08.27.15

Fixing Alaska's model VA system: Used to reform national veterans' care, state system now needs help

News-Miner opinion: A year and a half ago, the national Veterans Affairs health system was in disarray. At clinics across the Lower 48, veterans waited for care for weeks and months, in some cases dying before receiving treatment. But the Alaska system was a different story. Thanks to reforms pushed by the state’s congressional delegation, the Last Frontier’s veterans had shorter waits and better access to care. So Congress developed a national system akin to Alaska’s — only to have its rollout worsen conditions for veterans here. A state with as strong of a veterans’ presence as Alaska deserves better from the system.

The revelation that VA health care was widely inadequate rocked Washington, D.C., in spring 2014. The worst offender in the system was Phoenix, Arizona, where officials maintained two separate care lists. One was a partially fabricated record they sent to administrators in Washington, D.C., that showed procedures were prompt, while the real care record showed marathon waits for care — some of longer than a year. The fallout from the scandal was immense, eventually forcing the resignation of then-VA Secretary Eric Shinseki.

Spurred by the magnitude of the system’s failings, Congress exhibited a rare act of bipartisanship in debating and passing a system of reforms to the VA — ones that had roots in the Alaska VA system.

Veterans make up about 10 percent of Alaska’s population, and of those, about half are eligible for VA health benefits. So the 49th state had become aware of problems in the way its system worked earlier than the rest of the country. Alaska veterans often had to wait months for care, and then-Sen. Mark Begich helped enact reforms. He helped devise a system whereby veterans could go to clinics closer to home rather than be served in distant, centralized facilities with long waitlists for care. By the time the national VA scandal exploded, Alaska’s VA wait times were significantly decreased and the state was a model upon which Congress could base its reforms.

The reform bill, known colloquially as the Choice Act, went into effect in August 2014. It passed the Senate by a vote of 91-3, and indications are that it has helped ease the worst of the problems in the Lower 48. 

But here in Alaska, veterans say it’s made a good system worse. The Choice Act’s reforms were implemented by TriWest Health Care Alliance in Alaska. Veterans attending meetings on VA health care this week held by Sen. Dan Sullivan said they often have difficulty getting help through TriWest’s Lower 48-based phone system. Others chafed at the health care contractor’s scheduling, saying those waiting for care aren’t given consideration by TriWest representatives with regard to when treatment takes place, saying they were given a “take-it-or-leave-it” choice.

TriWest, for its part, says the problems with the system so far stem from the fact that the company was given a short time frame to redesign its administration of 21 states’ VA health care. Many of the problems raised by Alaska veterans have already been addressed, TriWest CEO David McIntyre Jr., told the News-Miner this week.

If that’s the case, the problems experienced by Alaska veterans should subside in the months to come. Sen. Sullivan is doing the right thing by listening to those in line for VA care to make sure that’s the case. Alaska was the model for the reforms instituted nationwide by Congress; it would be a cruel irony if those reforms cost the state the functionality of its own system.


By:  Fairbanks Daily News-Miner Editorial Board
Source: Fairbanks Daily News-Miner