Those who think that privatizing the Veterans Administration is a good idea should have a look at Kansas and the calamity of KanCare. It’s a lesson in what happens when a critical public service is palmed off to private – for profit –interests.
Five years ago, in 2013, Gov. Sam Brownback privatized Medicaid, which provided health care services for roughly 400,000 low-income and indigent Kansans. The new plan was called KanCare, its chief architect Jeff Colyer, then lieutenant governor. KanCare would be administered by three managed care organizations, companies that had donated heavily to Brownback’s election campaigns.
KanCare has been a disaster. Dozens of nursing homes, hospitals, clinics and other providers are choking on unpaid bills. Some had been forced to close. The system continues to confront a nightmare backlog of applications from thousands of people desperate for help that may never come.
A couple of years ago this spring, a new program called the Kansas Eligibility Enforcement System (KEES) was to resolve the backlog. The system had glitches. Applications that once took ten days to process were taking three months or more. The number of unprocessed applications was at 10,000 and counting. Some Kansans who had been on Medicaid for years were suddenly dropped with little or no warning, according reports by the Kansas Health Institute news service.
Nursing homes were especially hard hit. The state Department of Health and Environment took over all Medicaid processing, another change, but delays continued at such a rate that the governor’s supplemental budget for fiscal 2017 assumed an additional $3 million in Medicaid “savings” as enrollment eligibility continued to lag. Thus, unpaid processing bills were called “savings” in the gov- ernor’s budget.
Brownback left office late last summer to become a “religious ambassador” for Donald Trump; Colyer ascended to the state’s governorship and is among several Republican candidates for a full term. The legislature has worked itself into election-year paranoia over taxes and the constitutional distractions of school finance. Calls to expand Medicaid go neglected at a cost of more billions and more suffering, and its privatized stepchild stumbles on, backlogs and all.
This is what happens when a public health service is auctioned off to the private, for-profit, corporate market.
The U.S. Department of Veterans Affairs (VA), with a history to post-World War I, was established to provide care and assistance to military veterans across the country, now with special focus on medical centers and outpatient clinics. Of the nation’s 20 million veterans, roughly nine million now use the VA, which also offers a long list of non-health care benefits including education assistance, home loans and life insurance, burial and memorial ben- efits.
Trouble at some VA health care facilities has been widely publicized, problems that rise mostly from congres- sional neglect, a lack of adequate funding and oversight. Congress seems inclined to follow the privatization play- book: starve a government agency of funds, wait for it to spiral downward, declare it a case of government failure to be saved only by avaricious, for-profit owners.
For the VA, countless stories of superb treatment are given brief notice, but the commitment and skill of many VA doctors and staff continues to enhance a reputation for competence and compassion. This is hardly an agency that begs for a new and far different owner.
Veterans enlist to serve the country at risk to life, limb, even their sanity. War, even its prospect, is a terrible place and those who fulfill a commitment to meet it deserve the care they need at a nation’s expense. They do not deserve a clone of KanCare, with services “privatized” and shoved into the dark abyss of a for-profit hedge fund.
‒ JOHN MARSHALL
