The Right-Wing Attack on the Veterans’ Health Administration

The right-wing attack on the Veterans’ Health Administration:
One example of efforts to eclipse democracy,April 15, 2018

I’m going to focus on the issue of privatization in this post, but also frame it as just one part of a larger strategy by big business, the rich, the Republican Party and their allies to reshape government. Privatization is something that began to catch on after WWII and over the last 40 years as accelerated – at both the federal and state levels. Privatization is utilized most often in ways to advance the special interests of a corporation to the detriment of democratic values and influence, with negative effects on basic aspects of the lives of the great majority of Americans.

Privatization is just one part of the strategy of big business and the rich.
Donald Cohen describes privatization “as a standard conservative response to tight public budgets, a key pillar of attacks on government, and a lucrative market opportunity for domestic and global corporations” (http://talkingpointsmemo.com/features/privatization/one).

Tight budgets and rising government/public debt stem from over a trillion dollars of expenditures a year on military-related spending, lowered tax rates for corporations and the rich, coupled with massive tax avoidance by them. Additionally, the tight budgets and rising government debt reflect increasing expenditures on climate-related extreme weather incidences, most disturbingly exemplified in the number of such events annually costing a billion dollars or more. The list goes on. The tight budgets and rising debt also significantly reflect the costs related to the government bailouts and quantitative easing policies of the Federal Reserve, all in the wake of the Great Recession of 2007-2009, and largely to the benefit of the big Wall Street banks.

Privatization: why it is so attractive to the powerful and rich

Privatization is a method by which large corporations and other businesses hope to increase their profits by acquiring public assets (e.g., oil and gas leases), owning and controlling what were public responsibilities (e.g., for-profit prisons, charter schools), or contracting with government to carry out what was formerly done by government itself (e.g., food and maintenance services on military bases). Cohen writes: “Large corporations operate virtually every type of public service including prisons, welfare systems, infrastructure, water and sewer, trash, and schools.” He could have added to his list the large array of Pentagon consultants and contractors who provide extensive intelligence and military services in the U.S. and abroad, providing special forces in battle zones, and security at foreign embassies. Corporations and their powerful allies never cease looking for profitable opportunities to take over yet more government functions. For example, there are ongoing efforts by corporate interests and conservative legislators in the US Congress to privatize the Post Office, the Veterans Health Administration, Medicare, Social Security, the collection of student debt. In other words, corporations and big businesses want to privatize as much of what is potentially profitable in the public sector. The results are not so good. Privatization often means that the quality of the services diminishes, the costs of these services go up, and access to them becomes problematic for a growing part of the population.

Profits always a top priority

The CEOs and top owners and executives of big businesses, including corporations, family-owned businesses, hedge funds, private equity funds increase and consolidate their enterprises – and their power – in a multiplicity of ways, always with the goal of increasing profits unless forced politically or by organized employee power to do otherwise. This is true of all sectors of the economy. The life blood of business in a capitalist system is the bottom line. Businesses, especially the biggest, must grow through the unending and successful acquisition of profits. Otherwise, the CEOs are in trouble. With low profits, CEOs may be replaced by their boards, or the business they head may be taken over by a private equity firm and broken up, or the business may be acquired by another more financially viable corporation (the big fishes eat the little fishes), or it may just disappear after bankruptcy, as, for example, many of the manufacturing plants did in the Midwest rustbelt over the past 40 years.

The challenge for the biggest businesses, most prominently the large corporations, the ones you see listed in the Fortune 500 or 1000, the ones that have tens of billions in assets or more, the ones that also reap enormous sales and revenues, is to maintain their profitability, meet the expectations of shareholders, line the pockets of the top executives, have enough revenue to attract and retain the experts and experienced managerial staff they need, and improve productivity through technological innovation (e.g., automation, new versions of cell phones, updated appliances). And they do all this in a globalized economy in which the production of goods and services tends to exceed the demand as markets verge on becoming saturated, as vital resources become depleted, and as more and more consumers have wages and income that that limit what they can purchase.

Privatization is one of the policy tools capitalists support to keep profits flowing. In a reasonable system, the issue would be how to maintain a balance between the interests of businesses and the public interest, or what Robert Reich refers to as the common good. See Reich’s book by that name. In this case, public services and assets would be strengthened rather than sold off. Unfortunately, what we see happening is a growing imbalance in favor of businesses – and this largely reflects the power of big business in all sectors of the economy as well as in the right-wing domination of government at the federal and in many state governments.

Privatization: historical roots and examples of the present situation

The roots of privatization in the U.S. go back to the post-WWII era. Cohen offers this cryptic but illuminating explanation:

“The post-WWII era was a tough time for conservative economists, academics, intellectuals, and business leaders. Social Security, the Tennessee Valley Authority, the Securities and Exchange Act, and other New Deal programs represented a dangerous expansion of government’s role in the economy and society – nothing short of a frontal assault on freedom [of big business and the rich] and the beginnings of socialism in the U.S.” (http://talkingpointsmemo.com/features/privatization/one).

He illustrates his point on how privatization grew in the following years as follows:

“Private prisons didn’t exist thirty years ago. Today, publicly traded, billion-dollar corporations are key players in prisons and immigrant detention. Privatized immigration facilities now house over two-thirds of all detained immigrants.

“In 1988 AFT president Al Shanker proposed a new idea: To create charter schools where teachers could experiment and innovate and bring new ideas to the nation’s public schools. Today, nearly 3 million children attend charters, and large corporate chains and billionaires are funding the rapid growth of privatized, publicly funded charters.

“Former defense contractors, IT corporations and publicly traded corporations are running welfare, food assistance, and other safety net systems in many states across the country.

“Today the federal government employs more than three times as many contract workers as government workers, and state and local governments spend a combined $1.5 trillion on outsourcing.”

The Veterans Health Administration: Highlights

I’ll spend the rest of this post discussing the Veterans Health Administration, the health arm of the Veterans’ Administration. The budget for the VHA in 2015 was 65 billion. This fact alone makes it an enticing target for privatizers (https://en.wikipedia.org/wiki/Veterans_Health_Administration).

Suzanne Gordon, who has studied and reported on the VHA for 30 years, points out in an interview on Democracy Now that “the VHA is the nation’s largest (and only publicly funded)” healthcare system, that is, one that funds its own healthcare facilities and programs (https://www.democarcynow.org/2018/03/30/david_shulkins_firing_at_the_va).

It’s fair to say that the VHA is a socialist healthcare system.
It is a huge part of the U.S. healthcare system, serves millions of vets, and should serve even more. Gordon said in the interview: “The Department of Veterans Affairs is the federal government’s second-largest department, with 360,000 employees.” They are all on salary. In her book, The Battle for Veterans Healthcare, Gordon notes the significance of this fact, namely, there is less incentive to order treatments that are unnecessary. She writes:

“Because VHA physicians and other staff are on salary, they have little financial incentive to either over- or undertreat their patients and thus use medical equipment and treatments more judiciously than their counterparts in the private sector” (p. 33)

According to the U.S. Department of Veterans Affairs, the “Veterans Health Administration (VHA) is the largest integrated health care system in the United States, providing care at 1,240 health care facilities, including 170 VA Medical Centers and 1,061 outpatient sites of care of varying complexity (VHA outpatient clinics) to over 9 million Veterans enrolled in the VA health care program” (https://www.va.gov/health/aboutVHA.asp). Put slightly differently, Suzanne Gordon writes that “VHA includes “150 hospitals, 819 clinics, 300 mental health centers, and other facilities – many located in rural areas that the private sector ignores – care for more than 230,000 people a day” (The Battle for Veterans’ Healthcare: Dispatches from the Frontlines of Policy Making and Patient Care, p. 22)

Overall, VHA serves 9 million of the 22 million living veterans. Gordon writes: “Because Congress has not allocated funds sufficient to provide healthcare for all 22 million or more Americans who served in the military, the VHA must enforced eligibility rules that restrict care to the sickest and poorest veterans, while excluding more affluent and healthy ones. To be among the nine million vets who currently qualify for the VHA’s full Medical Benefits Package, applicants must have an honorable discharge and must have evidence – if they served after 1980 – of a ‘service-connected disability’” (p. 27). These numbers don’t include the family members of the veterans who help to care for them. However, the VHA does provides, among many other services, residential and respite care services for family members. Gordon describes it:

“In 2010 the VHA launched a program to support home-based caregivers. In our larger healthcare system, family caregivers are essentially on their own when they care for a loved one who has a major mental health or physical disability. Many are rewarded for their service by loss of jobs or promotions and may eventually sacrifice their own health because of the emotional and physical stress of their caregiving burden. The program provides these caregivers with training, supportive services – including mental health counseling – and even financial stipends to help them shoulder their burdens” (p. 27).

Some of the 125,000 vets who have received “other than honorable discharges” would in a rational and just system be allowed to get medical benefits from the VHA. Some were “mustered out unfairly – during the era of Don’t Ask, Don’t Tell or before it – because of their sexual orientation” (p. 28). Some commanders failed to consider whether the veteran had service-related PTSD or another mental health problem. And there are conditions that probably have led to less-than-honorable discharges, such as when a female soldier because “a victim of military sexual trauma who drank because of the abuse” and failed to fulfill her duties fully. Or a situation in which a woman reports harassment or rape by a senior officer and get kicked out of the service on trumped-up charges.”

VHA provides a wide array of programs in a single-payer, fully-integrated healthcare system

The VHA pays for all its services out of its budget and offers fully-integrated care. Gordon describes it: “…the VHA is a model of a fully integrated healthcare delivery system. Genuine integration affords veterans a level of care unavailable to most Americans, who remain subject to our fragmented private-sector healthcare system. A VHA patient moving from Boston to San Francisco can get uninterrupted care from professionals with access to his or her medical records. When the same patient sees his or her primary-care practitioner to discuss health problems – diabetes, say, or PTSD – he or she can then walk down the hall and talk to a nutritionist about a diet, a pharmacist about how to correctly administer insulin, or a mental health professional” (p 31).

In addition to its 1,240 to 1,260 facilities, the VHA offers a wide range of programs, including “traditional acute and ambulatory services, institutional services for those not able to live independently, palliative care and hospice care, nursing home and adult day health care, hospital-based home care, domiciliary and community residential care, and respite care” (p. 23).

The VHA provides more geriatric services than any other healthcare system in the U.S. This is not surprising since the average age of the veterans who are treated is 62. There is no other healthcare system in the United States that offers, manages, and coordinates anything like this. While Medicare and Medicaid also provide financial support for millions of Americans, VHA offers programs directly to patients in its own network of medical staff, hospitals, clinics, mental health centers. There are no intermediaries such as for-profit insurance corporations involved. Gordon reports that the VHA offers “pioneering treatments” in “cognitive behavioral therapy and prolonged exposure therapy” for those with mental-health issues. There are also programs that address drug addictions and suicide prevention. On the latter, there is a Veterans Crisis Line and “suicide-prevention coordinators at every VHA medical center train every employee” on how to recognize the signs that a veteran is at risk of suicide” (p. 24). Mental health care is given great attention, unlike in many private-healthcare systems. This is so because “16 to 30 percent of combat veterans have post-traumatic stress syndrome (PTSD),” while 80 percent of female veterans have been victims of some sort of sexual trauma-sexual assault (p. 24). On the latter point, the VHA has created “a system of women’s health clinics located within larger facilities” (p. 25).

In an interview Gordon did on Democracy Now, she offers further details on VHA patient.

“It has probably the best mental health system in the country, because our mental health system in the private sector is a disgrace. It has the best geriatric care in the country. It has incredible end-of-life care. It has amazing rehabilitation services—blind rehabilitation centers, stroke centers, spinal cord injury centers. And these don’t just treat veterans who have been in combat” (https://www.democarcynow.org/2018/03/30/david_shulkins_firing_at_the_va).

Teaching and Research

The VHA has two other missions in addition to patient care. It is affiliates with major academic teaching hospitals and, Gordon writes, “and now trains over 70 percent of American physicians as well as students and trainees in forty other healthcare professions.” And then there is the research mission. Here are three examples of the research done by the VHA, in partnership with the National Institute of Health.

• Partnered with the National Institute of Health – “conducted the studies to prove that the shingles vaccine – which millions of seniors now take – was indeed safe for all Americans” (p. 22).
• “VHA researchers also did pioneering work documenting a reduction in post-surgical mortality when patients with known cardiac risk were given beta blockers before surgery. Now this is standard practice not only for veterans but for all patients who undergo surgery.” (p. 23)
• “The VHA performed the first successful liver transplant and developed the nicotine patch” (p. 23).

Lower costs

Gordon cites 1999 data that found “the full range of services the VHA provided would have cost 21 percent more in the private sector. Inpatient care in the private sector would have cost 16 percent more, outpatient care 11 percent more, and prescription drugs a whopping 70 percent more” (p. 30). The lower costs of the VHA reflect several factors that distinguish it from for-profit health care systems. The VHA negotiates prices with pharmaceutical corporations and physicians rather than letting them set their own prices. The VHA has lower administrative prices than the for-profit health care systems because they do not provide patient care through a for-profit insurance-based system. They “do not waste taxpayer dollars on high executive salaries or expensive marketing and advertising” And, very importantly, “VHA care is…more focused on prevention, early treatment, and the patient’s ability to function as independently as possible” (p. 30)

The VHA is not problem-free

There is a continuing problem of underfunding. There has been a outcry of criticism that at a few VHA healthcare facilities wait times have been too long. There is a well-funded and powerful movement that is pushing for the privatization of the VHA, despite evidence that the VHA delivers healthcare services in a well-integrated patient-care system that has institutionalized a culture and practices in dealing with the health needs of veterans that exceeds that of the private sector.

The problems of underfunding, wait times reported by the media in some VHA facilities in 2014, and the push to privatize the VHA, are all tied together. The Republican-dominated U.S. Congress strongly wants to privatize the VHA, and thus is inclined to underfund it and highlight problems of patient care in the VHA that help them justify the reduction of funding. What do the Republicans and their powerful right-wing allies want? In the final analysis, they want to shrink the VHA budget and its ability to provided health care services to veterans. Then, as the VHA is forced to reduce services and amidst outcries from healthcare deprived or under-served veterans, they want to replace the VHA with for-profit insurance corporations that will reimburse healthcare providers in the private-sector for the more limited and more expensive services available. There will be insufficient restraint on what the insurers charge for their coverage, if historic and current practices continue. This will result in fewer veterans with any kind insurance or with insurance that has high deductibles and copayments for limited coverage. The Republicans and the other privatizers don’t care that veterans’ costs will increase, don’t care if access to health care for low-income and female veterans is sharply curtailed, don’t care if the integrated healthcare system of the VHA will decline, don’t care if mental- and physical- health problems of veterans are not adequately addressed. And, just to add one other examples, they don’t care that privatization of the VHA will mean the eventual end of negotiations for drug prices and the resultant increase in these prices for veterans. Gordon summarizes it succinctly:

“The long-term Republican goal is to privatize the VHA, a policy that would cap costs, increase the middleman profits, reduce the efficiencies of a fully-integrated system, and drastically cut care” (p. 37).

Wait times and how they are employed to advance the argument for privatizationGordon –

“…conservatives have exploited the wait-time problems and delays uncovered in 2013 in Phoenix and some other VHA facilities. They saw this an opportunity to “argue that the entire VHA system is broken and the VHA should no longer provide health care services.” They want “to eliminate the VHA and transfer veterans to the private-sector healthcare system, with the government serving as payer, rather than provider, of care” (Gordon’s book, p.33). Subsequently, the Senate Committee on Veterans Affairs blocked Senator Bernie Sanders request for a $24-billion appropriation for the Department of Veterans Affairs (mostly for healthcare).” “After the Phoenix wait-time controversy was exposed, Sanders brokered a deal with Republican Senator John McCain, and Congress grudgingly gave the Department $16 billion – $8 billion less than requested.” By the end of 2016, the VHA had corrected its wait-time issues and attracted many new enrollees

There are, Gordon points out, 4 studies that examined the controversy over wait times. One study “compared the outcome for 700,000 California cancer patients who were treated the VHA with patients covered by private insurance or Medicare and Medicaid. The chief finding: “although veterans has to wait longer for access to care than those covered by the other insurance programs, they received more appropriate treatment and better outcomes” (p. 43). The RAND Corporation conducted an independent assessment and documents “that the VHA outperforms the private sector on many measures, is equivalent on some, and marginally worse on only a few” (p. 31). Gordon also refers to a study published in JAMA that “reported that men with heart failure, heart attacks, or pneumonia were less likely to die if treated in a VHA hospital than a non-VHA hospital” (p. 31). And she describes a fourth study that “reported that women veterans have higher rates of screening for cervical and breast cancer whey they a specially designated women’s health provider” (p. 31). It should also be noted that these accomplishments occurred despite a shortage of primary-care physicians in the overall U.S. healthcare system.

In the meantime, after the wait-time controversy, “the VHA has so successfully addressed wait-time problems that it added 7 million more patient appointments and increased the number of patients receiving treatment, in some places by almost 20 percent. As a result, costs went up. The VHA then requested an additional $2.5 billion, which it eventually received, but at the same Republican Senators criticized the VHA for not operating efficiently, being mismanaged, and that it was a dysfunctional agency. In other words, it laid the ideological and political groundwork for the Republican privatizing line in the future (p. 37). Among other reasons, the major for-profit healthcare and pharmaceutical corporations have enormous influence on how the Congress acts. Indeed, this has been true under both Democratic and Republican administrations. The big healthcare insurers, Big Pharma, private-sector hospitals, and medical equipment companies – all want more customers, subsidized and paying, and a free hand in determining the prices of their services to augment their already high profits. If Republicans had their way, the government would spend less on health care with the privatization of the VHA, but more of what is spent would go into the coffers of the big for-profit healthcare corporations. There is also another issue that spurs the privatization forces, that is, they want a healthcare system devoid of unions. VHA employees are unionized. Get rid of the VHA and you eliminate yet another group of unionized workers.

Who is leading the push for the privatization of the VHA?

The forces for privatization include the leading corporations in all parts of the for-profit healthcare industry, the Republican-dominated U.S. Congress, the Republican Party in general, the billionaire Koch brothers, and a group called the Concerned Veterans for America (CVA),which is funded by the Kochs, and hedge fund insider trader Steven Cohen “who’s trying to set up an alternative mental health system to compete with the VA.” While the CVA is designated as a veteran’s group, it has no veteran members and provides no veteran services, according to Gordon (p. 34). Genuine veterans’ organizations such as the Veterans of Foreign Wars and the American Legion have opposed privatization proposals (https://www.democarcynow.org/2018/03/30/david_shulkins_firing_at_the_va).

Gordon describes the CVA:

“This group is central to the Koch brothers’ anti-government agenda and has been lobbying not only for partial and ultimately full privatization of the VHA but also against Obamacare and other government programs. In 2016 it launched a website. My VA Story, soliciting bad stories about the VHA from veterans” (p. 3

What specifically do the Koch brothers want? Suzanne Gordon offers one answer in her interview on Democracy Now. Here’s her full answer.

SUZANNE GORDON: “Well, they would like the VA [VHA] to be like TRICARE, which is the military insurance program, an insurance provider that pays for care, not delivers care. And the VA has great health outcomes. And really, it’s important for people to understand that in every single study—and they keep coming out, day after day after day—every single scientific study shows that the VA, in most areas, is equal or superior to the care delivered in the private sector, for much lower costs. So, if we were to privatize, veterans would lose integrated care.

“Now, it’s true that many veterans who live in rural areas have to travel to get to a facility where they can have surgery. But this is true for anybody in a rural area. And when they’ve studied the problem of would veterans get more expeditious care if they lived in rural areas under privatization, they found that they probably wouldn’t, because there just aren’t the doctors and specialists. I mean, Amy, if you look at the stats on mental healthcare in this country, 55 percent of American counties, all of them rural, have no psychiatrist, no psychologist or no social worker. There is no excess capacity out there to take care of these veterans. In San Francisco during flu season, University of California, San Francisco Hospital had people stacked up in the ER waiting for 60 hours for a bed, because there wasn’t enough capacity. Imagine adding 100,000 veterans, who now are cared for in veterans’ facilities, to those people in those ERs in flu season. It would be a disaster. The whole idea of privatization is based on this myth that we have excess capacity.

“Now, what they really want is, they don’t want to take—these hospitals and the Koch brothers and the hospital chains that are fighting for more veterans, they don’t want people with chronic illnesses and mental health problems and primary care. They don’t have enough people to take care of the patients that are already on their books. What they want is they want, you know, to do the colonoscopy, the high-cost colonoscopy, or the hip replacement. But why—that would cost more money, and veterans wouldn’t get integrated care.”

The privatization efforts of the Kochs and the Republicans are reflected notably in recent legislative initiatives and in the appointment of a physician with no administrative experience or experience treating veterans as Secretary of Veterans’ Affairs, that is, White House physician Dr. Ronny Jackson, Trump’s physician, a rear admiral in the Navy. He has no experience running a large agency.

Legislative initiatives

Michael Corcoran reports on the legislative issues in an article for Truth Out on April 3, 2018 (http://www.truth-out.org/news/item/44041-trump-s-new-va-pick-appears-poised-to-rubber-stamp-privatization-of-veterans-affairs). According to Corcoran,

“Among the legislation the Kochs are pushing is the Veterans Community Care and Access Act (S.2184, which was introduced by Sens. John McCain and Jerry Moran), the Veteran Empowerment Act (HR.4457, introduced by Rep. Doug Lamborn), which seek to privatize much of the VHA, and the Vet Protection Act (HR.1461), which would weaken the rights of VA employees.

Nikki Wentling of the Stars and Stripes reported is quoted by Corcoran that the Veterans Community Care and Access Act would “create a network of community medical providers that veterans could use at taxpayers’ expense.” If this bill is passed, the VHA would still act as a gate keeper determining when the care needed by a veteran is not available in VHA facilities. The Veteran Empowerment Act goes further than this. It would “create a government-chartered organization to operate a new veterans’ health insurance system.” In this case, the VHA would be replaced or on the road to being replaced altogether. Corcoran reports, “The Kochs, who, according to The Wall Street Journal, are spending millions to influence this debate, praised the bill. In an op-ed for The Hill, Dan Caldwell, executive director of Concerned Veterans for America, said the bill would ” truly expand veterans’ health care choice in an effective and sustainable way.”

Aside from the added costs of the bills, there is recent evidence that “the private sector is not ready for the specific health needs of veterans, according to a Rand Report published in March, which studied New York State providers. The report found that private providers knew ‘little about the military or veterans’ and are ‘not routinely screening for conditions common among veterans,’ among other critiques,” as reported by Corcoran.”

In an article published in The American Prospect, Suzanne Gordon describes the findings of the Rand study, along with two other research studies that come to the same conclusion (http://prospect.org/blog/tapped/studies-show-private-sector-providers-are-not-ready-care-veterans). Given the importance of this research, let me quote her at length.

“As Congress moves ahead with plans to outsource more and more veteran health care to the private sector, three high-profile studies should urge lawmakers to pump the brakes. The studies, published in recent weeks by RAND Corporation, Federal Practitioner, and the National Academies of Science, Engineering and Medicine, spotlight serious flaws in private-sector veterans’ care compared with the VHA, from suicide prevention to overall health care. In so doing, the reports underscore a critical fact: Despite their best intentions, few private-sector physicians, hospitals, mental health, and other health-care professionals have the knowledge, experience, and skill to provide the level of care veterans need and deserve.

“Perhaps the most damning of those studies comes from the RAND Corporation. In a report entitled “Ready or Not?” researchers examined whether private-sector health professionals in New York state had the ‘capacity’ and ‘readiness’ to deal with that state’s 800,000 veterans in need of care. Such patients, the study noted, are on average older, sicker, poorer, and far more complex than the ordinary civilian-sector patient.

“The conclusion? Only 2 percent of New York state providers met RAND’s ‘final definition as ready to provide timely and quality care to veterans in the community.’

“While the majority of providers said they had room for new patients, less than 20 percent of them ever asked their patients if they were veterans. Fewer than half used appropriate clinical practice guidelines to treat their patients, and 75 percent didn’t use the kind of screening tools commonly deployed in the VHA to detect critical problems like PTSD, depression, and risk of suicide.

“Most providers had no understanding of military culture and less than one-half said they were interested in filling such knowledge gaps. Mirroring a similar study conducted by the VA and Medical University of South Carolina in 2011, RAND found that New York state providers had little understanding of the high quality of VHA care. Informed by media reports rather than medical journals, they had a negative view of the VHA and would be unlikely to refer eligible veterans to the VHA for needed care in programs in which the VHA actually excels.”

There is a third bill, backed by the anti-union Republicans and the Koch brothers, called “The Vet Protection Act.” It is designed to “protect” veterans who seek healthcare services in the VHA system against unions. If ever enacted, the proposed legislation would have several effects. It would make it easier to fire employees, weaken public sector unions, monitoring and limiting the amount of time VA employees devote to union activities during working hours. The National Federation of Federal Employees said that the legislation serves only one purpose, that is to “weaken federal employee unions.” Another unstated implication of this legislation is that it would have reduce the already modest salaries of VHA employees, increase turnover, diminish the emphasis on quality of treatment, and end up giving the opponents of the VHA more reasons to privatize it. The other loser in this process would be the veterans who need healthcare.

What is it all about? In the final analysis, it is about how the Republican and right-wing groups not only want to push for the privatization of the VHA, but also about getting the government completely out of the management and regulation of health care, while continuing to pony up funds for it.

Trump fires Veterans Affairs Secretary David Shulkin who insisted the VA would not be privatized on his watch and replaces him with White House physician Dr. Ronny Jackson, a rear admiral in the Navy. Dr. Jackson has no experience running a large agency.

The Trump administration adds a new element in the privatization efforts of the Republican Party and groups like those funded and shaped by the Koch Brothers. Trump has the power to choose who will run important executive-branch agencies, sometimes with the consent of the Republican-dominated Senate and sometimes on his own initiative. Well, arch-privatizer Trump has just chosen his personal physician to fill the position of Secretary of Veterans’ Affairs, after firing the incumbent, David Shulkin who opposed privatization of the VHA.

Here’s what Suzanne Gordon had to say on Democracy Now about this blatantly self-serving, right-wing political decision who, needless to say, want a political system that is subordinate to the corporate-dominated economy and where their profits take precedence over democracy – and, in this case, over the interests of veterans.

“Well, the doctor has no administrative experience. He has very limited clinical experience. He was a combat military doctor in Iraq. He’s familiar with military medicine, which is basically get them up, get them out quickly, get them in line and get them fighting again. The VA medicine is entirely different. It’s dealing with veterans with multiple, complex, chronic conditions. His medical experience is, as I said, within—in the White House, with largely well-to-do people, who probably eat right, with the exception of the president, and maybe get enough exercise and so on. But veterans, the Veterans Affairs—the Veterans Health Administration, which he will be administering, is dealing with older, sicker, poor veterans who bear no resemblance to the kind of patients one treats in the White House.
“I mean, you know, basically, Jackson is just a doctor. That’s his qualification. He curried favor with Trump by minimizing Trump’s weight-related and diet-related problems. But I think he’ll be a puppet that will put the VHA and the VA on a starvation diet, rather than putting the president on the much-needed diet that he should have been on a long time ago.”

Concluding thoughts

As I’ve maintained throughout this post, relying heavily on the in-depth research of Suzanne Gordon, the efforts to privatize the VHA are just one manifestation of the more general right-wing goal of privatizing everything about government that has profit-making potential in the voracious eyes of the corporate CEOs and their allies. And, further, privatization is just one means by which they hope to go on diminishing democratic institutions and values, while generating opportunities for the consolidation of corporate power and for the rich continue to accumulate an ever-larger share of the society’s wealth and income. So, what’s the point? Curiosity. Education. Clarity. Having the information to know when you are being fed lies. Sharing the information. Perhaps, consequent engagement in the political process and support of progressives in or running for government. Hope that amidst the chaos of events, here and abroad, democratic and egalitarian values, peace and diplomacy, policies that foster a sustainable domestic and global economy, will come to prevail – before it’s too late. I’ll end with these encouraging words on the VHA privatization front from Corcoran:

“However, while the Kochs have enormous resources invested in their effort to dismantle the VA, there is organized resistance from most Veterans Service Organizations, as well as from progressives like Bernie Sanders, who seek to defend government-run health care on principle.

“With the Koch brothers’ role in trying to privatize the VHA now a matter of national debate, the best way to maximize opposition to their agenda is to make sure the US public knows who is most hurt by it: veterans.” (http://www.truth-out.org/news/item/44041-trump-s-new-va-pick-appears-poised-to-rubber-stamp-privatization-of-veterans-affairs)

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