by Suzanne Gordon on September 29, 2025 (BeyondChron.org)
Over the past several months, veterans and their caregivers have been holding rallies every week in front of the San Francisco VA Medical Center and the Santa Rosa VA Outpatient Clinic. They’ve joined hundreds of other VA patients and staff around the country protesting Trump Administration efforts to slowly but surely privatize the nation’s largest and only veteran centric healthcare system. That’s the Veterans Health Administration (VHA) run by the Department of Veterans Affairs, which employs almost 400,000 doctors, nurses, psychologists, housekeepers and other staff – a third of them veterans – and cares for nine million patients.
Since Trump appointed former Georgia congressman Doug Collins as Secretary of the Department of Veterans Affairs (VA), the administration has driven thousands of providers from the system by forcing them to return to work in increasingly difficult conditions and encouraging them to resign because, (as they have been told, they are “not contributing to American prosperity” or doing “productive’ work.
When they leave the VA, their jobs – which may add up to almost 30,000 vacancies, Secretary Collins has announced, won’t be filled. Collins has also arbitrarily canceled all VA union contracts as well as thousands of contracts with VA researchers and companies who provide critical services to the nation’s veterans. In his FY2026 budget request, Collins has also cut the VA’s inhouse (discretionary) budget by an unprecedented 17%.
According to Collins, none of these actions will impact the care of VA’s nine million patients. That’s because, Collins assures veterans, they can easily access care in the private sector, where thousands of doctors, therapists, and hospitals are ready and willing to care for them.
“VA is providing veterans with more health care choices,” Collins says, “while making it even easier for veterans to get their health care when and where it’s most convenient for them.”
The veterans and VA caregivers protesting weekly outside VA facilities insist that Collins is wrong – that staff and funding cuts will lead to delays and even the denial of needed care to veterans.
A 50- state analysis I recently conducted for the Veterans Healthcare Policy Institute, confirmed their concerns. The facts are quite clear, America is facing a serious shortage of doctors, mental health clinicians and hospital services that is making it difficult to meet the needs of the nation’s 322 million non-veteran patients. As one long time VA expert said, it is “delusional” to think that a system that is already under strain – and will be even more so thanks to the passage of President Trump’s new budget bill –can absorb an influx of millions of veterans with complex military service-related mental and physical health problems.
California is a perfect example of this dynamic. The state is home to the largest veteran population – 1.5 million – in the country. Of these veterans 750,000 are enrolled in VA healthcare. Should VA services be cut and more channeled into the private sector, the state’s serious shortages of healthcare personnel would make it more difficult – not easier – for them to get care, particularly if they live in rural areas.
According to the California Health Care Foundation, about a third of Californians live in areas where there is a shortage of primary care providers. Four Northern California counties have severe shortages of primary care providers, while other counties have partial shortages. Even in counties without shortages, many primary care practices are closed to new patients and primary care providers near retirement.
Shortages of mental health care providers in Northern California are nothing short of disastrous. Eighteen counties have severe shortages, and three have partial shortages of psychologists, psychiatrists and social workers. Even in the few counties where there seem to be no shortages, a third of psychologists and 45% of psychiatrists may not accept insurance of any kind.
Forty-five percent of rural hospitals in the state have lost services, 36% are at risk of closing, and seven percent at immediate risk of closing. Plus, 21-30% have lost obstetrical services. And all this is about to get much, much worse when, on top of cuts to the state’s academic medical centers, the administration’s cuts to Medicaid (Medi-Cal), and potentially Medicare are implemented.
In contrast, if VA is well funded and well- staffed, eligible veterans can count on a healthcare system solely dedicated to their needs. They may have to wait a few weeks for an appointment or travel longer distances than they might like, but they can get care at The VA Northern California Health Care System’s, two medical centers, 12 outpatient clinics, 4 Vet Centers, and Residential Rehabilitation Programs. Plus, veterans in Northern California also have access a Blind Rehabilitation Center, Spinal Cord Injury Center and Polytrauma Center.
VA caregivers who work in these facilities know how to take care of patients who have suffered from toxic exposures and have more mental health problems, chronic illnesses, pain and higher risk of suicide than non-veterans.
As studies document, VA care delivery is more timely, accessible, and less costly than private sector doctors, nurses, and therapists, who too often lack specialized knowledge, to care for veterans.
If the Trump Administration continues to reduce VA staff and divert funding from direct care to costly and unnecessary out-sourcing, veterans in Georgia may find themselves in the same long lines and “medical deserts” as their friends, neighbors, and non-veteran relatives as the first choice of most veterans—the VA—simply vanishes.
Suzanne Gordon is a healthcare journalist and Senior Policy Analyst at the Veterans Healthcare Policy Institute as well as author of Wounds of War: How the VA Delivers Health, Healing, and Hope to the Nation’s Veterans (Cornell University Press).
