New Book Sheds Light on VA Clinic

New Book Sheds Light on VA Clinic

The observations of former Secretary of Veterans Affairs (VA) David Shulkin may shed light on why the VA project at Alameda Point continues to be delayed. Building a new clinic at Alameda Point conflicts with the Trump Administration’s goal of privatizing VA healthcare services.

In his book It Shouldn’t Be This Hard to Serve Your Country – Our Broken Government and the Plight of Veterans (Public Affairs Books, October 2019), Shulkin recounts his experiences after being appointed to head the VA by President Donald Trump in January 2017, and then fired by Tweet 15 months later. Shulkin asserts he was fired because he would not go along with efforts of White House insiders to privatize VA healthcare. 

Under the Obama Administration, $4 million of the $17 million budgeted in 2011 was spent on project planning. The rest was diverted to cover cost overruns at other VA projects, thereby delaying preliminary work at Alameda Point. Another delay came when Congress couldn’t agree on the fiscal year 2016 federal budget. But by the end of 2016, the Alameda Point VA project had $83 million — more than enough to start and complete the first phase of the project. 

In the three years since taking office in 2017, the Trump Administration has still not broken ground. One of the reasons given for the delays is that the VA had to first complete the administrative change of management of the project to the U.S. Army Corps of Engineers. That task was completed in October 2017. The next reason given was that Corps had to then review the VA’s plans for possible design flaws. 

The Alameda Point project received another $26 million in the 2020 budget. Despite having funding available, the VA has yet to complete and submit its wetland mitigation plan, which they began studying in 2012, or perform its required environmental review for the regional Water Board to certify the wetland plan. 

Meanwhile, the permit issued by the Bay Conservation and Development Commission in 2014 was left to expire in 2017 due to inaction. It is now a waiting game to see if the VA continues its lackadaisical pace until November, anticipating President Trump’s re-election and the possible shelving of the clinic plans.

In his book, Shulkin recalls how his staff was working on legislation to update the policy that allows veterans, in certain circumstances, to use private healthcare providers instead of the VA. This is to reduce excessive wait times to see a physician and excessive travel time to a VA facility. The bipartisan Senate veterans affairs committee favored Shulkin’s moderate approach by a vote of 14 to 1. But the White House sided with the lone senator advocating for the more aggressive private-access standards. The bill that got passed is the version favored by the lone senator. 

The problems with the private-access-for-all model, in Shulkin’s view, are that it would cost billions of dollars more to deliver healthcare to veterans in this manner, and that private providers aren’t geared for the intensity of care needed for war injuries.

“With me out of the way,” said Shulkin, “not only could progress toward strengthening the existing VA stop, but it would be much easier to reverse direction and work toward breaking down the entire system.” 

While Shulkin did not write about the VA’s construction activities, there is one ominous passage in his book that may be relevant to the property at Alameda Point. “Some people within the Trump Administration […] believed the VA system was unfixable and that the real estate was too valuable,” said Shulkin. “They suggested restricting the eligibility of new veterans into the system so that after the wave of current veterans died off, the VA would finally be able to display an ‘out of business’ sign on its front door.”

If the health clinic is never built, the only veteran services at Alameda Point will be the cemetery. It will also mean Alameda unnecessarily gave up 74 acres of open space in order for the health clinic to be moved further from the least tern nesting site. The endangered terns nest for four-and-a-half months lies in the middle of 512 acres of open space, which the VA has no expertise or interest in managing as a nature preserve.

Shulkin’s book is available at the Alameda Library.

 

An extended version of this review is on Richard Bangert’s blog, Alameda Point Environmental Report.