By Suzanne Gordon
Cornell University Press
The publisher’s book description:
U.S. military conflicts abroad have left nine million Americans dependent on the Veterans Health Administration (VHA) for medical care. Their “wounds of war” are treated by the largest hospital system in the country—one that has come under fire from critics in the White House, on Capitol Hill, and in the nation’s media. The resulting public debate about the future of veterans’ health care has pitted VHA patients and their care-givers against politicians and policy-makers who believe that former military personnel would be better served by private health care providers.
This high stakes controversy led Suzanne Gordon, award-winning health care journalist and author, to seek insight from veterans and their families, VHA staff and administrators, advocates for veterans, and proponents of privatization. Gordon spent five years closely observing the VHA’s treatment of patients suffering from service related injuries, physical and mental.
In Wounds of War, Gordon describes how the VHA – tasked with a challenging patient population – does a better job than private sector institutions offering primary and geriatric care, mental health and home care services, and support for patients nearing the end of life. The VHA, Gordon argues, is an integrated health care system worthy of wider emulation, rather than piece-meal dismantling for the benefit of private contractors. In the unusual culture of solidarity between patients and providers that the VHA has fostered, the author finds a working model for higher quality health care and a much-needed alternative to the practice of for-profit medicine.
Brief excerpts from the book, “Wounds of War”:
In this book I focus on how the VHA accomplishes its multiple missions and functions differently from its private-sector counterparts, whose care delivery is more costly, fragmented, and market-driven. As the largest health care system in the country, the VHA has its share of problems. But overall, as the studies and experiences I will cite convey, the VHA provides high-quality care to a very complicated patient population.
Several years ago, when I was visiting the VA Medical Center in West Haven, Connecticut, where my daughter worked, I joined a meeting with visiting staff from the UK’s National Health Service. The assembled British doctors, nurses, psychologists, social workers, and administrators had just trooped through one of the most prestigious teaching hospitals in the United States, the nearby Yale New Haven medical center. They were clearly grappling with the contradictions of what they had just seen. At a well-endowed institution, patients arrived in the emergency room with no insurance, they were discharged prematurely, medical specialists commanded huge salaries unheard of in their own country, primary care seemed undervalued, inter-professional training was spotty, caregivers of all kinds had no union voice, and coordination of care was, well, not exactly “world class.”
And then the UK delegation toured the veterans’ hospital just a few miles away from Yale New Haven. As they sat with VHA caregivers afterward, asking questions and exchanging information in a government-issue conference room, the same realization sank in: they had finally landed in a system – an actual system in the United States – that worked much like their own back home. One doctor finally asked the question on every visitor’s mind. “Why,” he wondered out loud, “do you have to be a military veteran to get this level of care in America? Why isn’t it available to all Americans?” Why indeed.
Unreliable Sources: How Corporate Funders Influenced Mass Media Coverage of Veterans’ Healthcare
By Suzanne Gordon and Jasper Craven
Veterans Healthcare Policy Institute
Phoenix is where today’s deep disdain of the VA first germinated. In the summer of 2014, evidence emerged that administrators at the VA Phoenix hospital had tampered with scheduling data, leaving veterans to wait months for an appointment. The scandal spurred passage of the Veterans Access, Choice and Accountability Act, which made it much easier for veterans to seek care in the private sector, and ignited a deeply divisive national debate over the government’s ability to deliver health care.
When the Phoenix scandal broke, Concerned Veterans for America (CVA) was a fledgling advocacy group working from the fringes. As the Washington Monthly reported, the group’s staff – led by telegenic veteran Pete Hegseth – brilliantly packaged, framed and fed the Phoenix story to a salivating news media desperate for a scandal in the Obama administration. The most serious charges out of Phoenix – that veterans died because they were unable to access care – were never substantiated. The cover up of wait times was more indicative of the agency’s chronic capacity and funding challenges than anything else – issues that to this day have not been meaningfully addressed.
Today, CVA holds incredible sway in Washington. Numerous CVA officials have entered President Donald Trump’s White House, or his Department of Veterans Affairs. Hegseth is now an anchor on the president’s favorite morning news show, Fox & Friends. And the group has built an incredibly effective organizing and messaging apparatus.
What is left out of most coverage is the voices of veterans who have been helped by the VA, as are studies demonstrating the high quality of VA care or explaining the countless challenges of privatization.
The RAND Corporation has been studying VA care since at least the early aughts, and its findings have consistently given the VA high marks while warning that the private sector is unprepared to deal with the complex needs of veterans.
This year alone, RAND has released two comprehensive studies: one that documented the excellence of VA healthcare; the other which revealed the gross inadequacies of New York state’s private healthcare system to treat veteran patients. Neither report attracted serious media attention.
By Don McCanne, M.D.
Believe it or not, we have several individuals in our government who do not believe in government, but rather claim to believe that the private sector can always do things better. Right now the privatizers are taking advantage of a few problems that exist in the Veterans Health Administration (VHA), and they are attempting to switch more veterans’ services to the private sector. The media has been complicit in covering only the problems and leaving out the real story of the VHA. Suzanne Gordon’s thoroughly researched and highly credible book – “Wounds of War” – describes the phenomenal accomplishments of the VHA and what that means for our veterans with service-connected health care needs.
“Wounds of War” should be mandatory reading for all legislators and government administrators who really do care about the welfare of our veterans. At the same time, we all need to be aware of the distortion of the perception of the VHA caused by the selective reporting of the supposedly reliable media of only the problems, and nothing about the great care veterans are receiving. The disinformation campaign is so intense that even many of the veterans themselves believe that the VHA is bad everywhere except at the facility where they happen to be. Their view? “Don’t fire anyone here – everyone here is a great, dedicated caregiver, driven by their commitment to veterans. As for everywhere else, heads should roll.”
If a cockroach crawled across Leonardo da Vinci’s “The Last Supper” would the painting be condemned and sent to a flea market? No? Then why do they want to take comparable action against the VHA?
At the national PNHP meeting in San Diego this weekend, Saturday, November 10, Suzanne Gordon will be conducting a workshop on this topic. If you can’t make it, at least read her book. Even if you do go, read it anyway.
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