Supporters say the president has made great strides in reforming the Veterans Administration, but others worry he is on the road to privatizing the agency.
When attorney Thomas Bandzul served in the Air Force during the Vietnam War in the early 1970s, he had no aspirations of becoming an advocate for his fellow veterans.
He didn’t reach his decision to become an advocate until years after the war ended.
That’s when he received a call from a colleague who said a homeless Vietnam veteran desperately needed Bandzul’s legal help to get his disability benefits from the Department of Veterans Affairs (VA).
“No one should have to go through what veterans have to in order to get what they have earned and what the government had contractually promised,” said Bandzul, a corporate lawyer who has worked for Mobil Oil, Bell Atlantic, Verizon, and the Koch brothers.
But helping that one homeless vet changed Bandzul’s life.
He decided to walk away from the corporate world and spend his days lending his considerable legal prowess to helping his fellow veterans entangled in the bureaucratic web of the VA.
He’s been an advocate on the front lines of veteran-focused legal and legislative battles ever since.
Bandzul, now legislative counsel with Veterans and Military Families for Progress, has spoken multiple times before Congress and had his hand in several major pieces of pro-veteran legislation.
Bandzul, who lives just 20 miles from the White House, says he feels obligated to make sure President Donald Trump backs his pro-veteran rhetoric with action — especially when it comes to needed reforms at the VA.
Last month, Trump signed a bill expanding the Veterans Choice Program, the service that allows some veterans to seek private care outside the VA.
It’s a program many veterans say is bogged down in bureaucracy and poor service.
In addition to the expansion of the Choice Program, Trump also signed an executive order last week establishing the Office of Accountability and Whistleblower Protection at the VA.
The idea was originally the brainchild of Rep. Ann Kirkpatrick, D-Ariz., after a widely covered scandal at the Phoenix VA.
In that case, program managers were accused of lying about the length of time veterans waited to see a doctor.
It was estimated that at least 40 veterans in Phoenix died while waiting.
The Phoenix VA scandal was made public in 2014 by whistleblowers who worked at the hospital.
Trump said the new office will provide veterans with the “healthcare they need and the healthcare they deserve.”
Officials at the VA also announced last month that some veterans who have minor illnesses or injuries can now use the health benefits at CVS “MinuteClinics.”
The pilot program, which came out of the scandal at the Phoenix VA, is only available in Phoenix now.
But VA Secretary David Shulkin hopes to eventually make it available nationally as part of his effort to increase public-private partnerships for veterans.
At a congressional hearing on May 3, Shulkin said his department may close as many as 1,100 VA facilities nationwide as it develops these partnerships. He said the VA has identified 430 vacant buildings and 735 facilities that are under-utilized for potential closure. The move, he said, would save $25 million a year.
Several veteran advocates, as well as some Republican political experts, say the actions of the past few weeks are a good sign and that Trump has gotten off to a good start with regard to veterans’ issues.
Bill Rausch, founder and executive director of Got Your 6, a veterans’ group that works with the entertainment industry to increase awareness of vet issues, is cautiously optimistic about the new administration’s plans to reform the VA.
“What we’ve seen so far at VA with Shulkin’s nomination, the proposed budget, and the executive order on accountability, right now the president has done a pretty good job of reinforcing what he said in the campaign,” Rausch told Healthline. “Veterans are an issue he cares about and so far that activity has reinforced that.”
Dr. Phil Roe, the Tennessee Republican congressional representative who now chairs the House Veterans Affairs Committee, agrees.
In a statement last week, he said, Trump “has made advocating for America’s heroes one of his highest priorities. His actions in the past week are a testament to that commitment.”
But Bandzul and a half-dozen other veteran advocates interviewed for this story are far less enthusiastic.
They believe that instead of fixing the problems at VA, Trump could make things worse by delving too deeply into the privatization of the agency.
Bandzul said the Choice Program expansion, while good in theory, “will only further enable Trump to privatize the VA at the expense of veterans.”
He and others noted that the President seems to want to privatize Medicare, education, public broadcasting, transportation, Native American lands, and air traffic control.
Many veteran advocates fear that Trump’s VA is heading to full-blown privatization.
That’s despite the fact that virtually every major veterans group from the American Legion to, Iraq and Afghanistan Veterans of America, to even Shulkin himself, oppose the idea.
More public-private partnerships for veterans’ health are not necessarily a bad thing, most everyone agrees.
But will President Trump take this too far?
Bandzul and other veteran advocates believe Trump is likely to adopt the corporate profiteering model at the VA.
That would be a flashback to President George W. Bush’s VA a decade ago.
In 2007, Bush named retired Army Lt. Gen. James Peake to run the VA.
Peake came from a private company that made hundreds of millions of dollars from contracts with the VA. He also helped develop proposals for the company to contract with the VA.
But as the website Salon noted in 2007, that appointment raised serious questions about conflict of interest, potentially pitting veterans’ care against corporate profits.
Peake was the second person to head the VA under the Bush administration who came from the same private contractor, >QTC Management, a California firm that bills itself as “the largest provider of government-outsourced occupational health and disability examination services in the nation.”
The first person from QTC to run the VA under Bush was Anthony Principi, who’s reportedly a lobbyist with QTC.
The Los Angeles Times >reported at the time that while Principi ran the VA, Principi’s QTC company collected about $246 million in fees.
Principi told the Times he had no role in awarding, amending, or administering VA contracts with QTC.
“While at the VA, I had no contact with QTC on any business matter and recused myself entirely from any issues or business that QTC might have had with the VA,” he said.
He added he complied with federal statutes barring contact with the VA after his departure.
Citing his two sons’ combat service, Principi told the Times, “Caring for these young men and women we send to war is the only thing that motivates me whether I’m in public service or in any aspect of business, where their interests are at stake.”
However, while he was VA secretary, Principi >reportedly steered all veterans’ compensation and pension medical and mental health exams to his QTC company.
Bandzul said the denial rate for veteran claims “skyrocketed” after QTC took over the exams for veterans.
“Obviously, every time there was an exam, QTC made money, so needless to say there were more denials to veterans seeking their disability benefits to generate more exams,” said Bandzul.
The veterans’ attorney said he believes Trump may be headed in that same direction.
Another clue to Trump’s plans for the VA, Bandzul said, is that he appears to be relying on the advice of representatives from Concerned Veterans for America (CVA).
That’s a veterans’ organization comprised of Republicans funded by the Koch brothers.
According to a Time magazine story last year, CVA is “part of the sweeping network backed by Charles and David Koch, the industrialist billionaires.”
Even though the Kochs didn’t warm up to Trump during the presidential campaign, they were adamant about privatizing the VA. And they evidently still are.
In an opinion piece last year for Forbes magazine, Michael Cannon, the health policy studies director for the Koch-funded Cato Institute, said Congress should “privatize the entire” VA.
Now that Trump is in the White House, the Koch brothers will likely make peace with the president for business reasons, Bandzul said.
As the Washington Post reported in late December, Trump met with David Koch at Trump’s Mar-a-Lago hotel.
There are also a number of Koch loyalists in Trump’s inner circle, including Vice President Mike Pence and adviser Kellyanne Conway.
Mike Pompeo, the former Kansas Congressman who was sworn in as the new director of the CIA in late January, has been referred to as the “Koch Brothers’ Congressman” and “the Congressman from Koch.”
Bandzul said the Koch-funded Concerned Veterans for America and Principi’s QTC are “in bed together and pushing for all veteran and military healthcare to be provided to the government by one of five umbrella physicians’ groups funded by QTC.”
QTC currently does most of the exams for veterans whose disability claims have been appealed, Bandzul said.
He added that QTC employs mostly nurses, medical assistants, phlebotomists, radiographic technology technicians, and various ancillary support personnel, but no doctors.
“This alone should be cause for concern,” he said. “The major source of funding to start this company was various wholly owned subsidiary companies of Koch Industries.”
Before joining the VA, Principi secured all outsourcing of medical health exams (MEB) and physical (PED) exams for the Navy and Marines, Bandzul said.
“QTC has just acquired a new, sole source VA contract to provide specific nursing specialists,” Bandzul said. “This contract was not put out for bid and was not allowed any completion before it was awarded.”
This logic behind QTC’s business model, Bandzul said, is that, “If I control who I send veterans to, and I have a financial interest in making certain the veterans are seen by as many healthcare people as possible, I can increase my revenue dramatically, which is what goes on with re-exams and claim denials.”
The logical conclusion, he said, is that “If the government should allow the expansion of the Choice Program to outsource medical business to a private organization, QTC can raise its hand and say, ‘I’m here and ready to do business.’”
Rebekah Lloyd is a veterans’ advocate, Army veteran, and founder and chief executive officer of Her Story, which empowers women veterans by giving them a forum to share their stories of service and sacrifice.
Lloyd said she doesn’t know to what extent CVA has Trump’s ear.
But she is certain that CVA’s agenda is to privatize the VA healthcare system.
“Privatizing VA healthcare puts the burden on the veteran to ensure he or she is properly cared for rather than holding the government accountable,” Lloyd said. “In addition to burdening the veteran in many respects, I see this as a problem for future generations because if the government is not responsible for caring for veterans, then who’s to say they will properly be treated while actively serving?”
A second concern of the privatization of veterans’ healthcare, Lloyd added, is the lack of special knowledge in the civilian sector when dealing with the veteran population.
“If the veteran has to spend the bulk of his or her appointment explaining terminology or military situations, then he or she will not receive adequate healthcare,” Lloyd said. “Not only will this prevent needed health treatment, it will cause undue stress on the veteran. More importantly, this will only serve to further delay an already extremely backlogged disability claim system, and civilian doctors will all have to work together to ensure records are properly documented, stored, and transferred.”
Denise Nichols is a retired major in the Air Force, flight nurse, and professor of nursing at several universities. She also has a 100 percent service-connected disability from her time in the first Gulf War.
She said she doesn’t like the direction she sees Trump taking the VA.
“I am against totally privatizing the VA,” she said. “I do support fee basis in the past, or choice as needed, based on where a veteran lives and based on a veteran needing a specialist that VA cannot match, depending on type of surgery, etc., the veteran needs to choose a doctor he has faith and trust in.”
Nichols concluded, “It seems that Republicans always support active duty and send us to the war, but it seems harder to get them in gear to pay the cost of the after effects of war. Not all, but many.”