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Our VA is Threatened
By John Ketwig
In mid-February, I attended the Save Our VA (SOVA) conference in Washington, hosted by Veterans for Peace. Attendees came from all over America, even Alaska, and they were a wonderful group of experienced veterans, activists, and lobbyists. This conference was timed to coincide with the national convention of AFGE, the Amalgamated Federation of Government Employees, many of whom are VA employees. There was also an associated Town Hall by National Nurses United, which includes many, if not most, VA nurses. The conference was very effective in attracting other guests and speakers who have been working to prevent the privatization of the VA.
A prominent speaker and participant in all of these activities was Suzanne Gordon, the author of Wounds of War, a hugely important book I recently reviewed for The Veteran. Wounds of War is the "textbook" of the SOVA movement, and Suzanne Gordon is a former VA medical professional and an award-winning journalist and author. She has researched the subject extensively, and is an extremely knowledgeable and motivated spokesperson for this effort.
Basically, the infamous "Koch brothers" are no more as David recently died, but brother Charles continues to bankroll many "conservative" efforts. Among his priorities is a movement to privatize the VA, turning over its medical health care activities to the for-profit health industry. Are you aware that there is a Koch-funded "veterans" organization, Concerned Veterans of America, that is pressuring legislators to back legislation that threatens to undermine and, ultimately, abolish the VA? They don't have a large membership, but they have the bucks to generate lots of attention-getting paperwork, literature, and lobbying activity.The Koch campaign is intending to diminish the VA's activity before the Trump administration gets voted out of office in November, and there is a huge flood of legislation pending and anticipated. The MISSION Act's "Veterans Community Care Program" (VCCP) has been passed and is currently in place, encouraging up to 60% of all eligible vets across America to go to for-profit healthcare providers instead of the VA. These "outsourced" visits are billed to the VA's budget, and of course the private sector visits are far more costly than VA healthcare, slowly depleting the VA's financial abilities.
Sadly, many of the for-profit health industry's proposals and legislative suggestions, often Koch-funded, have been camouflaged as efforts to reduce veteran suicides. The first steps of their long-term plans are to fund millions of dollars in grants to a wide range of private sector, or for-profit, health care providers outside of the Veterans Health Administration (VHA) network. These providers would be tasked with conducting outreach and providing outpatient mental health treatment, along with other types of medical care, to veterans with a potential for suicide.
The most notable example of this charade is the Improve Well-Being for Veterans Act, a Trump administration effort that masquerades as a suicide prevention bill and is co-sponsored by a bi-partisan crowd that includes conservative Republicans and even some liberal Democrats like Senator Elizabeth Warren. The bill is opposed by Disabled American Veterans, the American Legion, American Psychological Association, and the Veterans Healthcare Policy Institute, among others.
The actual purpose of the bill is to farm out various VA activities to the for-profit industry, but with no provisions for oversight or quality of care, and no set standards for the providers to provide "care" or track the progress of any potentially suicidal veteran. Providers will not be required to meet any performance or experience standards, they will be allowed to "care for" needy vets by any process or procedure they choose, and the terms used in the legislation to describe the boundaries of that care are not familiar to the mental health industry. There are no provisions to help vets with support services that would include housing, employment, or financial problems. While the VA has experience in dealing with PTSD and veterans' mental health problems related to their war-time experiences, the for-profit providers usually do not. The wide-ranging activities to be funded by the bill would be debited to the VA's budget, which is already far short of what's needed. There are more than 55,000 openings for physicians, psychiatrists, psychologists, and nurses throughout the VA system.
Currently, 14 of the VA's 18 regions have spent or committed their annual budgets, so they cannot add desperately needed staff, improve their facilities, purchase equipment, or increase efforts to reach out to veterans who are not enrolled in their programs. The SOVA movement's aims are to fully fund the VA as needed, which would require a financial investment far beyond the VA's current budget, fix the problems, and fully staff the VA.
Secretary of Veterans Affairs Robert Wilkie has maintained an adversarial approach to all efforts to question or delay the selling off of VA services to the for-profit healthcare industry. The House Committee on Veterans Affairs (HVAC) is chaired by Democrat Mark Takano of California, and he has been attacked by Republican members of the committee for questioning the Trump administration's proposals. Takano has proposed alternative legislation that would place limits on the for-profit institutions funded. He insists that "The urgency of addressing veteran suicide should not be the pretext for allowing VA money to go to providers who are not held to account for measurable outcomes, who are not subject to oversight." Wilkie, a Navy veteran who describes himself as a war historian, has falsely claimed that the VA did not care about veteran suicides until Trump came into office. He has indicated that he would award grants to groups who provide questionable therapies, as well as "post-traumatic growth therapy" at luxury resorts. His office has pressured legislators to embrace the bill, and is being supported by the for-profit healthcare industry. There is, after all, big, big money at stake.
I am no expert, but I recognize the need to get veterans aware of, and actively voicing their opinions about this topic. Please take a look at www.SaveOurVA.org. Approximately 86% of all veterans who use VA healthcare facilities favor the SOVA position of "Fix – Fund – Fully Staff the VA".
Study after study documents that VA healthcare is equal, and often superior, to care provided by private sector, for-profit doctors and hospitals. VA personnel are experienced and mindful of the special needs of veterans, especially combat vets, while the for-profit folks only view their customers by the size of their insurance coverages. Clearly, the VA healthcare program is the largest and most prominent example of single payer healthcare in America, and it is a model for all of the universal healthcare / "Medicare for All" program movements.
This is a huge, important, and constantly-changing issue that will ultimately affect all veterans. The for-profit industry realizes that their conservative, pro-Trump supporters in Congress may not be around after the end of the year, and they are pushing a lot of proposals in hopes that some of them will get passed before the election. Unfortunately, VFP and the other groups say they have no ability to monitor legislation and advise us of which bills we should be for or against.(!) The only recommendation they offer at this time is to get behind HR 701, a bill that would require full funding and staffing of the VA without farming out any of the VA's activities unless for issues of distance or availability. That bill would pretty much eliminate the influence of Charles Koch and the three influential members of the President's Mar-A-Lago club in Florida.
The next issue of The Veteran will be targeted to Veterans Day and will appear shortly before the election, but probably won't be distributed in time to resist the Trump administration's efforts to cripple the VA. What can we do? First, call your Congressman and ask him or her to support HR 701, and see that it is passed. Sign onto www.SaveOurVA.org and stay abreast of the situation, and don't hesitate to let your Congressman know what you are thinking. Veterans for Peace are planning to picket at the entrances of many VA hospitals, with a target date of June 5th. Letters to the editor of your favorite newspaper can certainly help to sway public opinion. Just pay attention, or the VA hospital you visit might be out of business soon, and that would be a disaster!
John Ketwig is a lifetime member of VVAW and the author of two books about the Vietnam War.