We’re witnessing the largest war in Europe since World War II, as Russia invades Ukraine. At the moment, U.S. troops are not directly involved in the conflict, but it has got us thinking about the healthcare that military personnel receive, particularly after they’re discharged and rejoin civilian life. There is no one better to talk with about veterans’ healthcare than our guest Suzanne Gordon.
Suzanne Gordon is an award-winning journalist and author. She has written for The New York Times, The Los Angeles Times, The Washington Post, and many other publications. She is also the author or co-author of 22 books including, most recently, Wounds of War: How the VA Delivers Health, Healing, and Hope to the Nation’s Veterans. She also wrote The Battle for Veterans’ Healthcare: Dispatches from the Frontlines of Policy Making and Patient Care.
Most of us who aren’t veterans don’t know much about the Veterans Administration. Why should Medicare for All supporters learn more about the VA?
The Veterans Health Administration (one of three branches of the Department of Veterans Affairs) is the largest healthcare system in the country, and the only publicly funded, fully integrated and coordinated healthcare system in the country.
While Medicare for All is a payment method only, the VA is both a payer and a provider, which allows them to create innovative new models of care. Suzanne reminds us that the VA essentially invented geriatric care, put PTSD (Post-Traumatic Stress Disorder) on the map in response to the Vietnam War, and developed models of palliative care.
The VA is also a major hub for healthcare professional teaching system. It’s also the biggest research hub after the National Institutes of Health. Finally, the VA serves as backup to the civilian healthcare system in times of emergency.
Accessing care from the VA is not automatic for veterans. They have to meet certain thresholds, which essentially results in the VA caring for the sickest and poorest veterans. Then – despite the fact that this is an expensive population to treat – the VA provides those patients with better quality care at a lower cost than average Americans with private insurance receive.
The VA is both a publicly-funded and publicly delivered healthcare system, much like the way healthcare is provided through the NHS in the UK. This is what the right likes to call “Socialized Medicine.”
The VA model allows more coordinated care and innovation that are nearly impossible in the fragmented, profit-driven private healthcare system. You might even say it’s a model for a healthcare for all system nationally.
Behind the Covert Campaign to Privatize the VA
Like any well-functioning, efficient public program, profit-driven forces are trying to privatize the VA. Much like efforts to privatize Medicare and public schools, these folks are using the same playbook to privatize and profit off of the VA. They claim the public system doesn’t work, they blame public employees, and assert that the private sector is the only way to provide the service well. They advocate for legislation that moves more people into private sector services, starving the public services of resources.
VA privatization efforts originated with funding from the Koch Brothers. They’re joined by the pharmaceutical industry who doesn’t want to have to negotiate drug prices with the VA. (Medicare is legally prohibited from negotiating drug prices, and Pharma has fought every effort to change that, because it essentially allows them to set prices as high as they like.)
Healthcare profiteers all want a chance at the pot of gold that is the VA Health Administration. They’ve spent millions to infiltrate the right wing media sphere as well as the mainstream media like the New York Times, NPR and Washington Post, and discredit the VA.
The VA is the most accountable healthcare system in the country. If a patient has a complaint they can go right to their member of congress, who can initiate an investigation. Privateers have used this transparency to jump on every blip in the system and manufacture scandals around things like wait times. In fact, the wait time problem, especially in the time of COVID, is in the private sector. The privateers are actually contributing to longer wait times and poorer outcomes through legislation driving more veterans into the private sector (the MISSION Act of 2018).
While we in the Medicare for All haven’t done a great job engaging with the veterans’ community, the right wing has put a lot of effort into cultivating veterans to oppose Medicare for All. Under the Trump Administration, the former Secretary of the VA claimed Medicare for All would destroy the VA. Op Eds in national media echoed that message.
We know that the Medicare for All bills leave the VA untouched. It’s important for Medicare for All advocates to know this and debunk these myths. The VA will not be changed by M4A legislation, and it will actually eliminate the main privatizing mechanism that is currently undermining the VA.
Privatizers in Congress come from both sides of the aisle. For example, most Democrats voted for the MISSION Act of 2018, which rapidly accelerated outsourcing. Yet they claim it’s not privatization because it doesn’t go to the extreme of fully closing down the VA.
How do we Save the VA?
Advocate for Medicare for All. Reach out to veterans in your community to oppose privatization and outsourcing. And sign up for the 2022 Medicare for all Conference, where we’ll learn more about the campaign to save the VA.
The Veterans Healthcare Policy Institute: https://www.veteranspolicy.org/
Suzanne Gordon: https://suzannecgordon.com/
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