The VA Is Being Privatized. Here’s How I’d Stop It.
The VA has lost 40,000 employees in the past year. Nine out of ten were healthcare workers. At the same time, Congress is sending 75% of all new VA medical funding to private companies. Over the next decade, roughly $800 billion is on track to go to corporate healthcare chains.
This didn’t happen in one big decision. It happened one step at a time, and both parties were involved.
How VA Privatization Is Actually Happening
In 2014, the VA wait-time scandal broke. Veterans were dying on secret waiting lists. Congress responded with the Veterans Choice Act — bipartisan, signed by Obama, co-written by Bernie Sanders, passed 91–3. The idea was simple: if the VA can’t see you fast enough, go to a local doctor and the VA pays.
In 2018, the MISSION Act made that permanent and set specific rules: if your VA primary care appointment is more than a 20-day wait or 30-minute drive, you can see an outside doctor. For specialists: 28 days or 60 minutes. Also bipartisan — passed 92–5, signed by Trump.
Both bills had the right idea. Veterans shouldn’t wait months for care. But instead of letting local doctors work directly with the VA, Congress routed everything through insurance middlemen — Optum (owned by UnitedHealth) and TriWest. They manage the referral network, process the bills, and take their cut.
The rules were loose enough to create a ratchet:
- Loose rules push veterans to outside care
- Outside care budget doubles — money flows to Optum and TriWest
- VA runs short on funding — hiring freezes, staff cuts
- Fewer VA staff means longer wait times
- Longer waits push even more veterans outside
- More outside referrals mean more money to the middlemen
- Return to step 1
Outside care went from roughly 12% of VA appointments to about 40%. Each turn of this cycle made the VA weaker and the middlemen stronger. It follows a pattern we’ve seen before:
- Starve it — cut funding, block hiring, let wait times grow.
- Point at it — “See? Government can’t do anything right.”
- Sell it — hand it to a contractor who donates to the people who starved it.
Same playbook, every time. Public schools to charter schools. Post office to private carriers. Social Security to Wall Street. And now: the VA to private healthcare networks.
Obama signed the Choice Act. Trump signed the MISSION Act. Biden could have tightened the rules — the VA Secretary can adjust them without new legislation — and never did. Now the ACCESS Act would lock those rules into law permanently. This isn’t one party’s fault. Both parties built this. Both maintained it. The insurance industry donates to both.
The Fix: Bring Doctors In, Keep Insurance Companies Out
The problem was never letting veterans see local doctors. Veterans in rural FL-3 genuinely need that. The problem was routing it through insurance middlemen instead of building it into the VA.
Let individual doctors join the VA system directly. The doctor stays in their own office, in your town. Their computer connects to the VA. When a veteran walks in, that visit goes through the VA’s system — records, billing, payment — all handled in one place. No Optum. No TriWest. No corporate billing system skimming every transaction.
This does two things at once. It adds to VA staffing — these doctors become part of the VA system. And it costs less because there’s no corporate middleman taking a cut. The money goes to care, not overhead.
These doctors get paid the same way VA doctors get paid — salary broken down by time, in fifteen- or thirty-minute brackets. Not per-procedure at Medicare rates. That matters because Medicare rates are roughly half what private insurance pays — the number one reason private doctors refuse community care referrals today. A salary-by-time model eliminates that complaint and kills the billing overhead entirely.
Over time, it grows. A VA-certified doctor’s practice expands. A second provider joins. It becomes urgent care, then an ER, then a community hospital — built by demand, not by decree. The A.K. Baker VA Clinic in Middleburg proved this works: when it opened in 2020, Clay County veterans finally had local access. Now picture that in Baker County, in Bradford County, along the US-301 corridor — not by building from scratch, but by credentialing doctors who are already there.
This isn’t limited to doctors. Dentists, chiropractors, eye doctors, hearing specialists — every type of care that veterans currently drive hours to receive can be brought into the VA system right in their own community.
Think of it like a barbershop. Each barber rents a chair, builds their own clientele, keeps their earnings. Same idea here: shared office space and equipment — like at a community health center — with each doctor independently credentialed and paid by time for VA patients. No corporate practice group taking a cut. A doctor in Branford doesn’t need to build a whole clinic — just rent a chair.
The current plan sends your tax dollars to corporate chains and calls it “veteran choice.” My plan gives veterans the same choice — but the money stays in the VA system and the doctor stays in your town.
If you served in the early ’90s, you remember BRAC. They closed bases and cut personnel to save money. Then they hired contractors to do the same jobs. Service contract costs jumped 73%. The military budget didn’t shrink — it grew 9% a year through the 2000s. Pentagon spending on contractors went from 41% to over 54%. They cut active duty, hired replacements at higher cost, and the budget ballooned.
I know because I was one of the casualties. Less than a year from promotion, I became a “peace dividend.” Dumped into a jobless recovery with no jobs in my field because the field itself had shrunk. I used the GI Bill to retool — learned something completely new with no guarantee there’d be a job waiting at the end. A lot of us went through that. Some never came back from it.
That’s exactly what’s happening to the VA right now. Different decade, same playbook, same result. And the veterans who’ll pay for it are the ones who already paid once.
When DeJoy took over the post office and cut services, I had a couple of rent checks go missing — forcing me to pay late fees and eventually pay a different way. I don’t vote by mail anymore. I hand-deliver my ballot to the drop-off box, or vote in person. One political appointment led to degraded service, which led to my money lost, which changed how I participate in democracy. That’s the pattern in miniature.
Salaried employees serve the mission. Contractors serve the contract. When you privatize the VA, you don’t make it more efficient — you change who it serves. It stops serving veterans and starts serving shareholders.
Closing the Gap: Mobile Clinics Now, Permanent Clinics Next
Direct credentialing works where doctors exist. But some FL-3 counties have almost no doctors at all — Dixie County has zero physicians, Lafayette has one. You can’t credential someone who isn’t there. And the current community care system through Optum and TriWest is actually slower than VA direct care — 49 days average wait vs. 41 for the VA. Veterans were promised faster access and got slower access with more paperwork. Mobile units cut through both problems.
Nine of our twelve counties have zero VA facilities:
- Baker (~29,000 residents) — nearest VA: Lake City, 33 mi (also ~30 mi from Jacksonville-area VA clinics, including the A.K. Baker VA Clinic in Middleburg)
- Bradford (~27,500) — nearest VA: Gainesville, 25 mi
- Dixie (~17,500) — nearest VA: Gainesville, 51 mi (Cross City may be closer to the Perry VA Clinic in Taylor County, ~35–40 mi)
- Gilchrist (~19,700) — nearest VA: Gainesville, 25 mi
- Hamilton (~14,200) — nearest VA: Lake City, 32 mi
- Lafayette (~8,600) — nearest VA: Lake City, 30 mi
- Levy (~46,300) — nearest VA: Gainesville, 25 mi
- Suwannee (~47,300) — nearest VA: Lake City, 30 mi
- Union (~16,800) — nearest VA: Lake City, 30 mi
Some veterans can reach VA clinics in neighboring districts. But your congressman represents THIS district — and 9 of 12 counties in it have no VA presence. That’s what I’m here to fix.
Have you ever seen a brand new school without trailers for classrooms because there are more kids today than when the school was proposed? We keep building for what we have today, not what’s coming.
Remember how annoying it was when your phone kept dropping calls because there wasn’t a tower nearby? A VA clinic in a small county is the same — you don’t use it every day, but you’re glad it’s there when you need it.
These clinics start serving veterans, but they grow to serve everyone. Non-veterans support them too, because the community knows the clinic will eventually be open to all. The clinic is the seed. Community healthcare is the tree.
Drive the US-301 corridor between Gainesville and Jacksonville. You won’t pass a single VA clinic. Not in Starke, not in Lawtey, not in Macclenny. Building a permanent clinic takes years — site selection, funding, construction, staffing. Veterans in those counties can’t wait that long.
The mobile clinic program puts care on the ground now, with veterans served first. While the mobile units are running, they also show us exactly where the demand is. Which stops have the longest lines. Which corridors need permanent facilities. The mobile clinics aren’t just a stopgap — they’re the site survey for what comes next.
The goal is permanent VA clinics where they’re needed most — placed based on real usage data from the mobile routes, not by someone drawing lines on a map in Washington.
This Is One We Can Start Locally
Mobile clinics don’t need new laws. Federal grants already exist to fund them. Community health centers already know how to bill on a sliding scale. The money and the authority are already there.
What’s missing is a representative who connects the VA, the community health centers, and the towns that need care. A veteran in Lake Butler shouldn’t have to drive to Gainesville or Jacksonville because Union County has no VA presence at all. Someone needs to hold the VA accountable for serving veterans where they live — not just where the building is.
This isn’t a ten-year plan. This is a Day One priority. The authority exists. The funding exists. The need is urgent. We connect the pieces and get clinics on the road.
FL-3 Is a Veterans District
This district is home to the Malcom Randall VA Medical Center in Gainesville — one of the five busiest VA hospitals in the country. We also have the Lake City VA Medical Center and VA clinics in Ocala. More veterans live here than in almost any other part of Florida. The VA isn’t some faraway government program. It’s where your neighbors and family go for care.
But that care is packed into a few spots. Bradford, Union, and Baker counties have zero VA clinics. The good news: the A.K. Baker VA Clinic in Middleburg opened in 2020 and proved that expanding access works when people commit to it. We need more of that.
The care is there. The problem is getting to it.
The Distance Problem
Say you’re a veteran in Mayo, Lafayette County. There is one doctor in the entire county. No hospital. The nearest VA facility is the Lake City medical center — 42 miles, almost an hour each way. But there is a state prison in Mayo with 1,345 inmates and a full medical staff. Inmates get on-site care. Veterans drive an hour.
It’s not just the deep rural counties either. Macclenny is the county seat of Baker County, and there’s no VA clinic at all. The nearest options are about 30 miles in either direction. That works if you have a car and a flexible schedule. Some veterans have neither.
A checkup can eat an entire day. That’s if you have a car, if you can take the time off, if you’re well enough to make the drive. That’s why mobile clinics matter — they go where veterans are. And if the local care isn’t getting it done, a mobile unit is a second option that doesn’t ask a veteran to burn a whole day on the road.
My business had stores in places like Keystone Heights and Old Town. From there to any VA clinic is easily an hour, one way. I know what those drives look like — I drove to all my stores several times a week.
Federal law already says that if you’re more than 30 minutes from a VA facility, you can see a local doctor and the VA pays. But that only works if local doctors are still around. When HCA converted Shands Starke to emergency-only, Bradford County lost its hospital beds. The remaining providers — small clinics, community health centers — are stretched thinner every year. The law gives you a right. The geography takes it away.
Veterans don’t need another promise. They need a clinic that shows up where they live.
How VA Certification Changes Your Experience
With a VA doctor, I never feel like they’re trying to get me out of the room. If he spends fifteen minutes with me, the VA pays for fifteen minutes. If it’s thirty, he gets paid for thirty. There’s no insurance company on the other end of the clock telling the doctor to wrap it up.
Nobody’s banned from private practice. But the everyday family doctors, rural dentists, and small-town eye doctors tend to move toward the simpler system because it works better for everyone — them and you.
It works for doctors too — simpler billing, less paperwork, more time with patients. The details are on another page. What matters to you is: your doctor stays in your town, has more time for you, and nobody’s telling them to rush you out.
Eliminate VA Copays
The government’s own auditors have said, more than once, that the VA can’t even tell whether its copay system pays for itself. If you can’t prove your billing system is worth running, stop running it. Getting rid of copays means getting rid of the whole billing operation that goes with them — the staff, the payment processing, the collections, the letters. Simpler is almost always cheaper, and it means we actually know where the money is going.
Right now, I get a bill in the mail, have to remember to pay it because there is no autopay, log into pay.gov, get identified through ID.me, navigate through several pages of approval checkboxes, enter a multi-digit payment code, then either pay by credit card with a convenience fee or enter my checking account numbers and hope I get them right.
One time I forgot to pay and was only a day late. I got another bill with the amount plus a penalty, so I paid it right then — which meant I double-paid. Some time later I got an envelope from the IRS and my heart skipped a beat. Until I got my next bill from the VA and figured out what happened, I had no idea what this check was for. I thought it was a mistake and didn’t cash it for a few months. Instead of just crediting my next bill, the VA told the IRS to cut me a check for $1.89. Two federal agencies, postage, printing, processing — each step one more thing that can go wrong, each one costing more than the $1.89 it was trying to return.
Every Veteran Deserves Care — Regardless of Discharge Status
Veterans with less-than-honorable discharges have twice the suicide rate of other veterans. Many were discharged for conditions the military itself caused — PTSD, brain injuries, substance use that started as self-medication for wounds nobody treated.
The military gave them the condition. Then it punished them for having it. Then the VA turned them away for being punished.
That’s not a policy failure. That’s a betrayal.
Recent changes have opened some VA services to these veterans, especially mental health and crisis care. But coverage is still patchy, the paperwork is real, and many don’t even know they might now qualify.
Our mobile clinics serve every veteran who shows up. We connect them with the VA benefits they’ve earned, help them get their discharge upgraded, and partner with community health centers for anything the VA still won’t cover. No veteran gets turned away at our door.
That includes recruits who got hurt in basic training before they ever finished. They raised their hand, took the oath, showed up. They got hurt serving. They should be eligible for VA care.
And it includes veterans in prison. Losing your freedom shouldn’t mean losing your healthcare. The mobile unit can make a stop inside prison grounds with vetted staff. A veteran is still a veteran.
Veterans Connect to Every Issue
- Healthcare — The mobile clinic model starts with veterans and grows to serve the whole community. For our plan to extend this to all FL-3 residents — including gaps in Gainesville, the maternal care shortage, and medical debt — see the healthcare plan.
- Economy — A veteran who isn’t broke isn’t desperate. Economic stability is suicide prevention. Building a floor under everyone — including those who served — is a long-term goal worth fighting for.
- Housing — Veterans in rural FL-3 face the same housing crisis as everyone else. Hurricane-rated co-op housing serves the whole community.
I Can’t Do This Alone
I can’t do this alone. But we veterans know something most people don’t. We know how to say yes sir and no sir, but we also know how to get the job done — even if it’s behind the scenes. Instead of waiting three weeks for something, we call our buddy in supply or engineering and get it done.
I can’t do all this myself. You’re going to have to help me. What I can do is open the doors for us, and carry the big stick if we get blocked. Once a veteran, always a veteran. I took my oath at a MEPS in Philadelphia in 1983. I still hold myself bound to that oath today.