A cost-free Rx to end the VA backlog
Since the Congressional Budget Office pinned a whopping $35 billion to $50 billion annual price tag on the VA “reform” bill pushed by Sens. Bernie Sanders and John McCain, the legislation looks dead. Don’t shed any tears.
There’s a better way to solve the VA backlog without fattening its already exploding budget: Focus on the roughly 4 million seniors using VA health-care despite having Medicare coverage.
Encouraging them to use civilian doctors and hospitals instead could cut the backlog by as much as half, solving a national crisis.
Here are the astounding facts that make this no-cost remedy possible.
First, over 1 million vets enrolled in the VA health system also are covered by Medicare Advantage plans.
The federal government is prepaying private insurance companies to cover them and then paying again when they go to the VA.
Shockingly, one tenth of the VA health-care budget is wasted on this double paying.
In 2012, the Journal of the American Medical Association reported that the waste grew from $1.3 billion in 2004 to $3.2 billion in 2009. It likely exceeds $5 billion annually now.
It’s a bonanza for the insurance companies and a rip-off for taxpayers. Stopping this preposterous double payment would free up $5 billion to help solve the backlog problem.
The second fact is that nearly half (45 percent) of vets using the VA are seniors. In addition to the 1 million-plus with Medicare Advantage, there are another 2.5 million or so with regular Medicare coverage.
Instead of using civilian doctors, these older vets stick with the VA, because they can’t afford the higher out-of-pocket costs with civilian doctors. That can be fixed by using the freed-up $5 billion to finance a military medi-gap plan.
Seniors are familiar with medi-gap, the private policies sold only to Medicare enrollees to help pay out-of-pocket costs. RAND found that seniors in the VA program tend to be poorer, and fewer than half have medi-gap coverage.
Buying them a medi-gap card would eliminate the added costs of getting civilian care. The median premium for medi-gap coverage is about $1,400 a year. The $5 billion is more than enough to fund a medi-gap card for seniors who need it.
Vets were promised cost-free care. The medi-gap card keeps the promise and relieves the burden on the VA. As older vets opt for civilian care, the backlog will shrink, enabling younger vets to see a VA doctor faster.
Plus, seniors will have better results for procedures like bypass surgery and angioplasty. Civilian hospitals that perform these procedures in high volume have higher survival rates than most VA centers.
The medi-gap incentive need only be temporary. By 2016, senior vets will be less numerous than the younger Gulf War-era veterans.
Using incentives to cut the backlog is a far cry from the Sanders-McCain bill. This bill keep vets at the mercy of the VA bureaucracy.
To access civilian care, vets would have to get a permission letter from the VA secretary, and their civilian doctor would have to call the VA for prior approval. Good luck getting the letter or doctor’s call answered.
Most important, few civilian doctors would be willing to treat vets under the Sanders-McCain program, because they know how hard it is to get paid by the VA.
A General Accountability Office study in March confirms that doctors who provide emergency care to vets because of a car accident or heart attack have to cope with late payments, rampant mistakes and an unresponsive bureaucracy.
Good riddance to the Sanders-McCain bill, which would have expanded this dysfunctional system at great expense. Enabling older vets to opt for civilian care will solve the deadly backlog at no additional cost to the vet, the VA or taxpayers.