Interview by Meagan Day

Veterans’ health care is “horrible, horrible, and unfair” according to Donald Trump. But how true is that? Pretty untrue, judging by the numerous studies the US Department of Veterans Affairs’ (VA) health care system performs better than private systems in quality, safety, and effectiveness of treatment.

The VA runs the largest health care system in the US, and the only one that’s publicly funded from top to bottom, with not only its own insurance program but its own doctors and hospitals as well. And despite having an older, poorer, and sicker clientele than the general population, the VA is both the most cost-effective health system in the country and boasts the nation’s highest rates of patient satisfaction. Its continuing success is a stinging rebuke to the neoliberal axiom that private corporations and capitalist markets can deliver everything society needs, better and more efficiently than tax-funded social programs can.

It comes as no surprise, then, that free market crusaders like the Koch brothers have set out to convince the public that the VA is actually a disaster. They and other billionaires and hard right-wingers want the Trump administration to do to veteran health care what previous administrations have done to public housing and education: bring it to its knees, then denounce it as a failure, then privatize it.

The script is familiar. First, wage a dishonest propaganda campaign against a functioning public program. Then starve the public program of funds through “fiscally responsible” austerity measures. Point to failures caused by underfunding as evidence of the program’s irredeemable flaws. Elevate private alternatives as a panacea for the problems caused by deliberate budget cuts, then repeat until the public program has been eroded and largely replaced by a patchwork of nonpublic entities that treat the original public good like a commodity.

Even the rhetorical tricks are well-worn: just as the “school choice” movement has done in promoting the charterization of public education, and just as HUD’s “housing choice” vouchers have done in order to shunt poor people into the private rental market rather than build public housing, the term “veteran choice” has been thrown around to describe siphoning patients out of the VA and into the private sector.

In the name of “veteran choice,” earlier this month the Senate passed the VA Mission Act, which will (among other changes, some of which are positive) “streamline veterans’ access to non-VA community care” — that is, pay tax dollars for them to leave the VA. The reality, says journalist Suzanne Gordon, is that such privatization efforts will ultimately “increase middleman profits, reduce the efficiencies of a fully integrated system, and drastically cut care.”

Jacobin spoke with Gordon about the assault on the VA system. She’s the author of several books on veterans’ health care; her latest is The Battle for Veterans’ Healthcare: Dispatches from the Frontlines of Policy Making and Patient Care.