In the Bay Area, public meetings critical of conservatives are not hard to find. But when about 200 San Francisco military veterans jammed into an auditorium in their city’s Veterans War Memorial Building in mid-April, they added diversity to the local “resistance.” Those in attendance—representatives of veterans-service organizations, patients of the Veterans Health Administration, health-policy experts, and local Congresswoman Nancy Pelosi—were trying to educate veterans and the public about proposals that could destroy a single-payer plan for 9 million Americans whose past military service, in combat and noncombat jobs, makes them eligible for VHA coverage.
The threat—faced by VHA users and staff (one-third of whom are veterans themselves)—is privatization. The Trump administration has no trouble boosting an already swollen Pentagon budget. But it favors only a modest increase in VHA funding, most of which would be spent on steering veterans’ care toward non-VHA doctors and hospitals and to for-profit companies for services like audiology and optometry. As part of their ever-expanding outsourcing strategy, Trump’s Republican allies—and even some Democrats—have demonized VHA employees and attacked their workplace rights and union protections. Meanwhile, according to a number of VHA clinicians I have recently spoken with, VHA leadership is making it difficult for facilities to hire needed staff. An in-house electronic medical-records system that’s one of the best in the country is slated to be replaced by one produced by a private vendor. More importantly, Congress is considering legislation that could pave the way for agency dismantling.