Letter to Congress from Dr. Kenneth Fisher – A PWT Member’s Perspective
Our nation has a long and distinguished history of caring for our veterans within federally maintained health facilities. The U.S. naval home was built in 1812 in Philadelphia. More facilities were built in Washington D.C. in the 1850s. Perhaps the most famous statement was by Abraham Lincoln in his 1865 second inaugural address, ”to bind up the nation’s wounds, to care for him who shall have borne the battle…”
After WWI, the number of veterans needing care was too great for federal facilities causing private institutions to be contracted for care of many of the wounded. Thus contracting or paying for care outside the federal system does have precedent. In the early 1920s, facilities were consolidated under the Veteran’s Administration. It saw growth in response to WWII and more recent conflicts while developing a huge bureaucracy, becoming the second largest item in the federal budget. 1
Today the VA budget is approximately $160 billion (mostly, but not all for healthcare) with over 340,000 employees, many with only administrative responsibilities in Washington, D.C., various regions and within each hospital. There are three powerful groups seeking to sustain the size and present function of this entity – the federal employees union, some veteran groups enjoying special status and the Congress for patronage and other budgeting concerns. 2
There exist serious problems with the present system. For many if not most veterans significant travel is necessary to obtain care at a VA facility. In 2014 scandals arose, initially focused on the Phoenix VA hospital. There were deaths occurring because of problem with access, serious enough to cause the resignation of the VA Secretary, Erik Shinseki. However, the same issues still remain with a recent VA inspector general reports finding over half of facilities are using improper scheduling procedures. An attempt in 2014 giving veterans choice, the Veterans Access, Choice and Accountability Act has been a failure. 3
What to do in this difficult situation?
There is an American solution: Competition.
Give our veterans the choice of private care or the present VA system. Private care could be supported with a yearly deposit of an annuitized amount into a health savings account that would also cover a high deductible health insurance plan and a direct care physician contract. Savings could be shared between the veteran and the government. This plan is somewhat similar to one recently proposed in Congress. 4
Congress: It is time for you to seriously address this vital issue; costs are out of control, while care is inadequate in many areas.
Veterans: Insist on a real choice.
Those pleased with the current situation by all means stay with the VA as it is. To those veterans wishing an alternative, this is your chance to tell your organizations and the Congress that you want this option.
1 Kenneth A. Fisher, “Understanding Healthcare: A Historical Perspective”, an electronic book, available at: Understanding Healthcare Perspective Freedom in Healthcare, Kalamazoo, Michigan, 2016
2 Peter Hegseth, The VA Scandal: Two Years On – Our veterans deserve better from the nation they have served, National Review, April 7, 2016, (Accessed July 17, 2016)
3 Mark Kirk, U.S. Senator for Illinois, Kirk to VA Secretary: The Choice Act is Failing Vets, February 5, 2016 (Accessed July 17, 2016)
4 Arnaldo Rodgers, Veterans News Now, Cathy McMorris Rodger’s Far Reaching Bill Offers Veterans Options for Private Insurance and Care, June 13, 2016 (Accessed July 17, 2016)
About Dr. Fisher
Dr. Fisher graduated from Tufts University in 1962 majoring in chemical engineering, and with distinction from George Washington University School of Medicine in 1968 having been elected to the Alpha Omega Alpha honor medical society in his third year. He was a resident, and then chief resident in Internal Medicine at the Mount Sinai Hospital in New York City, and a fellow in Kidney Diseases at Yale University, finishing training in 1974. He was employed at a number of teaching medical centers throughout his career. He has been an insulin-requiring diabetic since 1963.
Dr. Fisher has been the program director for two internal medicine residencies and two nephrology fellowships and has published several scientific papers on nephrology along with many articles and a chapter regarding health policy. Dr. Fisher was also a consultant nephrologist in Kalamazoo, Michigan and the Medical Director for the Free Clinic in Kalamazoo from 2007 till its closing in 2010. He is the author of In Defiance of Death: Exposing the Real Costs of End-of- Life Care, Praeger, Westport, Connecticut, 2008, and The Ten Questions Walter Cronkite Would Have Asked About Health Care Reform, (2011) a free e-book available at: http://drkennethfisher.com/The10Questions.pdf and his latest book, Understanding Healthcare: A Historical Perspective, Freedom In Healthcare, Kalamazoo, Michigan February, 2016 available on-line: http://www.amazon.com/Understanding-Healthcare-perspective-Kenneth-Fisher-ebook/dp/B01BX98TC2/ or https://store.kobobooks.com/en-us/ebook/understanding-healthcare