Brown argues that the Trump-backed VA MISSION Act of 2018 was a much needed effort to “fix the VA health care system, hold its failed administrators accountable, modernize VA facilities, and expand care choices for veterans.” (Photo: Getty Images
Former Army captain Sam Brown’s bid for the US Senate should have had natural appeal to his fellow veterans, particularly the 112,00 in Nevada who use the Department of Veterans Affairs (VA) for their health care.
A combat veteran in Afghanistan, Brown needed extensive government-provided medical care himself after he suffered grievous and disfiguring wounds of war.
When he recovered from his injuries, with the help of a world class burn victim treatment program at an Army hospital in Arizona, he started a vet-owned business that received $2.7 million in federal contracts to expedite prescription deliveries to some VA patients.
However, on the campaign trail, Brown is not a defender of the VA and its high-quality care for 9 million veterans, which has long enjoyed the support of even conservative veterans’ organizations like the VFW and American Legion.
Instead, he claims that “too many of us have been left behind” by an overly-“centralized” and “socialized system” of healthcare delivery. According to Brown, the work of 300,000 VA care-givers—a third of whom are veterans– should be supplemented, if not replaced, by federally-funded private sector treatment.
Brown’s embrace of VA privatization—and he is careful not to use that “P” word—echoes the controversial VA-related recommendations of the Heritage Foundation’s Project 2025, which he, like President Trump, downplays as a guide to his likely post-election thinking about federal government “reform.”
Like Project 2025 contributors on veterans affairs, Brown argues that the Trump-backed VA MISSION Act of 2018 was a much needed effort to “fix the VA health care system, hold its failed administrators accountable, modernize VA facilities, and expand care choices for veterans.” He claims that that legislation—now resulting in more than $30 billion a year in VA outsourcing to the private sector has reduced wait times for appointments and time spent travelling to doctors, hospitals, and clinics.
This rosy view of the damaging impact of the Mission Act is not shared by six healthcare experts who produced a recent bi-partisan report for VA Secretary Denis McDonough on the “existential crisis” facing the agency, after six years of partial privatization.
Their so-called Red Team Executive Roundtable report confirmed, what many other studies have shown—namely, that the private sector care favored by Brown is more costly, of lower quality, and not even faster or more accessible.
Under the guise of giving veterans more “choice,” the mounting cost of reimbursing 1.6 million private contractors (like Brown’s old firm, Palisades Strategy) is bankrupting the VA-run Veterans Health Administration (VHA) That’s why Red Team members—none of whom work for the agency now –urged McDonough to clamp down on costly and unnecessary referrals outside the VA’s own direct care system.
Without such a course correction, they warn, the VA will not “continue to be available to serve the diverse, specialized, and often highly complicated health care needs of enrolled Veterans.” Instead, looming budget deficits will force the agency to reduce staff, curtail services, and close hospitals and clinics–thus “eliminating choice for the millions of Veterans who prefer to use the VHA direct care system for all or part of their healthcare needs.”
Veterans value that care because the nation’s largest public healthcare system is mission-driven, not profit driven. They are generally older and have more complex medical and mental health conditions than the average private sector patient. As numerous research studies confirm, its skilled and dedicated caregivers are able to deliver the kind of integrated and coordinated care that is hard to find in fragmented, fee-for-service world of private sector medicine.
As a Senate candidate, Brown tells fellow veterans that their issues have been overly “politicized.” His own political response is to assure former service members they can have their tax-payer funded cake and eat it too. But the reality is military veterans will lose access to a properly staffed and well-maintained health care system, devoted to their special needs, if the VHA’s patient population is further cannibalized by outsourcing, as Brown proposes.
VA-run medical centers across the country are already under severe financial strain. Even Secretary McDonough has warned that, if outsourcing costs continue to rise, “VA medical facilities, particularly those in rural areas, may not be able to sustain sufficient workload to operate in their current capacity.”
The big decision facing veterans today is whether they want to chase the chimera of choice, offered by VA privatizers like Sam Brown, or side with veterans’ organizations like the Legion. Seven years ago, at its national convention in Reno, that 1.6 million member group issued a detailed report declaring VA healthcare to be a “system worth saving.”
Why? Because, it continues to perform as well as, and often better than, than the rest of the U.S. health-care system on key quality measures, including patient safety, patient satisfaction, care coordination, and adherence to evidence-based medical practices. All of which are being eroded by diverting billions of dollars, every year, from VA direct care to for-profit hospital chains, medical practices, and private clinics.