Boston Public Library
Journalist and author Suzanne Gordon has covered health care in America for more than three decades, including five years closely scrutinizing the Veterans Health Administration. Despite the constant criticism of the VA in the press, Gordon was impressed by its holistic care and promising outcomes for patients.
Gordon’s new book, Wounds of War: How the VA Delivers Health, Healing and Hope to the Nation’s Veterans, has just been published by Cornell University Press. Recently, we spoke by phone about her findings, and how the VA could be a “model for American health care.”
Q: There’s a narrative out there of the VA as a faltering public agency. Why is that?
Suzanne Gordon: Before the Koch brothers created their astroturf veterans organization, the Concerned Veterans for America—into which they put some $14 million—the VA actually had a very good reputation. There were some problems in the VA in 2014 about wait times [for treatment]. Those have been remedied largely, but the anti-democratic right really took advantage of this scandal to tarnish the reputation of the VA. Sadly, the liberal media has largely carried that narrative. The New York Times, CNN—it’s sad. There’s really thousands of scientific studies documenting the superior quality of care in the VA and the media seems to be immune to the facts.
Q: You say the VA offers better care than the private sector. Why is that?
The VA gives better care at lower costs to sicker patients. And the private sector is fragmented care, while the VA is an integrated system. Why is the care of the veterans so far superior to the care I will receive, and I have the best health insurance around? Because my doctors aren’t on salary, and they have huge incentives to overtreat, and they never talk to each other. Its
Cornell University Press
completely uncoordinated.
Q: President Donald Trump infamously fired Veterans Affairs Secretary David Shulkin, who says he was being pressured to privatize VA’s services. Where do things stand now?
If you look at privatization as outsourcing more and more care—starving their budget—that was something that Shulkin was for, and they really accelerated that. But he didn’t accelerate it enough, apparently, and he got himself in trouble about some dubious travel. Trump used that as an excuse to fire him, and now we have a much more pro-privatization secretary, Robert Wilkie. We’re now seeing a huge acceleration of attacks on the VA.
Q: Is anyone pushing back against this privatization agenda?
Gordon: Absolutely. Veterans for Peace has done an anti-privatization campaign, along with the unions American Federation of Government Employees and National Nurses United, the Veterans Healthcare Action Campaign. But no one in Congress really understands the VA, they don’t understand healthcare, they are very focused on individual doctors appointments and procedures. They don’t understand the kind of care coordination and integration that the VA puts into practice which I describe in my book.
Q: You talk specifically about a public health care system, not merely single-payer health care.
Gordon: There’s a movement to have Medicare-for-All, and we need something like that. But Medicare is a payer, not a system, and the VA is both a payer and a system. So Medicare just pays for the service and it still doesn’t address high-quality health care. What’s scary to me is that many liberals and progressives who don’t buy the propaganda about climate, or about education, buy the propaganda about the VA. So I really hope that readers realize that this is a giant hoax.