Making America Pain-Free for
Plutocrats and Big Pharma, But Not Vets
By Ann Jones
A friend of mine, a Vietnam
vet, told me about a veteran of the Iraq War who, when some civilian said, “Thank
you for your service,” replied: “I didn’t serve, I was used.” That got me
thinking about the many ways today’s veterans are used, conned, and exploited
by big gamers right here at home.
Near the end of his invaluable
book cataloguing the long, slow disaster of America’s War for the Greater Middle East, historian Andrew
Bacevich writes:
“Some individuals and
institutions actually benefit from an armed conflict that drags on and on.
Those benefits are immediate and tangible. They come in the form of profits,
jobs, and campaign contributions. For the military-industrial complex and
its beneficiaries, perpetual war is not necessarily bad news.”
Bacevich is certainly right
about war profiteers, but I believe we haven’t yet fully wrapped our minds
around what that truly means. This is what we have yet to take in: today, the
U.S. is the most
unequal country in the developed world, and the wealth of the plutocrats on
top is now so great that, when they invest it in politics, it’s likely that no
elected government can stop them or the lucrative wars and “free markets” they
exploit.
Among the prime movers in our
corporatized politics are undoubtedly the two billionaire Koch brothers,
Charles and David, and their cozy network of secret donors. It’s hard to
grasp how rich they really are: they rank fifth (David) and sixth (Charles) on Business
Insider’s list of the 50 richest people in the world, but if you pool their
wealth they become by far the single richest “individual” on the planet. And
they have pals. For decades now they’ve hosted top-secret gatherings of their richest collaborators that sometimes
also feature dignitaries like Clarence Thomas or the late
Antonin Scalia, two of the Supreme Court Justices who gave them the Citizens
United decision, suffocating American democracy in plutocratic dollars.
That select donor group had reportedly planned to spend at least $889
million on this year’s elections and related political projects, but recent reports note a scaling back and redirection of
resources.
While the contest between
Trump and Clinton fills the media, the big money is evidently going to be aimed
at selected states and municipalities to aid right-wing governors, Senate
candidates, congressional representatives, and in some cities, ominously
enough, school board candidates. The Koch brothers need not openly support the embarrassing Trump, for they’ve already proved that, by
controlling Congress, they can significantly control the president, as they have already done in the Obama
era.
Yet for all their influence,
the Koch name means nothing, pollsters report, to more than half of the U.S. population. In fact,
the brothers Koch largely stayed under the radar until recent years when their
roles as polluters, campaigners against the environment, and funders of a new
politics came into view. Thanks to Robert Greenwald’s film Koch Brothers Exposed
and Jane Mayer’s book Dark Money: The Hidden History of the Billionaires Behind the
Rise of the Radical Right, we now know a lot more about them, but not
enough.
They’ve always been ready to
profit off America’s wars. Despite their extreme neo-libertarian goal of
demonizing and demolishing government, they reportedly didn’t hesitate to pocket about $170 million as contractors
for George W. Bush’s wars. They sold fuel (oil is their principal
business) to the Defense Department, and after they bought Georgia Pacific,
maker of paper products, they supplied that military essential: toilet paper.
But that was small potatoes
compared to what happened when soldiers came home from the wars and fell victim
to the profiteering of corporate America. Dig in to the scams exploiting
veterans, and once again you’ll run into the Koch brothers.
Pain Relief: With Thanks from
Big Pharma
It’s no secret that the VA
wasn’t ready for the endless, explosive post-9/11 wars. Its hospitals
were already full of old vets from earlier wars when suddenly there arrived
young men and women with wounds, both physical and mental, the doctors had
never seen before. The VA enlarged its hospitals, recruited new staff,
and tried to catch up, but it’s been running behind ever since.
It’s no wonder veterans’
organizations keep after it (as well they should), demanding more funding and
better service. But they have to be careful what they focus on. If they leave
it at that and overlook what’s really going on -- often in plain sight, however
disguised in patriotic verbiage -- they can wind up being marched down a road
they didn’t choose that leads to a place they don’t want to be.
Even before the post-9/11 vets
came home, a phalanx of drug-making corporations led by Purdue
Pharma had already gone to work on the VA. These Big Pharma
corporations (many of which buy equipment from Koch Membrane Systems) had developed new
pain medications -- opioid narcotics like OxyContin (Purdue), Vicodin, Percocet, Opana (Endo
Pharmaceuticals), Duragesic, and Nucynta (Janssen, a subsidiary of Johnson
& Johnson) -- and they spotted a prospective marketplace. Early in
2001, Purdue developed a plan to spend hundreds of thousands of dollars targeting the VA. By the end of that year, this
country was at war, and Big Pharma was looking at a gold mine.
They recruited doctors, set them up in private “Pain Foundations,” and paid them handsomely to give
lectures and interviews, write studies and textbooks, teach classes in medical
schools, and testify before Congress on the importance of providing our
veterans with powerful painkillers. In 2002, the Food and Drug
Administration considered restricting the use of opioids, fearing they might be
addictive. They were talked out of it by experts like Dr. Rollin Gallagher of the American Academy of Pain
Medicine and board member of the American Pain Foundation, both largely funded
by the drug companies. He spoke against restricting OxyContin.
By 2008, congressional
legislation had been written -- the Veterans’ Mental Health and Other Care Improvement Act --
directing the VA to develop a plan to evaluate all patients for pain.
When the VA objected to
Congress dictating its medical procedures, Big Pharma launched a “Freedom from Pain” media blitz, enlisting
veterans’ organizations to campaign for the bill and get it passed.
Those painkillers were also
dispatched to the war zones where our troops were physically breaking down under the weight of the equipment they carried. By 2010, a
third of the Army’s soldiers were on prescription medications -- and nearly half of them,
76,500, were on prescription opioids -- which proved to be highly addictive,
despite the assurance of experts like Rollin Gallagher. In 2007, for instance,
“The American Veterans and Service Members Survival Guide,” distributed by the
American Pain Foundation and edited by Gallagher, offered this assurance: “[W]hen used for medical purposes
and under the guidance of a skilled health-care provider, the risk of addiction
from opioid pain medication is very low.”
By that time, here at home,
soldiers and vets were dying at astonishing rates from accidental or deliberate overdoses.
Civilian doctors as well had been persuaded to overprescribe these drugs, so
that by 2011 the CDC announced a national epidemic, affecting more than 12
million Americans. In May 2012, the Senate Finance Committee finally
initiated an investigation into the perhaps “improper relation” between
Big Pharma and the pain foundations. That investigation is still “ongoing,”
which means that no information about it can yet be revealed to the public.
Meanwhile, opioid addicts,
both veterans and civilians, were discovering that heroin was a cheaper and no less effective way to go. Because
heroin is often cut with Fentanyl, a more powerful opioid, however, drug deaths
rose dramatically.
This epidemic of death is in
the news almost every day now as hard-hit cities and states sue the drug makers, but rarely is it traced to its
launching pad: the Big Pharma conspiracy to make big bucks off our country’s
wounded soldiers.
It took the VA far too long to
extricate itself from medical policies marketed by Big Pharma and, in effect,
prescribed by Congress. It had made the mistake of turning to the Pharma-funded
pain foundations in 2004 to select its Deputy National Program Director of Pain
Management: the ubiquitous Dr. Gallagher. But when the U.S. Drug Enforcement Agency
finally laid down new restrictive rules on opioids in 2014, the VA had to comply.
That’s been hard on the thousands of opioid-dependent vets it had unwittingly hooked, and it’s
becoming harder as Republicans in Congress move to privatize the VA and send
vets out with vouchers to find their own health care.
Cute Cards Courtesy of the
Koch Brothers
To force the VA to use its
drugs, Big Pharma set up dummy foundations and turned to existing veterans’
organizations for support. These days, however, the Big Money people have found
a more efficient way to make their weight felt. Now, when they need the
political clout of a veterans’ organization, they help finance one of their
own.
Consider Concerned Veterans for America
(CVA). The group’s stated mission: “to preserve the freedom and prosperity we
and our families fought and sacrificed to defend.” What patriotic
American wouldn’t want to get behind that?
The problem that concerns the
group right now is the “divide” between civilians and soldiers, which exists,
its leaders claim, because responsibility for veterans has been “pushed to the
highest levels of government.” That has left veterans isolated from their own
communities, which should be taking care of them.
Concerned Veterans for America
proposes (though not quite in so many words) to close that gap by sacking the
VA and giving vets the “freedom” to find their own health care. The 102-page proposal of CVA’s Task Force on “Fixing Veterans’ Health
Care” would let VA hospitals treat veterans with “service-connected health
needs” -- let them, that is, sweat the hard stuff -- while transforming most VA
Health Care facilities into an “independent, non-profit corporation” to be “preserved,”
if possible, in competition “with private providers.”
All other vets would have the
“option to seek private health coverage,” using funds the VA might have spent
on their care, had they chosen it. (How that would be calculated remains one of
many mysteries.) The venerable VA operates
America's largest health care system, with 168 VA Medical Centers and 1,053
outpatient clinics, providing care to more than 8.9 million vets each year. Yet
under this plan that lame, undernourished but extraordinary and, in a great
many ways, remarkably successful version of single-payer lifelong socialized
medicine for vets would be a goner, perhaps surviving only in bifurcated form:
as an intensive care unit and an insurance office dispensing funds to free and
choosy vets.
Such plans should have marked
Concerned Veterans for America as a Koch brothers’ creation even before its
front man gave the game away and lost his job. Like those pain
foundation doctors who became self-anointed opioid experts, veteran Pete
Hegseth had made himself an expert on veterans’ affairs, running Concerned
Veterans for America and doubling as a talking
head on Fox News. The secretive veterans’ organization now carries on
without him, still working to capture -- or perhaps buy -- the hearts and minds
of Congress.
And here’s the scary part:
they may succeed. Remember that every U.S. administration, from the
Continental Congress on, has regarded the care of veterans as a sacred trust of
government. The notion of privatizing veterans’ care -- by giving each veteran
a voucher, like some underprivileged schoolboy -- was first
suggested only eight years ago by Arizona Senator John McCain, America’s most
famous veteran-cum-politician. Most veterans’ organizations opposed the idea,
citing McCain’s long record of voting against funding the VA. Four
years ago, Mitt Romney touted the same idea and got the same response.
That’s about the time that the
Koch brothers, and their donor network, changed their strategy. They had
invested an estimated $400 million in the 2012 elections and lost the presidency
(though not Congress). So they turned their attention to the states and
localities. Somewhere along the way, they quietly promoted Concerned
Veterans for America and who knows what other similar organizations and think tanks
to peddle their cutthroat capitalist ideology and enshrine it in the law of the
land.
Then, in 2014, President Obama
signed into law the Veterans’ Access to Care Through
Choice, Accountability, and Transparency Act. That bill singled out certain
veterans who lived at least 40 miles from a VA hospital or had to wait 30 days
for an appointment and gave them a “choice card,” entitling them to see a
private doctor of their own choosing. Though John McCain had originally
designed the bill, it was by then a bipartisan effort, officially introduced by the Democratic senator who chaired the Senate
Committee on Veterans’ Affairs: Bernie Sanders.
Sanders said that, while it
was not the bill he would have written, he thought it was a step toward cutting
wait times. With his sponsorship, the bill passed by a 93-3 vote. And so an
idea unthinkable only two years earlier -- the partial privatization of
veteran’s health care -- became law.
How could that have
happened? At the VA, there was certainly need for improvement. Its
health care system had been consistently underfunded and wait times for
appointments were notoriously long. Then, early in 2014, personnel at
the Phoenix VA in McCain’s home state of Arizona were caught falsifying records to hide the wait-time problem.
When that scandal hit the news, Concerned Veterans for America was quick to exploit the situation and lead a mass protest. Three
weeks later, as heads rolled at the VA, Senator McCain called a town hall meeting to announce his new bill, with
its “hallmark Choice Card.” His website notes that it “received praise... from
veterans’ advocacy organizations such as Concerned Veterans for America.”
That bill also called for a
“commission on care” to explore the possibilities of “transforming” veterans’
health care. Most vets still haven’t heard of this commission and its
charge to change their lives, but many of those who did learn of it were
worried by the terminology. After all, many vets already had a choice
through Medicare or private insurance, and most chose the vet-centered
treatment of the VA. They complained only that it took too long to get an
appointment. They wanted more VA care, not less -- and they wanted it faster.
In any case, those choice
cards already handed out have reportedly only slowed down the process of getting
treatment, while the freedom to search for a private doctor has turned out to be anything but popular. Nevertheless,
the commission
on care -- 15 people chosen by President Obama and the leaders of the House
and Senate -- worked for 10 months to produce a laundry list of “fixes” for the
VA and one controversial recommendation. They called for the VA “across the
United States” to establish “high-performing, integrated community health care
networks, to be known as the VHA Care System.”
In other words, instead of
funding added staff and speeded-up service, the commission recommended the
creation of an entirely new, more expensive, and untried system. Then there was
the fine print: as in the plan of Concerned Veterans of America, there would be
tightened qualifications, out-of-pocket costs, and exclusions. In other
words, the commission was proposing a fragmented, complicated, and iffy system,
funded in part on the backs of veterans, and “transformative” in ways ominously
different from anything vets had been promised in the past.
Commissioner Michael Blecker,
executive director of the San Francisco-based veterans’ service organization
Swords to Plowshares, refused
to sign off on the report. Although he approved of the VA fixes, he saw
in that recommendation for “community networks” the privatizer's big boot in
the door. Yet while Blecker thought the recommendation would serve the
private sector and not the vet, another non-signer took the opposite view.
Darin Selnick, senior veterans' affairs advisor for Concerned Veterans for
America and executive director of CVA's Fixing Veterans Health Care Taskforce, complained that the commission had focused too much on
“fixing the existing VA” rather than “boldly transforming” veterans’ health
care into a menu of “multiple private-sector choice options.” The lines
were clearly drawn.
Then, last April, Senator
McCain made an end run around the commission, a dash that could only thrill the
leaders of Concerned Veterans for America and their backers. Noting that his
choice card legislation was due to expire, McCain, together with seven other
Republican senators (including Ted Cruz), introduced new legislation: the Care Veterans Deserve Act of 2016. It’s a bill
designed to “enhance choice and flexibility in veterans’ health care” by making
the problematic choice card “permanently and universally” available to all
disabled and other unspecified veterans. You can see where the notion
came from and where it’s going. By May 2016, when Fox News featured a joint statement by Senator McCain and Pete
Hegseth, late of Concerned Veterans for America, trumpeting the VA Choice Card
Program as “the most significant VA reform in decades,” you could also see
where this might end.
As real veterans’
organizations wise up to what’s going on, they will undoubtedly stand against
the false “freedom” of a Koch brothers-style “transformation” of the VA system.
The rest of us should stand with them. The plutocrats who corrupted veterans’
health care and now want to shut it down, and the plutocrats who profit from
this country’s endless wars are one and the same. And they have bigger plans
for us all.
Ann Jones, a TomDispatch regular, is the author most recently of They Were Soldiers: How the Wounded Return from America’s Wars
-- the Untold Story, a Dispatch Books original. This piece is adapted from
the keynote address she recently gave to the annual convention of Veterans for Peace.
She is a member of the international advisory board of that organization.
