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Hundreds of current and former clinicians from the Department of Veterans Affairs have signed an open letter to VA Secretary Doug Collins. They warn that staff shortages are threatening veterans' health. Now, the VA disputes this. It says it is serving veterans better than ever in part by increasing funds for private health care outside the VA. But the VA doctors say this initiative is actually a big part of the problem, as NPR's Quil Lawrence reports.
QUIL LAWRENCE, BYLINE: This open letter comes after months of uncertainty at VA with goals of cutting tens of thousands of VA positions and experienced staff accepting early retirement offers made by the Trump administration. The letter warns that current policies will, quote, "undermine VA's health care system, overwhelm VA's budget and negatively affect the lives of all veterans."
DEAN WINSLOW: The VA is an excellent integrated health care system, and it's both cost-effective, but most important, effective care for veterans.
LAWRENCE: Dean Winslow signed the letter. He served four tours in Iraq and Afghanistan as a flight surgeon. He's now a doctor and professor at Stanford, and he consults for VA. He says most studies show VA care rates as good or better than private health care, and Winslow says there's another thing he sees as a combat veteran himself.
WINSLOW: Very few civilian providers really understand veterans and our experience, but the physicians that work at the VA often get paid a lot less than people would in the private sector. They choose to work at the VA because they love the mission.
LAWRENCE: VA spokesman Pete Kasperowicz rejected the premise of the letter. In an email to NPR, he said VA is serving veterans much better under the Trump administration than it was under the Biden administration, and the numbers prove it. He cited a decrease in the VA claims backlog and said VA has offered nearly 1 million appointments outside of normal operating hours to make care more convenient, and he cited the VA's increased use of non-VA providers at the department's expense. But that last point has been debated for years. Veterans generally support having the choice to see a VA provider or a private one for free. But it's not really free, says Lars Osterberg, who was a VA physician for more than 20 years.
LARS OSTERBERG: Diverting resources to these private vendors are not always that effective. There's vendor incentives, obviously, to jack up prices and charge a lot and not necessarily get the best quality of care for our veterans.
LAWRENCE: Osterberg signed the open letter in part because he worries that the push for privatizing VA care is starting to bleed out VA resources, and there's no evidence that private options are better or even faster than a VA appointment in most parts of the country.
OSTERBERG: Mainly, we want to stop the staff cuts. It's hard to provide quality of care when you have inadequate support from ancillary staff. And then the frustrations also result in clinicians leaving, going to other places to care for patients.
LAWRENCE: That could mean VA has to outsource more at greater expense, which the letter warns could start a spiral that threatens the viability of VA's health care system. Quil Lawrence, NPR News.
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