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We Still Need To Oppose Privatizing the VA

By John Ketwig

In 2018, at the height of the Trump administration, the MISSION Act created an independent Asset and Infrastructure Review (AIR) Commission. This Act required the VA to compare local market assessments of VA and private-sector or for-profit capacities and capabilities to provide healthcare for American veterans across every area of the US. The resulting recommendations called for the closing of many VA hospitals and replacing them with clinics, among many other out-of-date actions intended to limit the VA's ability to provide healthcare for veterans. Throughout his presidency, Donald Trump relied upon three members of his Mar-a-Lago Club to advise him regarding the VA, or the US Department of Veterans Affairs. None of the three had any military, medical, or large-scale corporate leadership experience. They were, however, avid conservatives, and they subscribed to the idea that the VA should be disabled and, ultimately, dismantled.

That objective came with enormous funding from the Koch brothers, and although Charles Koch has passed away, surviving brother David is continuing to support abolishing the VA! The plan is to remake the VA into just another insurance company that will be allocated funds just like today, but all veterans healthcare would be relegated to the private, or for-profit healthcare system. It is important to mention that the Kochs are thought to be heavily invested in that immensely profitable private system. One can only imagine the increased number of accountants and bookkeepers that would be required for the proposed system, let alone the degrees of computerization.

The MISSION Act's provisions have proved to be an outstanding example of government bureaucracy and pork barreling, but this summer the Senate Committee on Veterans Affairs surprisingly acted to disrupt the heart of the program by refusing to approve the proposed members of the AIR Commission. This was an astoundingly good and responsible decision, as the appointments to the Commission were a pack of unqualified military lifers and PhDs eager to feed at the trough. There was, notably, not a single NCO or enlisted man nominated, although it is doubtful that any of the suggested lifers have ever visited a VA facility, let alone depended upon the VA for their healthcare. The disapproval of the AIR Commission appears to have completely derailed the entire AIR program, but we cannot allow ourselves to be misled. The MISSION ACT is still the law of the land, and the threat to our VA healthcare continues to be intense.

This is a good place to mention an organization called Concerned Veterans for America, a Koch-financed group whose only purpose seems to be lobbying for the complete privatization of the VA. Of course, those guys are representing you and me, and they are in the halls of the House and Senate every day, pushing their program and calling it our agenda!

Sadly, millions of dollars are being spent by organizations and individuals that are seeking to dismantle the Department of Veterans Affairs and divert, or "outsource," veterans care for private profits (and profiteers) instead of directing it to the VA. In stark contrast, what's needed is the expansion of the VA by providing more VA hospitals, rural clinics, mobile clinics, and increased telemedicine under the supervision of each vet's primary VA doctor.

The VA's most recognized operation is the VHA, or Veterans Health Administration, the federal government's largest single agency. Since a scandal involving delayed appointments at a VHA hospital in Phoenix erupted in 2014, conservatives have supported an array of measures that appeared to improve access to healthcare by allowing "distant" vets, or veterans requiring specialized care not available at local VHA facilities, to be treated at nearer mainstream private, or for-profit medical facilities. Of course, given limited access to the VA's sizable budget ($301.4 billion in 2023), the for-profit medical industry, and those heavily invested in that industry, have swarmed like sharks smelling blood.

The reality is that the VHA is a non-profit entity. VA doctors are salaried, and they don't have to beg on bended knees to the insurance industry for permissions or payments. They can spend however much it takes, and however long it takes to fully understand and treat a veteran's often unique medical or mental needs. The results have consistently been more effective than those provided by the private sector.

Surveys repeatedly show that more than 80% of veterans who have received health care from the VA prefer it to the for-profit system. The comparison between the private sector or for-profit medical industry and the VHA healthcare system is unmistakable, and because the VA offers superior care in virtually every way, and far more genuine health care for every dollar spent, it is an excellent example of why America needs to adopt a system of universal healthcare. The conservatives see that as "socialism," and they continue to invest a mountain of money into efforts to abolish the VA and divert those billions of dollars to their industry. True health care for veterans be damned; this is about money!

The VA is currently providing health care to approximately 9,300,000 vets, up 82% since 2001, and the recent passage of the PACT Act and the end of the long wars in Iraq and Afghanistan will surely bring a larger number shortly, with very serious disabilities. The Department of Veterans Affairs is better equipped than most non-VA providers to coordinate complex veteran care and provide continuity of resources for veterans, but it cannot maintain its high standards while a band of reckless and uncaring for-profit pirates seeks to plunder the chests of treasure allocated to take care of our veterans.

Of course, a veteran who lives far away from the nearest VA facility should be allowed to get his care from a local non-VA facility, but make no mistake, the bill for those services goes to the VA, and it is enormously more expensive. The privatization folks suggest that the VA supply the money for a veteran's care, but have no input into the quality of that care! Most private physicians are unfamiliar with the particular needs of combat vets, especially their mental health needs. Since the passage of the MISSION ACT, the excuses offered for transferring veterans to private health industry facilities and physicians have been extraordinarily creative, and "Community Care" has already devoured an unprecedented and troubling portion of the VA's annual budget!

What can we do to resist the privatization efforts? A major step is already underway, although its progress has met with resistance. House Resolution #701 was submitted back in November of 2019. This resolution would effectively condemn privatization efforts while it supports a robust and well-funded Veterans Health Administration. One of the co-sponsors of this legislation, Rep. Raul M. Grijalva of Arizona said, "Our veterans have made countless sacrifices in service to our nation and deserve the best health care available to them. Instead of auctioning off their care to the highest bidder, Congress should invest more money and craft better policies to ensure exceptional treatment for the unique health needs of our veterans." Rep. Ann Kirkpatrick, also from Arizona, added "We must fight with all our might to protect the VA and put the health of our veterans before profit."

What does your Representative in Congress think of this resolution? Are they aware of it? Are they aware of your feelings about the privatization of the VA? Are they willing to support adequate funding to attract the additional personnel needed by the VA, build the necessary facilities and purchase the state-of-the-art equipment needed to provide the very best quality health care to every veteran? In July of this year, the VA said it had 67,000 open positions!

Congress will respond to pressure from veterans. If you value the VA, you will contact your congressional Representative today. Tell them that nearly all of the veterans service organizations (VSOs) oppose the privatization of the VA, along with the American Federation of Government Employees (AFGE) and National Nurses United (NNU). And, remind your Congressperson that they must also oppose any efforts to restrict unions or collective bargaining procedures.

The only way we can ensure the survival of the VA is if we present a chorus of so many veterans voices that we cannot be ignored. Please dial the phone, or put a postcard into your mailbox. This threat won't go away soon, but with your help, we can make it go away.

John Ketwig is a lifetime member of VVAW, and the author of the best-selling memoir ?and a hard rain fell: A G.I.'s True Story of the War in Vietnam, and Vietnam Reconsidered: The War, the Times, and Why They Matter.