Suzanne Gordon and Jasper Craven from the Veterans Health Care Policy Institute join Henri to discuss critical issues surrounding VA policy, particularly privatization. The discussion highlights the staffing shortages in the VA, the implications of the Veterans Choice and Accountability Act, and the complications arising from Project 2025, including its policies on privatization and cuts in service-related benefits and care, alongside the challenges around the PACT Act and the influx of for-profit entities exploiting veterans' claims. Additionally, they address abortion services and transgender care in the VA, emphasizing the larger agenda behind Project 2025 and the need to preserve the comprehensive VA healthcare system.
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00:00:22
Don: This is Fortress On A Hill, with Henri, Danny, Kaygan,
00:00:25
Jo vonni, Shiloh, and Monisha
00:00:29
Henri (2): welcome everyone to Fortress On A Hill, a podcast about U.
00:00:32
S.
00:00:33
foreign policy, anti imperialism, skepticism, and the American way of war.
00:00:38
I'm Henri.
00:00:39
Thank you for being with us here today.
00:00:42
We are here to talk to Suzanne Gordon and Jasper Craven.
00:00:47
of the Veterans Health Care Policy Institute to talk about a whole
00:00:52
bunch about what's happening in VA policy right now, VHA mostly.
00:00:58
gonna talk about privatization.
00:00:59
We're gonna talk about the huge differences and actually could be seen
00:01:05
as even more negatives between The predecessor, VA Secretary, Robert Wilkie,
00:01:11
and the current one, Dennis McDonough.
00:01:14
Did I say that right?
00:01:15
McDonough?
00:01:15
Suzanne Gordon: Yes, McDonough.
00:01:16
Henri (2): So, Jasper, Suzanne, welcome to Fortress On A Hill.
00:01:18
How are you both doing this morning?
00:01:21
Suzanne Gordon: We're good.
00:01:23
Jasper Craven: Yes.
00:01:25
Henri (2): So, the impetus for this discussion was, going through some things
00:01:28
about project 2025 and specifically the, policy changes that it touches on.
00:01:35
it's important to remember, that Project 2025 is a version of something
00:01:39
that not only the Heritage Foundation, but lots of other private think tanks
00:01:43
have been doing for a long time.
00:01:45
The Heritage Foundation, specifically, since 1980, is
00:01:48
a right leaning institution.
00:01:50
not all of its recommendations are adopted or even seriously considered,
00:01:55
but what we're going to discuss today is some of the most important
00:01:58
aspects that are touched on by Project 2025 as we see them, along with a
00:02:04
few foreign policy aspects as well.
00:02:07
So, Suzanne.
00:02:09
Let's start by talking a bit about privatization.
00:02:13
can you tell us, what's your take on the current staffing shortages that the
00:02:18
VHA is trying to deal with right now?
00:02:22
and, tell us about the 23 billion opportunity up for grabs, please.
00:02:27
Suzanne Gordon: Well, I think that, right now, and Jasper can
00:02:32
really come in and help on this.
00:02:34
The basic privatization picture is that in 2014, they passed something called
00:02:42
the Veterans Choice and Accountability Act, which began outsourcing
00:02:46
veteran care to the private sector.
00:02:49
based on whether you had to wait a certain amount of time for an
00:02:54
appointment at the VA or drive a certain amount of miles to reach a VA.
00:03:01
And that was supposed to be a temporary program.
00:03:04
It was supposed to give the VA money, unfortunately not enough money.
00:03:09
The VA needed 21 billion to deal with staffing and other issues and
00:03:15
the TRACE Act gave it 6 billion.
00:03:17
So that means.
00:03:19
That it needed, you know, another, how many billion, God, I can't add, I
00:03:27
can't, I'm, you know, Jasper, help me.
00:03:29
Jasper Craven: 14, roughly.
00:03:31
so it, you know, if you're looking at this as a shell game, you know,
00:03:37
they keep forgetting that they needed 14 more billion than they
00:03:42
got, and this was supposed to be a law that sunsetted after 3 years.
00:03:49
And it was supposed to be temporary.
00:03:51
And basically it was a compromise between Bernie Sanders and John McCain.
00:03:56
And John McCain almost immediately said, Oh, you know, I was actually wasn't
00:04:00
being serious about it being temporary.
00:04:03
And then when Trump came in, They not only made it permanent, this option of
00:04:09
going to the private sector, but they made, put it on steroids and they created
00:04:14
this Veterans Community Care Program, which essentially allowed veterans
00:04:20
to go to private sector providers through a separate VA set up called
00:04:28
the Veterans Community Care Program.
00:04:31
And Trump's VA secretary, Robert Wilkie, created eligibility standards
00:04:38
for this program, this Veterans Community Care Program, that guaranteed
00:04:42
a huge amount of outsourcing.
00:04:43
So, any vet who had to wait more than 20 days or drive more than 30 minutes to a
00:04:50
primary care mental health appointment could go to the private sector.
00:04:53
And any vet who had to wait more than 28 days.
00:04:58
drive more than 60 minutes could go to the private sector
00:05:01
for a specialty appointment.
00:05:03
So, I mean, just think about your own experience.
00:05:06
how long do you have to wait in the private sector for
00:05:10
a primary care appointment?
00:05:11
Well, I mean, how can you even find a private primary care
00:05:15
provider in the private sectors?
00:05:17
PrEP sector, much less get an appointment with them.
00:05:19
How long does it take to get a dermatology appointment?
00:05:23
I mean, I just had a little spot on my cheek.
00:05:26
I tried to get my dermatologist to look at and it's like a four
00:05:30
month wait in the private sector.
00:05:32
So basically, rather than, I mean, it would have been VA had taking a
00:05:40
look at each particular healthcare market and said, okay, we're going
00:05:43
to see what the wait times are in the private sector and, and, and we're
00:05:47
going to match those or even best them.
00:05:50
I mean, even if you could get a dermatology appointment in 3
00:05:53
months, as opposed to 4 months or 8 months or whatever, but no, they
00:05:57
set these very unrealistic wait time and drive time standards.
00:06:02
And that guaranteed that, you know, now, it's something like 40 percent of
00:06:06
VA care is given in the private sector.
00:06:10
I think it's, something like they have 1.
00:06:12
7 million providers that they're supposed to oversee.
00:06:16
And here's the other thing that is really extraordinary is not only is the
00:06:21
VA supposed to pay for these people to go to the private sector, it's supposed
00:06:26
to coordinate the care that the private sector delivers, even though there's
00:06:31
no requirements that the private sector coordinate care with the VA.
00:06:36
and so it's a kind of a nightmare.
00:06:38
you have to get medical records back.
00:06:40
and there's something like 12 million appointments or something.
00:06:44
So imagine getting records back for 12 million appointments, and coordinating 1.
00:06:50
7 million providers and so forth.
00:06:53
it's A logistical nightmare and the VA, of course, fails because it's
00:06:58
supposed to be both an insurance company paying for care and a health
00:07:04
care system that, provides care.
00:07:06
And so what we're seeing is that there's not enough money to hire staff.
00:07:11
They have now a 15 billion budget shortfall.
00:07:17
there's, not enough money.
00:07:18
Congress isn't giving them enough money to hire.
00:07:21
rebuild their infrastructure, renovate.
00:07:24
So even if they had the money to hire staff, they need something like 20, 000.
00:07:29
we don't even know how many people they actually need to deal
00:07:34
with the demand that they have.
00:07:36
And all this money, 30 percent of their clinical care budget,
00:07:40
over 30 percent is going out of the VA to pay for private care.
00:07:45
And then as you asked, Henry, the VA Secretary and his Undersecretary for
00:07:50
Health, Sharif El Nahal, have come up with schemes to spend something like 23
00:07:56
billion in 10 years and, 14 billion in 10 years to get, higher contract rates.
00:08:05
workers to come in and deal with staffing shortages and consultants
00:08:09
to hire those people and then more consultants to, advise them on innovation.
00:08:17
So you basically have, patients pouring out of the VA system and money pouring
00:08:27
out of the VA system and that's not good.
00:08:30
Henri (2): the vast majority, I'd say, you know, what is it, at least like 99
00:08:34
percent of the doctors that you just referenced have no training with the VA.
00:08:39
they have no veteran care specific knowledge.
00:08:43
they're just normal practitioners.
00:08:46
Suzanne Gordon: Well, and it's not, it's doctors, nurses, physical therapists,
00:08:51
psychologists, and the, you know, veteran, veterans, as you know, because you are
00:08:56
one, Henri, have very specific health care conditions, whether it's mental
00:09:01
health, or, or physical health, right?
00:09:04
And you have to know about how to distinguish between the two.
00:09:08
You have to understand, about prostate cancer and diabetes
00:09:13
created by Agent Orange.
00:09:15
You have to be able to help veterans sign up for the registries
00:09:19
and sign up to get compensation.
00:09:22
These private sector clinicians know nothing about this stuff.
00:09:26
Most private sector mental health professionals are not trained to
00:09:29
treat PTSD at all, much less combat related or military related PTSD.
00:09:35
They don't know what military sexual trauma is.
00:09:38
They've never heard of it and they are not required.
00:09:43
In order to participate in the Veterans Community Care Program, Congress has not
00:09:47
required them to have any training in veteran specific health care conditions
00:09:53
and mental health conditions, military culture, or anything, that is required
00:09:58
of, intensely required of VA providers.
00:10:02
I mean, we just passed the PACT Act, which Jasper can talk more about,
00:10:06
which is giving care to people exposed to toxins since World War II, and VA
00:10:14
has, in anticipation of millions of veterans coming in who suffered these
00:10:20
exposures, done huge trainings, and VA providers and staff are required
00:10:27
to take these trainings, and they don't require these private sector
00:10:31
providers to take these trainings.
00:10:33
I mean, suicide prevention is another huge issue among veterans.
00:10:37
So the VA.
00:10:38
Every employee in the VA gets at least an hour of suicide prevention training.
00:10:44
Every employee, including, the receptionist, including the transport
00:10:48
worker, the dentist, whatever, not just mental health professionals, and they
00:10:53
get screened for suicide prevention.
00:10:55
This is not required in the private sector.
00:10:57
Well, because they don't really care about the quality of care, they just
00:11:01
care about the bucks leaving the VA because these laws were designed by
00:11:05
people who want to privatize the VA.
00:11:08
Henri (2): that was actually the PACT Act was the next thing I was going
00:11:11
to, ask about, Jasper, in terms of the PACT Act, since it got signed,
00:11:17
what has kind of been the status of his implementation, especially
00:11:21
considering the budgetary constraints that, Suzanne is talking about?
00:11:25
Jasper Craven: Yeah, well, there was initially a more, ambitious version of
00:11:30
the PACT Act on the table in Congress that would essentially allocate more
00:11:36
money for more conditions and, adequately, fund benefits for veterans sickened by
00:11:44
toxic exposures dating back decades.
00:11:48
you know, what passed was still a good bill.
00:11:50
there was a lot of money, allocated for this expanded, slate of, Sicknesses,
00:11:57
disabilities, however, there has not really been an adequate buildup in
00:12:04
staff within the Veterans Benefits Administration, and no real support
00:12:10
for this network of accredited claims agents who, are historically employed
00:12:17
by congressionally chartered veteran service organizations like the American
00:12:20
Legion or the VFW that help veterans navigate the morass of regulations
00:12:27
and paperwork to ensure that they're properly, sketching out, Their service
00:12:32
history and making strong claims to secure the right disability rating.
00:12:38
so the money's there and a lot of people have been helped.
00:12:41
I think the Biden administration does deserve some credit for moving pretty
00:12:47
quickly to, dole out a lot of money to veterans who've been waiting for a really
00:12:52
long time for the benefits owed them.
00:12:56
and, you know, that's involved in some cases cutting back on
00:13:00
all of the stringent rules and regulations for proving a disability.
00:13:06
but, as is so often the case in the world of veterans, many entities,
00:13:13
for profit entities, see dollar signs with all of this money.
00:13:17
And so, there's really emerged in the last few years, but especially so
00:13:24
since 2022, for profit, agents that are helping, or oftentimes not really
00:13:30
helping veterans get their benefits.
00:13:32
The Legion and the VFW simply do not have the number of accredited
00:13:36
claims agents to help the population.
00:13:40
It's this massive crush of new claims and these organizations have been in
00:13:45
decline for a while, their membership is declining, their revenues are declining,
00:13:49
the number of accredited agents that can connect to veterans through posts at
00:13:54
the local level is declining, accredited claims agents are accredited through
00:14:00
the VA's Office of General Counsel.
00:14:03
they face really intense oversight.
00:14:05
They're very well briefed on all the regulations.
00:14:08
They're, given, ongoing courses to ensure that they are
00:14:12
aware of changes in statutes.
00:14:15
and if they mess up, they can be punished.
00:14:17
They are the only people that are supposed to help veterans with their
00:14:20
claims, but there's sort of this weird loophole in the law that has allowed
00:14:25
these unaccredited players to step in and basically claim that they're not
00:14:31
helping process claims, they're just sort of like coaching in a generalized
00:14:35
sense, and so by asserting that, they say that they're not in violation of the
00:14:39
law, many veterans are submitting really weak claims because the people helping
00:14:46
them don't know what the hell they're talking about, and then, if the claim
00:14:49
does go through, these companies are taking a really big slice of the resulting
00:14:56
disability award, this is a multi billion dollar industry that has sort of popped
00:15:00
up overnight, and so, a lot of That money that was allocated through Congress for
00:15:06
veterans is being gobbled up by these for profit actors and not making it to the
00:15:13
veteran and their family to support them.
00:15:16
So, there really needs to be Legislation passed, to reel these guys
00:15:23
in, to reimpose criminal penalties over these unaccredited actors.
00:15:27
There's, some legislation floating around, but because these companies have taken
00:15:31
in so much money, they now have very savvy, lobbyists in Washington, they're
00:15:38
dropping hundreds of thousands of dollars to oppose these bills, and so the prospect
00:15:43
of reform at this point is not great.
00:15:47
Henri (2): Are there, do either of you know of any places That
00:15:50
kind of separate the wheat from the chaff, between companies that
00:15:54
genuinely help veterans in that way that are like, for example, I got.
00:15:59
Both my social security and my VA disability, my 100 percent
00:16:03
through also, and they worked with me for years and years.
00:16:07
They were very professional.
00:16:08
They, you know, and I did have to give them a portion of my back pay.
00:16:13
but, from the sounds of it is that these guys are, there is no comparison in
00:16:17
terms of doing what you do, you know, how they're describing coaching versus
00:16:22
actually being accredited, understanding the policies and not sending off.
00:16:27
Bullshit claims, wasting the time and the money of veterans who I'm sure
00:16:31
they're, they're, and the reason I ask is there's gotta be quite a few folks out
00:16:35
there that are just confused about it.
00:16:37
You know, if you're a 60 or 70-year-old veteran and you're trying to file a claim,
00:16:41
especially a claim based on stuff that happened way back when, and now you've
00:16:45
wasted this time and money on these folks that are not accredited, not supposed
00:16:50
to be doing what they're doing, but like you said, because of the loophole
00:16:53
of the law, that they can't be stopped.
00:16:56
Jasper Craven: Yeah, I mean, it's a really good question, and to be completely
00:17:00
honest, there is not a centralized repository, what every veteran should
00:17:07
do initially is connect with the local VSO if they can, even if they're not
00:17:12
a member, and see what the resources are, the free resources are for them.
00:17:18
oftentimes they will be able to be connected with a, accredited
00:17:22
agent through one of the VSOs.
00:17:24
The other.
00:17:25
The thing is that a lot of states, especially those with big
00:17:28
veterans populations, like Texas and California, have state VAs
00:17:33
essentially, and those VAs often employ accredited agents that can help.
00:17:41
So even if you're not a member of a VSO, you can get that help.
00:17:44
and you know, basically the rule of the road is that Veterans should not need
00:17:52
to pay anything for their initial claim.
00:17:55
Sometimes if a claim is denied, you go to an accredited lawyer and they charge
00:18:02
something and there's, you know, the rates are heavily regulated, but there
00:18:07
should hopefully be a path for most veterans still to find an accredited
00:18:11
agent Just really want to emphasize that veterans should do as much groundwork
00:18:18
as they can with their state veterans affairs office and with local VSOs.
00:18:26
because should be resources for them and, you know, I would really urge them not to
00:18:31
go with these for profit companies because there's no oversight and the results
00:18:37
are often, quite negative for veterans.
00:18:41
Henri (2): Thank you.
00:18:41
Thank you for that.
00:18:43
So, I wanted to touch on a different part of Project 2025, and this is something
00:18:50
that's been ongoing for years now in terms of the policy and trying to change it.
00:18:54
But the way that Project 2025 couches.
00:18:58
The idea of, benefits for transgender veterans and abortion services, that it
00:19:06
has become such An albatross around the neck of the VA in that way, that they're,
00:19:11
trying to provide all of these different services and that through just sheer
00:19:18
bullshit political means they have been able to, mess with the ability of veterans
00:19:23
to be able to get that kind of care.
00:19:25
And of course, that's not, that's not new for, the transgender veteran community
00:19:29
or for women veterans either in terms of care that things have always, you know,
00:19:34
that, that it's, Something that has slowly changed, but only has only gone so much.
00:19:38
And so, Suzanne, I'm, I'm wondering what your thoughts are on this.
00:19:42
do you think that the conversation is worth it?
00:19:46
Or do you think that the fight currently being had is worth it?
00:19:49
Or do you think it's just a lot of noise?
00:19:50
GMT20240730-174812_Recording_separate2: Mean the fight around abortion
00:19:52
and transgender, care?
00:19:54
Henri (2): pertaining to the VA,
00:19:55
Suzanne Gordon: Well, I think that what veterans have to consider is
00:20:00
that if you're a veteran who is, finds it appealing, That the Project
00:20:10
2025 folks are against abortion or against providing transgender care.
00:20:15
If you find that appealing, I would think again.
00:20:20
Because that is part of a much larger agenda and that is, if you don't need
00:20:29
an abortion or don't think you'll ever need one, and if you're not transgender
00:20:33
or if you're opposed to that, Your view is being distracted to focus on these
00:20:38
things that you don't agree with while, they're going to pick your pocket.
00:20:42
I mean, these people are like the pickpockets in David Copperfield,
00:20:46
you know, like they're, I
00:20:48
Suzanne Gordon (3): mean, Charles Dickens, for
00:20:49
Suzanne Gordon: those who don't know the reference, you know, they're very
00:20:52
well organized and they're going to pick your pocket while you're looking in a
00:20:57
direction and what the real threat is, you know, There's a tremendous threat
00:21:01
obviously for women who need abortions and also who need appropriate care if
00:21:07
they've had a miscarriage or whatever, you know, and can't get care because that
00:21:12
involves those kind of drugs and services.
00:21:16
But I think the real issue that folks need to think about is, what Project 2025 plans
00:21:24
for access to health care And compensation for service connected conditions, because
00:21:30
these people, don't want to give veterans, compensation or, service connected
00:21:38
disability ratings for many conditions that folks have, like, Wilkie and allied
00:21:45
himself with this guy, Daniel Gade, who's the head of the, Department of Veterans
00:21:49
Affairs for the state of Virginia.
00:21:51
And he wrote this book about, I can't remember what it's called.
00:21:55
I have to look it up, but I can do that in a minute.
00:21:58
But, it's called Wounding Warriors, How Bad Policy is Making Veterans Sicker
00:22:05
and Poorer, and so Wilkie and Gade and this whole, Project 2025 crew contend
00:22:12
that the VA, is infantilizing veterans by giving them all this comprehensive
00:22:17
care and, you know, that there really is no such thing as PTSD, and people
00:22:23
who have PTSD are really just having a bad morning, you know, and, you
00:22:26
know, And I mean, it's shocking.
00:22:29
people should read the book, because this is really what these
00:22:34
folks have in mind for veterans.
00:22:37
They really want to limit the kind of service connected disabilities
00:22:42
that are considered disabilities.
00:22:45
And they also want the VA, they don't want the VA to compensate for them.
00:22:50
And so this could cost veterans, you know, 000 a year.
00:22:55
So while you're worrying about the very few people who could get an
00:22:58
abortion, they're picking your pocket for 40, 000, and they're going to
00:23:03
prepare to take away your benefits.
00:23:05
They want to take away, health care services Because they want the VA to only
00:23:11
care for service related disabilities.
00:23:13
So what does that mean?
00:23:15
That means that Joe Smith, you know, in Iraq, got his arm amputated, And the
00:23:23
VA will take care of his amputated arm.
00:23:27
But if Joe Smith gets diabetes later in life, not because of a toxic exposure,
00:23:34
but just because he gets diabetes or has hypertension, they will not
00:23:38
take care of the hypertension, or diabetes, which could really affect
00:23:44
his amputated arm or leg or whatever.
00:23:47
this is where the VA was.
00:23:49
Free 1994.
00:23:51
You know, they would only take care of service connected disabilities, and
00:23:57
they wouldn't take care of any other problem that the veteran had, and the
00:24:02
reason why the VA is such an excellent healthcare system is that now it takes
00:24:06
care of everything, and these people don't want the VA to take care of everything.
00:24:12
They also want VA providers to meet, Department of Defense health care
00:24:18
system standards of productivity.
00:24:21
But, and this is very important for vets to understand, the Department of
00:24:26
Defense takes care of largely healthy people because you can't get in.
00:24:35
To the military, or you shouldn't be able to get in if you have a
00:24:37
whole bunch of health problems.
00:24:39
Now, and if you get these health problems, like an amputation,
00:24:43
they kick you out, right?
00:24:44
They medically discharge you.
00:24:46
So you're dealing with healthy people, largely.
00:24:52
The VA deals with people who have, you know, 6, 7, 30 presenting problems,
00:24:59
what we call comorbidities, right?
00:25:01
You know, I mean, you could talk about your own problems, Henri, you know, you
00:25:06
are not some 18 year old, they go into the military and they spit them out
00:25:11
with all kinds of problems and you don't even have to be in combat to have, you
00:25:16
know, back, neck and shoulder problems or PTSD or, traumatic brain injuries.
00:25:21
we're learning how just firing these weapons, repeatedly can
00:25:24
give you a traumatic brain injury.
00:25:27
I think that veterans really need to understand what's in store for them if
00:25:33
Trump is reelected, and that is they will have less access to health care.
00:25:37
They will not have access to comprehensive health care.
00:25:40
they may have no access to health care if certain kinds of service
00:25:45
connected, disabilities are, wiped out.
00:25:50
They won't get compensated.
00:25:52
It's going to be a disaster.
00:25:54
not to mention if there are veterans who work at the VA I mean, Trump views them as
00:26:00
sadists and cruel and, out to get veterans as opposed to out to help veterans.
00:26:05
he's the one who's out to get the veterans and the folks in the VA
00:26:09
are the ones who want to help them.
00:26:11
You mentioned about pre 1994, the VA and the idea of them, you know, slivering down
00:26:18
exactly what kind of a benefit somebody could get I was so thankful when I got
00:26:23
out of the military that my initial rating was 50%, and by that, that meant
00:26:28
that all my care could come from the va.
00:26:31
Henri (2): And so if, if all my care, if I'm so injured,
00:26:35
and again, it's only at 50%.
00:26:37
so there are lots and lots of folks that never, that don't ever make it to
00:26:41
a hundred percent, but still need all of that care and they need whole healthcare.
00:26:46
It can't be something where, like you said about an amputee that we're not
00:26:50
dealing with these other things that are common conditions that might come
00:26:53
with that, or even just general quality of life, helping somebody maintain a
00:26:59
certain living standard when it comes to it health wise and making it that
00:27:03
much more difficult like going back to where we started from this is that,
00:27:06
you know, like women veterans deserve to be able to have all of their.
00:27:11
Obgyn care and anything that they need for that, potentially, including
00:27:14
abortion services to be included.
00:27:17
That would all be part of whole health.
00:27:19
The idea that they would disinclude it just seems farcical
00:27:23
and horrifying on its face.
00:27:27
Suzanne Gordon: Well, I think that, over the past, since 1945, particularly
00:27:33
46, the American public has.
00:27:36
Invested billions and billions of dollars into creating a comprehensive
00:27:41
health care system for veterans, and it delivers stellar health outcomes,
00:27:46
it is really, it's not just a medical system, it's a health care system, so
00:27:51
veterans get help with homelessness, with legal problems, and housing with
00:27:57
economic problems, with vocational rehabilitation, cooking classes,
00:28:02
meditation, you name it, the VA offers it.
00:28:05
Now, you may have to drive to get to those services, but if you
00:28:10
live in rural America, you have to drive to get any service, you know.
00:28:15
And the VA is willing to do telehealth and if you don't have a laptop or an iPad
00:28:23
or an iPhone, they'll give you a laptop or an iPhone so you can do telehealth.
00:28:28
And so I just think it's tragic that, veterans don't appreciate
00:28:34
what the taxpayer has done for them.
00:28:38
People don't understand that the VA cannot run a insurance company where
00:28:45
they pay for exorbitant costs from the private sector or care that is not veteran
00:28:52
centric and often of lower quality.
00:28:55
Veterans need to really make a choice and somebody needs to tell them that
00:29:01
America will not pay for two separate healthcare systems for its veterans.
00:29:06
It's too much.
00:29:07
It's a bad business model.
00:29:09
There is no choice.
00:29:11
Health care system in the world or in the country, where if you go out of
00:29:15
network, that somebody else pays for it.
00:29:18
And I think really what veterans need to understand and somebody needs to have
00:29:23
the courage to say to them is you've got this great health care system.
00:29:29
If you want it to be better, if you want it to provide more care in more
00:29:33
places, then stop stealing money from it to give it to somebody else who
00:29:39
doesn't know how to care for you and doesn't really care about you, you know.
00:29:43
And I mean, we're now giving 36 billion, you know, the 36
00:29:49
billion is only clinical care.
00:29:50
We're paying these Third party insurance companies, TriWest and Optum, they're
00:29:55
getting, I don't know how much it is now, Jasper, almost 200 billion
00:29:59
dollars to administer this system.
00:30:02
Imagine what you could do with close to 500 billion dollars If the VA got
00:30:09
it and not the private sector, and who is going to say that to veterans?
00:30:14
I hope at some point, Kamala Harris, if she wins, says that to veterans.
00:30:18
I hope that VSOs and groups like the one we belong to, Veterans Health Care
00:30:23
Policy Institute, say this if we get new Democrats in office, because they've
00:30:28
been continuing the privatization policies in sort of a privatization
00:30:33
light form that Trump and others.
00:30:37
in the conservative movement have, initiated.
00:30:40
Henri (2): You know, just like with the DOD budget, it's not about the expenditure
00:30:46
of hundreds of billions of dollars.
00:30:47
It's where it ultimately ends up going.
00:30:50
I mean, because they'll spend it.
00:30:51
Robert Wilkie, Donald Trump, all those are perfectly happy
00:30:55
to spend the money, but where it actually ultimately ends up going.
00:31:00
it really makes it a different question.
00:31:02
so I think, it's a good time to wrap up our discussion for today.
00:31:06
was there anything that you either you guys wanted to jump
00:31:08
in on before we, sign off?
00:31:11
Suzanne Gordon: I think we covered a lot of the sort of most pressing topics here.
00:31:16
really when it comes down to it, and this is a point I, will scream until the cows
00:31:20
come home, what is happening right now and what has been happening over the last
00:31:25
decade since the Choice Act was passed is the buildup of intense corporate power
00:31:31
Over the Department of Veterans Affairs.
00:31:33
It's a similar phenomenon to the military industrial complex.
00:31:36
And for many decades, the VA was sort of immune to those trends for
00:31:40
a number of reasons, including the fact that the VSOs were some of the
00:31:45
most powerful forces on Capitol Hill.
00:31:48
But since they are on the decline, all of these Corporate and ideological actors
00:31:54
are coming out of the woodwork and they are attempting to profit in massive ways
00:31:59
from the VA budget and also to basically shift attention away from all of the good
00:32:05
that the VA does because the truth of the matter is, is that The VA system is
00:32:11
the one that should be expanded out into the civilian sector, rather than having
00:32:19
this incredibly flawed private system creep into the VA and disrupt what is
00:32:24
the best healthcare system in America.
00:32:27
And so, you know, the stakes are very
00:32:30
Oh, Jasper, you, you kind of disappeared entirely.
00:32:36
I did.
00:32:37
You disappeared at stakes.
00:32:40
Maybe you should finish my sentence, Suzanne, because we're so simpatico.
00:32:46
Yeah, I'm I mean, I was just gonna say that the stakes are incredibly high.
00:32:50
The stakes are about not only the future of veterans health care, but of health
00:32:55
care reform at large in this country.
00:32:59
yeah, and, and I, I think, I'm really glad Jasper brought that up because,
00:33:04
you know, I think the VA touches on larger issues, and the, the threats to
00:33:09
the VA, both ideological and corporate.
00:33:13
Exists because American capitalism doesn't want a government
00:33:18
health program that works.
00:33:20
And so we have this amazing health system that could be a model for
00:33:26
the kind of health care that all of us should get that, that many
00:33:29
people get in other countries.
00:33:31
And it's really a superior model.
00:33:34
And so I think that This issue of saving the VA, expanding the VA, improving the
00:33:40
VA, is not just about helping veterans, but about how the VA serves the nation
00:33:46
and allowing it to continue to serve the nation through its teaching,
00:33:50
research, and emergency preparedness missions, but also how it can serve
00:33:55
the nation by being a model for health care reform activists For Who, want
00:34:00
to give, promote models of government run healthcare systems that work.
00:34:05
And you don't have to go to Taiwan or Scandinavia or Canada to find
00:34:11
a healthcare system that works.
00:34:13
It's around the corner.
00:34:14
And the reason why so many ideological ag are, are attacking it.
00:34:21
It's not just because they can get public money for private, to
00:34:25
serve private profit, but because they don't want a competition.
00:34:31
You know, Secretary McDonough is always into this neoliberal idea of
00:34:36
competition, but American capitalism doesn't want to compete with a government
00:34:44
run system and lose, which it is doing.
00:34:46
And so they prefer to destroy the government run system that
00:34:52
has won the Super Bowl, the World Cup, the, World Series, etc.
00:34:57
And, you know, veterans have a winner and they should stick with the winner and
00:35:01
they should be going to their political representatives to get them To fund the
00:35:09
winner even, you know, more efficiently and effectively than is happening now.
00:35:15
So, I think, you know, Jasper and I, being simpatico, we agree that, the
00:35:21
stakes are not just for veterans and their families and their communities,
00:35:25
but for the entire country.
00:35:28
Henri (2): thank you.
00:35:28
Thank you both for laying that out so well.
00:35:31
it's something I think that everybody, you know, that.
00:35:34
The many veterans I know that listen to this podcast I hope all of us take
00:35:37
that stuff to heart to understand that we are, for lack of a better phrase,
00:35:42
soldiers in this fight, if we want, the VA to stay strong, to continue serving
00:35:47
veterans in the way that it does, we have to advocate for ourselves and say those
00:35:51
kinds of things to our representatives
00:35:55
I know that I'm going to be.
00:35:56
Cared For Better, and that it's going to fit into a system of overall care
00:36:00
where my doctors do actually talk to each other, Suzanne Jasper, thank you
00:36:05
so much for being here today, folks makes sure that you go online and visit
00:36:10
the Veterans Health Policy Institute.
00:36:12
They have a lot of policy papers and resources on a whole host of different
00:36:18
VHA related topics and also on some other.
00:36:22
Health topics, not specific to the VHA, but it's all good stuff.
00:36:25
Suzanne, what is, the website for the PHBI?
00:36:28
Suzanne Gordon: It's veteranspolicy.
00:36:30
org.
00:36:31
And please consider signing up for its newsletter if you want
00:36:35
to keep up with, what's going on in the veterans healthcare world.
00:36:39
Thank you.
00:36:40
Henri (2): Absolutely.
00:36:42
And, thank you to everybody for joining us today here on Fortress On A Hill.
00:36:46
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00:36:47
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