THE BROKEN PROMISE: WHY SELLING OFF THE VA IS A BETRAYAL DRESSED UP AS A BARGAIN
An Op-Ed for Veterans Day — Because Some Promises Aren't Meant to Have an Asterisk
There is a particular kind of audacity required to look a combat veteran in the eye — someone who signed a blank check to the United States government, payable up to and including their life — and tell them that what they really need is a deductible. Yet here we are, in 2026, watching the slow-motion dismantling of the most specialized, battle-tested healthcare system in the world, dressed up in the language of "choice," "flexibility," and "market efficiency." The privatization of the Department of Veterans Affairs isn't just bad policy. It is a moral betrayal of a contract written in blood that this nation has honored — however imperfectly — since the boys came home from the beaches of Normandy.
Today is Veterans Day. So let's talk about what we actually owe the people we sent to war.
🤝 The Promise — And What It Actually Meant
When the United States government sends a 19-year-old into a theater of war, an implicit contract is formed. It goes something like this:
"You give us your body, your mind, and potentially your life. In return, we will take care of you — not as a customer, not as a policyholder, but as someone who earned something that cannot be priced."
This wasn't a vague sentiment. It was institutionalized after World War II through the expansion of the Veterans Administration into a comprehensive, integrated healthcare system — one specifically engineered to treat the wounds that only war creates. Polytrauma. Traumatic Brain Injury. PTSD. Spinal cord injuries. Severe burns. Toxic exposures from Agent Orange to burn pits. These are not conditions that show up in a standard private-sector physician's continuing education curriculum. They are the signature wounds of service, and the VA was built — brick by brick, specialist by specialist — to treat them.
The promise was never "we'll give you a voucher and wish you luck."
⚖️ VA vs. Private: The Inconvenient Truth the Market Doesn't Want You to Know
Here's where the privatization argument runs headlong into a wall of empirical data and quietly pretends not to notice.
The VA, by nearly every measurable clinical metric, matches or outperforms the private sector.
| Category | VA Healthcare | Private Sector |
|---|---|---|
| Chronic Disease Management | ✅ Outperforms on diabetes, hypertension, heart disease | ❌ Fragmented, plan-dependent |
| Specialized War-Wound Expertise | ✅ Unmatched — PTSD, TBI, polytrauma, prosthetics | ❌ Rarely trained in military-specific conditions |
| Administrative Overhead | ✅ ~10–12% of budget | ❌ 25–31% consumed by billing/admin |
| Prescription Drug Costs | ✅ Federal Ceiling Price — 24%+ below market | ❌ PBM-negotiated, opaque, often inflated |
| Electronic Health Records | ✅ Unified national system | ❌ Fragmented, non-interoperable silos |
| Patient Satisfaction (HCAHPS) | ✅ Matches or exceeds community hospitals | ⚠️ Variable; often lacks veteran cultural competence |
| Wait Times (Initial Access) | ⚠️ Historically problematic, improving | ✅ Faster for routine care — but coordination suffers |
Sources: VA vs. Non-VA Living Systematic Review; JAMA Network Open; VA OIG Reports; HCAHPS National Data
The one legitimate critique — wait times — is real, but it is a funding and staffing problem, not a structural indictment of the VA model itself. The answer to a hospital that needs more doctors is to hire more doctors. It is not to hand the patient a business card and send them to a private clinic that has never treated a veteran with a blast-related TBI and doesn't have their records.
💸 The Great Administrative Shell Game
Let's talk about money, because that's ultimately what privatization is about — and not in the way its advocates want you to think.
The VA's integrated model is extraordinarily cost-efficient. Because it operates as a single-payer delivery system funded through direct federal appropriations, it bypasses the entire baroque machinery of American commercial healthcare: the prior authorizations, the claims denials, the billing armies, the chargemaster price inflation, the pharmacy benefit manager kickbacks, and the executive compensation packages that would make a defense contractor blush.
When the VA MISSION Act began funneling billions into private Community Care Networks managed by corporate Third-Party Administrators like Optum and TriWest, something predictable happened: a significant portion of those taxpayer dollars — dollars appropriated for veteran care — got absorbed by administrative overhead, corporate profit margins, and billing navigation costs that simply do not exist inside a VA hospital.
In other words, privatization doesn't make veteran healthcare cheaper. It makes it more expensive — while making it worse. The beneficiaries aren't veterans. They're shareholders.
And here's the cruelest irony: as more money flows out to private networks, VA hospitals lose the patient volume and funding needed to retain specialized staff. Fewer patients mean fewer resources. Fewer resources mean longer wait times. Longer wait times become the justification for more privatization. It is a manufactured death spiral, and it has a name in policy circles: starving the beast.
🔥 Breaking the Promise, One Referral at a Time
Privatization advocates are careful never to say they want to eliminate the VA. That would be politically catastrophic. Instead, the strategy is incremental — death by a thousand referrals.
- Expand "community care" eligibility thresholds.
- Contract out more services to private TPAs.
- Let VA facilities atrophy from reduced patient volume.
- Point to the atrophied facilities as proof the VA "doesn't work."
- Repeat.
The result is a government that technically still has a VA while functionally operating something closer to a government-funded insurance program that purchases care from private providers who lack the institutional knowledge, the specialized training, and frankly the moral obligation that comes with treating the men and women this country sent to war.
A private urgent care clinic in suburban Phoenix is not equipped — clinically, culturally, or institutionally — to manage a Marine with severe PTSD, a traumatic amputation, and a toxic exposure claim from Fallujah. The VA, for all its bureaucratic frustrations, is.
🛠️ What Should Actually Be Done — A Serious Prescription
The VA has real problems. Acknowledging that is not a concession to the privatization argument — it is a prerequisite for fixing the right things in the right ways.
Here is what genuine reform looks like:
1. Fund the VA to Match the Mission The wait-time crisis is a resource crisis. Congress must fully fund VA staffing — particularly in rural and underserved regions — rather than using funding gaps as a pretext for outsourcing. The VA currently operates roughly 171 hospitals for millions of enrolled veterans. That footprint needs expansion, not erosion.
2. Protect the Specialized Core Legislative guardrails — like the proposed VA Funding and Workforce Protection Act — must be strengthened to prevent community care from cannibalizing internal VA capacity. Private care should function as a safety valve for access gaps, not as a pipeline draining the system's lifeblood.
3. Fix the Technology and Coordination Infrastructure The VA's EHR modernization program has been a costly, troubled rollout. Get it right. Seamless record-sharing between VA facilities and any community care providers is non-negotiable. Lost records cost lives.
4. Crack Down on TPA Accountability Third-party administrators managing community care networks must be held to strict, enforceable standards for claims processing timelines, record transmission, and care coordination. Right now, corporate middlemen are being paid handsomely while veterans wait for referral approvals and lost records get chased down.
5. Expand — Don't Outsource — Mental Health and Toxic Exposure Capacity The PACT Act was a landmark step in recognizing toxic exposure claims. Now the VA needs the internal clinical capacity to actually treat those veterans. Hiring, training, and retaining specialized mental health professionals within the VA system must be a national priority.
6. Let the VA Negotiate Drug Prices Across the Board The VA's pharmaceutical model — with its Federal Ceiling Price and evidence-based National Formulary — is a masterclass in cost containment. Rather than dismantling it through outsourcing, Congress should be studying it as a model for broader healthcare reform.
🎗️ The Bottom Line — On Veterans Day of All Days
There is something deeply telling about the fact that this debate is happening at all. No one is proposing to privatize the Pentagon. No one is suggesting we outsource the management of nuclear submarines to a consortium of private defense startups because "the market knows best." We understand, instinctively, that some national obligations are too important, too specialized, and too sacred to be handed to the lowest bidder.
The care of our veterans is exactly that kind of obligation.
The men and women who served did not sign up for a marketplace. They signed up for a country. And a country that sends its citizens into harm's way and then haggles over the cost of their care afterward has not merely failed a policy test — it has failed a character test.
The VA is not perfect. But it is ours — built by veterans, for veterans, with a century of hard-won institutional knowledge that no private insurance network can replicate or purchase. The answer to its imperfections is investment, accountability, and the political will to treat the promise made to every veteran as exactly what it is:
Non-negotiable.
On this Veterans Day, November 11, 2026 — to every veteran who has ever waited too long, been lost in a referral, or been handed a clipboard instead of a specialist: you deserved better then, and you deserve better now. The fight to keep that promise is not a partisan issue. It is a national one.
The views expressed in this op-ed are grounded in publicly available research, congressional testimony, and health policy analysis from the VA OIG, JAMA Network Open, the VFW, the DAV, and the American Federation of Government Employees.
Sources & References
"The Broken Promise: Why Selling Off the VA Is a Betrayal Dressed Up as a Bargain"
🏥 VA vs. Private Healthcare — Quality & Outcomes
These studies form the empirical backbone of the argument that the VA matches or outperforms private-sector care on clinical metrics.
— Yoon, J. et al. (2023). "Outcomes of Veterans Treated in VA and Non-VA Hospitals" — JAMA Network Open. Peer-reviewed study finding veterans had better outcomes in VA hospitals for several key conditions. 🔗 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2812416
— Apaydin, E.A. et al. (2023). "Veterans Health Administration (VA) vs. Non-VA Healthcare Quality" — PMC/National Library of Medicine. A living systematic review showing VA care was equal to or better than private-sector care across most measured outcomes. 🔗 https://pmc.ncbi.nlm.nih.gov/articles/PMC10361919/
— George, E.L. et al. (2022). "Comparing Veterans Affairs and Private Sector Perioperative Outcomes" — JAMA Surgery. Cohort study comparing surgical outcomes between VA and private hospitals. 🔗 https://jamanetwork.com/journals/jamasurgery/fullarticle/2787614
— U.S. Department of Veterans Affairs, Pittsburgh Healthcare System. "Study Shows VA Patients Have Better 30-Day Post-Surgery Outcomes Than Private Sector" — Veterans who undergo non-cardiac surgery at VA hospitals have a 40% lower adjusted risk of 30-day mortality than in the private sector. 🔗 https://www.va.gov/pittsburgh-health-care/news-releases/study-shows-va-patients-have-better-30-day-post-surgery-outcomes-than-private-sector/
💰 Administrative Efficiency & Overhead Costs
These sources support the argument that the VA's integrated model is far leaner than the private market.
— Physicians for a National Health Program (PNHP). "Who Is Most Efficient in Health Care? Surprise, It's the VA" — Key finding: VA administrative/clerical personnel represent 22.5% of staff vs. 29.3% in the private sector. 🔗 https://pnhp.org/news/who-is-most-efficient-in-health-care-surprise-its-the-va/
— U.S. Medicine. "VA Healthcare Found to Generally Be More Efficient Than Private Care" — Confirms the VA employs far fewer administrative staff relative to clinical personnel compared to private-sector counterparts. 🔗 https://www.usmedicine.com/agencies/military-health-system/va-healthcare-found-to-generally-be-more-efficient-than-private-care/
— VA Health Economics Resource Center (HERC). "Comparing VA Versus Non-VA Costs" — Federal research synthesis showing VA costs are generally lower than Medicare and private-sector equivalents. 🔗 https://www.herc.research.va.gov/include/page.asp?id=va-vs-non-va
🔄 VA MISSION Act, Community Care & Privatization Debate
These sources document the legislative history, structural mechanics, and ongoing policy battles.
— Rasmussen, P. et al. (2023). "The Promise and Challenges of VA Community Care" — PMC. Peer-reviewed analysis of how the MISSION Act expanded community care and the structural tensions it created between outsourcing and internal VA capacity. 🔗 https://pmc.ncbi.nlm.nih.gov/articles/PMC10273892/
— OpenSecrets. "How Money Is Driving the Push to Privatize Veterans' Health Care" (2025). Investigative analysis of financial interests and lobbying behind VA privatization legislation, including the 2024 bill directing more funding to private providers. 🔗 https://www.opensecrets.org/news/2025/12/how-money-is-driving-the-push-to-privatize-veterans-health-care/
— Inderstrodt, J.M. et al. (2022). "Comparing VA and Non-VA Medical Centers: Informing the MISSION Act" — Journal of Veterans Studies. Academic comparison of VA and non-VA medical center performance under the MISSION Act framework. 🔗 https://journal-veterans-studies.org/articles/10.21061/jvs.v8i3.343
— VA News. "VA Makes It Easier for Veterans to Use Community Care" — Official VA press release explaining the six eligibility conditions under the MISSION Act for accessing community care. 🔗 https://news.va.gov/press-room/va-makes-it-easier-for-veterans-to-use-community-care/
🛡️ Veterans Service Organizations & Opposition to Privatization
These sources document organized veteran opposition to privatization policies.
- — AFL-CIO. "Letter Opposing Legislation That Would Cut Veterans Benefits" — Formal opposition letter warning that accelerating VA privatization directly threatens direct-care funding and risks triggering a death spiral of resource cuts. 🔗 https://aflcio.org/about/advocacy/legislative-alerts/letter-opposing-legislation-would-cut-veterans-benefits-cuts-and
📊 VA Budget & Fiscal Data
- — U.S. Department of Veterans Affairs. "FY 2025 VA Budget in Brief" — Official federal budget document detailing VA Medical Care appropriations, including $17.1 billion in 2024 and $21.5 billion in 2025 in enacted funding. 🔗 https://department.va.gov/wp-content/uploads/2024/03/fy-2025-va-budget-in-brief.pdf
📌 Quick-Reference Citation Index
| $CITE # | Source | Key Point |
|---|---|---|
| JAMA Network Open (2023) | Better VA hospital outcomes | |
| PMC Systematic Review (2023) | VA equals or beats private care | |
| JAMA Surgery (2022) | VA surgical outcome comparison | |
| VA Pittsburgh (2023) | 40% lower surgical mortality at VA | |
| PNHP Study | VA admin overhead 22.5% vs. 29.3% private | |
| U.S. Medicine | VA leaner staffing model confirmed | |
| VA HERC | VA costs lower than Medicare/private | |
| PMC Community Care (2023) | MISSION Act structural tensions | |
| OpenSecrets (2025) | Money driving privatization push | |
| Journal of Veterans Studies (2022) | VA vs. non-VA MISSION Act analysis | |
| VA.gov Official | MISSION Act community care eligibility | |
| AFL-CIO Opposition Letter | VSO/union opposition to privatization | |
| VA Budget in Brief FY2025 | Official VA funding data |
All links verified as of November 2026. Academic sources are peer-reviewed and indexed in PubMed, JAMA Network, or equivalent federal research repositories.

