Will Trump Jeopardize Prostate Cancer Research

shulkin_vha-3-960x640Will Trump Jeopardize VA Prostate Research?

by Suzanne Gordon on January 3, 2017  Beyond Chron

President-elect Donald J. Trump will soon announce his pick for Secretary of Veterans Affairs, and his nominee should honor the phenomenal research that the Veterans Health Administration provides. VHA research — the nicotine patch, the first implantable cardiac pacemaker, the Shingles vaccine, among many others — benefits not only veterans but all Americans.  Last year alone, according to VA Undersecretary for Health David Shulkin, VHA researchers published 9,480 papers in the scientific literature.

Most recently, the VHA, in partnership with the Prostate Cancer Foundation, which has helped fund the research for many major treatments,  embarked on another critical research initiative.  The Foundation has donated $50 million to the VHA, making this, Shulkin says, the largest commitment to cancer research the VHA has ever received, one that will help deliver better care to veterans  particularly those in rural and remote areas.  Foundation, CEO and President physician Jonathan Simons says the foundation is eager to work with the VHA because it is the largest health care system in America, with the most men suffering from prostate cancer of any healthcare system or institution.  Because of this the VHA, he says, provides a unique opportunity to help solve some of the most vexing riddles about prostate cancer, democratize treatment through the VHA’s superior telehealth capacity, and accelerate the pace at which new drugs and treatments are made available to the nation’s veterans.   READ MORE

Fact Checking the Fact Checkers at the Washington Post

imagesJust did this new blog post for the American Prospect.  Please read and share.

Fact-Checking Fact-Checkers on Privatizing Vets’ Health Care

In the debate over the future of the Veterans Health Administration (VHA), no concept has attracted more controversy than “privatization.” Since wholesale privatization of the VHA is deeply unpopular among veterans and their advocacy organizations, groups like the Koch brothers-funded Concerned Veterans for America (CVA) argue that they do not support “privatization” of the VHA. As the CVA’s “Fixing Veterans Health Care” report, published earlier this year explains, the group just wants to give veterans “the same degree of choice that is available to other Americans,” with the federal government paying the tab.

Last week, The Washington Post entered the fray. Writing for the paper’s “Fact Checker” column, reporter Michelle Ye Hee Lee gave Senator Jon Tester of Montana and Representative Mark Takano of California, both Democrats, three out of a possible four Pinocchios (signifying “significant factual error and/or obvious contradictions”) for suggesting that the CVA and Trump transition team members support VHA privatization. According to Lee, the CVA’s position does not constitute privatization because, the “CVA has not proposed a wholesale transfer of VHA’s services over to the private sector—which is what ‘privatization’ usually describes.”


Jeff Miller Doesn’t Believe Veterans Deserve the Healing Arts

Another blog post on how low people will stoop to deny veterans excellent care.

In Defense of Art in VA Hospitals

Conservatives are mad about spending government money on art, but it provides real medical benefits.

The Veterans Health Administration (VHA) has taken a lot of heat lately about using money to purchase art for its hospitals and other facilities. Last week, Gail Collins, in a column in the New York Times, joined in the pile-on. While Collins defended the VHA and opposed its privatization, writing that veterans “are satisfied” with its services and that “the care is in many cases excellent,” she couldn’t resist a jab at the VHA for spending $670,000 on two sculptures that were placed in a blind rehabilitation center. Her conclusion? “Veterans healthcare for everybody! But maybe with less art.”

The issue of spending on art first emerged last year when Congressman Jeff Miller (R. FLA) , Chairman of the House Veterans Affairs, a staunch advocate of VHA privatization, lambasted the VHA for spending $483,000 for a sculpture in a hospital courtyard. For Miller, whom Donald Trump has promised to appoint to the post of Secretary of Veterans Affairs should he be elected, the issue was not the quality of the art used at VHA facilities but the fact that the VHA was using taxpayer money to spend on art, period. Miller called such spending “wanton and abusive.” 

Read More


Veterans Health Is Really Good


Studies Show Veterans Health Care Improving

When the House Veterans Affairs Committee holds a hearing on September 7 to assess the future of the Veterans Health Administration, federal lawmakers would do well to consider recent reports that challenge the continual drumbeat of negative and often unfair coverage and congressional criticism of the VHA.

One report, from the RAND Corporation, said that while there were differences in care and leadership culture across the system, researchers “did not find evidence of a system-wide crisis in access to VA care.” In fact, the report identified congressional policies as one of the main barriers to VHA improvements (despite the Veteran Affairs Committee Chairman Jeff Miller’s apparent belief that firing VHA leaders is the solution to any access problems). The report noted that “inflexibility in budgeting stem[med] from the congressional appropriation processes,” and concluded that the hastily designed and implemented Veterans Choice Program, “further complicated the situation and resulted in confusion among veterans, VA employees, and non-VA providers.”

Though it received no media attention, another positive report on the VHA came this month from the Joint Commission, the independent nonprofit that accredits U.S. hospitals and health-care organizations. After surveying the VHA between 2014 and 2015, the commission found improvements in access, timeliness, and coordination of care, as well as in leadership, safety, staffing, and competency.  Read More.

My OpEd in the San Francisco Examiner

This was published on Sunday July 24, in the San Francisco Examiner.

Veterans question VHA privatization push

Rep. Cathy McMorris Rodgers, R-Wash., and Speaker of the House Paul Ryan are pictured during a news conference on Capitol Hill in Washington on Nov. 3, 2015. (Andrew Harnik/AP)

California has more veterans — about 1.85 million — than any other state in the country. Many of its former military personnel utilize Veterans Health Administration facilities like Fort Miley in San Francisco or VHA in Sacramento. The nation’s only fully integrated, publicly funded healthcare system has had widely publicized problems with wait times.

In spite of this, a congressionally mandated study recently praised the VHA for providing clinical care comparable to or better than that provided in the private sector. Other research has shown the VHA provides some of the best mental health care services in the country and that its healthcare professionals have specialized knowledge of military related problems — from Agent Orange-related diseases to homelessness — lacking in the private sector.

This is why major veterans groups — often assumed to be politically conservative — almost all favor maintaining the publicly funded hospitals and clinics that now serve nine million VHA patients. Nevertheless, the VHA faces multiple threats from Republican politicians, right-wing ideologues and for-profit providers hoping to increase their “market share” through privatization of veterans’ health care.

Donald Trump, for example, favors total outsourcing of VHA services so its patients can become customers of the U.S. health care industry. In Congress, two prominent Republicans — Arizona Sen. John McCain and U.S. Rep. Cathy McMorris Rodgers, R-Wash. — have proposed legislation that would dismantle the VHA, despite estimates that this would almost triple the overall cost of veterans’ care.

McCain worked with Sen. Bernie Sanders two years ago to add $10 billion to the VHA budget to create a trial program called “Choice,” which allowed veterans faced with appointment delays or long drives to use private sector providers. The program, which was poorly conceived and hastily implemented, has been an abject failure.

To try to remedy problems the VHA has in enhancing access to and reducing wait times for VHA services, another proposal has just been made by members of the congressionally mandated VA Commission on Care.

In its final report, the commission, among many other things, recommends the creation of a new VHA Care System. Veterans eligible for VA services because they have low incomes or service-related health care conditions could choose to seek care from either VHA or private sector providers.

These non-VA providers would be supervised by the VHA, follow its protocols, develop expertise in military-related health problems and utilize a common electronic medical record.

The report predicts that in 20 years, 40 to 60 percent of veterans would use private-sector providers if this approach was implemented,

San Francisco’s Michael Blecker, a Vietnam vet and executive director of the local veterans rights organization Swords to Plowshares, served on the Commission. He bucked the commission majority because of his concerns about the consequences of outsourcing VHA services.

In a dissenting opinion, he argues this approach would deprive the VHA of the patient base it needs to continue operating, fragment specialist from primary care, thus “threaten the viability of VA care for millions of veterans who rely on it. … That is not a veteran health care system worth serving for.”

Blecker says he is not opposed to some expansion of the use of outside physicians or hospitals under limited circumstances.

The VHA has always contracted with providers in the community to provide healthcare services unavailable within the system. Indeed, the VHA’s current undersecretary, David Shulkin, has proposed extending the use of outside providers, as long as the VHA can assure that they provide high-quality care.

That is not the same thing, Blecker says, as creating an entire parallel private-sector network of veterans health care providers, who would potentially deliver inferior care at higher cost than veterans would receive if the VHA itself were properly funded, staffed and managed.

Blecker is not alone in his critique of broader privatization threats.

In an unprecedented letter of protest, 26 veterans service organizations, including the Disabled American Veterans,  Veterans of Foreign Wars, Vietnam Veterans of America, and Paralyzed Veterans of America have denounced the McMorris Rodgers bill. They reminded her that “over the past two years VA has made significant progress to expand access and begun major reforms that could transform the entire system.”

Veterans who actually use the VA health care system overwhelmingly want to see it fixed and reformed, not downsized or dismantled.”

Suzanne Gordon is a Bay Area health care journalist who is writing a book about the veterans health care system.