Suzanne Gordon

Suzanne Gordon is the Senior Policy Fellow at the Veterans' Health Care Policy Institute, as well as a journalist and co-editor of a Cornell University Press series on health-care work and policy issues. Her latest book is The Battle for Veterans' Healthcare: Dispatches from the Frontlines of Policy Making and Patient Care. She has won a Special Recognition Award from Disabled American Veterans for her writing on veterans' health issues, much of which has appeared in The American Prospect. Her website is www.suzannegordon.com.

Recent Articles

AOC Defends an American Socialist Success: Veterans’ Health Care

While proponents of privatization, ignoring the evidence, find one more reason to attack her. 

As top Trump-appointed Department of Veterans Affairs (VA) leaders pursue their efforts to privatize the Veterans Health Administration (VHA), Congress is desperately in need of members who will assertively oppose VHA privatization. It needs senators and representatives who will champion adequately financing and staffing the nation’s largest, and only publicly funded, fully integrated health-care system. Newly elected Congresswoman Alexandria Ocasio-Cortez (D-NY) has joined the handful of Democrats who have opposed VHA privatization, which proponents are promoting through the VA MISSION Act passed in the last session of Congress and set to be implemented in June. At an April 17 Bronx town hall on the VA, in which I also participated, Ocasio-Cortez told an audience of veterans and VHA caregivers, “If it ain’t broke, don’t fix it.” She argued that the VHA “provides some of the highest quality care to our veterans,” and warned against those...

Putting Veterans at Risk

Even VA privatizers agree that the MISSION Act is likely to stumble.

David Zalubowski/AP Photo
A potentially costly and harmful experiment in veterans’ health care is scheduled to begin eight weeks from now. The Veterans Community Care Program (VCCP), created under the VA MISSION Act of 2018, will channel millions of the nation’s most vulnerable veterans to private-sector doctors and hospitals. VA leadership is determined to launch the program on June 6, in spite of federal reports and Capitol Hill testimony by both friends and foes of privatization that say it is not ready for rollout. This was made abundantly clear at an April 10 Senate Committee on Veterans’ Affairs hearing. Chairman Johnny Isakson (R-GA), a leading proponent of outsourcing veterans’ care from the Veterans Health Administration (VHA) to private doctors and hospitals, predicted, “We’re going to stumble before we walk.” It was a staggering admission: VA leaders and Republicans like Isakson seem willing to send waves of patients into the private sector where the care is...

The VA Is Privatizing Veterans’ Health Care While Launching a Campaign to Deny It

Acutely aware that its privatization plan has little support among veterans, the VA has launched a PR blitz to obscure what it's doing. 

The Trump administration’s multipronged effort to privatize the VHA and push millions of veterans out of the VA system remains deeply unpopular among American veterans. But rather than adjust its proposals to meet the needs and wishes of veterans, the administration has a better idea: deny that the changes—which include funding private care at taxpayer expense—amount to privatization at all. Over the past several weeks, VA Secretary Robert Wilkie and his advisors from the Koch brothers-funded Concerned Veterans for America (CVA) have launched a PR offensive refuting critics who contend that the agency’s plan to funnel money to private care will lead to VHA privatization. In multiple press releases, Wilkie adamantly denied that channeling millions of veterans—and billions of taxpayer dollars—to private-sector health care providers amounts to VA privatization. Wilkie even convinced four former VA secretaries, including one who served under President...

Inside the Administration’s Plan to Push Millions of Veterans into Private-Sector Health Care

The VA's plan to implement the recently passed MISSION Act could seriously imperil veteran health care—and push the department even further toward privatization. 

On January 30, Robert Wilkie, the secretary of the Department of Veterans Affairs unveiled a plan that could push millions of veterans out of VA care and into the private sector. Wilkie’s announcement follows the passage of the VA MISSION Act of 2018, legislation that gives Wilkie broad latitude to develop guidelines allowing far more veterans to get private-sector care at taxpayer expense. Critics, including veterans organizations and Democratic members of Congress, have warned the plan could seriously weaken veteran health care and move the VA perilously close to privatization. As my colleague Jasper Craven and I predicted, Wilkie’s plan is to expand private-sector access for veterans currently at the VHA. But instead of basing this access on the needs of individual patients or the quality of private providers, Wilkie focuses exclusively on wait times. Under his proposal, any VHA patient who has to drive for more than 30 minutes for a primary care or mental health...

Trump Administration Moves Forward on VA Privatization

Under the guise of reducing veteran suicides, the Trump administration has released a plan that could radically reshape veteran care in the United States. The stated goal is to expand mental health services for newly transitioned veterans, the proposal, which administration officials approved on May 31, contains provisions that could starve the Veterans Health Administration of needed resources, add impossible burdens to already struggling VHA staff, and privatize veteran mental health care by outsourcing it to non-VA providers. As studies have consistently shown, such private-sector providers are ill equipped to address veterans’ complex needs. 

Released on May 3, the Joint Action Plan represents an outline of how the Departments of Veterans Affairs, Defense, and Homeland Security propose to implement an executive order President Donald J. Trump signed in January. The order called for providing all service-members transitioning out of the military—about 245,000 a year—with 12 months of free mental health care. The impetus behind the plan—preventing veteran suicides—and a number of things in it are praiseworthy, even essential. But according to a careful analysis by the Veterans Healthcare Policy Institute, the plan could actually jeopardize the stellar suicide prevention and mental health programs that the VA has long pioneered.

The action plan stipulates that transitioning service-members will have access to 12 months of mental health benefits. Service-members must also be informed that they don’t have to seek help from the VHA and are free to go to private-sector mental health providers, if they are, for any reason, not interested in VHA care. The plan calls for some VHA oversight of these private-sector providers, but provides no funding for staff needed to monitor their care. 

The danger is that VHA veterans could be cared for by providers who may not understand their specific problems or provide evidence-based treatment for them. As studies have documented, private-sector care falls well short of the public sector in treating veterans. Unlike the care delivered at the VHA, which is well-coordinated, veteran care in the private sector would be uncoordinated and their providers largely unaccountable. Even worse, the funds to pay for expensive care in the private sector will come directly from the VHA budget. Without new congressionally approved allocations, the VHA will be forced to cannibalize existing programs to pay for the mandates.

Such threats come at a time when the VA system is already plagued by underfunding and understaffing. On June 14, 2018, the VA Office of the Inspector General (OIG) issued a report that once again highlights the problems created by Congress’s long-standing failure to fully fund and staff the Veterans Health Administration. Its detailed, facility-by-facility list of staff vacancies includes the mental health professionals needed to serve a growing number of veterans with serious mental health and substance abuse problems. (Seventy percent of facilities had shortages of psychiatrists and 40 percent of psychologists.) 

 The Joint Action Plan does not require that the Defense Department or others provide transitioning service-members with information about the high quality of programs the VHA has developed to deal with complex mental health problems. This kind of education is essential because any current or future problems the VHA faces provide fodder for right-wing critics—like Fox and Friends—as they churn out a steady stream of anti-VHA stories designed to convince veterans that the VHA can never serve their needs. Neither conservative nor liberal media do much reporting on the many innovations the VHA has pioneered in the delivery of integrated primary care, mental health care, or suicide prevention. Yet as studies have shown, the VHA has a far better track record on these issues than the private sector. 

The Joint Action Plan doesn’t even call for measuring whether newly discharged service-members receive such information. It does, however, recommend measuring how quickly department personnel are trained on the referral process to community-based support resources.

The plan’s defects don’t end there. Without offering additional funding, the plan requires the VA to train outreach workers and peer support staff, who then must repeatedly contact all 245,000 transitioning veterans. Staff will also have to provide care for an estimated 32,000 veterans each year. Finally, the VA will have to evaluate the success of all these and other programs.

Yet the plan does not suggest conducting an assessment of how many new VHA staff would need to be added, and thus funded, to accommodate these new caregiving and outreach responsibilities. Because twice as many veterans receive mental health treatment compared with ten years ago, VA mental health staff are already overwhelmed by their high caseloads. A recent report on VA mental health care from the National Academies of Science, Engineering, and Medicine said that the VHA’s mental health-care system could be a model for the nation but that it was plagued by shortages of staff and clinical and exam space, which had created high staff burnout and turnover. Trying to accommodate thousands of new patients will lead to increased burnout and delays, which, absent attention to increased staffing, will fuel demands to outsource more and more care.   

Because the Joint Action Plan claims that its provisions will advance the laudable mission of preventing veteran suicide, it may receive support from Congress and some Veterans Service Organizations. Like the recently passed VA Mission Act, the VA Accountability Act, and many other recent measures, it is rife with intended consequences. As advocated by representatives of the Concerned Veterans for America—a Koch brothers’-backed group whose representatives now advise the VA and White House—it is, in fact, just another step down the slippery slope of VHA privatization.    

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