Why Trump's plan for private doctors for veterans is controversial

As he moves toward the general election, Donald Trump is reiterating a focus on veterans’ issues, wading into what has often been a fraught debate about how best to reform the healthcare provided to veterans through the Department of Veterans Affairs.

“We made a promise to these heroes. You defend America, and America will defend you,” Mr. Trump, the presumptive Republican nominee, said in a speech on Monday in Virginia Beach, Va., the Associated Press reports.

Trump’s 10-point plan calls for veterans to be allowed to seek government-funded private medical care, while also criticizing the Obama administration for the 2014 VA scandal where many veterans faced long wait times for care.

The speech could also serve a broader public relations function for Trump, who has faced a slew of controversies around his statements involving veterans – including criticizing Arizona's Republican Sen. John McCain, who was a prisoner of war in Vietnam; comments that seemed to equate Trump's own experience at a military boarding school with military service itself; and questions about his donations to veterans' charities.

Under the plan he unveiled last fall, eligible veterans would be able to bring a veterans’ identification card to any private doctor or facility that accepts Medicare and receive immediate treatment. “The guiding principle of the Trump plan is ensuring veterans have convenient access to the best quality care,” the plan says.

But for some veterans’ groups, that guarantee sounds uncertain.

“We do not agree with the go-anywhere card. Just because you have a go-anywhere card doesn’t necessary mean the private doctors have space for you,” says Joe Davis, the public affairs director at the Veterans of Foreign Wars.

The group instead supports combining care offered by the department with private care in particular situations, such as to fill in for a doctor who works in an unusual specialty at a particular hospital who is unavailable at the time of care.

“The thing about the VA, it's family. Once [veterans] get into the VA, they want to see the VA, you’re surrounded by veterans in the waiting room, and you’re seeing a doctor that understands the issues that veterans face,” he tells The Christian Science Monitor.

Trump’s plan shares some similarities with existing efforts, including the Choice Plan created by Congress in 2014 in response to the wait-time scandal. The plan allowed veterans to see a private doctor if they lived more than 40 miles from a veterans’ hospital or faced wait times of more than 30 days.

Last week, a congressional commission with members from healthcare providers and veterans organizations recommended creating a new, nationwide network that would include doctors from the VA, military hospitals, and private doctors who have been approved by the Department.

But the report has prompted a controversy of its own, with three commissioners refusing to sign it and penning letters of dissent.

Stewart Hickey, former director of the lobbying and service group AMVETS, and Darin Selnick, of the Concerned Veterans for America, describe the commission’s final report as “deeply compromised, disjointed and incomplete.” They had supported turning the veterans’ healthcare system into a nonprofit public corporation.

Michael Blecker, executive director of the veterans group Swords to Plowshares, offered blunter criticism of the commission’s proposed care system, saying it “will result in the degradation or atrophy of important health services that the VA provides.”

The system relies too much on privatization, he wrote, and comes with “alarming” proposals, such as paying for the increased costs of the system by reducing the number of veterans eligible for VA health care.

On Monday, Trump continued his push to allow veterans to use any doctor they choose, including outside local VA hospitals.

“Veterans should be guaranteed the right to choose their doctor and clinics, whether at a VA facility or at a private medical center,” he said. His plan also includes proposals for improved mental health services, increased funding for job training, and placement programs for veterans.

Reports that many of Trump's donations to veterans' organizations only came in recent weeks have sparked controversy. Some reports suggest that Trump donated to many of the groups he had already claimed to have paid only after a Washington Post investigation raised doubts about the funds, as well as his claims to have donated to charity throughout his career. 

Nevertheless, some polls suggest that he continues to enjoy support of many veterans over Democratic rival Hillary Clinton. A May poll by Morning Consult of veterans and active duty troops showed Trump beating Mrs. Clinton by 9 percentage points, while a Military Times poll of active duty troops showed his lead to be as much as 2 to 1.

One key factor, especially when it comes to efforts to reform the VA, is Trump’s status as a political outsider, some say.

“The perceived outsider status of Trump and [Democrat Sen. Bernie] Sanders has brought new people into the political process and fired up the base of both major parties,” wrote Michael McPhearson, executive director for Veterans for Peace, in an essay for BillMoyers.com. “Trump has masterfully used the media and large crowds to create a spectacle to build support. He has featured veterans in his stage show, using them as props to gain credibility, and making us more visible in the process.”

But Mr. McPhearson, and many online commenters, some of whom also said they were military veterans, distanced themselves from Trump’s other stances, including his ban on Muslims entering the United States.

“Veterans should watch Trump making fun of the disabled,” wrote commenter Gwenn Murry, referring to his mocking of a New York Times reporter with a physical disability. There are nearly 4 million disabled veterans in the US today, she noted.

Mr. Davis, of the VFW, which doesn’t issue endorsements, says many of Trump’s proposals looked familiar.

“Fixing the VA is on every candidate’s platform, because its a story, veterans vote, their spouses vote, their voting age children vote,” he says. “Taking care of America’s veterans, service members and their families is a national responsibility, and no one running for president can ignore that responsibility.”