Senator Dean Heller markets himself as a friend of veterans, even while being MIA at many meetings of the Senate Veterans Affairs Committee, as the Current recently reported. But former military personnel who use the Veterans Health Administration (VHA) have another reason to scrutinize Heller’s record.
Senator Heller has been part of a concerted effort by the White House and Congress to outsource VHA services to private doctors and for-profit hospitals. This incremental privatization of the VHA has jeopardized the quality of care for 9 million veterans’ and left their existing hospital network underfunded and understaffed.
Thanks to the VA MISSION Act, passed last Spring with Heller’s backing, the Trump Administration will be diverting billions of dollars more, over the next five years, to private sector providers, who have far less experience treating the mental and physical ailments of veterans.
Some of the Act’s authorized subsidies—for example, to the families of veterans providing in-home care—are long overdue. The Administration, with the support of Senators like Dean Heller, refuses to add funding for these new programs, and every dollar that goes to the private sector comes out of the VHA budget. As a result, VHA hospital repairs will be under-funded, thousands of vacant staff positions will not be filled, VHA caregivers – many of them veterans –will be laid off and veteran’s benefits may be reduced or eliminated.
As I discovered while researching a new book called Wounds of War, most veterans and their organizations, like the American Legion and VFW, strongly support the VHA because they value its specialized patient care. About one third of the VHA’s own workforce of 300,000 has served in the military, which creates a unique culture of solidarity among patients and providers.
In VHA facilities throughout the country, I encountered highly skilled and dedicated professionals who have devoted their careers to veterans’ health care. Among them are some of the best doctors, nurses, and medical researchers I have met anywhere in 40 years of reporting on medicine, nursing, and the U.S. hospital industry.
Unfortunately, Senator Heller believes that veterans need more outside help, including from start-up companies like CereCare. As the Pulitzer Prize-winning Pro Publica reported earlier this month (co-published with the Nevada Independent), two of its partners have ties to Glenna Smith, Heller’s former senior aide in Reno, now the Public Affairs Officer at the Reno VA. This may explain the Senator’s energetic effort to get the VHA there to pay for CereCare’s experimental, method of treating addiction and post-traumatic stress, by using electromagnetic brain stimulation.
Along with that agency lobbying, Heller co-sponsored a bill mandating that the VHA start a pilot program utilizing CereCare’s procedure, which would be delivered by a private sector provider. As Pro Publica revealed, one of CereCare’s non-physician partners “participated in drafting the legislation,” which “provides no additional funding, so the pilot program would come at the expense of other treatments that are already proven to be effective.” According to this report, Heller wanted to pilot CereCare’s procedure in Reno “to put it on a path for widespread adoption” throughout the VHA.
Heller’s bill drew immediate fire from the Veterans of Foreign Wars (VFW). The VFW argued that patients would better served by the VHA spending “its already scarce health care resources on therapies that have shown promise or have a proven track record.” The Veteran Affairs committee has yet to vote on Heller’s bill, but it typifies the kind of special pleading, on behalf of investor-owned firms and private hospitals, that the MISSION Act will unleash.
To treat their varied and complex wounds of war, veterans need an integrated, national system of care delivery. It must be adequately funded and staffed, not systematically dismantled for the benefit of private contractors peddling remedies of unknown effectiveness. As critics of privatization have predicted, VHA out-sourcing has already spawned opportunities for federal contracts to be awarded on the basis of political connections, rather than the cost, quality, or proven utility of the outside care delivered.
Changing the composition of Congress can limit future damage to the VHA, due to privatization. When military families cast their ballots on Nov. 6, they should support candidates who want to keep veterans’ health care in the hands of those who genuinely care about their patients, as opposed to private vendors just trying to profit from them—and their own political connections.