This is a Feature, Not a Bug

It looks like the Veterans Administration plan to provide an option for privatized services has resulted in massive cost overruns and delays even worse than the government run VA system.

Imagine that.

In 2014, Congress passed the Veterans Access, Choice, and Accountability Act, which set up a temporary program that outsourced veterans’ care from the Veterans Health Administration (VHA) to private sector providers. In 2018, President Donald Trump signed the VA MISSION Act, which made this outsourcing program permanent and greatly expanded it. Indeed, the legislation set up a parallel private sector network—the Veterans Community Care Program or VCCP—which pays private sector providers to treat more than a third of the nine million veterans enrolled in the VHA.

The Veterans Community Care Program promised to give veterans speedier access to high-quality care if they couldn’t get a timely appointment at the VHA or had to drive too long to get to one. Instead, as many studies have documented, VCCP care is of lower quality than that provided by the VHA. It also takes longer, on average, to get an appointment with a VCCP provider than it does with one at the VHA, and perhaps most importantly, the cost of this private sector program is soaring. Between 2014 and 2024, expenses for veterans’ care in the community quadrupled from $8 billion to $31 billion, accounting for a third of the budget for veterans’ medical services.

One reason for surging costs is that too many VCCP providers are unnecessarily utilizing high-cost tests and procedures and fraudulently billing for care that was never delivered.

Imagine that.  Adding a profit motive led to fraud and cost plus waste?

As a friend of mine is wont to say, "Chaos is job won!"

………

Furnishing veterans with more expensive services might theoretically be justified if it produced better outcomes. Three economists connected to the Bureau of Economic Research tested this hypothesis in a meticulously designed study of dually eligible veterans experiencing a medical emergency. An ambulance transported them to either a VA or private sector emergency department. The results of their respective care revealed that overtreatment was associated with poorer outcomes. Veterans who went to a non-VA facility received more services attached to higher reimbursement rates, for example, a cardiogram or inpatient admission. But rather than improving their lives, veterans brought to private sector EDs had a 46 percent greater chance of dying in the following month than if they’d gone to a VA facility.

(emphasis original)

Of course they were more likely to die.  Private sector profits are not free.  You have to sacrifice veteran's lives in order to support capitalism.

Killing the program is probably too toxic right now, but aggressively pursuing, and prosecuting, fraud, including the actions of executives who create a criminogenic environment, would be a good idea.

If the hedge fund owners of many of these medical practices were frog marched out of their offices in handcuffs, one would find the problems going away.