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  • Washington Highlights

    Senate, House VA Panels Examine Veterans Health Administration

    Matthew Shick, Sr. Director, Gov't Relations & Regulatory Affairs

    The Senate and House Veterans Affairs committees held hearings to consider reforms to the Veterans Health Administration (VHA).

    The Oct. 6 Senate hearing reviewed pending health care and benefits legislation, including the Delivering Opportunities for Care and Services (DOCs) for Veterans Act (S. 1676), introduced by Sen. Jon Tester (D-Mont.) and endorsed by the AAMC [see Washington Highlights, July 31]. At the hearing, Sen. Tester thanked the AAMC for early engagement on and support of this bill. In regard to expanding VA Graduate Medical Education (GME) under the VA Choice Act [see Washington Highlights, July 19], he noted, “[E]ven though the VA is willing, non-VA affiliates are hamstrung by the current cap on Medicare funded residencies.”

    Sen. Tester added, “[T]hat cap was established in 1997, for the committee’s information. It is woefully insufficient to meet the needs that are out there…I just think this is critically important if we are going to be able to address the medical needs we have on the ground. And I think it applies to not only rural but also urban VA centers. But, it absolutely has benefits to rural America, make no mistake about it. And big ones. It would lead to more VA and non-VA affiliate partnerships, more doctors ultimately joining the workforce.”

    S. 1676 would allow teaching hospitals at or above their Medicare GME cap to receive additional Medicare support for residents who rotate through VA positions created under the VA Choice Act. At the hearing, Thomas Lynch, VHA’s assistant deputy under secretary for health clinical operations, agreed it was a good strategy.

    Secretary of Veterans Affairs Robert McDonald testified at the Oct. 7 House hearing on an independent assessment of the VHA. Responding to the idea of privatizing the VA, Sec. McDonald noted, “VA is not only essential for veterans, it’s essential for American medicine and it’s essential for the American people.” He went on to outline the “three-legged stool” of VA and its academic affiliates.

    He discussed the success of the $1.8 billion VA research enterprise noting, “We invented the nicotine patch. We were the ones who discovered that aspirin was important for heart disease — take an aspirin every day. First liver transplant. First implantable pacemaker. Last year, two VA doctors invented the shingles vaccine. I could go on. That research is important for the American people, and I didn’t even mention Post Traumatic Stress or Traumatic Brain Injury or prosthetics, things that we’re known for.”

    Regarding VA’s education mission, he highlighted the scale of GME and clinical rotations within the VA, “We train 70 percent of the doctors in this country,” and opined, “Who’s going to train those doctors without the VA?”

    McDonald concluded with high praise of VA’s academic affiliations and how they improve care within the VA, “Third leg is clinical work. Our veterans get the best clinical care because our doctors are doctors that not only do the clinical care, but also do research and teach in the best medical schools of our country.”