SUBSCRIBE TO OUR FREE NEWSLETTER
Daily news & progressive opinion—funded by the people, not the corporations—delivered straight to your inbox.
5
#000000
#FFFFFF
5
#000000
#FFFFFF
veterans affairs
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.
Keep ReadingShow Less
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.
Keep ReadingShow Less
Previous Trump Attack on VA Proves 2024 Win Would Be Threat to Workers
Trump makes union grievance settlement a presidential campaign issue
Oct 30, 2023
It’s rare that a union grievance settlement becomes a U.S. presidential campaign issue. But, thanks to the American Federation of Government Employee’s successful defense of workers unfairly dismissed by the Department of Veterans Affairs (VA), Donald Trump is now running for the White House on a platform that includes firing “every corrupt VA bureaucrat who Joe Biden has outrageously refused to remove from the job or put back in the job.”
Trump made that pledge, during an August speech in New Hampshire, delivered shortly after AFGE and the VA settled their long-running dispute about the impact of Trump-era legislation on the due process rights of 300,000 VA staffers. In Trump’s view, the union’s defense of “bad VA employees” represents a “shocking act of betrayal of America’s veterans, as well as the tens of thousands of dedicated professionals” also employed by the agency.
As reported by the Federal News Network on July 31, thousands of fired workers will be eligible for either reinstatement or back pay, at a total cost estimated “to be in the hundreds of millions of dollars.” Hundreds of former employees “who the VA and AFGE mutually agreed were terminated for grievous misconduct will not be eligible for return to work,” the VA announced.
“This agreement will allow VA and AFGE to move forward and focus on what matters most: delivering world-class care and benefits to veterans, their families, caregivers and survivors,” said VA Secretary Denis McDonough. “Union employees are the backbone of VA’s workforce, and we are proud to support them.” AFGE National President Everett Kelley called the settlement “historic” and a demonstration of “what’s possible when labor and management come to the table in good faith to solve problems together.”
Due Process Still Under Fire
Their joint announcement ended a long legal battle over the VA Accountability and Whistleblower Act, Trump-backed legislation enacted in 2017, with bipartisan support. That struggle began when—as the Federal Labor Relations Authority (FLRA) later found—Trump’s VA Secretary Robert Wilkie refused to bargain with AFGE over the impact and implementation of the new law. In an August interview with News Max, the right-wing media outlet, Wilkie blamed Biden, not an arbitrator, the FLRA and a federal appeals court, for “negating the authority that President Trump gave me” to “circumvent the usual bureaucratic protections that bad employees use to stay on for life.”
On the presidential campaign trail, Wilkie’s former boss is promising to put the Accountability Act “back in full force” when and if he returns to the White House. Trump’s Republican allies in the House are also trying to pass the “Restore VA Accountability Act,” to fast-track VA firings in the future, whether Trump wins or not. Their bill would allow the third largest federal agency to demote, suspend, and fire workers based on a lesser standard of proof already successfully challenged in a federal appeals court decision. According to AFGE, it would also undermine the new collective bargaining agreement the national union reached with the VA earlier this year and ratified in June.
How did federal employee due process rights become a 2024 campaign topic? The back story is worth recalling because Trump launched an all-out assault on workers’ rights during his four years in office; a second term could be even worse. As noted above, bipartisan majorities in the House and Senate voted six years ago to weaken due process protections for VA employees and limit their right to appeal job-related discipline. Among Democrats, the legislation was backed by now Sen. Kyrsten Sinema (I-Ariz.), a Democrat at the time and a big proponent of out-sourcing veterans’ care to the private healthcare industry.
A leading Republican champion was Sen. Marco Rubio (R-Fla.), whose 2016 reelection campaign for the Senate received financial help from the Concerned Veterans for America (CVA), an astro-turf group backed by the Koch Brothers to further their agenda of VA privatization and union busting. During Trump’s first year in office, CVA made a six-figure investment in getting the Accountability Act passed, via media buys and creation of a digital tool that facilitated direct lobbying of members of Congress. This campaign gained credibility when old-line Veterans Service Organizations (VSOs), which has an actual membership base, bought into the idea that the VA needed new tools to weed out bad managers and bargaining unit members.
Part of a Larger Plan
Ian Hoffmann, a former AFGE legislative and political organizer, helped VA caregivers lobby against the measure because, in his view, “it was part of a larger plan to dismantle and privatize the VA by weakening the collective voice of its workforce.” In the leadup to the vote, he recalls, “it quickly became clear what we were up against. Lobbying in Nevada and California, we heard expressions of sympathy from our ‘friends’ in Congress, but many were swayed by VSO support for the Accountability Act. One staffer told us that her member of Congress was getting mail, which favored passage of the legislation by a 10-1 margin. When pressed, she acknowledged that the letters were almost entirely from templates provided by the CVA.”
In his later work with frontline VA caregivers, Hoffmann saw firsthand “how the actions of top managers appointed by Trump, who were hostile to the mission of the agency, used the Accountability Act to make personnel policies, working conditions, and staffing levels immeasurably worse.” This had a far greater adverse impact on nine million patients than any individual failings of union-represented workers or lower-level managers in the nation’s largest public healthcare system.
In 2018, Trump used a series of executive orders to further modify disciplinary procedures, weaken seniority rights, and limit the long-established practice of allowing union stewards to spend compensated time representing their coworkers during working hours. VA management began to remove AFGE offices from agency property, making it harder for workers with job-related questions and concerns to access union reps. A union lawsuit temporarily blocked these changes, but they were finally implemented in February of 2020. In contract bargaining with AFGE and other VA unions, Trump appointees sought major concessions from AFGE, including weakening job safety and health protections.
Whether VA employees belonged to a union or held a career manager job, the Trump administration succeeded in creating a toxic work environment for many of them. In the view of Steve Robertson, former legislative director for the American Legion and a past Senate Veterans Affairs Committee staffer, the VA’s new personnel policies did far-reaching and intentional damage. “It no longer made sense for people to prioritize the VA when seeking government work,” he points out. “Why would someone come to work at the VA when they could work at the DOD or NUH or other agencies where there were more protections?”
As AFGE attorney Cathy McQuiston noted, when the union launched its legal fightback in 2018, the Trump Administration was implementing the Accountability Act “in the most harmful way and the broadest way it can. And it will only pull back from doing that if ordered to do so by some third party.”
Whistleblower Protection for Who?
As we report in our book, Our Veterans: Winners, Losers, Friends and Enemies on the New Terrain of Veterans Affairs, during the first six months that the VA Accountability Act was in effect, only a handful of higher-level officials were removed for their poor performance or misconduct. Meanwhile, there were 1,264 other discharge cases—all involving low-level employees who worked in VA claims processing, food service, and custodial jobs. Veterans comprise about a third of the agency’s workforce and some VA patients, with a history of homelessness or mental illness, can qualify for compensated work-therapy programs at VA facilities. Even these disabled workers were at risk of unfair discipline under the Accountability Act.
The 2017 law also established an Office of Accountability and Whistleblower Protection, with dozens of investigators. Its first director, Peter O’Rourke, was—like then-VA Secretary Wilkie—a former Republican Party operative not very interested in rooting out “corrupt bureaucrats” among his fellow Trump appointees. At the VA, O’Rourke ended up “collecting pay, but doing little work,” as the Washington Postreported. He was forced to resign in 2018. During O’Rourke’s brief tenure, he was also accused of protecting political allies, within the agency, who were under investigation and not providing timely reports to Congress. As of late 2019, several thousand whistleblower complaints had been received, but only one resulted in any recommended discipline of a senior official, according to the Project on Government Oversight.
In the meantime, a dedicated professional staffer of the VA in northern California—who became eligible for back pay and reinstatement under the AFGE grievance settlement—paid a heavy price for being a whistle-blower in 2017. Then a member of AFGE Local 2152, Patty Stamos was a licensed clinical social worker at a community-based clinic in Auburn, CA, which serves about 4,000 veterans. According to Stamos, “over fifty mental health patients, some high risk for suicide, failed to receive vital mental health care” during two periods of her approved absence.
After making this supposedly “protected disclosure” to management, Stamos became the subject of supervisory complaints about delays in her written documentation of work on a heavy case-load of patients. During her nearly five years at the VA, she had never been put on a Performance Improvement Plan (PIP) or received any actual prior discipline. But, in early 2018, she was fired.
Stamos believes that the Accountability Act, contrary to its stated purpose, “did not hold VA mental health management accountable for abuses of power and neglect of veterans. It did not protect me, or any other VA employee from Whistleblower retaliation. And it did not protect vulnerable veterans whose mental health treatment was sidelined for months.” Last month, Stamos left her job at a private and returned to work at the VA clinic in Auburn, where she was fired more than five years ago. She has been assigned to a new position, rather than her preferred old one, and “still has not seen a dime of back pay.” She estimates that her back pay, minus interim earnings, will amount to hundreds of thousands of dollars.
Accountability Act, the Sequel?
As Stamos and other Accountability Act victims await full compensation for their financial losses, VA unions and their allies are warning Congressional Democrats not to join Republicans—and Donald Trump—in further costly and counter-productive grand-standing about VA worker “accountability.” On Capitol Hill, the “Restore VA Accountability Act” has backers like House Veterans Affairs Committee Chair Mike Bost (R-Ill.), who claims to be once again just targeting that “small percentage of employees who are hurting veterans” through their poor performance or personal misconduct.
In its letter of opposition, the Partnership for Public Service, a non-partisan, non-profit group, argues that the legislation backed by Bost would “erode and eliminate the role of third, party independent executive review” of discharge cases by the Merit Systems Protection Board (MSPB). “This approach unnecessarily compromises due process for line employees while reducing accountability for senior executives and political leaders during removal proceedings,” the Partnership points out.
The National Federation of Federal Employees (NFFE), which represents about 9,000 nurses, medical officers, pharmacists, and social workers at the VA, reminded Congress that the last time it lowered the burden of proof for misconduct from a “preponderance of the evidence” to “substantial evidence,” the result was disciplinary action based on scant evidence of wrongdoing.
AFGE’s objections include the fact the “Restore VA Accountability Act” would result in more employees being disciplined before being put on a Performance Improvement Plan. Echoing former Legion official Steve Robertson’s observation about the impact of the original Accountability Act, the union warned that “diminishing the due process and collective bargaining rights of VA employees compared to federal employees in other agencies” will “dissuade potential employees from working at the VA” if similar jobs are available with better protections elsewhere in the federal government.
Other critics fear that any negative impact on new hiring will make it harder for the VA to meet the expanded demand for its services created by passage of the PACT Act last year. That legislation allocated $280 billion, over the next ten years, for healthcare and benefits for hundreds of thousands of former soldiers suffering from burn pit exposure in Iraq and Afghanistan. According to Don Kettl, a former dean of the University of Maryland School of Public Policy, the Bost bill “is a serious mistake that would harm the Department of Veterans Affairs and injure the nation’s effort to care for those who have given so much to it.”
In the Republican-dominated U.S. House, the current volume of seriously mistaken legislation is so large that a bill claiming to “restore accountability” at the VA doesn’t draw much attention and might even sound like a good idea. But legislation passed six years ago, under that same misleading label, proved to be detrimental to veterans, their care-givers, and taxpayers who fund the VA healthcare system. So Trump’s recent campaign pledge to restore “historic VA reforms” like this in 2025, if he’s elected next November, is a political threat that needs to be taken very seriously.
Keep ReadingShow Less
Most Popular