Our Veterans: Winners, Losers, Friends, and Enemies on the New Terrain of Veterans Affairs

Military veterans occupy an honored yet ambivalent place in American culture. They are hailed as exemplars of cherished social values (e.g., patriotism, sacrifice, selflessness) but often neglected or ignored once they reenter civilian life. In part, this ambivalence reflects public dissatisfaction with post–World War II conflicts that resulted in stalemate (Korea) or defeat (Vietnam and Afghanistan) or victories that have proven either short-lived or pyrrhic (the wars in Iraq). Also, the creation of a volunteer army has relegated the experience of military service to a much smaller group of Americans. These developments have tended to isolate veterans and limit expressions of pride and recognition that typically accompany military service or achievements on the battlefield. And, as Suzanne Gordon, Steve Early, and Jasper Craven describe in Our Veterans, vets find that the principal institution designed to meet their needs, the Veterans Health Administration (VHA), suffers from dwindling resources and a steady shift toward privatization.The book rests on several premises: ill-advised "forever" wars and an often toxic military culture have created "the most disabled generation of veterans in American history" (232); the new terrain of veterans affairs is denying many veterans the quality care they deserve; and division among veteran advocacy groups has complicated efforts to bolster the VHA, which the authors describe as a "a unique culture of empathy and solidarity . . . that has no counterpart in American medicine" (17).The authors' story begins with the sobering assertion that military service encompasses a "collection of very dangerous occupations" whether in combat or noncombat roles (29). The wounds of war include damage to body and mind, exposure to toxic materials, and sexual harassment and assault resulting in the phenomenon of military sexual trauma. These wounds compound the difficulties many veterans face in their adjustment and reintegration into postmilitary life. Although the military touts a seamless transfer of veteran skills to the civilian job market, the authors find that many vets (outside those in the officer class) have difficulty finding secure and remunerative employment. And for some veterans, their alienation from the world they reenter leads to substance abuse, troubles with the law, and even suicide. In the authors' view, these challenges underscore the need for comprehensive veterans' services, which the VHA is uniquely equipped to provide. As a national public health care system that is often staffed by veterans, heavily unionized, and able to provide accessible and coordinated care, the authors view VHA as a "homegrown model for socialized medicine" that urgently needs political support (238).Historically, veterans service organizations (VSOs) such as the American Legion, Veterans of Foreign Wars, and Disabled Veterans of America have advocated for veterans' interests. These organizations have been joined by an array of VSOs that emerged following the Vietnam War and more recent conflicts in Iraq and Afghanistan. Spanning the political spectrum from the right-leaning Concerned Veterans for America, which is funded by the Koch brothers, to Veterans for Peace, a left-leaning group founded after the Vietnam War, these organizations have struggled to speak with a common voice. The authors assert that some of the newer organizations' reliance on corporate funding has muted their support for VHA. These corporate connections complicate efforts by VSOs to contest a "manufactured scandal" over waiting times for services that has allowed the political right to defame the VHA as "socialized medicine at its worst" (127). This orchestrated campaign has led Congress and the executive branch to accelerate the outsourcing of VHA functions, a move Gordon, Early, and Craven see as lowering the quality of care while enriching private interests.The authors note that the number of veterans currently serving as members of Congress (18 percent in the House, 17 percent in the Senate) falls far below their 70 percent representation in the early 1970s. Over the past two decades, Democrats and Republicans have intensified their recruitment of military candidates, calculating that swing and independent voters will find them attractive. However, the authors lament that most veterans in Congress, regardless of party affiliation, hold centrist views and are unwilling to question military spending, the direction of US foreign policy, or efforts to outsource VHA functions. Moreover, although the percentage of veterans voting for Donald Trump dropped somewhat during the 2020 election, this ardent advocate of VHA privatization still won over 50 percent of veterans' votes. Noting the defeats of well-funded former officers running as moderates in key 2020 Senate races, Gordon, Early, and Craven suggest that greater support for working-class veteran candidates and stronger progressive stances on domestic and foreign policy might have achieved a different result.The book combines impressive research, deep knowledge of the world of veterans' care, and attentiveness to social and historical context. The authors consistently allow veterans' voices to be heard, lending their argument a sense of authenticity and credibility. However, the evidence they present highlights a gap between their advocacy of a radical reorientation in American military and foreign policy and the more conservative attitudes of many veterans and VSOs. Their determination to defend VHA as the bridge to creating a system of universal health care coverage, however laudable, also faces obstacles in garnering veterans' support. One promising approach the authors outline involves deepening ties between veterans' groups and labor organizations, potentially creating a broader alliance better positioned to support VHA and advance a progressive political agenda. This book can serve as an invaluable resource for such efforts and prompt a much-needed public conversation about how the nation meets its obligations to "our veterans."