil Roe of Tennessee, the Republican chairman of the House committee, said he planned to proceed with his bipartisan legislative plan to fix Choice without integrating TRICARE.}

Hope Yen’s article and her comments are exactly what I wanted to say and we need to support of all veterans and supporters of veterans to “keep the pressure” on to avoid privatizing our VA Healthcare.

I remain cautiously optimistic that the President and Secretary Shulkin will continue to fully support all efforts to improve the VA Healthcare System. Unfortunately, they had different views on how to best accomplish this where the President touted privatization while Secretary Shulkin stated that “the VA will not be privatized under his watch.”

I will continue to follow what they say and what they do. And, all along this road to success or failure, I will keep you informed.

If you missed any of my earlier articles you can go to the Veterans Reporter News webpage at <> to review any Back Issues.

I hear from MANY readers about my articles (most are positive) and I thank you for your positive or challenging “constructive” comments. Feel free to contact me if you believe any of the information provided is inaccurate or if you have additional information that I can share with our readers.

By: Thomas (Tom) Waters, Lt. Colonel, USAF (Ret), Ed.D. /