VA prizatization update w/ Suzanne Gordon and Jasper Craven - Ep 159

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This is Fortress On A Hill, with Henri, Danny, Kaygan,

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Jo vonni, Shiloh, and Monisha

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Henri (2): welcome everyone to Fortress On A Hill, a podcast about U.

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S.

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foreign policy, anti imperialism, skepticism, and the American way of war.

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I'm Henri.

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Thank you for being with us here today.

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We are here to talk to Suzanne Gordon and Jasper Craven.

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of the Veterans Health Care Policy Institute to talk about a whole

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bunch about what's happening in VA policy right now, VHA mostly.

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gonna talk about privatization.

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We're gonna talk about the huge differences and actually could be seen

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as even more negatives between The predecessor, VA Secretary, Robert Wilkie,

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and the current one, Dennis McDonough.

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Did I say that right?

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McDonough?

Suzanne Gordon: 00:01:15

Yes, McDonough.

Suzanne Gordon: 00:01:16

Henri (2): So, Jasper, Suzanne, welcome to Fortress On A Hill.

Suzanne Gordon: 00:01:18

How are you both doing this morning?

Suzanne Gordon: 00:01:21

We're good.

Jasper Craven: 00:01:23

Yes.

Jasper Craven: 00:01:25

Henri (2): So, the impetus for this discussion was, going through some things

Jasper Craven: 00:01:28

about project 2025 and specifically the, policy changes that it touches on.

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it's important to remember, that Project 2025 is a version of something

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that not only the Heritage Foundation, but lots of other private think tanks

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have been doing for a long time.

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The Heritage Foundation, specifically, since 1980, is

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a right leaning institution.

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not all of its recommendations are adopted or even seriously considered,

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but what we're going to discuss today is some of the most important

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aspects that are touched on by Project 2025 as we see them, along with a

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few foreign policy aspects as well.

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So, Suzanne.

Jasper Craven: 00:02:09

Let's start by talking a bit about privatization.

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can you tell us, what's your take on the current staffing shortages that the

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VHA is trying to deal with right now?

Jasper Craven: 00:02:22

and, tell us about the 23 billion opportunity up for grabs, please.

Suzanne Gordon: 00:02:27

Well, I think that, right now, and Jasper can

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really come in and help on this.

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The basic privatization picture is that in 2014, they passed something called

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the Veterans Choice and Accountability Act, which began outsourcing

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veteran care to the private sector.

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based on whether you had to wait a certain amount of time for an

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appointment at the VA or drive a certain amount of miles to reach a VA.

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And that was supposed to be a temporary program.

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It was supposed to give the VA money, unfortunately not enough money.

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The VA needed 21 billion to deal with staffing and other issues and

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the TRACE Act gave it 6 billion.

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So that means.

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That it needed, you know, another, how many billion, God, I can't add, I

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can't, I'm, you know, Jasper, help me.

Jasper Craven: 00:03:29

14, roughly.

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so it, you know, if you're looking at this as a shell game, you know,

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they keep forgetting that they needed 14 more billion than they

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got, and this was supposed to be a law that sunsetted after 3 years.

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And it was supposed to be temporary.

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And basically it was a compromise between Bernie Sanders and John McCain.

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And John McCain almost immediately said, Oh, you know, I was actually wasn't

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being serious about it being temporary.

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And then when Trump came in, They not only made it permanent, this option of

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going to the private sector, but they made, put it on steroids and they created

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this Veterans Community Care Program, which essentially allowed veterans

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to go to private sector providers through a separate VA set up called

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the Veterans Community Care Program.

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And Trump's VA secretary, Robert Wilkie, created eligibility standards

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for this program, this Veterans Community Care Program, that guaranteed

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a huge amount of outsourcing.

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So, any vet who had to wait more than 20 days or drive more than 30 minutes to a

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primary care mental health appointment could go to the private sector.

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And any vet who had to wait more than 28 days.

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drive more than 60 minutes could go to the private sector

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for a specialty appointment.

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So, I mean, just think about your own experience.

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how long do you have to wait in the private sector for

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a primary care appointment?

Jasper Craven: 00:05:11

Well, I mean, how can you even find a private primary care

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provider in the private sectors?

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PrEP sector, much less get an appointment with them.

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How long does it take to get a dermatology appointment?

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I mean, I just had a little spot on my cheek.

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I tried to get my dermatologist to look at and it's like a four

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month wait in the private sector.

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So basically, rather than, I mean, it would have been VA had taking a

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look at each particular healthcare market and said, okay, we're going

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to see what the wait times are in the private sector and, and, and we're

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going to match those or even best them.

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I mean, even if you could get a dermatology appointment in 3

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months, as opposed to 4 months or 8 months or whatever, but no, they

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set these very unrealistic wait time and drive time standards.

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And that guaranteed that, you know, now, it's something like 40 percent of

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VA care is given in the private sector.

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I think it's, something like they have 1.

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7 million providers that they're supposed to oversee.

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And here's the other thing that is really extraordinary is not only is the

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VA supposed to pay for these people to go to the private sector, it's supposed

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to coordinate the care that the private sector delivers, even though there's

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no requirements that the private sector coordinate care with the VA.

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and so it's a kind of a nightmare.

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you have to get medical records back.

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and there's something like 12 million appointments or something.

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So imagine getting records back for 12 million appointments, and coordinating 1.

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7 million providers and so forth.

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it's A logistical nightmare and the VA, of course, fails because it's

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supposed to be both an insurance company paying for care and a health

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care system that, provides care.

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And so what we're seeing is that there's not enough money to hire staff.

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They have now a 15 billion budget shortfall.

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there's, not enough money.

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Congress isn't giving them enough money to hire.

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rebuild their infrastructure, renovate.

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So even if they had the money to hire staff, they need something like 20, 000.

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we don't even know how many people they actually need to deal

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with the demand that they have.

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And all this money, 30 percent of their clinical care budget,

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over 30 percent is going out of the VA to pay for private care.

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And then as you asked, Henry, the VA Secretary and his Undersecretary for

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Health, Sharif El Nahal, have come up with schemes to spend something like 23

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billion in 10 years and, 14 billion in 10 years to get, higher contract rates.

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workers to come in and deal with staffing shortages and consultants

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to hire those people and then more consultants to, advise them on innovation.

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So you basically have, patients pouring out of the VA system and money pouring

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out of the VA system and that's not good.

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Henri (2): the vast majority, I'd say, you know, what is it, at least like 99

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percent of the doctors that you just referenced have no training with the VA.

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they have no veteran care specific knowledge.

Jasper Craven: 00:08:43

they're just normal practitioners.

Suzanne Gordon: 00:08:46

Well, and it's not, it's doctors, nurses, physical therapists,

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psychologists, and the, you know, veteran, veterans, as you know, because you are

Suzanne Gordon: 00:08:56

one, Henri, have very specific health care conditions, whether it's mental

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health, or, or physical health, right?

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And you have to know about how to distinguish between the two.

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You have to understand, about prostate cancer and diabetes

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created by Agent Orange.

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You have to be able to help veterans sign up for the registries

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and sign up to get compensation.

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These private sector clinicians know nothing about this stuff.

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Most private sector mental health professionals are not trained to

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treat PTSD at all, much less combat related or military related PTSD.

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They don't know what military sexual trauma is.

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They've never heard of it and they are not required.

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In order to participate in the Veterans Community Care Program, Congress has not

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required them to have any training in veteran specific health care conditions

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and mental health conditions, military culture, or anything, that is required

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of, intensely required of VA providers.

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I mean, we just passed the PACT Act, which Jasper can talk more about,

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which is giving care to people exposed to toxins since World War II, and VA

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has, in anticipation of millions of veterans coming in who suffered these

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exposures, done huge trainings, and VA providers and staff are required

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to take these trainings, and they don't require these private sector

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providers to take these trainings.

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I mean, suicide prevention is another huge issue among veterans.

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So the VA.

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Every employee in the VA gets at least an hour of suicide prevention training.

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Every employee, including, the receptionist, including the transport

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worker, the dentist, whatever, not just mental health professionals, and they

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get screened for suicide prevention.

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This is not required in the private sector.

Suzanne Gordon: 00:10:57

Well, because they don't really care about the quality of care, they just

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care about the bucks leaving the VA because these laws were designed by

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people who want to privatize the VA.

Suzanne Gordon: 00:11:08

Henri (2): that was actually the PACT Act was the next thing I was going

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to, ask about, Jasper, in terms of the PACT Act, since it got signed,

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what has kind of been the status of his implementation, especially

Suzanne Gordon: 00:11:21

considering the budgetary constraints that, Suzanne is talking about?

Jasper Craven: 00:11:25

Yeah, well, there was initially a more, ambitious version of

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the PACT Act on the table in Congress that would essentially allocate more

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money for more conditions and, adequately, fund benefits for veterans sickened by

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toxic exposures dating back decades.

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you know, what passed was still a good bill.

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there was a lot of money, allocated for this expanded, slate of, Sicknesses,

Jasper Craven: 00:11:57

disabilities, however, there has not really been an adequate buildup in

Jasper Craven: 00:12:04

staff within the Veterans Benefits Administration, and no real support

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for this network of accredited claims agents who, are historically employed

Jasper Craven: 00:12:17

by congressionally chartered veteran service organizations like the American

Jasper Craven: 00:12:20

Legion or the VFW that help veterans navigate the morass of regulations

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and paperwork to ensure that they're properly, sketching out, Their service

Jasper Craven: 00:12:32

history and making strong claims to secure the right disability rating.

Jasper Craven: 00:12:38

so the money's there and a lot of people have been helped.

Jasper Craven: 00:12:41

I think the Biden administration does deserve some credit for moving pretty

Jasper Craven: 00:12:47

quickly to, dole out a lot of money to veterans who've been waiting for a really

Jasper Craven: 00:12:52

long time for the benefits owed them.

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and, you know, that's involved in some cases cutting back on

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all of the stringent rules and regulations for proving a disability.

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but, as is so often the case in the world of veterans, many entities,

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for profit entities, see dollar signs with all of this money.

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And so, there's really emerged in the last few years, but especially so

Jasper Craven: 00:13:24

since 2022, for profit, agents that are helping, or oftentimes not really

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helping veterans get their benefits.

Jasper Craven: 00:13:32

The Legion and the VFW simply do not have the number of accredited

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claims agents to help the population.

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It's this massive crush of new claims and these organizations have been in

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decline for a while, their membership is declining, their revenues are declining,

Jasper Craven: 00:13:49

the number of accredited agents that can connect to veterans through posts at

Jasper Craven: 00:13:54

the local level is declining, accredited claims agents are accredited through

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the VA's Office of General Counsel.

Jasper Craven: 00:14:03

they face really intense oversight.

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They're very well briefed on all the regulations.

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They're, given, ongoing courses to ensure that they are

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aware of changes in statutes.

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and if they mess up, they can be punished.

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They are the only people that are supposed to help veterans with their

Jasper Craven: 00:14:20

claims, but there's sort of this weird loophole in the law that has allowed

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these unaccredited players to step in and basically claim that they're not

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helping process claims, they're just sort of like coaching in a generalized

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sense, and so by asserting that, they say that they're not in violation of the

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law, many veterans are submitting really weak claims because the people helping

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them don't know what the hell they're talking about, and then, if the claim

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does go through, these companies are taking a really big slice of the resulting

Jasper Craven: 00:14:56

disability award, this is a multi billion dollar industry that has sort of popped

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up overnight, and so, a lot of That money that was allocated through Congress for

Jasper Craven: 00:15:06

veterans is being gobbled up by these for profit actors and not making it to the

Jasper Craven: 00:15:13

veteran and their family to support them.

Jasper Craven: 00:15:16

So, there really needs to be Legislation passed, to reel these guys

Jasper Craven: 00:15:23

in, to reimpose criminal penalties over these unaccredited actors.

Jasper Craven: 00:15:27

There's, some legislation floating around, but because these companies have taken

Jasper Craven: 00:15:31

in so much money, they now have very savvy, lobbyists in Washington, they're

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dropping hundreds of thousands of dollars to oppose these bills, and so the prospect

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of reform at this point is not great.

Jasper Craven: 00:15:47

Henri (2): Are there, do either of you know of any places That

Jasper Craven: 00:15:50

kind of separate the wheat from the chaff, between companies that

Jasper Craven: 00:15:54

genuinely help veterans in that way that are like, for example, I got.

Jasper Craven: 00:15:59

Both my social security and my VA disability, my 100 percent

Jasper Craven: 00:16:03

through also, and they worked with me for years and years.

Jasper Craven: 00:16:07

They were very professional.

Jasper Craven: 00:16:08

They, you know, and I did have to give them a portion of my back pay.

Jasper Craven: 00:16:13

but, from the sounds of it is that these guys are, there is no comparison in

Jasper Craven: 00:16:17

terms of doing what you do, you know, how they're describing coaching versus

Jasper Craven: 00:16:22

actually being accredited, understanding the policies and not sending off.

Jasper Craven: 00:16:27

Bullshit claims, wasting the time and the money of veterans who I'm sure

Jasper Craven: 00:16:31

they're, they're, and the reason I ask is there's gotta be quite a few folks out

Jasper Craven: 00:16:35

there that are just confused about it.

Jasper Craven: 00:16:37

You know, if you're a 60 or 70-year-old veteran and you're trying to file a claim,

Jasper Craven: 00:16:41

especially a claim based on stuff that happened way back when, and now you've

Jasper Craven: 00:16:45

wasted this time and money on these folks that are not accredited, not supposed

Jasper Craven: 00:16:50

to be doing what they're doing, but like you said, because of the loophole

Jasper Craven: 00:16:53

of the law, that they can't be stopped.

Jasper Craven: 00:16:56

Yeah, I mean, it's a really good question, and to be completely

Jasper Craven: 00:17:00

honest, there is not a centralized repository, what every veteran should

Jasper Craven: 00:17:07

do initially is connect with the local VSO if they can, even if they're not

Jasper Craven: 00:17:12

a member, and see what the resources are, the free resources are for them.

Jasper Craven: 00:17:18

oftentimes they will be able to be connected with a, accredited

Jasper Craven: 00:17:22

agent through one of the VSOs.

Jasper Craven: 00:17:24

The other.

Jasper Craven: 00:17:25

The thing is that a lot of states, especially those with big

Jasper Craven: 00:17:28

veterans populations, like Texas and California, have state VAs

Jasper Craven: 00:17:33

essentially, and those VAs often employ accredited agents that can help.

Jasper Craven: 00:17:41

So even if you're not a member of a VSO, you can get that help.

Jasper Craven: 00:17:44

and you know, basically the rule of the road is that Veterans should not need

Jasper Craven: 00:17:52

to pay anything for their initial claim.

Jasper Craven: 00:17:55

Sometimes if a claim is denied, you go to an accredited lawyer and they charge

Jasper Craven: 00:18:02

something and there's, you know, the rates are heavily regulated, but there

Jasper Craven: 00:18:07

should hopefully be a path for most veterans still to find an accredited

Jasper Craven: 00:18:11

agent Just really want to emphasize that veterans should do as much groundwork

Jasper Craven: 00:18:18

as they can with their state veterans affairs office and with local VSOs.

Jasper Craven: 00:18:26

because should be resources for them and, you know, I would really urge them not to

Jasper Craven: 00:18:31

go with these for profit companies because there's no oversight and the results

Jasper Craven: 00:18:37

are often, quite negative for veterans.

Jasper Craven: 00:18:41

Henri (2): Thank you.

Jasper Craven: 00:18:41

Thank you for that.

Jasper Craven: 00:18:43

So, I wanted to touch on a different part of Project 2025, and this is something

Jasper Craven: 00:18:50

that's been ongoing for years now in terms of the policy and trying to change it.

Jasper Craven: 00:18:54

But the way that Project 2025 couches.

Jasper Craven: 00:18:58

The idea of, benefits for transgender veterans and abortion services, that it

Jasper Craven: 00:19:06

has become such An albatross around the neck of the VA in that way, that they're,

Jasper Craven: 00:19:11

trying to provide all of these different services and that through just sheer

Jasper Craven: 00:19:18

bullshit political means they have been able to, mess with the ability of veterans

Jasper Craven: 00:19:23

to be able to get that kind of care.

Jasper Craven: 00:19:25

And of course, that's not, that's not new for, the transgender veteran community

Jasper Craven: 00:19:29

or for women veterans either in terms of care that things have always, you know,

Jasper Craven: 00:19:34

that, that it's, Something that has slowly changed, but only has only gone so much.

Jasper Craven: 00:19:38

And so, Suzanne, I'm, I'm wondering what your thoughts are on this.

Jasper Craven: 00:19:42

do you think that the conversation is worth it?

Jasper Craven: 00:19:46

Or do you think that the fight currently being had is worth it?

Jasper Craven: 00:19:49

Or do you think it's just a lot of noise?

Jasper Craven: 00:19:50

GMT20240730-174812_Recording_separate2: Mean the fight around abortion

Jasper Craven: 00:19:52

and transgender, care?

Jasper Craven: 00:19:54

Henri (2): pertaining to the VA,

Suzanne Gordon: 00:19:55

Well, I think that what veterans have to consider is

Suzanne Gordon: 00:20:00

that if you're a veteran who is, finds it appealing, That the Project

Suzanne Gordon: 00:20:10

2025 folks are against abortion or against providing transgender care.

Suzanne Gordon: 00:20:15

If you find that appealing, I would think again.

Suzanne Gordon: 00:20:20

Because that is part of a much larger agenda and that is, if you don't need

Suzanne Gordon: 00:20:29

an abortion or don't think you'll ever need one, and if you're not transgender

Suzanne Gordon: 00:20:33

or if you're opposed to that, Your view is being distracted to focus on these

Suzanne Gordon: 00:20:38

things that you don't agree with while, they're going to pick your pocket.

Suzanne Gordon: 00:20:42

I mean, these people are like the pickpockets in David Copperfield,

Suzanne Gordon: 00:20:46

you know, like they're, I

Suzanne Gordon: 00:20:48

Suzanne Gordon (3): mean, Charles Dickens, for

Suzanne Gordon: 00:20:49

those who don't know the reference, you know, they're very

Suzanne Gordon: 00:20:52

well organized and they're going to pick your pocket while you're looking in a

Suzanne Gordon: 00:20:57

direction and what the real threat is, you know, There's a tremendous threat

Suzanne Gordon: 00:21:01

obviously for women who need abortions and also who need appropriate care if

Suzanne Gordon: 00:21:07

they've had a miscarriage or whatever, you know, and can't get care because that

Suzanne Gordon: 00:21:12

involves those kind of drugs and services.

Suzanne Gordon: 00:21:16

But I think the real issue that folks need to think about is, what Project 2025 plans

Suzanne Gordon: 00:21:24

for access to health care And compensation for service connected conditions, because

Suzanne Gordon: 00:21:30

these people, don't want to give veterans, compensation or, service connected

Suzanne Gordon: 00:21:38

disability ratings for many conditions that folks have, like, Wilkie and allied

Suzanne Gordon: 00:21:45

himself with this guy, Daniel Gade, who's the head of the, Department of Veterans

Suzanne Gordon: 00:21:49

Affairs for the state of Virginia.

Suzanne Gordon: 00:21:51

And he wrote this book about, I can't remember what it's called.

Suzanne Gordon: 00:21:55

I have to look it up, but I can do that in a minute.

Suzanne Gordon: 00:21:58

But, it's called Wounding Warriors, How Bad Policy is Making Veterans Sicker

Suzanne Gordon: 00:22:05

and Poorer, and so Wilkie and Gade and this whole, Project 2025 crew contend

Suzanne Gordon: 00:22:12

that the VA, is infantilizing veterans by giving them all this comprehensive

Suzanne Gordon: 00:22:17

care and, you know, that there really is no such thing as PTSD, and people

Suzanne Gordon: 00:22:23

who have PTSD are really just having a bad morning, you know, and, you

Suzanne Gordon: 00:22:26

know, And I mean, it's shocking.

Suzanne Gordon: 00:22:29

people should read the book, because this is really what these

Suzanne Gordon: 00:22:34

folks have in mind for veterans.

Suzanne Gordon: 00:22:37

They really want to limit the kind of service connected disabilities

Suzanne Gordon: 00:22:42

that are considered disabilities.

Suzanne Gordon: 00:22:45

And they also want the VA, they don't want the VA to compensate for them.

Suzanne Gordon: 00:22:50

And so this could cost veterans, you know, 000 a year.

Suzanne Gordon: 00:22:55

So while you're worrying about the very few people who could get an

Suzanne Gordon: 00:22:58

abortion, they're picking your pocket for 40, 000, and they're going to

Suzanne Gordon: 00:23:03

prepare to take away your benefits.

Suzanne Gordon: 00:23:05

They want to take away, health care services Because they want the VA to only

Suzanne Gordon: 00:23:11

care for service related disabilities.

Suzanne Gordon: 00:23:13

So what does that mean?

Suzanne Gordon: 00:23:15

That means that Joe Smith, you know, in Iraq, got his arm amputated, And the

Suzanne Gordon: 00:23:23

VA will take care of his amputated arm.

Suzanne Gordon: 00:23:27

But if Joe Smith gets diabetes later in life, not because of a toxic exposure,

Suzanne Gordon: 00:23:34

but just because he gets diabetes or has hypertension, they will not

Suzanne Gordon: 00:23:38

take care of the hypertension, or diabetes, which could really affect

Suzanne Gordon: 00:23:44

his amputated arm or leg or whatever.

Suzanne Gordon: 00:23:47

this is where the VA was.

Suzanne Gordon: 00:23:49

Free 1994.

Suzanne Gordon: 00:23:51

You know, they would only take care of service connected disabilities, and

Suzanne Gordon: 00:23:57

they wouldn't take care of any other problem that the veteran had, and the

Suzanne Gordon: 00:24:02

reason why the VA is such an excellent healthcare system is that now it takes

Suzanne Gordon: 00:24:06

care of everything, and these people don't want the VA to take care of everything.

Suzanne Gordon: 00:24:12

They also want VA providers to meet, Department of Defense health care

Suzanne Gordon: 00:24:18

system standards of productivity.

Suzanne Gordon: 00:24:21

But, and this is very important for vets to understand, the Department of

Suzanne Gordon: 00:24:26

Defense takes care of largely healthy people because you can't get in.

Suzanne Gordon: 00:24:35

To the military, or you shouldn't be able to get in if you have a

Suzanne Gordon: 00:24:37

whole bunch of health problems.

Suzanne Gordon: 00:24:39

Now, and if you get these health problems, like an amputation,

Suzanne Gordon: 00:24:43

they kick you out, right?

Suzanne Gordon: 00:24:44

They medically discharge you.

Suzanne Gordon: 00:24:46

So you're dealing with healthy people, largely.

Suzanne Gordon: 00:24:52

The VA deals with people who have, you know, 6, 7, 30 presenting problems,

Suzanne Gordon: 00:24:59

what we call comorbidities, right?

Suzanne Gordon: 00:25:01

You know, I mean, you could talk about your own problems, Henri, you know, you

Suzanne Gordon: 00:25:06

are not some 18 year old, they go into the military and they spit them out

Suzanne Gordon: 00:25:11

with all kinds of problems and you don't even have to be in combat to have, you

Suzanne Gordon: 00:25:16

know, back, neck and shoulder problems or PTSD or, traumatic brain injuries.

Suzanne Gordon: 00:25:21

we're learning how just firing these weapons, repeatedly can

Suzanne Gordon: 00:25:24

give you a traumatic brain injury.

Suzanne Gordon: 00:25:27

I think that veterans really need to understand what's in store for them if

Suzanne Gordon: 00:25:33

Trump is reelected, and that is they will have less access to health care.

Suzanne Gordon: 00:25:37

They will not have access to comprehensive health care.

Suzanne Gordon: 00:25:40

they may have no access to health care if certain kinds of service

Suzanne Gordon: 00:25:45

connected, disabilities are, wiped out.

Suzanne Gordon: 00:25:50

They won't get compensated.

Suzanne Gordon: 00:25:52

It's going to be a disaster.

Suzanne Gordon: 00:25:54

not to mention if there are veterans who work at the VA I mean, Trump views them as

Suzanne Gordon: 00:26:00

sadists and cruel and, out to get veterans as opposed to out to help veterans.

Suzanne Gordon: 00:26:05

he's the one who's out to get the veterans and the folks in the VA

Suzanne Gordon: 00:26:09

are the ones who want to help them.

Suzanne Gordon: 00:26:11

You mentioned about pre 1994, the VA and the idea of them, you know, slivering down

Suzanne Gordon: 00:26:18

exactly what kind of a benefit somebody could get I was so thankful when I got

Suzanne Gordon: 00:26:23

out of the military that my initial rating was 50%, and by that, that meant

Suzanne Gordon: 00:26:28

that all my care could come from the va.

Suzanne Gordon: 00:26:31

Henri (2): And so if, if all my care, if I'm so injured,

Suzanne Gordon: 00:26:35

and again, it's only at 50%.

Suzanne Gordon: 00:26:37

so there are lots and lots of folks that never, that don't ever make it to

Suzanne Gordon: 00:26:41

a hundred percent, but still need all of that care and they need whole healthcare.

Suzanne Gordon: 00:26:46

It can't be something where, like you said about an amputee that we're not

Suzanne Gordon: 00:26:50

dealing with these other things that are common conditions that might come

Suzanne Gordon: 00:26:53

with that, or even just general quality of life, helping somebody maintain a

Suzanne Gordon: 00:26:59

certain living standard when it comes to it health wise and making it that

Suzanne Gordon: 00:27:03

much more difficult like going back to where we started from this is that,

Suzanne Gordon: 00:27:06

you know, like women veterans deserve to be able to have all of their.

Suzanne Gordon: 00:27:11

Obgyn care and anything that they need for that, potentially, including

Suzanne Gordon: 00:27:14

abortion services to be included.

Suzanne Gordon: 00:27:17

That would all be part of whole health.

Suzanne Gordon: 00:27:19

The idea that they would disinclude it just seems farcical

Suzanne Gordon: 00:27:23

and horrifying on its face.

Suzanne Gordon: 00:27:27

Well, I think that, over the past, since 1945, particularly

Suzanne Gordon: 00:27:33

46, the American public has.

Suzanne Gordon: 00:27:36

Invested billions and billions of dollars into creating a comprehensive

Suzanne Gordon: 00:27:41

health care system for veterans, and it delivers stellar health outcomes,

Suzanne Gordon: 00:27:46

it is really, it's not just a medical system, it's a health care system, so

Suzanne Gordon: 00:27:51

veterans get help with homelessness, with legal problems, and housing with

Suzanne Gordon: 00:27:57

economic problems, with vocational rehabilitation, cooking classes,

Suzanne Gordon: 00:28:02

meditation, you name it, the VA offers it.

Suzanne Gordon: 00:28:05

Now, you may have to drive to get to those services, but if you

Suzanne Gordon: 00:28:10

live in rural America, you have to drive to get any service, you know.

Suzanne Gordon: 00:28:15

And the VA is willing to do telehealth and if you don't have a laptop or an iPad

Suzanne Gordon: 00:28:23

or an iPhone, they'll give you a laptop or an iPhone so you can do telehealth.

Suzanne Gordon: 00:28:28

And so I just think it's tragic that, veterans don't appreciate

Suzanne Gordon: 00:28:34

what the taxpayer has done for them.

Suzanne Gordon: 00:28:38

People don't understand that the VA cannot run a insurance company where

Suzanne Gordon: 00:28:45

they pay for exorbitant costs from the private sector or care that is not veteran

Suzanne Gordon: 00:28:52

centric and often of lower quality.

Suzanne Gordon: 00:28:55

Veterans need to really make a choice and somebody needs to tell them that

Suzanne Gordon: 00:29:01

America will not pay for two separate healthcare systems for its veterans.

Suzanne Gordon: 00:29:06

It's too much.

Suzanne Gordon: 00:29:07

It's a bad business model.

Suzanne Gordon: 00:29:09

There is no choice.

Suzanne Gordon: 00:29:11

Health care system in the world or in the country, where if you go out of

Suzanne Gordon: 00:29:15

network, that somebody else pays for it.

Suzanne Gordon: 00:29:18

And I think really what veterans need to understand and somebody needs to have

Suzanne Gordon: 00:29:23

the courage to say to them is you've got this great health care system.

Suzanne Gordon: 00:29:29

If you want it to be better, if you want it to provide more care in more

Suzanne Gordon: 00:29:33

places, then stop stealing money from it to give it to somebody else who

Suzanne Gordon: 00:29:39

doesn't know how to care for you and doesn't really care about you, you know.

Suzanne Gordon: 00:29:43

And I mean, we're now giving 36 billion, you know, the 36

Suzanne Gordon: 00:29:49

billion is only clinical care.

Suzanne Gordon: 00:29:50

We're paying these Third party insurance companies, TriWest and Optum, they're

Suzanne Gordon: 00:29:55

getting, I don't know how much it is now, Jasper, almost 200 billion

Suzanne Gordon: 00:29:59

dollars to administer this system.

Suzanne Gordon: 00:30:02

Imagine what you could do with close to 500 billion dollars If the VA got

Suzanne Gordon: 00:30:09

it and not the private sector, and who is going to say that to veterans?

Suzanne Gordon: 00:30:14

I hope at some point, Kamala Harris, if she wins, says that to veterans.

Suzanne Gordon: 00:30:18

I hope that VSOs and groups like the one we belong to, Veterans Health Care

Suzanne Gordon: 00:30:23

Policy Institute, say this if we get new Democrats in office, because they've

Suzanne Gordon: 00:30:28

been continuing the privatization policies in sort of a privatization

Suzanne Gordon: 00:30:33

light form that Trump and others.

Suzanne Gordon: 00:30:37

in the conservative movement have, initiated.

Suzanne Gordon: 00:30:40

Henri (2): You know, just like with the DOD budget, it's not about the expenditure

Suzanne Gordon: 00:30:46

of hundreds of billions of dollars.

Suzanne Gordon: 00:30:47

It's where it ultimately ends up going.

Suzanne Gordon: 00:30:50

I mean, because they'll spend it.

Suzanne Gordon: 00:30:51

Robert Wilkie, Donald Trump, all those are perfectly happy

Suzanne Gordon: 00:30:55

to spend the money, but where it actually ultimately ends up going.

Suzanne Gordon: 00:31:00

it really makes it a different question.

Suzanne Gordon: 00:31:02

so I think, it's a good time to wrap up our discussion for today.

Suzanne Gordon: 00:31:06

was there anything that you either you guys wanted to jump

Suzanne Gordon: 00:31:08

in on before we, sign off?

Suzanne Gordon: 00:31:11

I think we covered a lot of the sort of most pressing topics here.

Suzanne Gordon: 00:31:16

really when it comes down to it, and this is a point I, will scream until the cows

Suzanne Gordon: 00:31:20

come home, what is happening right now and what has been happening over the last

Suzanne Gordon: 00:31:25

decade since the Choice Act was passed is the buildup of intense corporate power

Suzanne Gordon: 00:31:31

Over the Department of Veterans Affairs.

Suzanne Gordon: 00:31:33

It's a similar phenomenon to the military industrial complex.

Suzanne Gordon: 00:31:36

And for many decades, the VA was sort of immune to those trends for

Suzanne Gordon: 00:31:40

a number of reasons, including the fact that the VSOs were some of the

Suzanne Gordon: 00:31:45

most powerful forces on Capitol Hill.

Suzanne Gordon: 00:31:48

But since they are on the decline, all of these Corporate and ideological actors

Suzanne Gordon: 00:31:54

are coming out of the woodwork and they are attempting to profit in massive ways

Suzanne Gordon: 00:31:59

from the VA budget and also to basically shift attention away from all of the good

Suzanne Gordon: 00:32:05

that the VA does because the truth of the matter is, is that The VA system is

Suzanne Gordon: 00:32:11

the one that should be expanded out into the civilian sector, rather than having

Suzanne Gordon: 00:32:19

this incredibly flawed private system creep into the VA and disrupt what is

Suzanne Gordon: 00:32:24

the best healthcare system in America.

Suzanne Gordon: 00:32:27

And so, you know, the stakes are very

Suzanne Gordon: 00:32:30

Oh, Jasper, you, you kind of disappeared entirely.

Suzanne Gordon: 00:32:36

I did.

Suzanne Gordon: 00:32:37

You disappeared at stakes.

Suzanne Gordon: 00:32:40

Maybe you should finish my sentence, Suzanne, because we're so simpatico.

Suzanne Gordon: 00:32:46

Yeah, I'm I mean, I was just gonna say that the stakes are incredibly high.

Suzanne Gordon: 00:32:50

The stakes are about not only the future of veterans health care, but of health

Suzanne Gordon: 00:32:55

care reform at large in this country.

Suzanne Gordon: 00:32:59

yeah, and, and I, I think, I'm really glad Jasper brought that up because,

Suzanne Gordon: 00:33:04

you know, I think the VA touches on larger issues, and the, the threats to

Suzanne Gordon: 00:33:09

the VA, both ideological and corporate.

Suzanne Gordon: 00:33:13

Exists because American capitalism doesn't want a government

Suzanne Gordon: 00:33:18

health program that works.

Suzanne Gordon: 00:33:20

And so we have this amazing health system that could be a model for

Suzanne Gordon: 00:33:26

the kind of health care that all of us should get that, that many

Suzanne Gordon: 00:33:29

people get in other countries.

Suzanne Gordon: 00:33:31

And it's really a superior model.

Suzanne Gordon: 00:33:34

And so I think that This issue of saving the VA, expanding the VA, improving the

Suzanne Gordon: 00:33:40

VA, is not just about helping veterans, but about how the VA serves the nation

Suzanne Gordon: 00:33:46

and allowing it to continue to serve the nation through its teaching,

Suzanne Gordon: 00:33:50

research, and emergency preparedness missions, but also how it can serve

Suzanne Gordon: 00:33:55

the nation by being a model for health care reform activists For Who, want

Suzanne Gordon: 00:34:00

to give, promote models of government run healthcare systems that work.

Suzanne Gordon: 00:34:05

And you don't have to go to Taiwan or Scandinavia or Canada to find

Suzanne Gordon: 00:34:11

a healthcare system that works.

Suzanne Gordon: 00:34:13

It's around the corner.

Suzanne Gordon: 00:34:14

And the reason why so many ideological ag are, are attacking it.

Suzanne Gordon: 00:34:21

It's not just because they can get public money for private, to

Suzanne Gordon: 00:34:25

serve private profit, but because they don't want a competition.

Suzanne Gordon: 00:34:31

You know, Secretary McDonough is always into this neoliberal idea of

Suzanne Gordon: 00:34:36

competition, but American capitalism doesn't want to compete with a government

Suzanne Gordon: 00:34:44

run system and lose, which it is doing.

Suzanne Gordon: 00:34:46

And so they prefer to destroy the government run system that

Suzanne Gordon: 00:34:52

has won the Super Bowl, the World Cup, the, World Series, etc.

Suzanne Gordon: 00:34:57

And, you know, veterans have a winner and they should stick with the winner and

Suzanne Gordon: 00:35:01

they should be going to their political representatives to get them To fund the

Suzanne Gordon: 00:35:09

winner even, you know, more efficiently and effectively than is happening now.

Suzanne Gordon: 00:35:15

So, I think, you know, Jasper and I, being simpatico, we agree that, the

Suzanne Gordon: 00:35:21

stakes are not just for veterans and their families and their communities,

Suzanne Gordon: 00:35:25

but for the entire country.

Suzanne Gordon: 00:35:28

Henri (2): thank you.

Suzanne Gordon: 00:35:28

Thank you both for laying that out so well.

Suzanne Gordon: 00:35:31

it's something I think that everybody, you know, that.

Suzanne Gordon: 00:35:34

The many veterans I know that listen to this podcast I hope all of us take

Suzanne Gordon: 00:35:37

that stuff to heart to understand that we are, for lack of a better phrase,

Suzanne Gordon: 00:35:42

soldiers in this fight, if we want, the VA to stay strong, to continue serving

Suzanne Gordon: 00:35:47

veterans in the way that it does, we have to advocate for ourselves and say those

Suzanne Gordon: 00:35:51

kinds of things to our representatives

Suzanne Gordon: 00:35:55

I know that I'm going to be.

Suzanne Gordon: 00:35:56

Cared For Better, and that it's going to fit into a system of overall care

Suzanne Gordon: 00:36:00

where my doctors do actually talk to each other, Suzanne Jasper, thank you

Suzanne Gordon: 00:36:05

so much for being here today, folks makes sure that you go online and visit

Suzanne Gordon: 00:36:10

the Veterans Health Policy Institute.

Suzanne Gordon: 00:36:12

They have a lot of policy papers and resources on a whole host of different

Suzanne Gordon: 00:36:18

VHA related topics and also on some other.

Suzanne Gordon: 00:36:22

Health topics, not specific to the VHA, but it's all good stuff.

Suzanne Gordon: 00:36:25

Suzanne, what is, the website for the PHBI?

Suzanne Gordon: 00:36:28

It's veteranspolicy.

Suzanne Gordon: 00:36:30

org.

Suzanne Gordon: 00:36:31

And please consider signing up for its newsletter if you want

Suzanne Gordon: 00:36:35

to keep up with, what's going on in the veterans healthcare world.

Suzanne Gordon: 00:36:39

Thank you.

Suzanne Gordon: 00:36:40

Henri (2): Absolutely.

Suzanne Gordon: 00:36:42

And, thank you to everybody for joining us today here on Fortress On A Hill.

Suzanne Gordon: 00:36:46

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