Earlier this month, Darin Selnick, a VA privatizer with ties to the Trump and Koch worlds, offered his characteristically misinformed opinion piece in Military Times. Entitled “Health Equity for Women Minority Veterans Can Only be Achieved by Choice,” it made numerous misleading claims in support of his long-held obsession with pushing veteran patients into the private sector.
His piece relied on a dated study that reported racial and ethnic minority disparities in the VA for a few medical conditions. It completely ignored a far-reaching 2020 study comparing VA to non-VA emergency care that found VA had a 45 percent lower mortality rate. Importantly, this new report noted that veterans who benefitted most from the VA were the disadvantaged, including people of color and those with lower incomes.
Selnick sidestepped other studies showing that the VA is one of the only healthcare systems in the United States to seriously attend to the vital issue of health equity. In 2014, the American Journal of Public Health dedicated an entire issue to the VA’s efforts to reduce healthcare inequity. The publication outlined a variety of projects and programs designed to identify, analyze — and then reduce — the causes of health care disparities that negatively impact African American, Native American, and LGBT veterans, among others. One piece described an effort to make sure homeless veterans get the medical attention they need through a program that delivers text messages to remind them about upcoming appointments. This program has reduced patient cancellations, no-shows, emergency room visits, and hospital admissions.
As we have seen in the pandemic, these long-standing efforts have been highly successful. One recent study found there has been no racial death disparity for VA patients diagnosed with COVID-19. This has not been the case in the private sector system that Selnick promotes.
Another studySelnick also skipped revealed that Black veterans with certain heart conditions fared better than Caucasians in the VA because they had greater access to healthcare services. Particularly powerful was the study’s conclusion:
Black veterans with normal estimated glomerular filtration rate and equal access to healthcare have lower all-cause mortality and incidence of coronary heart disease and a similar incidence of ischemic stroke. These associations are in contrast to the higher mortality experienced by black individuals in the general US population.
In a well-articulated response to Selnick’s piece, the Executive Directors of VA’s Centers for Minority Veterans and for Women Veterans noted that the former Trump official flagrantly disregarded the fact that health disparities are “widespread across the entire American healthcare system and negatively impacts underserved communities regardless of where they get their healthcare.”
The final area where Selnick misconstrued the facts concerns the well-being of women veterans. These veterans represent about seven percent of the VA patient population. And yet in spite of the size of this patient cohort, the VA has devoted billions of dollars, plus incalculable staff time, to setting up healthcare services focused specifically on the healthcare needs of women veterans.
Should the VA do more for women veterans? Certainly, and it continues to do so. Would the private sector do better? Not at all was the conclusion in a recent review by Disabled American Veterans (DAV): “Clinical studies show VA can achieve better health outcomes for women veterans than the private sector, largely due to extensive medical research conducted over the past decade. Women using VA are likely to have complex health care needs and benefit greatly from its holistic and integrated approach to care, benefits and services.”
Like many other ideologues on veterans’ issues, Selnick is hellbent on warping the truth in his determination to demonize the VA. He thus keeps inventing problems for which privatization is the solution. We wish we could completely ignore these egregious claims, but as long as they keep finding purchase in reputable publications, VHPI will continue refuting them with the facts.
