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veterans
Privatizer Pete Hegseth Is Bad for Military Families and Veterans
Most media reports ignore that Hegseth was a leading advocate for turning veterans care over to private doctors and hospitals.
Dec 02, 2024
Much media coverage of Pete Hegseth’s nomination as Secretary of Defense has focused, understandably, on controversial things he has said or done, along with his complete lack of administrative experience relevant to running a federal government department with a $920 billion budget and a workforce of three million.
But anyone in charge of the Pentagon also gets to oversee the Military Health System (MHS), which provides either private health insurance coverage or direct care for over 9.5 million service members, military retirees, and their families. As Defense Secretary Lloyd Austin noted in a recent DOD National Defense Strategy report, the MHS mission is to ensure that active duty personnel and their dependents are well-served by a skilled cadre of “medical personnel in uniform,” who number nearly 170,000.
Hegseth served as an ROTC-trained Army officer deployed to Iraq, Afghanistan, and Guantanamo Bay and is a longtime critic of “government healthcare,” claiming that it “doesn’t work.” So if Hegseth succeeds Austin, Pentagon officials trying to end a failed experiment with MHA privatization may find themselves ordered to march backward.
Rather than being upgraded and improved, the DOD’s network of military hospitals and clinics would remain under-resourced. And more of the MHA’s $61 billion annual budget would be spent on private insurance coverage that has failed to meet the needs of many service members and their dependents, particularly in rural areas.
A White House Advisor
During the first Trump Administration, Hegseth was a White House advisor who pushed the Department of Veterans Affairs (VA) to expand care outsourcing for nine million former service members. Trump’s first VA Secretary, a hold-over from Barack Obama’s administration, dragged his feet on implementing this ill-advised policy.
As a result, Dr. David Shulkin, an experienced hospital system administrator in the private and public sectors, was fired by Trump in 2018 after keeping him around for over a year. In his memoir, It Shouldn’t Be This Hard to Serve Your Country, Shulkin blames his downfall on Hegseth, who “never worked at the VA, knew nothing about managing a healthcare system, and had little understanding of the clinical and financial impact of the policies he was advocating.”
Hegseth does have a background as “a capable midgrade officer” who earned two Ivy League degrees and Bronze Stars, plus media experience ranging from writing for the Princeton Tory, a conservative undergraduate publication, to opining about military and veterans’ affairs on Fox & Friends Weekend where he’s a host. In any other Republican administration, this resume would qualify him as a Pentagon press secretary.
That Hegseth has instead risen to a cabinet pick is a testament to the continuing impact of the Koch Brothers-backed Concerned Veterans for America (CVA). After a failed bid to become the GOP nominee in a 2002 Republican primary race for a U.S. Senate seat in his native Minnesota, Hegseth became CVA’s first CEO and a leading advocate for turning veterans care over to private doctors and hospitals.
CVA was an astroturf upstart in veterans’ affairs and an outlier in pushing VA privatization. Traditional Veterans Services Organizations (VSOs)—like Veterans of Foreign Wars, American Legion, Disabled American Veterans, or Vietnam Veterans of America—represent millions of veterans. Their members pay dues and elect their leaders. They have local chapters and national conventions. They have roots in the community and provide valuable services to individual veterans who need help filing disability claims for service-related conditions, which qualifies them for VA care.
VSO lobbying victories include the passage of the PACT Act of 2022. This legislation made VA benefits and related medical coverage easier to obtain for nearly a million veterans, including many whose health was damaged due to burn pit exposure during post-9/11 wars in the Middle East. (Hegseth initially applauded and then criticized the wars in Iraq and Afghanistan, a flip-flop characteristic of his career. As Iraq war veteran and VoteVets co-founder Jon Soltz says about him, “I have been debating Pete Hegseth for years, and I can’t tell you what he stands for other than himself and his own ambition.”
An Astro-Turf Group
With few actual dues-payers, no VSO-style membership service programs, and a political agenda bankrolled by libertarian billionaires, CVA helped pass few bills that benefited the nation’s 19 million veterans. Instead, during the Obama era, the media-savvy group became a battering ram against tax-payer-funded healthcare in any form, a longtime bête noir of the Kochs.
Hegseth became their most visible and effective mouthpiece in a wide-ranging campaign to discredit VA care and the Affordable Care Act (ACA). In 2013, CVA ran video ads warning, in Hegseth’s words, that all Americans would soon “face long wait times, endless bureaucracy, and poor service” if Congress expanded health care access by subsidizing private insurance coverage. The result, he claimed, would be billions of dollars wasted on “a nationalized health care plan that will bring the same bureaucratic dysfunction to the larger U.S. healthcare market”–as if the VA were a model for “Obamacare,” which it certainly wasn’t.
A year later, this propaganda offensive, closely coordinated with right-wing Republicans on Capitol Hill, claimed the scalp of retired four-star General Eric Shinseki, the Vietnam veteran who was Barack Obama’s first VA Secretary. Shinseki became the fall guy for a localized scandal involving misconduct by a few VA hospital managers in Phoenix. Their doctoring of data on medical appointment wait times—to earn bonus payments—led to CVA-amplified false claims that 40 Phoenix area vets had died due to delayed care. The result was that mainstream media packed journalism at its worst, and there was growing pressure for more out-sourcing of VA care despite its higher quality, lower cost, and greater accessibility than private alternatives.
On Capitol Hill, bi-partisan majorities passed the VA Choice Act of 2014 and, four years later, the VA MISSION Act. Both opened the floodgates for increasingly costly and disastrous privatization of the nation’s most extensive public healthcare system. CVA helped engineer the passage of each measure. After stepping down as CEO of Concerned Veterans of America ten years ago and becoming a Fox News commentator, Hegseth continued to advise President Trump on veterans’ affairs; other CVA alums served in official positions at the White House or VA headquarters in Washington.
Hegseth’s return to the conservative media eco-system of his college years has paid handsome rewards; he has become a multi-millionaire (despite two divorces) as a Fox & Friends talking head, paid speaker, and bestselling author of The War on Warriors, a critique of what he calls a "woke military." Like other high-paid former military officers, his benefit package in the private sector leaves Hegseth unlikely ever to need the VA, federally subsidized insurance coverage obtained through the ACA, or, when he retires, Medicare coverage. If confirmed, his pay as DOD Secretary will be a mere $246,000 per year, but with lucrative “revolving door” opportunities in the future, when and if he transitions back to the private sector from the Pentagon.
Pentagon Cost Savings?
Meanwhile, enlisted personnel and veterans from poor and working-class backgrounds bear the brunt of failed CVA-backed experiments with the privatization of the Military Health System and the VA. Under Trump and Biden, the DOD was flush with money for military aid, expensive new weapons systems, and base maintenance worldwide. Nevertheless, the Pentagon cut healthcare delivery costs for its workforce, retirees, and dependents.
Military hospitals were closed, staff positions cut, and several hundred thousand more patients were shifted to TRICARE, a federally funded form of private insurance. Newcomers to the private sector soon reported having greater difficulty getting timely medical appointments or accessing care in areas of the country with a shortage of primary care providers and specialists.
The Pentagon found that contracting out left its hospitals and clinics “chronically understaffed” and less able to “deliver timely care to beneficiaries or ensure sufficient workload to maintain and sustain critical skills. After reassessing the situation, the DOD launched an effort to “re-attract” patients back to the MHS. As studies have shown, in-house care produces better outcomes at lower cost, with fewer racial disparities—an essential advantage for a patient population of nearly 40 percent non-white.
If Hegseth becomes DOD Secretary by recess appointment or Senate confirmation, he will undoubtedly stop bringing TRICARE beneficiaries back into the MHS. He will also halt efforts to rebuild the DOD’s in-house healthcare delivery capacity.
And Hegseth will not be the only ideological foe of “government healthcare” in a high-level Trump Administration position. His fellow cabinet nominee, former Congressman Doug Collins, an Iraq War veteran from Georgia, will be eager to pick up where Robert Wilkie, Trump’s second VA secretary, left off with his privatization efforts in 2021. And, with the biggest impact, Dr. Mehmet Oz, the TV celebrity picked by Trump to run the Centers for Medicare and Medicaid, will further undermine traditional Medicare by replacing it with for-profit Medicare Advantage plans, on a more universal basis.
On all three fronts, these Trump appointees will weaken the public provision of healthcare that currently benefits more than 80 million people, making expanding such programs even more difficult.
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Why Project 2025 Is Bad News for Wounded Veterans Like Me
Donald Trump and JD Vance want to privatize the system and make sure that future generations of veterans who have sacrificed so much for their country don’t get the kind of care that has literally saved my life.
Oct 20, 2024
In 1968, when I was twenty years old, I volunteered to serve with the Marines in Vietnam. I was trained to be a Navy Corpsman (medic) and attached to the Marines. I was only in Vietnam five weeks before being seriously wounded. I was with a company of 83 Marines when we were given orders to go to the top of a mountain, where we became completely surrounded by 1500 North Vietnamese Regulars. It is impossible for me to describe what it was like to be the target of 1500 machine guns firing all at once. Eighty percent of us were either killed or wounded in the first ten minutes of the battle. When the firing quieted down, I belly-crawled over to a Marine whose left arm was blown off and that’s when I was shot in the hip. My hip was blown off.
For most of the past fifty-plus years, I have been cared for by the VA Healthcare system. I’ve watched with admiration as the system has consistently improved - sometimes, remarkably - over those five decades. But now I watch with alarm as former President and current candidate for another term Donald Trump and his running mate J.D. Vance and their allies at the Heritage Foundation threaten the existence of the kind of care veterans like me depend on.
Trump and Vance and the Heritage Foundation’s Project 2025 accuse the VA of making veterans dependent on care they don’t really need. They attack the dedicated nurses, doctors and countless others who have cared for me as being bad apples and callous sadists, and they claim that our PTSD is nothing more than having a bad hair day. They want to privatize the system and make sure that future generations of veterans who have sacrificed so much for their country don’t get the kind of care that has literally saved my life.
Let me tell you more about my journey and about the care I have received. After being shot in the hip, I lay with an open wound in dense jungle for five days before help could reach me. After being rescued by helicopter, it took seven days at a field hospital for surgeons to stabilize me enough to be flown to a much larger and better equipped hospital in Japan. My whole right hip joint was destroyed, plus my hip was horribly infected with osteomyelitis, a recurrent life-threatening bacterial infection. The kind of care I received back in the early 70’s at the VA was too often hit and miss, so I stopped going. But I returned in the mid-1990’s to find that the quality of care had radically changed for the better.
The change was so obvious when I walked in the door. The attitude towards us by the staff was wonderful. The whole VA staff had learned a lot about how to manage the complex symptoms of PTSD. When I went back to the VA hospital for care I knew I needed help dealing with psychological and emotional issues, not just my physical illness and injury. I was angry at my country and thought I had every right to be angry, even the responsibility to be angry. VA healthcare has helped me find the options I needed to deal with my anger.
Pain management has been another major challenge for me and many other Vietnam veterans over the past five decades. If I hadn’t had constant care from the VA, I strongly believe I wouldn’t be here today.
Over the past five decades I have seen first-hand how VA doctors and nurses have evolved in their understanding of the complex issues that veterans are dealing with. I experienced horrible healthcare treatment back in the 1970s and 80s, but now I’m receiving what I consider the best care there is. I wouldn’t go anywhere else.
This is why I urge all veterans and non-veterans to pay close attention to the anti-VA messages that are being broadcast by folks whose main goal is to send veterans to private sector doctors and hospitals.
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Rising Military Suicides Bring the War on Terror Home
As with its post-9/11 wars and interventions, the U.S. military’s effort to stem suicides has come up distinctly short.
Jul 26, 2024
At the end of the last century, hoping to drive the United States from Saudi Arabia, the home of Islam’s holiest sites, al Qaeda leader Osama bin Laden sought to draw in the American military. He reportedly wanted to “bring the Americans into a fight on Muslim soil,” provoking savage asymmetric conflicts that would send home a stream of “wooden boxes and coffins” and weaken American resolve. “This is when you will leave,” he predicted.
After the 9/11 attacks, Washington took the bait, launching interventions across the Greater Middle East and Africa. What followed was a slew of sputtering counterterrorism failures and stalemates in places ranging from Niger and Burkina Faso to Somalia and Yemen, a dismal loss, after 20 years, in Afghanistan, and a costly fiasco in Iraq. And just as bin Laden predicted, those conflicts led to discontent in the United States. Americans finally turned against the war in Afghanistan after 10 years of fighting there, while it took only a little more than a year for the public to conclude that the Iraq war wasn’t worth the cost. Still, those conflicts dragged on. To date, more than 7,000 U.S. troops have died fighting the Taliban, al Qaeda, the Islamic State, and other militant groups.
As lethal as those Islamist fighters have been, however, another “enemy” has proven far more deadly for American forces: themselves. A recent Pentagon study found suicide to be the leading cause of death among active-duty U.S. Army personnel. Out of 2,530 soldiers who died between 2014 and 2019 from causes ranging from car crashes to drug overdoses to cancer, 35%—883 troops—took their own lives. Just 96 soldiers died in combat during those same six years.
The war that bin Laden kicked off in 2001—a global conflict that still grinds on today—ushered in an era in which SEALs, soldiers, and other military personnel have continued to die by their own hands at an escalating rate.
Those military findings bolster other recent investigations. The journalism nonprofit Voice of San Diego found, for example, that young men in the military are more likely to take their own lives than their civilian peers. The suicide rate for American soldiers has, in fact, risen steadily since the Army began tracking it 20 years ago.
Last year, the medical journal JAMA Neurology reported that the suicide rate among U.S. veterans was 31.7 per 100,000—57% greater than that of non-veterans. And that followed a 2021 study by Brown University’s Costs of War Project which found that, compared to those who died in combat, at least four times as many active-duty military personnel and post-9/11 war veterans—an estimated 30,177 of them—had killed themselves.
“High suicide rates mark the failure of the U.S. government and U.S. society to manage the mental health costs of our current conflicts,” wrote Thomas Howard Suitt, author of the Costs of War report. “The U.S. government’s inability to address the suicide crisis is a significant cost of the U.S. post-9/11 wars, and the result is a mental health crisis among our veterans and service members with significant long-term consequences.”
Military Shocked (Shocked!) by a Rise in Suicides
In June, a New York Timesfront-page investigation found that at least a dozen Navy SEALs had died by suicide in the last 10 years, either while on active duty or shortly after leaving military service. Thanks to an effort by the families of those deceased special operators, eight of their brains were delivered to a specialized Defense Department brain trauma laboratory in Maryland. Researchers there discovered blast damage in every one of them—a particular pattern only seen in people exposed repeatedly to blast waves like SEALs endure from weapons fired in years of training and war-zone deployments as well as explosions encountered in combat.
The Navy claimed that it hadn’t been informed of the lab’s findings until the Times contacted them. A Navy officer with ties to SEAL leadership expressed shock to reporter Dave Philipps. “That’s the problem,” said that anonymous officer. “We are trying to understand this issue, but so often the information never reaches us.”
None of it should, however, have been surprising.
Unfortunately (though Osama bin Laden would undoubtedly have been pleased), the military has a history of not taking suicide prevention seriously.
After all, while writing for the Times in 2020, I revealed the existence of an unpublished internal study, commissioned by U.S. Special Operations Command (SOCOM), on the suicides of Special Operations forces (SOF). Conducted by the American Association of Suicidology, one of the nation’s oldest suicide-prevention organizations, and completed sometime after January 2017, the undated 46-page report put together the findings of 29 “psychological autopsies,” including detailed interviews with 81 next-of-kin and close friends of commandos who had killed themselves between 2012 and 2015.
That study told the military to better track and monitor data on the suicides of its elite troops. “Further research and an improved data surveillance system are needed in order to better understand the risk and protective factors for suicide among SOF members. Further research and a comprehensive data system is needed to monitor the demographics and characteristics of SOF members who die by suicide,” the researchers advised. “Additionally, the data emerging from this study has highlighted the need for research to better understand the factors associated with SOF suicides.”
Quite obviously, it never happened.
The brain trauma suffered by SEALs and the suicides that followed should not have been a shock. A 2022 study in Military Medicine found Special Operations forces were at increased risk for traumatic brain injury (TBI), when compared with conventional troops. The 2023 JAMA Neurology study similarly found that veterans with TBI had suicide rates 56% higher than veterans without it and three times higher than the U.S. adult population. And a Harvard study, funded by SOCOM and published in April, discovered an association between blast exposure and compromised brain function in active-duty commandos. The greater the exposure, the researchers found, the more health problems were reported.
Studies on the Shelf
Over the last two decades, the Defense Department has, in fact, spent millions of dollars on suicide prevention research. According to the recent Pentagon study of soldiers’ deaths at their own hands, the “Army implements various initiatives that evaluate, identify, and track high-risk individuals for suicidal behavior and other adverse outcomes.” Unfortunately (though Osama bin Laden would undoubtedly have been pleased), the military has a history of not taking suicide prevention seriously.
While the Navy, for example, officially mandated that a suicide hotline for veterans must be accessible from the homepage of every Navy website, an internal audit found that most of the pages reviewed were not in compliance. In fact, according to a 2022 investigation by The Intercept, the audit showed that 62% of the 58 Navy homepages did not comply with that service’s regulations for how to display the link to the Veterans Crisis Line.
Last year, a Pentagon suicide-prevention committee called attention to lax rules on firearms, high operational tempos, and the poor quality of life on military bases as potential problems for the mental health of troops.
The New York Timesrecently investigated the death of Army Specialist Austin Valley and discovered gross suicide prevention deficiencies. Having just arrived at an Army base in Poland from Fort Riley, Kansas, Valley texted his parents, “Hey mom and dad I love you it was never your fault,” before taking his own life. The Times found that “mental healthcare providers in the Army are beholden to brigade leadership and often fail to act in the best interest of soldiers.” There are, for example, only about 20 mental-health counselors available to care for the more than 12,000 soldiers at Fort Riley, according to the Times. As a result, soldiers like Valley can wait weeks or even months for care.
The Army claims it’s working to eliminate the stigma surrounding mental health support, but the Times found that “unit leadership often undermines some of its most basic safety protocols.” This is a long-running issue in the military. The study of Special Operations suicides that I revealed in the Times found that suicide prevention training was seen as a “check in the box.” Special operators believed their careers would be negatively impacted if they sought treatment.
Last year, a Pentagon suicide-prevention committee called attention to lax rules on firearms, high operational tempos, and the poor quality of life on military bases as potential problems for the mental health of troops. M. David Rudd, a clinical psychologist and the director of the National Center for Veterans Studies at the University of Memphis, told to the Times that the Pentagon report echoed many other analyses produced since 2008. “My expectation,” he concluded, “is that this study will sit on a shelf just like all the others, unimplemented.”
Bin Laden’s Triumph
On May 2, 2011, Navy SEALs attacked a residential compound in Pakistan and gunned down Osama bin Laden. “For us to be able to definitively say, ‘We got the man who caused thousands of deaths here in the United States and who had been the rallying point for a violent extremist jihad around the world’ was something that I think all of us were profoundly grateful to be a part of,” U.S. President Barack Obama commented afterward. In reality, the deaths “here in the United States” have never ended. And the war that bin Laden kicked off in 2001—a global conflict that still grinds on today—ushered in an era in which SEALs, soldiers, and other military personnel have continued to die by their own hands at an escalating rate.
The suicides of U.S. military personnel have been blamed on a panoply of reasons, including military culture, ready access to firearms, high exposure to trauma, excessive stress, the rise of improvised explosive devices, repeated head trauma, an increase in traumatic brain injuries, the Global War on Terror’s protracted length, and even the American public’s disinterest in their country’s post-9/11 wars.
Bin Laden is, of course, long dead, but the post-9/11 parade of U.S. corpses continues.
During 20-plus years of armed interventions by the country that still prides itself on being the Earth’s sole superpower, U.S. military missions have been repeatedly upended across South Asia, the Middle East, and Africa including a sputtering stalemate in Somalia, an intervention-turned-blowback-engine in Libya, and outright implosions in Afghanistan and Iraq. While the peoples of those countries have suffered the most, U.S. troops have also been caught in that maelstrom of America’s making.
Bin Laden’s dream of luring American troops into a meat-grinder war on “Muslim soil” never quite came to pass. Compared to previous conflicts like the Second World War, Korean, and Vietnam wars, U.S. battlefield casualties in the Greater Middle East and Africa have been relatively modest. But bin Laden’s prediction of “wooden boxes and coffins” filled with the “bodies of American troops” nonetheless came true in its own fashion.
“This Department’s most precious resource is our people. Therefore, we must spare no effort in working to eliminate suicide within our ranks,” wrote Secretary of Defense Lloyd Austin in a public memo released last year. “One loss to suicide is too many.” But as with its post-9/11 wars and interventions, the U.S. military’s effort to stem suicides has come up distinctly short. And like the losses, stalemates, and fiascos of that grim war on terror, the fallout has been more suffering and death. Bin Laden is, of course, long dead, but the post-9/11 parade of U.S. corpses continues. The unanticipated toll of suicides by troops and veterans—four times the number of war-on-terror battlefield deaths—has become another Pentagon failure and bin Laden’s enduring triumph.
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