On the campaign trail, President-elect Donald Trump repeated one key promise: to "Make America Great Again" by increasing the country's military might and supporting its 24 million military veterans. After all, he promised to raise money for veterans and said he donated a million dollars out of his own pocket to veterans' charities.
But Trump showed his true colors long before Election Day. He finally wrote a personal check to one veteran's group but only after four months when reporters shamed him into doing so. Trump dissed mentally ill veterans for being weak. Most famously, he called Senator John McCain, who was a Navy pilot during the Vietnam War, a "loser" after being shot down in combat, badly injured, captured, and then abused as a prisoner of war. Nevertheless, many veterans voted for Trump by a large margin.
That's no great start for "veterans affairs." But the mistreatment of vets could go from rhetorical to real. That's because Trump favors some form of privatization of all Veterans Health Administration services, a long sought-after goal of congressional Republicans. His allies on Capitol Hill and his appointees plan to take aim at taxpayer-supported health-care coverage for veterans that actually works better than the federally-subsidized, private health insurance system that was expanded under the Affordable Care Act, which Trump has promised to repeal.
The federal government currently provides veterans with comprehensive and highly specialized care as needed; outside the VHA, the same services would be far more costly and much harder to find. The VHA Commission on Care estimated that treating veterans in the private sector would be almost four times as high-a whopping $450 billion.
However, to the right-wing ideologues already shaping VHA policy under Trump, private health care is the best kind of care there is. Any public program that threatens that framework by being cost-effective, widely accessible, and popular with its patients needs to be curtailed, they believe, regardless of the outcome for millions of veterans.
Trump promised to make outgoing Congressman Jeff Miller, a Florida Republican who chairs the House Veterans Affairs Committee, his secretary of veterans affairs. (Miller did not run for re-election.) He has been hostile to the VHA and will certainly favor some form of VHA privatization. Also leading the Trump charge in the wrong direction is Darin Selnick, a Concerned Veterans for America (CVA) senior advisor and executive director of its "Fixing Veterans Health Care" taskforce. The CVA is an inside-the-Beltway creation of the billionaire Koch brothers rather than a "veterans service organization" with hundreds of thousands of members like the Disabled American Veterans, Veterans of Foreign Wars, or Vietnam Veterans of America, which all support the VHA. CVA may not have pumped big money into the Trump campaign but now they see a golden opportunity to downsize government by installing paid hirelings like Selnick in Trump's VA transition team or in the executive branch.
Sally Pipes, president and CEO of the Pacific Research Institute, another conservative think tank funded in part by the Koch brothers, was one of Rudy Giuliani's top health-care advisers when he sought the 2008 Republican presidential nomination. She recently wrote a San Francisco Chronicle op-ed, which criticized the VHA as well as any other possible type of single-payer health care. She exaggerated and misrepresented recent problems at some VHA facilities, such as wait times, and accused the agency of "rationing care."
Selnick and Pipes are previews of coming attractions in the top administrative ranks of the VHA, when heads start to roll and Koch brothers-minded managers replace them. As Trump's plans for the VHA unfold, veterans and veterans service organizations must go on the offensive against behind-the-scenes power plays to protect a invaluable, specialized program that cannot be outsourced without compromising the quality of care.
Correction: This post has been corrected to reflect that Sally Pipes is the current (not former) president and CEO of the Pacific Research Institute, and does not hold a post on the Trump transition team nor does she advise them on VA or other health care issues.
