Members of a blue-ribbon panel studying VA health care defended the group's work last week, deflecting charges they want to shutter all Veterans Affairs medical facilities in favor of government-paid private care for veterans.
"We are going to continue to take input, continue to shape [our views] ... No one is going to fully understand our position until we understand our position, and that's not going to happen until we create the final report. And that comes out in June," Selnick said.
The 34-page document proposes giving all veterans access to private health services and closing VA health facilities gradually over 20 years, starting with those that are obsolete or underutilized in a process similar to a base realignment and closure.
The report also calls for VA to become "primarily a payer," much like Medicare, to provide health care for veterans.
Veterans organizations, including Disabled American Veterans, American Legion, Veterans of Foreign Wars, Vietnam Veterans of America and Iraq and Afghanistan Veterans of America, immediately took issue with the paper's content and its development, which they say was drafted "outside the open commission process … without the input or even knowledge of the other commissioners," according to a letter sent to Schlichting on March 31.
During an interview April 8, Selnick, an Air Force veteran and former VA employee who serves as senior adviser to Concerned Veterans for America, said the charges of secrecy simply aren't true.
"This [paper] was created at Nancy's direction because a lot of us have ideas. None of the [commission's] working groups know what the others are doing until they present, which is what we did. Nothing was done in secret. This is a normal process," Selnick said.
The Commission on Care was created by the 2014 Veterans Access, Choice and Accountability Act to make recommendations on reorganizing the Veterans Health Administration and delivering health care to veterans in the next two decades. Members were appointed by President Obama or a bipartisan group of congressional members.
Veterans service organizations expressed concerns about the professional background of many commissioners — at least six come from nonprofit private health care organizations — or, in the case of Selnick, played a role in drafting a report released last year by CVA, "Fixing Veterans Health Care."
That report called for consolidating VA medical facilities under a government-chartered nonprofit organization that specializes in service-related health conditions like amputations, traumatic brain injury and combat-related physical and mental injuries, and providing the rest of health care for veterans through a government-subsidized health care program similar to the Federal Employees Health Benefit Plan.
Disabled American Veterans executive director Garry Augustine said the strawman is similar to the content of the CVA assessment and that veterans services organizations sense that the commissioners who drafted the strawman are pushing to implement it.
"There was a lot of discussion leading up to this document that makes us believe the people who put this together are very serious about pushing this agenda," Augustine said.
Selnick said "no one on the commission represents the agencies they work for" and noted that 11 of 15 commissioners are veterans, and six of the seven commissioners who drafted the strawman are former service members.
"This media-veterans organization-VA-whoever-else-is continuing to talk about the strawman, which is not going to be, in any way shape or form, the final document, is doing a disservice to the commission and to the veterans," Selnick said. "Please come to our meetings and hear what's going on and let us do our job."
Schlichting said interested parties, including veterans, families, veterans service organizations, VA employees, elected officials and taxpayers are encouraged to provide input, either in person or through the commission's website.
"The Commission is committed to a vision of transforming veterans' health care to enhance access, choice, quality, and well-being," Schlichting said.
Patricia Kime covers military health care and medicine for Military Times. She can be reached at firstname.lastname@example.org.
Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.