Below is a commentary article written by Alaskan Senator Lisa Murkowski (R). The main topic is Alaskan VA healthcare, but the article is still an interesting read for those of us who live in the lower 48.
I’m sure everyone has heard about the construction struggles in Denver and how that has caused issues throughout the whole 50 states in regards to construction of new VA facilities. Thus, this affected the Choice Card funding (paraphrasing and hoping I’ve got it right), throughout the states. Now, Sen Murkowski, self-admittedly, wasn’t really in favor of the rural veterans in the lower 48 getting the Choice Card, but she did vote for it for Alaskans.
I think this article is mostly interested because she does a very good job of laying out how one thing affects another in the VA and how the problems the VA are having right now are such that a fix for one aspect might break another, because of the amount of duck-tape used in the past.
We need the VA; and its important that through all the political posturing, veterans continue to support the fixing of this vast system of benefit administration which includes healthcare, but isn’t only about healthcare.
Sometimes things seem too good to be true. Last year when the Phoenix VA waiting list scandal broke, and even as we began to discover that VA facilities in other parts of the country weren’t meeting wait time standards, things were better in Alaska.
It’s not that Alaska VA didn’t have staffing challenges like facilities in the Lower 48. Some of our challenges like staffing Wasilla with one doctor — who ultimately quit — when two were called for were even more difficult to fix than they might be in the Lower 48 because of our remote location. To its credit, Alaska VA faced up to its recent challenges before they became scandals.
That wasn’t by coincidence. Since 2006 I have been pressing hard on the VA to partner with community health centers, Native health and private practice providers. The VA was highly resistant. These were very tough conversations. I brought the VA inspector general up to investigate. I published a pretty tough op-ed about the problem. At times old VA hands accused my staff of VA-bashing. Whatever. The needs of the veteran came first. Period.
But all that tough love worked. When the VA was facing a waiting list of 900 veterans in need of primary care, it outsourced to the Anchorage Neighborhood Health Center. When Veterans Affairs Secretary Eric Shinseki told the VA to stop demanding veterans fly to Seattle for specialty care, it quickly formed relationships with the Alaska medical community. When Wasilla’s only doctor moved out of state, her patient load was moved to the Southcentral Foundation’s new clinic. And the VA began paying tribal health facilities to deal with the service connected medical challenges of veterans in rural Alaska. When a ventilation problem caused the shutdown of operating rooms at the new Anchorage clinic the VA leaned heavily on its Joint Venture Medical Treatment Facility with the Air Force. To be sure, there was still work to do, but after a decade of work we were seeing steady progress in adapting VA health care to the challenges in Alaska — not squeezing Alaska into a national VA model that didn’t work here.
All of that progress came to a screeching halt in recent weeks as the VA central office told Alaska to stop this innovation. It turns out the Lower 48 scandal caused the VA to spend its outside care budget much more quickly than it anticipated — eating up money that Alaska VA was relying on to run its innovative programs. And the Choice Program, funded by Congress at $10 billion was hardly being used anywhere.
Rumors flew that the VA was pulling out of the Elmendorf Joint Venture Hospital and that all of the Native partnerships would be canceled. And some private practices have called my Alaska offices to say the VA told them to cancel appointments because the VA could no longer pay.
This article was written by: Rachel Baker – Click to follow on Twitter