Trump administration continues to tear down the VA

His main goal is faster privatization of the nation’s largest public healthcare system.

Steve Early and Suzanne Gordon for Common Dreams

If any Trump appointees lose their posts, as part of a midterm cabinet reshuffling, Secretary of Veterans Affairs Doug Collins is not likely to be among them.

Unlike controversial former colleagues, already sacked as the heads of the Homeland Security, Justice, and Labor Departments—or Pete Hegseth, the next to go?—Collins keeps his own head down. He does the president’s bidding, without personal drama or political scandal.

This low-profile Air Force Reserve chaplain is a clean-living Southern Baptist minister, small-town lawyer, and former congressman from Georgia. When the Senate confirmed him last year, there was no need for a tie-breaking vote like the one JD Vance cast to push Pete across the finish line as secretary of defense.

VA defenders, inside and outside the Beltway, need a damage control agenda that will restrain—rather than enable—further White House attempts to defund and dismantle our best working model of socialized medicine.

The far more affable Collins won Senate approval with the bipartisan support of 22 Democrats! They included Richard Blumenthal (D-Conn.), a military veteran whose own son is a VA patient and, sadly, were joined by Bernie Sanders (I-Vt.), former chair of the Senate Veterans Affairs Committee (SVAC).

Expanded Outsourcing

Collins has proved to be Donald Trump’s worst VA Secretary ever; his main goal is faster privatization of the nation’s largest public healthcare system. The likelihood that he will control the third largest federal agency budget and second largest departmental workforce, for another two years, is not good news for 9 million VA patients.

By the time any Democrat replaces Trump in January, 2029, Collins will have diverted far more than $46 billion annually from the VA’s direct-care budget to a network of 1.7 million private sector providers and four healthcare companies who administer it.

Just two months ago, he awarded new contracts to the latter worth $1 trillion, over the next decade (if not cancelled or curtailed by a future administration). As a result, industry giants like United Healthcare and Humana will be profiting from further outsourcing of VA care that is costly, unnecessary, and not favored by veterans themselves.

VA defenders, inside and outside the Beltway, need a damage control agenda that will restrain—rather than enable—further White House attempts to defund and dismantle our best working model of socialized medicine. Otherwise, more VA staffing and budget cuts, plus facility closings, in the VA’s own system of 1,380 public hospitals and clinics around the country will be happening soon.

Reinforcements on the Way

Those most motivated to lead the charge against Secretary Collins on Capitol Hill in 2027 are newly elected pro-labor progressives, with personal experience in public healthcare systems, either as patients, their family members, caregivers, or administrators

Thanks to their successful campaigns against MAGA supporters, these VA defenders now include: former Army paratrooper Richard Ojeda in North Carolina; former Marine drill instructor JoAnna Mendoza in Arizona who has been treated for military sexual trauma at the VA; former Army surgeon Adam Hamaway, a Gaza war critic from New Jersey, who once operated on a helicopter pilot injured in Iraq named Tammy Duckworth, now Senator from Illinois; and Fred Wellman from Missouri, a West Point graduate who began rallying fellow vets against Trump six years ago through the Lincoln Project.

Last but not least is VA privatization critic Mitch Berman, “who spent over a decade serving veterans, active duty service members, and their families as a VA nurse”—and now represents conservative Republican Paul Ryan’s old district in Wisconsin. Any of the above could help energize a House Veterans Affairs Committee, where playing footsie with Collins (and his Biden administration predecessor) has gone on for too long, to the detriment of real agency oversight.

On the SVAC, the Democrats’ defense of our nation’s largest public healthcare system would be much improved by adding new Senators from either Michigan, Maine, and Iowa. Dr. Abdul El-Sayed, the just elected Michigan public health specialist and Medicare for All advocate, would be following in the footsteps of his big financial backer, Sen. Bernie Sanders.

Or El-Sayed could be joined by Troy Jackson, the former logger who ousted five-term Senator Susan Collins with Sanders’ support; as a state legislator, Jackson long championed the cause of Maine National Guard members who suffered Agent Orange exposure during their Vietnam-era training but were later deemed ineligible for compensation and healthcare.

In Iowa, its newly elected Sen. Josh Turek is not only the son of a Vietnam veteran but one who suffered birth defects due to his father’s Agent Orange exposure. As a wheelchair athlete, Turek played alongside disabled vets and worked with them in sports rehabilitation programs. He has pledged to “end unnecessary wars that put American lives at risk” and insure that “veterans exposed to toxic substances during their military service get the care and benefits they need.”

Ready, Fire, Aim

A recent report from Democracy Forward—by two former VA officials—provides plenty of ammo for new members of Congress to use in a long-overdue counteroffensive against Collins. As Josh Jacobs, a former VA undersecretary under former President Joe Biden, and Nicole Nedd, a past director of the agency’s national workforce management program, report:

The VA has lost approximately 30,000 employees through attrition, early retirements, deferred resignations, firings, and other departures. These staff had institutional knowledge and skills that cannot be quickly replaced. The staff who remain are bearing an unsustainable burden. Morale has deteriorated, and there is growing evidence that employees feel unable to raise safety concerns without fear of retaliation—a condition linked to more errors and worse patient outcomes.

In their indictment of Collins, entitled “Ready, Fire, Aim,” the authors warn that “the choices being made now by the Trump-Vance administration—at the White House and within VA’s own leadership—will adversely shape veterans’ care for a generation.”

Road Map for Fighting Back

Nobody new or old inside the Beltway—whether in Congress or veterans’ advocacy organizations—will get much done by themselves, without the pressure of grassroots opposition to cuts in VA care and benefits.

Paul Reickhoff, an Iraq War veteran who helped found Iraq and Afghanistan Veterans of America (IAVA) two decades ago, believes that “both parties are looking for quiet ways to control VA disability spending, which now tops $118 billion a year for 5.1 million disabled veterans.”

This fall, Reickhoff’s new group, Independent Veterans of America (IVA), backed candidates like Navy Veteran and former National Guard member Dan Osborn, who distanced themselves from both major parties. Unfortunately, Osborn suffered a second narrow defeat running as a labor-backed independent candidate for the US Senate from Nebraska.

Reickhoff fears that “career political operatives” in Washington are still floating “budget options” which include “cutting benefits and raising minimum disability rating thresholds.” To stop these changes, veterans have to “build the media and organizing muscle to mobilize fast when veterans’ benefits are on the line.”

Fortunately, veterans’ groups, across the political spectrum, had a major victory earlier this year when they blocked the misleadingly named “Take Care of America’s Veterans Act” (TACVA). Veterans Service Organizations (VSOs) like the Veterans of Foreign Wars, Disabled American Veterans, and Progressive Veterans of America all sounded the alarm about this Collins-backed bill pushed by Republican House Speaker Mike Johnson (La.).

TACVA would have helped 50,000 former service members—whose careers were cut short due to medical problems—collect both their military pensions and VA disability benefits. But, as Common Defense political director Naveed Shah warned last summer, this multi-part bill was heavily booby trapped. If enacted, hundreds of thousands of other veterans would have been adversely affected.

According to Shah, an Army veteran who served in Iraq, it would have “cut $57 billion from our future tinnitus and sleep apnea claims, tripled the VA home loan fee, allow disability appeals to be decided in bulk rather than on the merits of each veteran’s record, enable more layoffs that threaten the quality of VA care, and lay the groundwork for handing VA facilities over to private operators.” (Lame-duck Republicans may make a second attempt to pass TACVA, in similarly problematic form, before January.)

Grassroots Defense of VA Care

Veterans for Peace (VFP) has long been the most reliable first responder whenever veterans’ care has been threatened. VFP’s “Save Our VA” campaign has generated thousands of letters to members of Congress about privatization-related problems, too often downplayed or ignored by VSOs which take healthcare industry donations. VFP members have personally lobbied many members of Congress or their staffers on VA issues.

A newer Common Defense campaign—called “VA Not For Sale”—has sponsored VA-focused lobby days in DC and town hall meetings in Iowa, Wisconsin, Illinois, and other states. CD and the Veterans Healthcare Policy Institute (VHPI) also collaborated on a just-issued report called “The Privatization Playbook,” which documents the whole sorry history of bipartisan support for costly and unnecessary VA outsourcing since 2014.

In California, members of the Vietnam Veterans of America (VVA) and VFP have joined forces with active and retired VA caregivers to conduct weekly anti-privatization pickets and rallies at their local facility in Sonoma County.

Next year, there should be hundreds of events like this, in far more locations around the country. And, before it’s too late, more protests should target the costly and defective overhaul of VA medical recordkeeping hat’s occurring on Collins’ watch.

Stopping Oracle’s Roll Out!

As Ace Allen, a now retired VA medical oncologist, warned last spring in The Kansas City Star, in every place where the VA’s existing system has been “modernized” by Oracle-Cerner, the result has been serious disruption of patient record handling and widespread demoralization among VA caregivers forced to use an inferior system. As a result, “huge numbers have quit or retired early.”

During the president’s first term, Trump’s son-in-law Jared Kushner helped Oracle-Cerner get a no-bid contract to replace what Allen calls a “custom built, publicly owned electronic health record (EHR) system that was refined over decades by VA clinician-coder teams to support clinical care, not maximize revenue.”

A contract originally estimated to cost $10 billion has now ballooned to $32 billion in the same “cost-over-run” fashion as infamous Pentagon projects like the F-35 Joint Strike Fighter. That’s why Steve Friday, an Air Force veteran, VFP member, and former VA social worker in Michigan, is helping to rally foes of Oracle-Cerner around the country through StopTheRollout.org.

According to Friday, this grassroots initiative “brings together clinicians, VA employees, veterans, advocates, union members, and others who understand what is happening and are willing to act.” They are scouring contracting records; publicizing inspector general and GAO reports on Oracle-Cerner system failures; and sharing whistleblower information, from patients and providers, with members of Congress willing to hold Collins responsible for already occurring patient safety threats.

As Friday explains his involvement—and the stakes for everyone—“the VA, for all its problems, still demonstrates that we can publicly fund and deliver healthcare rather than turning every patient into a source of profit. Losing that,” he says, “would hurt veterans, workers, and the larger struggle for healthcare as a human right.” Thanks to last week’s midterm election results, this caregiver perspective will soon be much better reflected on Capitol Hill.

Steve Early lives in Richmond and belongs to its ten-year-old Progressive Alliance. He is the co-author with Suzanne Gordon of Courage or Complicity? How Veterans are Responding to the Assault on Democracy. (PM Press) They can be reached at Lsupport@aol.com.

Suzanne Gordon is a co-author with Steven Early of Courage or Complicity? How Veterans are Responding to the Assault on Democracy. (PM Press) and Our Veterans: Winners, Losers, Friends and Enemies on the New Terrain of Veterans Affairs.