The drive to privatize US veterans’ health care

Kate Randall and Barry Grey, Senior Editors, wsws.org

There is a largely hidden and deeply reactionary political agenda behind the current furor over the crisis in the US Department of Veterans Affairs’ health care system. On Friday, President Barack Obama responded to mounting demands from Democratic as well as Republican lawmakers and announced the resignation of VA Director Gen. Eric Shinseki (retired), promising “reform” of the system.

The so-called “reform” being prepared, however, represents a further attack on veterans and a precedent for laying siege to other government programs such as Medicare, Medicaid and Social Security. The scandal at the VA over long wait times for appointments, falsified records and related deaths of veterans has not prompted calls for any substantial increase in funding for the beleaguered department, but renewed calls for its privatization.

The hypocritical claims of the president and members of Congress that their proposals to deal with the crisis at the VA are motivated by genuine concern for veterans merit only contempt. The same politicians who bemoan the poor treatment of veterans are responsible for the human and social disaster that is reflected in the explosive growth of the patient load at VA health facilities. They are seeking to exploit the current scandal to allow for-profit insurance companies and health care firms to gain access to a lucrative market at the expense of veterans’ health care.

The far greater scandal is the social catastrophe reflected in the huge influx of veterans seeking treatment. The horrific injuries—both mental and physical—suffered by hundreds of thousands of veterans are a direct result of the endless wars and military interventions that have been authorized and perpetrated by the same politicians who now shed crocodile tears for the veterans’ plight.

More than half of the 2.6 million soldiers dispatched to the wars in Iraq and Afghanistan struggle with physical or mental health problems stemming from their deployment, according to a recent poll conducted by the Washington Post and the Kaiser Family Foundation. Some 470,000 current and former service members report being seriously injured while deployed to Iraq. These veterans present VA doctors with the task of caring for brain injuries, post-traumatic stress disorder (PTSD), amputations and other severely debilitating injuries.

But while primary care appointments at the VA have leapt by 50 percent in the past three years, the staff of primary care doctors has grown by only 9 percent. Primary care physicians, who are supposed to be responsible for about 1,200 patients each, now treat upwards of 2,000.

The crisis facing veterans spreads far beyond the hospitals and clinics operated by the VA. Shinseki’s last public appearance before heading to the White House to be sacked by Obama was at a conference of The National Coalition for Homeless Veterans. The very existence of such an organization—and what it says about the conditions veterans face in a society dominated by mass unemployment, declining wages and budget cuts on the one side, and ever more obscene levels of wealth at the top on the other—passes without comment in the media.

The Department of Housing and Urban Development estimates that 57,849 veterans are homeless on any given night, nearly half of them ageing veterans of the Vietnam War era. Another 1.4 million veterans are at risk of homelessness due to poverty, unemployment, lack of support networks and other social stresses.

An average of 22 US veterans kill themselves every day, according to the VA. This grim figure calculates to nearly 700 suicides a month and more than 8,000 a year, more than the combined toll of combat and other deaths in the more than 12 years of the wars in Iraq and Afghanistan. According to the poll cited above, more than half of the veterans of these wars, 51 percent, knew someone personally who committed or attempted suicide.

Democratic and Republican politicians alike endlessly heap praise on America’s “heroes” and “warriors,” even as they send more young people to be killed and mangled to secure the global interests of the US corporate-financial oligarchy. They then starve the VA and other social agencies of the funds they need to care for the victims of their militaristic policy.

In the face of the dire conditions at the VA, the House last month passed an annual spending bill that included a mere $1.5 billion increase for fiscal year 2015 to fund veterans’ programs.

Particularly revealing were the comments of Rep. Nancy Pelosi of California, who commented cynically that “Endless war abroad has its costs at home”—while in the next breath expressing her support for Republican proposals to privatize more health care services for veterans. “I don’t have any problem with that,” she said. This from the leader of Democrats in the House of Representatives who has supported every war of aggression under first Bush and then Obama, and supports the Obama administration’s doctrine of aggressive and unilateral war.

In an editorial Saturday, the Wall Street Journal wrote, “Instead of paying for shorter delays, a better option is to fix the structure that causes delays. That means decentralizing the VA and selling off most of the institution …. insurance vouchers for vets can replace socialized medicine, and markets will discipline a now-unaccountable bureaucratic culture” (emphasis added).

The ruling class and its political stooges and media mouthpieces look on the VA system—as well as every other government-run program, from the Post Office to Medicare, Medicaid and Social Security—as a potential source of new profit and income to add to already obscene private fortunes. They seek to tear down these programs along with everything else—health and safety rules, environmental regulations, workers’ health benefits and pensions—that diverts wealth from their own pockets.

Of course, the VA system, as with every government social program under capitalism, is wracked by bureaucracy, inefficiency and corruption. These problems are exacerbated as state resources are increasingly diverted to the military and austerity becomes the basis of all social policy.

Veterans’ health care is not, as the Journal would have us believe, socialized medicine. However, like every other genuine social reform, it is bound up with massive struggles by the working class in the face of violent repression and resistance from the ruling elite and its political representatives.

The Veterans Administration was established in 1930 in the early stages of the Great Depression. Two years later, an estimated 43,000 protesters—including World I veterans, their families and others—descended on Washington, DC to demand immediate cash payment of bonuses that had been promised to veterans for their service. Many had been out of work since the beginning of the Depression. The Bonus Army, as it came to be known, was brutally put down by the US Army on the orders of Hoover and dispersed.

The vast majority of veterans do not want to see the Veterans Health Administration, the largest integrated health care network in the US, privatized and turned over to the insurance companies and health care industry. They sense, correctly, that the result of the various voucher programs on offer will be a drastic reduction in the level of care and sharply increased out-of-pocket costs.

The defense of US veterans’ health care is bound up with the defense of health care as a social right for all people. At the same time it poses the need for a mass struggle of the working class against militarism and war.

The war machine of US imperialism, which consumes more than $1 trillion every year and maims and kills people all over the world, including Americans, must be shut down. The US foreign policy of war, aggression and domination must be replaced with a policy based on the international unity of the working class and human solidarity.

These urgent issues pose the need for an independent political struggle of the working class to break the grip of the corporate-financial aristocracy, establish a workers’ government, and restructure economic life on the basis of public ownership of the means of production, democratic control and social equality—that is, on a socialist basis.

Kate Randall and Barry Grey