The VA Is the Closest Thing We Have to Single Payer. Now Trump Wants to Privatize It.

Bryce Covert March 15, 2018

Unions and veterans' groups came together on March 1 to discuss saving the VA from privatization. (AFGE District 7/Flickr)

Aaron Hugh­es, who was deployed to Kuwait and Iraq in 2003 and 2004, now has a seri­ous, very rare lung con­di­tion. But he told In These Times he gets real­ly out­stand­ing care” at the near­by Jesse Brown VA Med­ical Cen­ter. The doc­tors are at the top of their class,” he said.

Because his con­di­tion is so rare, Hugh­es has been sent to a hos­pi­tal out­side of the Depart­ment of Vet­er­ans Affairs (VA) for spe­cif­ic tests. And his taste of the pri­vate health­care sys­tem has been sour. As soon as I went there, all hell broke loose,” he said said, explain­ing there were prob­lems with shar­ing records between the two insti­tu­tions. With the VA sys­tem, when you do tests, it’s all inte­grat­ed.” Every doc­tor Hugh­es sees is aware of all the oth­er treat­ment he gets, from vision to men­tal health. The pri­vate hos­pi­tals, on the oth­er hand, often refuse to send the records back to the VA. The pri­vate sec­tor isn’t about shar­ing your infor­ma­tion,” Hugh­es explained. It’s not about health­care, it’s about own­er­ship of care.”

Hugh­es thinks these prob­lems could get worse if efforts to ful­ly pri­va­tize the VA are suc­cess­ful. Pres­i­dent Don­ald Trump has sup­port­ed pri­va­tiz­ing the sys­tem, and has called to make per­ma­nent the Vet­er­ans Choice Pro­gram, an exper­i­ment Con­gress launched in 2014 that gives vouch­ers to vet­er­ans to see pri­vate doc­tors, while cut­ting oth­er parts of the agency. These devel­op­ments have pro­voked con­cerns that Trump will ush­er in a full pri­vate sec­tor takeover. 

I wor­ry that my care will become a prof­it motive,” Hugh­es said. And that means it’s not about me any­more, it’s about mak­ing money.”

Now Hugh­es’ orga­ni­za­tion, About Face: Vet­er­ans Against the War, has joined oth­er vet­er­ans’ groups, unions and health­care advo­cates to launch a cam­paign to stop the pri­va­ti­za­tion of the VA. After sev­er­al months of build­ing the coali­tion, the mobi­liza­tion now includes Vet­er­ans for Peace, Ser­vice Employ­ees Inter­na­tion­al Union, the Amer­i­can Fed­er­a­tion of Gov­ern­ment Employ­ees (AFGE) and Nation­al Nurs­es Unit­ed. Health­care advo­ca­cy groups includ­ing the Illi­nois Sin­gle Pay­er Coali­tion and the Demo­c­ra­t­ic Social­ists of Amer­i­ca Health­care Work­ing Group have also joined the cam­paign. When the orga­ni­za­tions came togeth­er on March 1 to hold a pan­el event in Chica­go, more than 100 peo­ple showed up.

The com­bi­na­tion of unions and vet­er­ans’ groups is potent. We as vet­er­ans can argue and demand things and raise issues that the unions can’t, and the unions can inform us about issues that we don’t under­stand,” Hugh­es said. We’re see­ing out­side, and they’re see­ing inside of the sys­tem. We’re able to have this inside/​outside strat­e­gy that I think is real­ly a win­ning strategy.”

Orga­niz­ers believe the time is right to invest in that team­work now. It came to our atten­tion last fall that things under the Trump admin­is­tra­tion have been get­ting real­ly bad,” Rober­to Clack, an orga­niz­er with the Right to Heal VA Cam­paign, told In These Times.

There are prob­lems with the VA, but the VA works,” Clack said. It pro­vides qual­i­ty care for the peo­ple that use it, and it saves lives.” A 2016 RAND Cor­po­ra­tion analy­sis found that the VA pro­vides good qual­i­ty care com­pared with oth­er health sys­tems, usu­al­ly in a time­ly man­ner. Pri­vate providers, on the oth­er hand, could expose vet­er­ans to low­er-qual­i­ty care, longer wait times and doc­tors who aren’t famil­iar with mil­i­tary service.

We agree that it could be bet­ter,” Clack said, but the way to make health­care bet­ter is to have a ful­ly sup­port­ed VA, fund­ed VA, and staffed VA.”

Pri­va­tiz­ing the VA wouldn’t just risk veteran’s health­care, how­ev­er. It could also threat­en the union­ized pub­lic sec­tor employ­ees who work for it. AFGE rep­re­sents more than 700,000 fed­er­al work­ers, 250,000 of whom work at the VA. It would be a seri­ous death knell for union­iza­tion in this coun­try,” said Anne Lind­gren, pres­i­dent of AFGE Local 789.

Pri­va­ti­za­tion is absolute­ly the wrong response,” Clack said. Privatization’s not going to make anyone’s health­care better.”

But the idea that the VA doesn’t work has become embed­ded many media reports and the gen­er­al pub­lic. What we’re real­ly up against is debunk­ing the nar­ra­tive that it’s just this bro­ken sys­tem,” Clack said.

So while the long-term goal is to block the pri­va­ti­za­tion of the agency, the short-term goal is to raise more aware­ness. We rec­og­nize that [stop­ping pri­va­ti­za­tion] is a big ele­phant, and you can’t eat an ele­phant in one bite, you need to eat it in small bites,” Lind­gren said. For that to hap­pen we need to edu­cate and orga­nize the public.”

After the launch event, the groups held a call-in day to have peo­ple con­tact their mem­bers of Con­gress and urge them to oppose a cur­rent­ly bill that would expand the Choice pro­gram. Next will be actu­al­ly vis­it­ing mem­bers of Con­gress. Frankly we’re going to take this to the streets and let not only Repub­li­cans know, but also Democ­rats who are vac­il­lat­ing on this issue, you have to have a firm no’ on pri­va­ti­za­tion efforts,” Clack said.

Par­tic­i­pants also hope to cre­ate an orga­niz­ing mod­el that can be repli­cat­ed in oth­er cities and com­mu­ni­ties across the coun­try. We’re not going to win this fight if it’s just a Chica­go fight,” Clack said. We def­i­nite­ly want to see this orga­niz­ing spread to oth­er parts of the country.”

The goal is also to move their efforts beyond just sav­ing the VA from pri­va­ti­za­tion to mak­ing a proac­tive argu­ment that the VA should be expand­ed and itself serve as a mod­el for the whole coun­try. I believe our com­mu­ni­ty of vet­er­ans orga­nized has the poten­tial to not just fight for our health­care, but health­care for every­one in this coun­try,” Hugh­es said.

That’s why the launch event includ­ed activists who are focused on uni­ver­sal health­care and a sin­gle-pay­er sys­tem. The VA real­ly resem­bles the clos­est thing there is to a sin­gle pay­er sys­tem in our coun­try,” Clack said. It’s not just the largest hos­pi­tal sys­tem and health­care provider in the nation, but it’s also the only sys­tem that nego­ti­ates direct­ly with phar­ma­ceu­ti­cal com­pa­nies over drug prices, and it’s also a one-stop-shop for vet­er­ans seek­ing all kinds of care, from men­tal health to phys­i­cal issues to social work.

We real­ly want to make a case that the pub­lic sec­tor pro­vides qual­i­ty ser­vices,” Clack said. The VA’s a great exam­ple of the pub­lic sec­tor working.”

Bryce Covert, a con­tribut­ing op-ed writer at the New York Times, has writ­ten for The New Repub­lic, The Nation, the Wash­ing­ton Post, the New York Dai­ly News, New York Mag­a­zine and Slate, and has appeared on ABC, CBS, MSNBC and NPR. She won a 2016 Excep­tion­al Mer­it in Media Award from the Nation­al Women’s Polit­i­cal Caucus.
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