This review of my book Wounds of War was just published in Labor Notes.

Another Look at the VA, in the Midst of a Pandemic

The current crisis has made painfully clear the deficiencies in our fragmented and profit-oriented health care system. As millions lose their jobs, the folly of basing access to health care on employment has never been more obvious, and the need for universal health care has never been more evident.

While many of us are calling for Medicare for All, it’s also a good time to take a second look at a national health care system that actually exists here in the U.S.—and has worked remarkably well (that is, except when it is severely underfunded, understaffed, and under constant attack by privatizers and union-busters): the Veterans Administration.

ROBUST BUT LITTLE-KNOWN

The Veterans Health Administration is one of three branches of the Department of Veterans Affairs (DVA). It provides a full range of health care services to 9 million veterans at 170 hospitals and 1,000 clinics nationwide. It also runs strong, well-respected medical research and education programs; about 70% of all U.S. physicians trained at a VA facility at some point in their education.

Other branches of DVA are the Veterans Benefits Administration (VBA) and the National Cemetery Administration (NCA). A “fourth mission” of the VA is as a backup national health system during emergencies (like a pandemic).

Almost 400,000 people work within DVA, the vast majority of those at VA. Over one-third of them are veterans themselves, with a special dedication to serving other veterans. It is a unionized workforce, represented by several unions, of which the American Federation of Government Employees (AFGE, my union) is the largest.

A slew of independent studies, such as by the Rand Corporation and Dartmouth researchers, consistently demonstrate the quality of VA care. A recent large survey by the Veterans of Foreign Wars showed that more than 90 percent of veterans who use the VA would recommend it to others. The wait times for appointments are good these days: more than 93 percent of appointments are scheduled within 30 days, and many sooner than that. Most care is provided without cost. The VA negotiates the best wholesale drug prices in the country, and patients with VA coverage are less likely to skip medications because of cost than other insured Americans.

Award-winning health care journalist Suzanne Gordon has spent years studying the VA.
Her conclusion: the VA is a remarkably effective and well-run health care system, providing care which is usually superior to the private sector, and at a lower cost. This is particularly impressive knowing that VA patients tend to be older and sicker than the general population.

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