Category: health care

  • On June 6, thousands of veterans, union members, VA hospital nurses, elected officials, and more gathered on the National Mall in Washington D.C. at the “Unite for Veterans, Unite for America rally” to protest the Trump administration’s attacks on veteran jobs, benefits, and healthcare. In this on-the-ground edition of Working People, we report from Friday’s rally and speak with veterans and VA nurses about how Trump’s policies are affecting them now and how to fix the longstanding issues with the VA.

    Speakers:

    • Peter Pocock, Vietnam War veteran (Navy) and retired union organizer
    • Everett Kelley, national president of the American Federation of Government Employees
    • Terri Henry, Air Force veteran
    • Ellen Barfield, Army veteran and national vice president of Veterans for Peace
    • Lindsay Church, executive director and co-founder of Minority Veterans of America
    • Lelaina Brandt, veteran (National Guard), 2SLGBTQIA+ advocate, and part-time illustrator and graphic designer.
    • Eric Farmer, Navy submarine veteran
    • Irma Westmoreland,  registered VA nurse in Augusta, GA, secretary-treasurer of National Nurses United, chair of National Nurses United Organizing Committee/NNU-VA
    • Andrea Johnson, registered VA nurse in San Diego, CA, medical surgical unit and the NNOC/NNU director of VA Medical Center- San Diego
    • Justin Wooden, registered VA nurse in the intensive care unit (ICU) at James A. Haley Veterans’ Hospital in Tampa, FL
    • Cecil E. Roberts, Vietnam War veteran (Army) and president of the United Mine Workers of America

    Additional links/info:

    Featured Music:

    • Jules Taylor, “Working People” Theme Song

    Credits:

    • Audio Post-Production: Jules Taylor

    Transcript

    The following is a rushed transcript and may contain errors. A proofread version will be made available as soon as possible.

    Maximillian Alvarez:

    Alright. Welcome everyone to another on-the-ground edition of Working People, a podcast about the lives, jobs, dreams, and struggles of the working class Today. Working People is a proud member of the Labor Radio Podcast Network and is brought to you in partnership within these Times Magazine and the Real News Network. The show is produced by Jules Taylor and made possible by the support of listeners like you. My name is Maximillian Alvarez and I am here on the National Mall in Washington, DC at the Unite for Veterans Unite for America rally, where thousands of veterans from all military branches and age groups, union members, VA hospital nurses, elected officials, and more have gathered to send a message to the Trump administration. This is a critical follow-up episode to our recent interview with VA nurses and national nurses, United Union reps, where we talked about the devastating impact that President Trump’s cuts to federal agencies and attacks on federal workers are causing for VA healthcare workers and the veteran patients that they serve as national nurses.

    United describes in their press release about today’s rally on Friday, June 6th, the anniversary of D-Day, dozens of registered nurses from National Nurses Organizing Committee slash National Nurses United will join Senator Tammy Duckworth, veterans federal workers, military families and allies in Washington DC for the Unite for Veterans, unite for America rally organized by the Unite for Veterans Coalition. This rally is modeled after the 1932 Bonus Armies march on Washington DC and will spotlight attacks on veteran benefits, call out attempts to privatize the VA and rally the veteran community to defend the institutions that serve them. So I am here on the ground talking to folks about why they’re here, why it’s important, and what message they want to send to the administration and to their fellow workers around the country.

    Peter Pocock:

    I’m Peter Pocock. I’m out on the mall here in DC with a whole bunch of other veterans. I’m an old timer. I’m pushing 80. I’ll be 80 this year. I was in the Vietnam era and happily for me and intentionally for me, I was in the Navy because you were more likely to avoid bullets in the Navy. Yeah, we’re out here on the mall today because the Veterans Administration, which takes care of a lot of us, myself included, I’m 90% disabled and we can go into that later, but we’re here because certain parties who are in the government are really trying to cut the hell out of what we have supposedly earned by our service over the years. Yeah, Gary from the podium, we’re here to fight back. First of all, there’s a whole lot of vets that actually are losing their jobs, particularly government jobs.

    We got a preference. That was one of our benefits of being in the service. We got a little bit of a preference for jobs coming out and especi people who have been working for the government for 10, 20, 30 years who are being basically told, we don’t need you anymore. Thank you very much. Actually, no, thank you very much. Let’s just go away. Not happy about that. I tend to do only family friendly language and interviews, but there’s a whole lot of words I could use to describe what the Trump administration is trying to do to labor. That’s something that the right wing has been after for what decades, maybe more, and I’ve been fighting. I was in the labor movement my whole working life after the Navy and been fighting it that whole time. Even in retirement. Keep on showing up is the way that you win every time.

    We’re not going to storm the capitol. We’re not going to surround the White House and take prisoners and things like that. What we’re going to do is keep on showing up everywhere in the country, every opportunity we have, every chance to have a conversation with somebody about it, talk to ’em about what’s going on, talk to ’em about the fact that people’s livelihoods are being taken away. Things that people have worked for their whole lives are being taken away. That’s not just veterans, that people with jobs. You got a job, you want somebody to take it away from you for no good reason except to send a little more money to some folks that have no need of more money. Thank you very much. I came back in 1970 to an environment that was not particularly friendly to veterans

    And I kept showing up. I kept telling people I never held it against somebody that they thought that I was at fault for this war. I was against the war myself. Well, another thing that has got me out here is I’m 90% disabled according to the Veteran’s Administration, and it’s because I’ve got Parkinson’s disease. See, there’s what I got is Parkinson’s Disease, and it’s generally attributed to the fact that I was exposed through Agent Orange during my service. My bet is that basically any of the folks that were in Southeast Asia in the late sixties and the early seventies all have been exposed to Agent Orange and many of them will if they haven’t already be displaying all kinds of symptoms because of it. In my case, Parkinson’s.

    I’m lucky that it didn’t show up until late so that I’m still, I’m going to make it to 80. Anyhow, a lot of my people have, the VA takes care of people like me. The VA takes care of people who are in wheelchairs because of their service for laying flat on their backs in a hospital bed because of their service, and that’s where they’re going to be. The VA’s taking care of them. That’s not waste, that’s not fraud, that’s not abuse. That’s what they have earned is that care and that’s what everybody in this whole country earns just by being citizens is care. How come we are not taking care of our people? We had all kinds of very interesting things going on in the Navy, in the army. I got friends that were doing some really good anti-war stuff that endangered them. So when I came back, that’s what I started doing and I mean doing it ever since. I wasn’t in a labor movement at the beginning. I was in left wing politics, anti-war politics, and from there being in the labor movement was just a natural. As soon as I got the kind of a job that actually had that kind of stuff going on in it, we don’t need to go into it too much, but I was a real hippie organizer in Politico. I was not in a position to be in anything but the IWW. So yeah, but I spent 30 years in the labor movement and I’m still with it.

    Everett Kelley:

    My name is Everett Kelley. I’m a proud Army veteran and I have the pleasure as the National President of the American Federation of Government Employees A FGE. First and foremost, I want to thank the Union Veteran Council for inviting me to speak and for putting on this necessary undue event. Now I want to welcome all of you who came here today from out of town. Your commitment is aspiring and I want to thank you for being here today. We’re here to unite on behalf of all veterans and to bring awareness and attention to this unprecedented and un-American attack on veterans jobs, benefits, healthcare and union rights. What do you say? Well, it doesn’t matter what branch you serve in, right? We’ve all made a huge sacrifice for our country and all of you are my family. Now though we all come from different backgrounds and different races have different religious beliefs and political views.

    We all have similar stories as veterans. My story starts in good water, Alabama, where at 18 years old I joined the United States Army and went on to serve in the Army Reserve for another eight years. After my three year tour, like many of you, after I my military services, I wanted to continue to serve my country. So I became a federal employee working at Anderson Army Depot with my fellow veterans while we continued supporting the mission. You see, just because the job change doesn’t mean your service is complete. Our mission has not changed. Our mission is protect and to serve, to support and defend, and that has not changed. But now what has changed, however, is the government’s promise to be there for us when we get home that changed the promise to care for our families, our caregivers, and our survivors. For years, politicians on both sides of the aisle have campaigned on their support of veterans, but once they get in the office, they cut our benefits on the fund, our services and take every opportunity to privatize our healthcare.

    What do you say about that? No, and guess what? Brothers and sisters, we are tired of it. Veterans are tired of being celebrated on Veterans Day remembered on Memorial Day and forgotten about after election day. What do you say about that? Are you tired? We’re tired of being thankful. Our service in the public and stabbed in our back in the private. We are tired now. This S ring no true than today. In January, the VA presented employees, what a fuck in the road. Wow. They encouraged members to end federal services in February, VA recklessly terminated more than 1500 probationary employees resulted in chaos and confusion within the department. In March, the VA announced plan to cut 83,000 jobs for no rhyme or reason whatsoever under disguise of efficiency. I say it’s not efficiency, it’s fraud and a FG been fighting sensely because we know what the big ass will do, don’t we?

    Right? And if you don’t know what the big enough plan for Americans veterans is, let me share it with you. The big enough plans for Americans, veterans, it’s a privatized veteran healthcare. In order to make themselves wealthier, they want to make a quick buck offer the sacrifices of the pain and the scars of all those of us who have served this country. They want to take away our VA medical centers claiming that private healthcare is better. However, study after study showed that vegetable prayer to get their care to be VA because it was created for us. Now, the VA is a place my brothers and sisters to go too far camaraderie and for exchanging stories where we are treated with respect and honor because nearly 30% of the employees are veterans too, and they understand who we are. They understand the sacrifices that we’ve made.

    They understand the specialties that’s needed. They understand a person that has PTSD. They know it’s not a sham. They know it’s for real. The VA plays for veterans by veterans and for veterans. However, these master reorganization plans that stand before us today is the targeted attack on veterans job, on healthcare, on benefits and union rights. The layoff plans aren’t just figments of our imagination. They are here. We’ve already seen thousands of employees being fired, but brothers and sisters, lemme tell you this, I got to leave you, but before I go, I want you to know that you have doctors, nurses, housekeepers, es, chiropractors, pharmacists, social worker, benefit specialists, police officers, janitors, engineers, painters, electricians, psychiatrists, cooks, greeters at the front door at the va.

    Terri Henry:

    I’m Terri Henry. I live in Alexandria, Virginia. I’m here in Washington DC today to protest the Trump administration’s treatment of veterans. I am a veteran. I’m married to a Vietnam veteran. My father is a veteran. My brother is a veteran. I believe in veterans. My husband and I had nowhere to go after high school graduation. We weren’t born with a silver spoon like Donald Trump. So we joined the military and his two brothers joined as well, and we got our educations through the va. So we are all college educated people who were able to improve our lives by virtue of our military service. That would not have been a path open to me. Only marriage and children would’ve been open to me. I had no education and no way to earn a living. The military taught me skills and I used those skills and I believe in America.

    The other thing that happened is my husband got agent orange cancer for his Vietnam service. So we rely on the VA for his cancer treatment. If it had not been for the va, I tell you, I would’ve had just a complete breakdown. But they were wonderful. They took him in, they gave him chemo. We never had to worry about a bill. Every American that gets cancer in America has to worry about how they’re going to pay for their treatments in the military. We never worried about that. We went to the doctor when we needed to go to the doctor and they gave us what we needed and they promised us that that care would continue after we left the military. And in my husband’s case it has. But now in the Trump administration that care is threatened, these veterans are threatened. We’ve got new veterans, young veterans, Afghanistan, veterans, Iraqi veterans, Vietnam veterans still alive.

    We need that care. You promised that care. Donald Trump is a draft dodger 1968. He refused to take the cough. In fact, he got his father to pay for a bone spurs excuse. That’s not courage. That’s not courage. And that man is insisting that we the veterans or the active duty military march in front of him like puppets and he is a draft dodger and a felon. The irony, the insult, it is such an insult to the American military to make them parade for him. This is not Hollywood. This is real life. And those federal workers that you’re un employing, they actually take a military member out of a combat seat. Why? Because the federal workers do the things behind the scenes that allow the military to deploy forward. Every federal worker you fire, you’re taking someone out of combat and you should know that you’re harming the mission and they don’t have time to do your petty tasks.

    Like this parade on the, what is it, 14th of June, which by the way, that parade is not a birthday parade for Donald Trump. It’s not a birthday parade for the army. What it is is a show of force, a show of force as was conducted in 1939 at another birthday parade in another nation where that dictator showed the world, his military and what they had to be afraid of. That’s what this parade is about. He’s using the US army to threaten the rest of the world with our military might. We’re very proud of our military. We have a great military, but they are already overt, tasked and now he’s cutting them as is Pete Heg said. Now Trump’s priority is real estate. What he wants to do is put Gaza puts the French Riviera in Gaza. He wants to own Greenland. All he sees when he sees other nations is real estate opportunities, opportunities to make money.

    That is not what the government does. The government is here for. We the people, they only exist to serve. We the people just as a church passes a collection plate. The government passes the tax plate, we put the money in with the intent that’ll be spent on our needs, not on his. And there’s quite the difference between the two. So I say to you, don’t believe Donald Trump, he is lying every day. He has a network that does that Cox News. He’s cutting down on journalism like N-P-R-P-B-S so that you will never hear the truth. And now voice of America as well. So this is a very dangerous time in our nation and it is time for us to stand up and say, no, no, Donald Trump, we see you. We’ve seen this before, but it’s not going to happen here in America.

    Ellen Barfield:

    My name’s Ellen Barfield. I’m a nearly 30-year-old Baltimore aunt originally from, did a lot of my life in Texas and I did four years in the Army, 77, 81. I’m the co-founder of the Baltimore Chapter of Veterans for Peace, and I’m back on the national board.

    Maximillian Alvarez:

    Well, it’s so great to chat you and yeah, Baltimore out here representing, we are literally sitting on the National Mall right now at the Unite for Veterans Unite for America rally. I wanted to just ask if you could say a little more about yourself, about why you’re out here and what the message today really is.

    Ellen Barfield:

    Well, the main messages stop trashing veterans and stop taking away our benefits and firing. So many of us disproportionately veterans are employed in the federal government. They do get a little bit of a point for being veterans and they come from that kind of mindset. So they want to keep serving, if you will. So the threats to our VA healthcare and the firings of so many veterans, those have got to be stopped and reversed. And that’s why we’re here now. A lot of the folks here are a good bit more politically conservative than veterans for peaces, but that’s okay. We have to get together to defend the promises this country made to its veterans to take care of us in exchange for our possibly being sacrificed. I personally think war is the enemy and humanity better unlearn war. It’s going to finish us. So I don’t glorify wars, but it is something nations have done for a long time. It’s had militaries. And part of the deal is you potentially risk your life in exchange for benefits afterward. That’s the promise. And they’re taking that away and we got to hang together here. Even if we don’t politically agree to say hell no, we’re not going to let you do that.

    Maximillian Alvarez:

    And can I just ask, as a veteran yourself as an organizer with Veterans for Peace, have we been fulfilling that promise to our veterans? And I guess that’s a two part question. How have we been treating our veterans in the aggregate before 2025 and what are these new attacks from the Trump administration doing to our veterans on top of that?

    Ellen Barfield:

    Yeah, thank you. Because that’s exactly right. The VA has essentially never been fully funded. It was already down about 60 or 70,000 staff around the country before Trump even got back into office. And now there’s threats of about 85 or 90,000 more cuts and they’re talking about, oh, we’ll keep the essentials doctors and nurses, excuse me, if the floor is a wash and trash and the toilet won’t flush and all of the staff is important, it’s not just the professionals. So give me a damn break.

    Maximillian Alvarez:

    Brian and I literally just interviewed multiple VA nurses to say like, look, when you cut our support staff, who do you think has to pick up the work us? Which we can’t tend to

    Ellen Barfield:

    Our patients take care of the patients, exactly. We got to have medical tests and we got to have clean bathrooms and all of that. I wear this shirt the same, our VA shirt when I go to the VA and talk to some of the staff. And some of them are very grateful to see it and some of them are kind of puzzled amazingly, this one guy who’s been doing the check-in for me, the blood pressure and whatnot before I see my endocrinologist have a thyroid condition. And this was before Trump got back in, but that’s exactly what I was talking to him about. The staff is way, way down across the nation. I’m sure y’all are tight here. And he said, yeah, as a matter of fact, you’re right, we are. So it was interesting that I was helping him understand, and you’re absolutely right, it was far from perfect for a long, long time, but it was a lot better than we’re looking at and being fearing right now. So yeah, it’s chipping away at something that was already far from the strength that needed to be.

    Maximillian Alvarez:

    And I guess, I know there’s a broad question, but we got a lot of folks who listen to the show who are not veterans, right? They’re workers union and non-union. I’m sure they’re curious if you had to give a general sort of overview, how is this country treating its veterans?

    Ellen Barfield:

    Well, how is this country treating anybody who isn’t a massively wealthy person? And I have said for a long time that VA healthcare, if fully funded and staffed is the way everybody’s healthcare should be. Single payer, everybody in, nobody out. And sadly, the VA has never been everybody in. They don’t cover everybody and they really should. It depends on timing, depends on a lot of things as to whether they will take you or not. But a large chunk at least of veterans, but it is a single system where your records are all together, your care is all in one place. They understand the specifics of you being a veteran. And there are lots of other categories of people that need particular attention paid. Everybody should have single payer get rid of the 30% insurance premium that the civilian world pays for their healthcare.

    Then we could afford to make sure everybody had primary care, everybody had preventive care. It wouldn’t be showing up at the emergency room at the last minute when you’re catastrophically sick and if they’re going to save you, they’re going to have to spend a lot of time and money, preventive, preliminary, that’s what everybody needs. The VA at least theoretically and to a large extent in fact is damn good. It’s a unified system where it’s all together and they take care of it all. It’s so much easier than having to ferry records across town because you have to go to a specialist who’s never seen you before. Everybody should have it. So yeah, the nation’s not being kind to veterans, but it’s not being kind to anybody that isn’t filthy rich.

    Maximillian Alvarez:

    Listen, truer words never spoken. And you mentioned something at the beginning of our interview here where you said there are a lot of conservative folks out here. There are folks more on the left, but this moment of crisis is bringing those folks together here as one crowd on the National Mall. Things are getting so bad that it is forcing a lot of folks to come together in common struggle. And I wanted to kind of end on that note from the veteran side of things. What possibilities, possi, do you think this moment presents and what do people need to do to seize on that moment and fight for our rights, fight for our future before they’re all gone?

    Ellen Barfield:

    Well, I have really avoided the thought that things have to bottom out to energize people, but it’s obviously happening sadly. People are terrified as they have reason to be here. And are we going to lose our Medicaid? Are we going to lose our healthcare? Are we going to lose our social security? And then what the hell are we going to do? Yeah, there is reason to be terrified and we have to unify across our differences and across our skin color and our religion and all those things that they are using. It is what imperialists fascists always do is to divide and conquer, to teach you that somebody who’s on the same level as you is threatening you. When that’s bullshit. Immigrants don’t threaten us. Black folks or white folks or brown folks don’t threaten each other. Pretty much all of us in the same boat now, there was a middle class, it’s pretty much gone.

    So we don’t have any damn choice and it is pulling people together. I’m glad of that, but I’m horrified that it had to get so bad. But here we are, veterans for Peace is 40 years old this year. We’re fixing to have our first face-to-face conference in a while because of COVID and other things. We are small. We’re only about 3000. We got up about 10,000 in the earlier Iraq years, but we’re small, but we speak out about challenging all war and there’s got to be a better way that the imperialists of Europe and the US have got to figure out they need to be just part of the world like the rest of it. We got to, there’s struggle in the United Nations and other international forum to recognize that the climate is going to kill us if we don’t stop pumping crap into it. And we have to work together to solve that. And the ridge world owes the global south a huge amount of funds to help them take care of it. And we got to do it here too. And that’s totally the direction we’re not going right now. We can’t possibly, as human beings expect it continue if we don’t come together. And sadly, when it gets this bad, it kind of knocks people upside the head and they understand it a little better.

    Lindsay Church:

    Good afternoon. My name is Lindsay Church. I’m a Navy veteran, the executive director of Minority Veterans of America, and someone who still holds tightly to a belief that this nation is worth fighting for, not with weapons or wars, but with truth, with compassion, and with conviction that we all deserve to belong. We stand here today not just in protests but in protection one another of our shared future of the Soul of public service itself. Because what we are witnessing is not theoretical, it is not slow moving. It is here, it is deliberate, and it is already doing harm. Today marks the beginning of what history will remember as a purge of transgender service members, an unconscionable order from Secretary of Defense, Pete Hexes that puts thousands of service members across the country and around the world in the crosshairs of their own government. Troops who serve with integrity and distinction are being told that their presence is a problem, that their identities are incompatible with patriotism, that they must choose, walk away from the careers that they’ve built or stand and stay to be persecuted. This week I walked to the halls of Congress beside some of them. Brave, steady, remarkable people who are carrying the weight of betrayal was grace that shouldn’t be required of them. I watched as they told their stories calmly, powerfully, beautifully. And I watched members of Congress and their staff move from polite interest to a deeper knowing. Those weren’t statistics in front of them, they were patriots. And no matter what, some want to believe they belong.

    But Secretary Hex says is not the only one making these decisions. At the Department of Veterans Affairs secretary Doug Collins has announced his goal to eliminate 83,000 jobs. Jobs failed by the very people who care for us. When the wars are over, people who process disability claims answer crisis lines, help veterans find housing and walk alongside us through recovery. Many of them veterans themselves, many of them survivors of the very systems now being dismantled. This isn’t reform, it’s abandonment, and it’s not isolated to VA today. The cuts, the job cuts are there, but they’re already spreading the workforces. Its social security, FEMA education, those pillars of community stability are already being slashed. Public servants across the country are being demoralized, discarded, and erased. Not because they failed in their duties, but because they dared to serve the people that those in power find inconvenient. This is not about cost saving, this is about consolidation of power, of control, of the very definition of who gets to be counted as an American. This week, the Navy quietly announced that it will rename the USS Harvey Milk.

    A name meant to honor courage, authenticity, and sacrifice stripped from our national memory. Without ceremony, without justification and without shame, the Harvey Milk story is not one they can erase. And neither are the stories of Harriet Tubman or Medgar Evers or Ruth Bader Ginsburg or John Lewis. All namesakes of navy ships, these aren’t just names, they’re the scaffolding of American progress. They remind us who we’ve been and they point to us towards who we could become. When we erase them, we do not become stronger, we become smaller. And while these symbolic erasers continue, the real world harm accelerates. Just weeks ago, the VA rescinded protections that in turn, the transgender non-binary veterans like me could access medically necessary care. Care that is affirming care, that is evidence-based and care that saves lives. This isn’t about budget, it’s not about medicine, it’s about cruelty, cloaked in bureaucracy.

    And while the spotlight is aimed at transgender people benefits for others, women, people of color, disabled veterans are being quietly dismantled in the shadows. Let me be clear, we are the canary in the coal mine. What they do to us in the headlines they will do to you in silence. I’ve stood besides veterans as we slept on the steps of the capitol to pass the Pact Act because our sick and dying friends deserved better. I’ve traveled to Ukraine with fellow veterans to stand with our allies in their fight for freedom. I’ve stood my life in the military and far beyond it answering the call to serve. Because to me, service isn’t defined by the uniform. It is defined by what we choose to protect, by who we choose to stand up for. Whether we leave behind a world that is more just more compassionate and more free. So I say this to secretaries, he Collins, and to every person who believes that they can quietly erase us from this country’s fabric. We are not going anywhere. We are your neighbors, your coworkers, your classmates, your family. We’re veterans, we’re public servants, we’re Americans, and we’re still here. We will not be erased. We’ll not be silenced, and we’ll not stop fighting, not just for ourselves, but for the America we know is still possible. Thank you.

    Leilana Brandt:

    So my name is Leilana Brandt. I am a veteran of the Army, national Guard, served from 1996 to 2002 in the 36 50th maintenance company in Colorado.

    Eric Farmer:

    My name is Eric Farmer. I served from 1999 to 2020 in the Navy. Did most of my time on submarines, also did a tour to Iraq and I come from Texas.

    Maximillian Alvarez:

    Well, thank you both so much for chatting with me. We are standing here on the National Mall to unite for veterans, unite for America rally. I was wondering if we could just hear a bit more about you all your time in the service and what the hell’s going on right now that is bringing so many folks out here to the mall?

    Leilana Brandt:

    Well, I am a transgender person and I also was in the military during Don’t ask, don’t tell last time. So I was completely closeted for my own safety, not just in the military, but in my life in general. And it took me a very long time to have the courage to do what some of the service members now are doing, which is being themselves while being in the military. And each and every one of us have taken an oath to the constitution just like every other service member and veteran. And I feel that them being stripped away from the military right now, not only losing their livelihoods but also their homes, their friends, they’re just being stripped from their lives completely just because of how they were born. And I think it is appalling and insulting to all of us.

    Maximillian Alvarez:

    And can I just ask on that note, could you remind folks who maybe forgotten what the hell it was like in the Don’t ask Don’t Tell era? It felt like we made quite a bit of progress in a short amount of time and now we’re just yanking it right back.

    Leilana Brandt:

    While for anyone in the two s LGBTQI plus community, they were expected to not speak of it, to not have any hints of who they were. And so they basically had to hide themselves in order to serve. And there were many that were separated through no fault of their own, but because they were outed by other people. And then there were just folks that used that as an opportunity to shirk deployments and stuff like that by falsely claiming it. So it’s not anything that makes sense as far as readiness goes. And also Hertz enlistment because there are many folks in the queer community that want to serve or that need to serve because that is the best way for them to make a livelihood for themselves in a country that discriminates against them already. And the military has long been a place that started to be more diverse before the public sector was. And so I believe that that’s something, or sorry, before the private sector was. So I believe that that’s something that should continue, that it should be at the front of the pack as far as allowing everyone who wants to serve to do so.

    Eric Farmer:

    My time in the Navy, like I said, was mostly on submarines. When I first started out, it was strictly men, it was strictly men. When I first started out in the submarine community, it wasn’t until about 2006 that they started allowing females to serve on submarines and that was started out as officers. My last submarine that I was on that I did a deployment on was integrated with enlisted females as well. And they stepped up. They stepped up and did the job that all the other men said that they wouldn’t be able to do. And so I have a feeling that what’s about to happen is that they’re going to try to do away with females in the submarine community and it’s not going to make us ready. The jobs are being filled by females right now, and if you take all those females out, we’re not going to be capable of deploying our submarines.

    Now what’s bringing out the veterans here is the fact that they are trying to take away the jobs of the veterans. They’re saying that that’s going to help the veteran community with the va. And I’m telling you that we’re about to find out that you can’t do more with less. I have had three to four phone calls where I’m trying to get community care on the phone so that way they can send something to the VA so I can get my work done. And they’re, they’re not picking up the phone. I’ve been on three or four phone calls where it’s been 30 plus minutes and no one’s picking up and it just cuts off and I have to call back. And so I’m waiting. I’m already waiting. And the cuts have just begun.

    Maximillian Alvarez:

    One, it really gives a grim meaning to that phrase, right? We are doing more with less, but it’s not what people think. You have more plane crashes around the country when you have fewer air traffic controllers. You have more wait times for veterans like yourselves when you have less healthcare staff at the va, right? That’s the kind of more we’re getting for less, which is nuts. But I wanted to ask you if you could both touch on that a bit more. Since your time in the service, what has your experience been like as veterans? How have we been doing as a country in caring for our veterans before the new Trump administration? And then we’ll talk about what the hell’s going on right now.

    Leilana Brandt:

    Well, I think that what I have seen, I never used the VA because I was never overseas, but my father was Lifetime and had multiple deployments and he has been someone who used the VA and he has always had complaints. He has always had complaints, and it is mostly about the understaffing. It’s not that there is waste happening as far as personnel goes, and that’s the place where they’re trying to make cuts is personnel. That’s the thing they need more of, not less. So if they need to find ways to make it more efficient, that’s great, but personnel is not the place to start with that.

    Eric Farmer:

    So when I first got out in 2020, I was scared about to go into the VA because I’ve heard all the horror stories. And for me, when I first got out, it was actually pretty good. Not very long wait time to get ahold of somebody. No wait time to get in. It wasn’t until recently that the wait times have become longer and longer and I’m not getting the care that I feel like I need. In fact, I go Wednesday to have a surgery on my shoulder from an injury from the Navy that I re-injured, but I’m not going through the va. I’m having to use my personal insurance. I’m going through TRICARE because the VA wants you to go through physical therapies before they do anything, and I have a tear in my labrum that needs to be fixed.

    Maximillian Alvarez:

    There’s been so much going on in the past three months alone, it’s hard to even know where to start. But like you said, the cuts to federal agencies across the board, including Veterans Affairs, and I just interviewed some of the nurses at VA hospitals, so they’re feeling it. Folks here in DC are feeling it on the administrative side. It’s going to take a while for us to really wrap our hands around the impact of all this. But I think one silver lining of the terrible moment we’re in is that it’s bringing so many folks out of complacency to gatherings like this. Even people who don’t normally agree on stuff, people who maybe aren’t down with L-G-B-T-Q rights, but who are saying, fuck it, we’re all getting destroyed right now. If we don’t start learning how to work together, we’re all going to fall like dominoes. So I wanted to kind of end on that note because things are obviously pretty grim right now, but what do you think it signifies that so many folks have come out to the mall, that there’s so many diverse groups of veterans, there’s union folks, non-union folks, older folks, younger folks. What message does that send and what do you think it’s going to take for us to really stand together as working people to fight this?

    Leilana Brandt:

    Well, I think that the military needs to continue to lead that way in diversity as it always has. Every person I ever served with, regardless of what their personal political views, religious views, anything like that, they didn’t give a shit what their buddy in the foxhole believed or where they came from or anything like that, as long as they had their six. And that’s something that we need to remember is that we need to have each other six. We need to be there for each other knowing that we all have a common goal and we have a common enemy, and that is anyone who is an enemy to the constitution that we took an oath to support and defend, and if any of us are under attack, then we all come together to fight that.

    Eric Farmer:

    I think the silver lining of having the diverse group to show up today is sending a message. It’s going to send a message that the oath that we took does not end, that it’s going to continue until we eradicate the fascism that is trying to implement our country. My grandfather fought in World War II against this, and never in my mind did I think that we would have to fight this, but taking it to the front lines today, to the front steps, to the front door of the capitol, as long as someone, even if they support a certain person, just listens to some facts from today, that might change their mind and go, you know what? I have that oath. I need to defend the constitution because I’ve asked people, well, what are you going to do whenever the constitution starts getting taken away? And they told me that they would fight, but they’re not here. They’re not protesting

    Leilana Brandt:

    Because they’d be here today if they

    Eric Farmer:

    Actually recognized it was already happening. They don’t go to any protests. They sit idly by and we can’t do that as veterans with the support of non-veterans. This is what it’s going to take. Non-veterans supporting the veterans, the veterans coming up and being the bonus army that this is about bonus Army of 2025.

    Irma Westmoreland:

    Well, good afternoon you guys. My name is Irma Westmoreland and I’m a registered nurse in Augusta, Georgia for the va. I’m also secretary treasurer for National Nurses United and chair of our VA division. While I’ve worked for the VA for 34 years as a nurse, some of my earliest memories are going to the VA in Augusta, Georgia to work with the veterans on bingo nights or dance parties. When I got older with my mother who spent 50 years as a VA volunteer, I know. Pretty cool, huh? Also, my husband is a retired SFC Army veteran of 21 years of service who has disabilities from its service. So the VA is deeply personal to me. Our servicemen and women were told, if you need us, we’ll be there for you. It’s a promise. Now, secretary Collins and the administration want to take that promise away and we’re not going to allow it. That’s why it deeply pains me to see these attacks on the va. When we have a contract for the VA care, the nurses and the doctors are going to be caring for these patients. When the administration says they won’t cuts, we say, no, we need to live up to what we told and promised our veterans. We told them that we would be there for them and we need to do that. They stood for you and me and I ask you now to stand for them. No cuts to the va.

    Maybe some of you know someone or love someone ill from burn pit smoke or from Agent Orange or lost a limb from an IED exposure or died or suffered from PTSD, military sexual trauma or other chronic illnesses. We know the VA is the best place to get care for these ailments and more. The VA is the only healthcare system centered around the special needs of service members. 30% of our employees are veterans themselves, but it’s more than that. It’s also the only healthcare system in the country that’s fully integrated will help with veterans in poverty, with homelessness, offers, clothing, allowances, and much, much more. I’ve seen magic happen at the VA friendships form fast and it’s not unusual to see veterans helping veterans, whether it’s pushing a wheelchair or walking them down the hall to an office. These veterans share a deep sense of camaraderie and a sense of belonging. That goes a long way in making a person feel better and stronger. Now, if you ask, is the VA perfect? No, it’s not. I can’t tell you that it is, but let me tell you, we’re light years better than the private sector.

    That’s why I will not stop fighting to see the VA improved and not destroyed. As you all know, secretary Collins is now looking to cut tens of thousands up to 80,000 jobs from the va eight. Yeah. These decisions are being made at the atmospheric level. The staff that do the work know best where things can be improved and streamlined. And I say ask them. He says, no mission critical positions will be cut. But let me tell you that all positions in the VA are mission critical. It’s important for every person to keep their job from the engineering staff to the housekeeper, to the dietary staff, secretarial staff, and many, many more. When cuts are made, who will be there to have to pick up the work that needs to be done? The nursing staff and the medical staff that are left when supply folks are cut. I heard that operations were being postponed so nurses could run, get clinical surprise. Let me explain that for you. In one place, a nurse had to go and to the warehouse in the VA to get supplies for surgery needed in the OR for a patient who was waiting. That’s not right. That’s right. But that veteran finally got their surgery. It was delayed, but it was done. But it was because the nurses stood for that veteran.

    When housekeeping was cut, I heard delays in veterans getting into beds because there was no one to clean the rooms. This causes delays for our patients getting needed treatments started, and in some cases it may need to lead for a more elevated critical need of treatment. It’s common sense cutting 80,000 jobs will cause delays in veteran care. So we say absolutely no cuts. That’s right. We know. We know we are. What we’re witnessing is an effort to push the VA past its breaking point. The ultimate goal is to privatize the VA and pour billions of taxpayer dollars into giant healthcare corporations and the pockets of billionaires instead of the veterans who served our country.

    Don’t sell us out because what they do, they know the VA and the federal government. It’s going to pay them on time every time. That’s why they want our care, but they don’t know our care. They don’t know how to provide our care. They don’t know that the VA does it better than anybody. The nurses and the doctors are specifically trained to do it. We’ve been training for years since the VA was incepted and while right now we are not going to go away for sale, we are not for sale. That’s exactly right. It is the nurses and the government workers who are standing up to block this privatization effort. It is because of our unwillingness to back down that nurses and other unions are filling the retribution that came down on March 27th with an executive order designed to strip us of our union rights. It is union busting and intimidation, plain and simple, but we’re fighting back national nurses united along with other federal workers, labor unions, and other veterans groups. We sued the administration over this outreach of executive power. This is not about us, it’s about our patients. We must have collective bargaining protections that allow us to advocate for our veterans and to speak up about issues in our facilities that cause us concerns for our patient safety. One example is we’ve had shortages of IV normal saline to mix medications. How stupid is that?

    With that being said, you all understand the VA is not a contract. The union’s not a contract. The unions are nurses. We represent, the union says, and I say no cuts. Keep the VA strong so that we can care for every veteran. NNU knows that an injury to one is an injury to all. So we say when we fight, we win. When we fight, we win and we will prevail. The VA will stand strong for our veterans. Thank you.

    Andrea Johnson:

    My name is Andrea Johnson and I’m a registered nurse. I work with veterans in San Diego.

    Justin Wooden:

    And I’m Justin Wooden. I am a registered nurse in the ICU and I work in Tampa, Florida.

    Maximillian Alvarez:

    Well, Andrea, Justin, thank you both so much for chatting with me today. We are of course standing out here on the National Mall at the Unite for Veterans, unite for America rally. You all with National Nurses United have shown up in full force because of course, these cuts that the administration is doing to the federal agencies across the board are impacting workers, including workers at the VA and across the board across the country. So I wanted to ask if you could just say a little more about who you guys are, the work that you do, and what it’s like to work where you work under the conditions we’re under right now.

    Andrea Johnson:

    So we’re a special breed, and I say that because we care for patients that are not typical patients. Veterans went overseas, they fought wars. They’ve done many things that affect them morally and mentally. And because of those actions and the things that they had to choose to do in wars, they come back broken. And that’s what is unique about the VA system and VA nurses and healthcare providers in general, is that we have that knowledge and experience to care for the veteran in their entirety, right? Outside public hospital systems don’t have that knowledge or experience working with veterans and the special, unique needs that they come back after serving their country with. So as BA nurses we’re there, we’re taking care of that whole veteran. We’re taking care of their medications, we’re taking care of their home life. We’re coordinating with social workers to make sure that they have all the resources that they need. It’s not just passing medications. We’re caring for that whole veteran. And I think that’s what’s special about being nurses

    Justin Wooden:

    And our veteran population that we care for is also different than the fact that I’ve worked private sector before and I’ve worked the va, the veterans, they’re not like the average person when it comes to their care. They want it straight, don’t beat around the bush. They want to know what’s going on, cut to the chase, just tell me what is going on. They don’t want sugarcoated. They want direct answers and we offer that.

    Andrea Johnson:

    That’s right. And I think the other thing that makes veterans unique is that they come from a system where they’ve been told what they can wear, how they can act, what they can say, what they can do. And soner, VA nurses and healthcare providers in general struggle sort of with this authority in a way where we educate and try to teach our veterans better ways to care for themselves.

    But we have that sort of roadblock because they put up a wall, it feels like we’re telling them what to do, and that’s never what we are trying to do. So we always have to find unique ways with each veteran. Each veteran is unique in how they receive and retain information. So I think that’s what makes us unique too than outside hospitals, is that veterans are a very special population and taking away the care that the VA provides them is despicable. And like I said, no outside hospital system could take on the number of patients that the VA system cares for or the special needs that the veterans have.

    Justin Wooden:

    And veterans, they have a little camaraderie. If you’re in the army, you’re army strong. If you’re in the Marines, you’re strong. So every branch kind of has a little internal battle with each other, but when it comes to it, they’re all a brotherhood. They will stand behind each other. A lot of our veterans in Tampa where I go, they come to the VA hospital just to be around veterans. So it’s a community to them. It’s not just a place to get healthcare, but they go there because they feel the camaraderie, they feel the brotherhood. So while they have appointments, they come early just to talk with other veterans that they know from places or they just feel more secure. And a lot of military veterans don’t like to talk about their time and their service, but at the va, we encourage it, it therapeutic, it’s cathartic, and they feel free to tell stories there that they haven’t told their families.

    I mean, we have patients who are towards the end of their life and they have all these things that they haven’t said that they finally want to say, and they feel comfortable with the nursing staff, with the doctors at the VA to have those conversations and tell the things that they were so afraid to talk about before. So I love working for the va. I think it’s a phenomenal thing and a wonderful place to work. But the current administration is causing a lot of rifts and making it a lot more difficult in a lot of ways.

    Andrea Johnson:

    These actions by the government are creating anxiety and fear for healthcare workers coming to the va. That’s not stopping us from coming to the va. We’re dedicated to our mission and we show up day in and day out to deliver that care despite what’s happening. But that’s why we’re here today, right? We’re fighting for what we know the vets earned and what they deserve.

    Maximillian Alvarez:

    Could you guys say a little more about what has been going on inside the VA over the past three months? I mean, how have these policies from the Trump administration affected you all in your day-to-day work? Right. I mean, there’s the current attack on the collective bargaining rights of federal employees, over a million federal employees, including nurses at National Nurses United work for the va, right? There’s like the voluntary resignations, staff cuts that are impacting agencies across the board in different ways. Could you just give listeners a little on the ground view of how has this been affecting you all and the work you do over the past few months?

    Andrea Johnson:

    Well, like I mentioned earlier, nurses, at least the nurses I’ve been speaking to in San Diego, and I’m hearing from my colleagues across other VA facilities as well, is that there’s a decrease in morale. People are feeling fearful and anxious coming to work because we don’t know what’s next. We don’t know if tomorrow when I go into work, I’m going to lose my job. So we’re dealing with those fears, but we’re still coming in, right? It’s not stopping us from coming in. It’s not making me want to quit my job and go find a job somewhere else. I know what I do at the VA is important, and I know that the veterans appreciate the care that they receive there. And I think the government and the people making these decisions need to actually come and spend some time with these people to better understand where they’re coming from, making these decisions without any of their, in my opinion, without any of the veterans in mind, any of the federal workers really, or the American people for that matter. But specifically for today, they’re making these decisions, not considering what the veterans want.

    Justin Wooden:

    So I work in the ICU at the bedside, and it affects me in ways because sometimes they send us to areas because they’re short staffed, that we are going to areas and covering areas that we’re not familiar with or used to working in these areas. And a lot of people are like, oh, well, you’re a nurse, you can work anywhere. Well, and I like to is like, would you go to a podiatrist to get your teeth done? They’re both doctors, but it’s similar. We have different specialties. And also as a leader in the union at my facility, I round the hospital and talk with all the nurses and all the units to see what their concerns are. And a lot of ’em come to me. They’re like, well, we’re told there’s no union. There is a union,

    Andrea Johnson:

    Andrea, Andrea. It’s really confusion.

    Justin Wooden:

    There’s a lot of animosity every day. You don’t know what’s going on. It’s just very tense. I guess that’s a good way to put it. But going around the hospital, a lot of the nurses that I work with are saying they feel that there’s more focus being put on numbers and metrics as opposed to the care of veterans or the staff. They’re putting numbers over the patients. And ever since I’ve been at the va, which is, I’ve always had a wonderful time, but recently it’s becoming very, like you said, very anxious. It becomes very nerve wracking like you’re walking on eggshells just because you don’t know what’s next.

    Andrea Johnson:

    Yeah. We just don’t have any clue. But I think, and Justin made a good point, that a lot of our nurses are concerned about the union because of these executive orders and attacks on union unions and the federal government in general. But as union leaders, we remind them that the contract our CBA, our contract is not the Union National Nurses United. Yes, we are the union. I’m not the union. It’s every single one of our nurses that are on the floor, right, collectively, so they can try to take us down, but they’re only going to succeed if we let them. And so I’m using that as sort of a motivator to keep my nurses motivated and encouraged to continue to fight the good.

    Justin Wooden:

    Because right now the current administration is, they’re doing union busting tactics. So being a federal government agency, they took away union dues being done through a direct deposit through your paycheck. So essentially we lost every member we had, and now we have to start from the ground up getting everyone to reset up. So essentially it’s like a grassroots project starting from the ground

    Andrea Johnson:

    Up. It’s very grassroots right now. Yeah.

    Maximillian Alvarez:

    Can I just ask a blunt question? What does eliminating collective bargaining rights and changing the structure of how union dues are paid, how does that serve the American people? How is that? Are you creating efficiency or cutting waste?

    Andrea Johnson:

    It has absolutely nothing to do with government efficiency and cutting waste. If anything, especially federal agency unions provide protections to the employees that they represent to speak out about fraud, waste, and abuse. We provide that layer of protection for VA nurses to speak out about patient safety issues when there’s not enough staff or if we have broken equipment, our collective bargaining agreement provides, in a way, it’s a bubble. It sort of insulates us from retaliation from being targeted by management. So I think that’s the importance of our collective bargaining agreement.

    Justin Wooden:

    And I worked in private sector, so I can see. So in the private sector, say you’re an employee and you’ve done something. So I call you into the office, say, Hey Max, you did this. Can’t be doing that. Here’s a writeup, right? If you are opposed to that or don’t agree with it, that’s your opinion and you have no say in a union, you have a union backing, you have union rights. You can have a representative there to say, Hey, I don’t think this is right. And we can investigate it and say, Hey, I don’t think this is just what you’re doing. So we stand up for our members.

    That’s just one scenario. We also ensure, like Andrea said, safe working additions. We make sure the veterans are safe, making sure that if they change any policies that, or any changes in working conditions that it’s safe for the staff or things like that. So there’s a lot of things the agency does to help protect workers, not just, it’s not saving money. I mean, yes, the union does fight for, we look at locality pay and we look at all the area hospitals, how much are they making? Why is our pay not equal or similar to the surrounding areas? We do those things as well. We also help our employees who have problems with hr. A lot of our time at my facility is spent because HR payroll hasn’t done what they’re supposed to do or bonuses weren’t given or a lot of unjust things are being done by HR because this is the federal government. It’s not just we don’t have our own HR department. We have to go through multiple steps to get things done. So we have a lot of resources that we use to get to the people so we can help our employees.

    Andrea Johnson:

    Yeah, yeah. Just to kind of last little thoughts on that, like I said, the collective bargaining agreement, and I hate to describe it this way, but it’s sort of an insurance policy for some people because like I said, there’s sometimes fear to speak out about safety issues and when something is being done incorrectly because of that fear of retaliation or being singled out and like I said, that collective bargaining agreement provides that protective layer. It makes people feel safe and comfortable to be able to speak out. And that’s why those are important. It holds management accountable. They can’t just decide to do whatever they want because if it’s written in a contract, they have to follow that

    Justin Wooden:

    Essentially having union is having a democracy. There’s due process and checks and balances in the private sector, it’s more authoritarian. This is what I say, do it

    Maximillian Alvarez:

    Well. And that’s always been my retort when I hear folks say they want government to be run a business. And I was like, well, as someone who interviews workers at businesses across the country, I can tell you you’re saying you want our government to be run like a dictatorship. How most businesses are run. I could talk to you guys for hours, but I know I got to let you go here, but I wanted to just pick up on something that you were saying both of y’all. But we’ve interviewed a lot of healthcare workers on this show over the years

    And through those interviews from folks who work at private Catholic hospitals to public hospitals, university hospitals, certain common like horrifying trends have become apparent in terms of what’s going on in healthcare. The crisis that we have been facing with more work being piled onto fewer workers, patient care, the quality of patient care going down as patients are increasingly treated like commodities to come in, get their care and get kicked out. This whole sort of McDonald’s model of healthcare is something that I’ve heard described from different healthcare workers around the country. I wanted to ask how much the VA has sort of been going the same way or how things are different within the va. I guess maybe to end on that note, what do you all in the VA deal with on a day-to-day basis that is indicative not only of problems that need to be fixed at the va, but problems that we’re facing in our healthcare industry across the board right now?

    Justin Wooden:

    I can speak to that first.

    Andrea Johnson:

    I’m going to let you go ahead

    Justin Wooden:

    Because working in private sector

    Before coming to the va, I’ve seen both sides. So I know everything is about billing. In private sector, it’s about getting money. Because they’re for profit, they need to make money. So every procedure that’s done has to be documented so they can bill for it to get money. At the va, it’s not like that at the va. So you were describing healthcare as like a fast food restaurant. So drive through, get what you need, and then at the VA we care about the veteran whole. So when they come in, we’re worried about discharge planning when they come in. So are there anything you need at home? Do you need shower bars? So we’re working on the discharge to make sure when they do leave, when it’s time for them to go, they have the appropriate things. Do they have problems with any meals? We’re going to get every resource.

    Mental health, we schedule their appointments before they leave. Where in private sector, they don’t do that. So before you’re discharged from the va, any follow up appointments, we we make sure they’re scheduled before you walk out the door and we print out a calendar of here’s all your upcoming appointments so you know what you have to have done and all your medications are listed, all these things are there. We don’t want to set up for failure. We want them to know their health course, know what they need to do and follow up with those treatments. We have social workers who call after they leave to make sure, hey, it’s been a week since you’ve been home, is everything okay? So those are the things that I see the biggest difference. I think that’s the biggest strength the VA has. So for them to do cuts and try and eliminate that system, I think is the worst thing we can do.

    Andrea Johnson:

    And to sort of piggyback off of what Justin was saying is, I mean you made a good point, max. Our people are talking across the country about our healthcare system and how broken it is. And so taking 9 million veterans who receive care in a system, that one has significantly higher standards than any hospital outside of a federal agency. Were held to a higher standard when we screw up. That’s in the news. When local hospitals make a mistake that’s not in the news because they’re smaller, it’s more central. But the VA is a federal agency where across the entire country. So if the VA does make a mistake, it’s known. But what we do very well isn’t necessarily spoken about in the public as much, but the VA does a lot of things very well for our veterans

    Justin Wooden:

    And veterans choose to come to the VA

    Andrea Johnson:

    That outside hospital systems cannot, cannot do. And if we eliminate the va, if we try to continue to push veterans into the community with a system who already or that already cannot serve the citizens that they’re set out to serve and we add 9 million more people to that system, what’s going to happen? We’re going to have a very sick America that is unhealthy, that can’t happen

    Justin Wooden:

    Paying through the nose

    Andrea Johnson:

    And paying through the nose. And

    Justin Wooden:

    The PAC Act added 400,000 more veterans that can get care and then they want to cut 80,000 plus jobs. So who’s going to care for those veterans, those newly signed veterans? You’re offering more services for veterans, but now you have less people to provide those services.

    Andrea Johnson:

    Right. And we know studies show our experience and our knowledge knows that the more staff you have on hand to care for people, the better healthcare outcomes there are. And that’s just, you can’t make that up. It’s documented, very well documented. And we should be looking at not dismantling one healthcare system that serves 9 million people, but looking at the healthcare system as a whole on how we can make it better. Not taking one away and throwing it into this other one that’s already a disaster. We need to be looking at trying to make our outside hospital systems more like the VA as far as standards and things like that go. I think we’d be better off in America if more outside hospital systems followed in the va, which is why we need to keep the VA in place.

    Maximillian Alvarez:

    Well, and just a final question on that note to everyone who’s out there listening right now, whether they’re in a union or not, whether they’re veterans or not, why should they care about this and what can they do to help? How can they stand in solidarity with you all at National Nurses United and what can they do to join this fight to save the va?

    Andrea Johnson:

    Okay. I think this fight, whether you’re Democrat or Republican, you are union or non-union. I think that this is an important issue because we’re dealing with our veterans. These are people who risk their lives, gave up time from their families, were injured, witnessed some atrocious things. And if we’re not supporting them and receiving healthcare, then there’s something wrong. And I think that we need to be focusing on making sure that the veterans continue to receive the care that they have earned and that they receive. And because this is just me, but what they’re doing to the veterans, this is just one step. They could easily turn that to people who are not in the union, to people who are not veterans, to just regular old Americans. And then what are we going to do when our already broken healthcare system is even worse? So I think that healthcare in general should be a human issue no matter what side of the aisle you fall on.

    Justin Wooden:

    And my point I always like to say is every one of us has family member. If your family member is sick and in the hospital and they hit their call bill because they need help, you want somebody to be there to respond with the way the current healthcare system is going. We’re being put spread more places, so it’s taking us longer to respond to those calls. We as humans, as you said, our job as nurses, we want to care for our patients. We don’t want do any harm to our patients. We want to be there. So we are just fighting and want people to know that we’re here fighting for your family members, for your loved ones and for our veterans because that’s our job. That’s our oath that we’ve taken as nurses. So we just want to be able to have the supplies, the tools and the resources we need to give the best care we can to our veterans and patients.

    Cecil E. Roberts:

    My name is not just Cecil Roberts, president of United Mine Workers of America. I used to be Sergeant Cecil e Roberts in Vietnam in 1 96, like infantry brigade.

    When I first got to Vietnam, I want you to listen to this. Some people tell me I was never scared when I went over there. You’re looking at a guy that was scared to death.

    I tell the truth, that’s the truth. I was scared when I first got here. It appeared that nobody liked me. These people with 15 months, 10 months, eight months counting the days, they looked at us new guys as like, that guy’s going to get me killed when they hurt my accent. Oh no. Another hill belly from West Virginia. That’s what they thought. They looked at me, these veterans, they said, how you going to act? I didn’t understand the question. How you going to act? I want you to remember that because I’m going to ask you how are we going to act moving forward from this place? That’s right.

    And then bullets go right by your nose. They look at me and say, don’t mean nothing, man. I’m thinking bullshit and say something to me and I want you to think about that. You get immune to this and I saw so many wonderful people with kids at home, mom and dad’s at home, wives at home, and all kinds of friends at home. Not make it. When I first got there, somebody with 30 days got killed, had a daughter he never met. Somewhere in this United States of America, there’s a 57-year-old woman, had never met her father. Now, how many veterans we have here? By show of hands, you’re going to get a test right now. How many of you met a million there in Vietnam or where you are stationed? How many of you met a millionaire? There’s a good reason millionaires don’t defend a country. They take advantage of the country, and if there’s people listening to this live broadcast, you could be mad. Your feelings could be hurt and I don’t care.

    The other thing I want to ask you, when you got back home, how many people patted you on the back, particularly if you was a Vietnam veteran? Didn’t happen. Didn’t happen. But I want to thank everybody, every veteran because we’ve been embraced for the last 20 years and that means so much to me. Thank God for you. It isn’t, isn’t enough to come here and rally. This is a great first step. Abraham Lincoln said, this is a country of the people by the people and for the people it has turned in to a country for the rich people who don’t care about the rest of us, I’m going to tell you what we should be planning on doing. We should demand that every person who worked for the federal government and lost their union rights be restored. Right now, I was in the army and I’m glad people recognized the service of people who were in the army, but we shouldn’t be having a parade.

    We shouldn’t be having to parade until every veteran has the healthcare they deserve and we shouldn’t be having a tax plan send to the rich who don’t need money. Here’s another tax cut for you. Until every American who has a job, doesn’t have a job, has a job until every homeless person has a home, we should make, I’m going to close with something. First of all, I’m calling on Congress. I’m calling on everybody that’s elected. I’m calling on every American, how are you going to act? Because this is terrible what’s happening to this country, and that’s why we’re here today.

    You do know, this is my last quote, okay? On map next to last, Dr. King was assassinated. One month before I left Vietnam and I watched these African-American soldiers so desperate, so frustrated, so hurt, pick up their rifles, pick up their M sixties, and went out into those rice patties and defended the United States. When the United States didn’t defend them, that was wrong. This one will really challenge you. Dr. King in the middle of the civil rights movement said this to those who were being bitten by dogs. He said, listen to this. If you don’t have something, not somebody, not your wife, not your daughter, got your mom, not your dad, something that you would die for, you don’t have a life worth living. Think about that.

    This is the last one. It’s strange that I jumped from Dr. King to Mother Jones. My great grandmother and Mother Jones were friends, two great radicals, and I’m so proud of our heritage. You may not know this history, but when you leave here today, read it. How many of you heard La Lulo at Ludlow? The gun thugs came off the hill after taking the machine gun and firing into the tent calling all day long. Sometime in the middle of the day, they cut a 12-year-old boy In two later in the day, they murdered the leader of that tent colony, and then they set those tents on fire and burned 13 women and children alive. That happened. That’s part of our history. Mother Jones did not quit. She called for a rally in Trinidad about 15 miles from the Ludlow site. She looked out on a crowd probably twice this size, and she looked at them, take this W when you go home. She said, sure, you lost. Sure you lost. But they had bayonets and all you had was the Constitution of the United States of America. And then she posed. Lemme assure you, any confrontation between a bayonet and a constitution, the bayonet will win every time. But you must fight. You must Fight and win. You must fight and lose, but you must fight. What must you do? You must fight. You must fight. You must fight.

    Maximillian Alvarez:

    All right, gang, that’s going to wrap things up for us this week, and I want to thank you for listening and I want to thank you for caring. We’ll see you all back here next week for another episode of Working People. And if you can’t wait that long, then go explore all the great work we’re doing at the Real News Network where we do grassroots journalism that lifts up the voices and stories from the front lines of struggle. And we need to hear those voices now more than ever. Sign up for the Real News Newsletter so you never miss a story. And help us do more work like this by going to the real news.com/donate and becoming a supporter today. I promise you it really makes a difference. I’m Maximilian Alvarez. Take care of yourselves. Take care of each other. Solidarity forever.

    This post was originally published on The Real News Network.

  • When Immigration and Customs Enforcement took José into its custody at Otay Mesa Detention Center in San Diego in January, he told medical staff at the facility that he had colon cancer. Since then, his symptoms have worsened, he said, and he has begged them for treatment — to no avail. “They have ignored me,” José said in Spanish. “They’ve ignored all the times I’ve been bleeding.”…

    Source

    This post was originally published on Latest – Truthout.

  • A woman with long dark hair sits on a bench swing. She wears a black short-sleeve top with shoulder cutouts and dark ripped jeans.

    This article was published in partnership with The Marshall Project, a nonprofit news organization covering the US criminal justice system. Sign up for their newsletters, and follow them on InstagramTikTokReddit, and Facebook

    A growing number of states are considering legislation to set up protections for patients who might be drug tested when they give birth.

    Three of the bills were introduced following an investigative series by The Marshall Project and Reveal that exposed the harms of drug testing at childbirth—including how many patients are often reported to child welfare authorities over false positive or misinterpreted test results and how women have faced child welfare investigations and removals over medications the hospitals themselves administered.

    In New York, a bill that would require hospitals to obtain consent from patients before drug testing has been advancing. Two proposed bills in Arizona and Tennessee failed to make it out of their legislative sessions. 

    “We know when there’s secret drug testing, families are often torn apart,” said New York state Rep. Linda Rosenthal, a Democrat from Manhattan, who noted cases of women who were reported to child welfare over positive tests caused by poppy seeds and prescribed medications. “This is not some theoretical discussion we’re having here. This is really something that occurs.”

    The New York bill, versions of which were first introduced by Rosenthal beginning in 2019, has faced years of resistance from lawmakers. Similar efforts in Minnesota, Maryland, and California also failed in prior legislative sessions. But in New York, The Marshall Project’s reporting on hospital drug testing helped convince more lawmakers to get on board, according to activists who lobbied for the legislation.

    Three items are arranged on a white surface: a copy of a sonogram, a printout of positive drug test results, and a salad in a white bowl.
    Poppy seeds, used in bagels, salads, and other foods, can yield positive results for opiates in urine tests. Credit: Andria Lo for The Marshall Project

    If passed, the law would permit hospitals to drug test birthing patients and their newborns only if medically necessary. It would also require them to obtain informed consent from patients before drug testing them, which would include disclosing the potential legal consequences of a positive test result.

    Similar bills were introduced this year in Tennessee by both a Democrat and Republican. Sen. Janice Bowling, a Republican from Tullahoma who frequently advocates for parental rights, was first approached about the issue by a progressive advocacy group and quickly saw the bipartisan appeal. She said she was shocked to learn that women had been tested and reported over false positive tests caused by poppy seeds, the heartburn drug Zantac, and other legal substances.

    “Can you imagine if someone took the baby from you out of your arms or never even let you hold your child?” she said. “Taking children from families because a state entity says they have the authority to determine whether or not you’re a fit parent, that’s a slippery slope.”

    After a particularly contentious legislative session, the bill failed to make it out of committee. Bowling said she plans to take up the bill again in 2026.

    In Arizona, lobbyists and activists said they plan to pursue a similar informed consent bill in the next legislative session, in addition to continuing to pursue a more far-reaching bill that was introduced but failed to advance this year.

    The Pro-Choice Arizona Action Fund and reproductive advocacy group Patient Forward began pursuing the legislation following a Reveal and New York Times Magazine investigation in 2023 that detailed the story of an Arizona woman whose baby was placed in foster care after she was reported to child welfare authorities for taking prescribed Suboxone during her pregnancy. Current state law requires health care providers to contact child welfare anytime a baby is born exposed to controlled substances, including legal medications such as Suboxone and methadone.

    “We were like, how does this happen? What are the mechanisms in place that allow this to happen?” said Garin Marschall, co-founder of Patient Forward. “We wanted to understand what we could do to make sure that it didn’t happen again.”

    The proposed legislation would have revised Arizona law to bar positive drug tests alone as a reason for a child welfare report or investigation. If health care providers have no concerns about abuse or neglect, the law would require hospitals to notify the health department instead of child welfare authorities. Other states, such as Massachusetts and New Mexico, have passed similar laws, while hospitals around the country have also made changes to their drug testing policies.

    In New York, advocates said their bill has historically faced resistance from lawmakers who worry that asking patients for consent to test them for drugs will lead more women to decline such tests. But health care providers interviewed by The Marshall Project have said it’s rare for patients to decline a drug test, and even so, drug tests rarely provide useful medical information. Doctors don’t typically need drug tests to identify or treat babies exposed to substances in the womb, and a positive test does not prove that a parent has an addiction, the experts said.

    Instead, studies have found that screening questionnaires, which collect certain information from patients, such as their partner’s history of drug use, are effective at identifying someone with an addiction without putting them at risk of needless child welfare intervention. Doctors have found that maintaining open communication with patients is also the best way to help them, whereas studies show more punitive policies lead women to avoid prenatal care altogether.

    “If the trust between a doctor and patient is broken, that will lead to much more severe consequences for the child and the mother,” Rosenthal said. “Everyone does better if that doesn’t happen.”

    From New York to Arizona, Efforts Emerge to Curb Drug Testing During Childbirth is a story from Reveal. Reveal is a registered trademark of The Center for Investigative Reporting and is a 501(c)(3) tax exempt organization.

    This post was originally published on Reveal.

  • Disabled people hold immense expertise in navigating both chronic illnesses and moments of crisis. And yet, despite all the public reflections on “lessons learned” at the five-year anniversary of the onset of the COVID-19 pandemic — from which hundreds of people in the U.S. are still dying each week — disabled people find themselves under increasing attack by the Trump administration.

    Source

    This post was originally published on Latest – Truthout.

  • The GOP’s proposed cuts to Medicaid could take away an important lifeline in the effort to combat violence. Despite significant reductions in violent crime since the pandemic, violence and the fear of violence remain a stubborn feature of daily life in too many communities across the U.S. A new strategy of using Medicaid funding to support community-based trauma counseling to reduce violence has…

    Source

    This post was originally published on Latest – Truthout.

  • As congressional Republicans muscle forward a budget bill that would strip health care away from millions of Americans, Democrats have been united in their formal opposition: No cuts to Medicaid, no cuts to SNAP, and no work eligibility requirements. “Our message is extremely simple: Care, not cuts,” said Pennsylvania State Senate Democratic Leader Jay Costa at a rally of state legislators in…

    Source

    This post was originally published on Latest – Truthout.

  • In a letter sent to Senate leaders on June 3, a team of health experts at Yale University and the University of Pennsylvania warn that funding cuts included in the budget reconciliation package narrowly passed by House Republicans last month would lead to 51,000 more people dying across the United States each year. The package, labeled the “big beautiful bill” by President Donald Trump…

    Source

    This post was originally published on Latest – Truthout.

  • On Saturday, May 31, people across the United States rallied as part of the first National Day of Action organized by National Single Payer to demand Health, not Profit: Put National Single Payer on the Nation’s Agenda. A national single payer healthcare system would cover every person living in the United States and its territories from birth to death and provide comprehensive coverage, including all medically necessary care, medications and therapies, and longterm care.

    The reality that healthcare in the US is designed to provide profits for the medical-industrial complex rather than protecting people’s health has spurred a growing coalition of organizations to take action together.

    The post From Coast To Coast, People Demand Health Care For All, Not Profits For A Few appeared first on PopularResistance.Org.

    This post was originally published on PopularResistance.Org.

  • Every mother of an incarcerated son has the day her child entered state custody memorized: Whether she had been waiting in semiconscious dread for the call that started it all, or was stunned by a sudden pounding on her front door — she will always remember the moment her role as a mother fundamentally changed, bringing with it new and relentless demands on her time, mental health and finances.

    Source

    This post was originally published on Latest – Truthout.

  • Saint Paul, MN – With Governor Tim Walz and legislators huddled behind closed doors making deals for a looming legislative special session, around 50 people from the immigrant rights movement protested May 27 at Walz’s office in the State Capitol. The protest was in response to Governor Walz and legislative leaders announcing that they intend to pass a budget that takes away access to health care from adult immigrants in the state.

    In the hallway outside Governor Walz’s office, four speakers talked powerfully about the human and social costs of denying health care access to immigrants.

    The post Immigrant Rights Organizers: Hands Off Health Care! Health Care For All! appeared first on PopularResistance.Org.

    This post was originally published on PopularResistance.Org.

  • Ours is the only nation in the industrialized world that has turned health care over to the private sector, subjecting all of us to life expectancy five years below the norm in other wealthy countries.

    More of our babies die in the first year of life and more of our moms die in childbirth than in any other industrialized country.

    We spend twice as much per person on health care in the United States as peer countries, yet we have the highest rates of death for conditions that are treatable.

    On the congressional agenda are cuts to Medicaid of more than $600 billion over 10 years. Hundreds of thousands Kentuckians are among those in the line of fire.

    The post The United States Could Have The Best Health Care appeared first on PopularResistance.Org.

    This post was originally published on PopularResistance.Org.

  • Earlier this year, as President Donald Trump was beginning to reshape the American government, Michael, an emergency room doctor who was born, raised, and trained in the United States, packed up his family and got out. Michael now works in a small-town hospital in Canada. KFF Health News and NPR granted him anonymity because of fears he might face reprisal from the Trump administration if he…

    Source

    This post was originally published on Latest – Truthout.

  • The MAGA movement claims to support health care for vulnerable Americans, but their budget tells a different story. 13.7 million people will lose Medicaid — nearly 1 in 5 current enrollees. Nationally, 72 million rely on Medicaid, including 1.6 million in Louisiana and 180,000 in New Orleans. Another 500,000 low-income Louisianans get subsidized ACA coverage. Everyone on Medicaid or ACA plans will suffer from these cuts. This isn’t “saving money” — it’s a war on the poor, sick, and vulnerable. Millions will suffer, hospitals will close, and families will be bankrupted — all to fund tax cuts for the wealthy. These cuts are cruelty by design.

    The post Trump’s ‘Big Beautiful’ Cuts To Social Security, Medicare, Medicaid And More appeared first on PopularResistance.Org.

    This post was originally published on PopularResistance.Org.

  • Yet another Trump administration deportation case is sparking outrage: This time, a 4-year-old Mexican girl and her parents face expulsion, despite the family coming to the United States legally and the child’s risk of death if she loses the medical care she is receiving in California. The Los Angeles Times on Tuesday shared the story of the family, which came to the United States on…

    Source

    This post was originally published on Latest – Truthout.

  • On May 15, 2025, the European Hospital in Khan Younis, Gaza, the last facility there capable of providing cancer treatment, ceased operations. According to the Gaza Health Ministry, “Israel’s targeting of the hospital has made it impossible to provide medical care due to the danger posed to medical staff and patients.” The following day, May 16, Joseph R. Biden, 46th President of the United States, was diagnosed with an “aggressive” form of prostate cancer that had spread to his bones.

    Joe Biden is the person most responsible for the destruction of Gaza’s last cancer treatment center. His decision to give Israel a free hand in the ethnic cleansing of Gaza beginning in October 2023 led to the destruction of hospitals, homes, schools, and even the tent camps where victims had fled.

    The post Biden’s Fate And Israel’s Sadistic Revenge appeared first on PopularResistance.Org.

    This post was originally published on PopularResistance.Org.

  • Privatization of publicly funded Medicare and Medicaid, managed care, and “value-based payment”1 have failed to reduce cost or improve population health despite over 30 years of trying, and a new paradigm for health policy is needed. Public funding is appropriate for essential public services necessary for everyone—funded by taxes and paid for with budgets based on cost of operations, with no opportunity for profit or loss. Examples include police and fire departments, public schools, the military, roads and bridges, and government services. Health care should be added to this list. Other industrialized countries with far more cost-effective universal systems treat health care as a public good, not a commodity.

    The post The Case For Single-Payer: Reduce Healthcare Cost With Administrative Simplification appeared first on PopularResistance.Org.

    This post was originally published on PopularResistance.Org.

  • The brief videos posted by a group called Seniors 4 Better Care to YouTube look just like the political ads that take over the airwaves during campaign season. The voiceover in one breezy video claims without context that former President Joe Biden “broke” Medicare, the popular government insurance program for seniors, and that only President Donald Trump can “fix it.”

    Another video suggests policies left over from the Biden era are thwarting research into a cure for cancer, while Trump’s election will bring a “golden age” and the elusive cure for cancer by “promoting innovation.” The video fails to mention that the Trump administration’s massive cuts to federal health agencies are causing mass layoffs at the National Institutes of Health, the largest funder of cancer research in the world.

    The post Big Pharma Front Groups Muddle Debate Over Drug Prices appeared first on PopularResistance.Org.

    This post was originally published on PopularResistance.Org.

  • On Friday, five Republicans in the House Budget Committee—including four members of the conservative House Freedom Caucus—joined all Democrats on the committee in blocking the bill from reaching the House floor. But some of the opposition want even deeper cuts to programs like Medicaid to offset exorbitant tax cuts for the rich.

    Now is the time to make sure every member of the House of Representatives knows how we feel. Here is the current expected timeline for activity on the legislation.

    Sunday, May 18 – Monday, May 19: The House Budget Committee reconvenes at 10 p.m. Sunday to markup and package the legislation into one bill.

    The post The Republican Budget Bill Will Hurt Rural America appeared first on PopularResistance.Org.

    This post was originally published on PopularResistance.Org.

  • Republicans pushed their massive reconciliation bill through the House Budget Committee late Sunday after striking a deal with GOP hardliners who tanked a vote on the package late last week, complaining that the measure’s proposed cuts to Medicaid and other programs were not sufficiently aggressive. The final vote on Sunday was 17-16, with the four Republicans who voted against the bill on…

    Source

    This post was originally published on Latest – Truthout.

  • We are heading down a perilous road. Vulnerable communities face growing threats. The climate crisis is outpacing scientists’ worst predictions. Authoritarianism is no longer a distant possibility — it is rising, with democracy backsliding across the globe. With Trump’s return, public services like education, labor protections, humane immigration policies, health care and diversity programs are being dismantled.

    Meanwhile, trust in democracy is eroding — especially among young people. As political scientist Steven Levitsky points out, part of the problem is motivational: The political right is fighting for a clear, albeit dangerous, vision. The left, by contrast, is often fighting against that vision, with fewer compelling alternatives on offer.

    The post Build Inspiring Alternatives To Counter Authoritarianism appeared first on PopularResistance.Org.

    This post was originally published on PopularResistance.Org.

  • As Congressional Republicans weigh major cuts to Medicaid and the Affordable Care Act (ACA), a new research paper reveals troubling disparities in how workers obtain health insurance in the United States. 

    The new paper from the Center for Economic and Policy Research (CEPR) – A Complicated Maze: How Workers Navigate the US Health Care System – finds major gaps in the availability of employer-based insurance. The complicated public and private system that attempts to fill those gaps, however, falls short of providing universal coverage – and Congress is considering changes that threaten to end coverage for millions of workers.

    The post New Report Documents Disparities In Workers’ Health Care Coverage appeared first on PopularResistance.Org.

    This post was originally published on PopularResistance.Org.

  • This article was produced for ProPublica’s Local Reporting Network in partnership with The Current. Sign up for Dispatches to get stories like this one as soon as they are published.

    Last summer, as political debate swirled over the future of Georgia’s experiment with Medicaid work requirements, Gov. Brian Kemp held a press conference to unveil a three-minute testimonial video featuring a mechanic who works on classic cars.

    Luke Seaborn, a 54-year-old from rural Jefferson, became the de facto face of Georgia Pathways to Coverage, Kemp’s insurance program for impoverished Georgians. In a soft Southern drawl, Seaborn explained how having insurance had improved his life in the year that he had been enrolled: “Pathways is a great program that offers health insurance to low-income professionals like myself.”

    Kemp lauds Pathways as an innovative way to decrease the state’s high rate of uninsured adults while reining in government spending, holding the program up as an example to other Republican-led states eager to institute Medicaid work requirements.

    But in the nine months since Seaborn’s video testimonial was released, his opinion of Pathways has plummeted. His benefits have been canceled — twice, he said, due to bureaucratic red tape.

    “I used to think of Pathways as a blessing,” Seaborn recently told The Current and ProPublica. “Now, I’m done with it.”

    Rather than an enduring symbol of success, Seaborn’s experience illustrates why the program struggles to gain traction even as the state spends millions of dollars to burnish Pathways’ brand. The Current and ProPublica previously reported that many of the approximately 250,000 low-income adults potentially eligible for the health insurance program struggle to enroll or maintain coverage.

    The politics of Pathways were not on Seaborn’s mind when he received a phone call last summer from an insurance executive who handles Pathways clients. One of the first Georgians to enroll in the program in 2023, Seaborn had written a letter thanking his insurance provider for covering a procedure for his back pain. The executive from Amerigroup Community Care wanted to know: Would he take part in a promotional video for Pathways?

    Seaborn, a supporter of the governor, said yes without hesitation. Soon afterward, Kemp’s press secretary, Garrison Douglas, arrived at his auto repair shop, located a few miles from the governor’s hometown, and spent hours filming in the garage filled with vintage Ford and Chevy trucks and handpainted gas station signs.

    A trained chemical engineer, Seaborn had quit his corporate job to embrace his dream of repairing classic cars. But the realities of being a small business owner made that path difficult, Seaborn said, especially when it came to shouldering the cost of health insurance for himself and his son. Pathways eased the way, he said.

    Seaborn said he was surprised when the governor called him out by name weeks later at the press conference during which his testimonial video was released. He wasn’t expecting to be the singular face of Pathways.

    By November, though, Seaborn encountered some of the problems that other Georgians say have soured their opinion on Pathways. Seaborn said he had logged his work hours into the online system once a month as required. But his benefits were canceled after he failed to complete a new form that he said the state had added without adequate warning. Seaborn said the form asked for the same information he had been submitting every month, just in a different format. The state’s Medicaid agency did not respond to questions about Seaborn’s experience or the new form.

    He said he called the same insurance executive who had asked him to take part in the testimonial. She told him she would be lunching with one of Kemp’s aides that day and promised to help, he recalled. Within 24 hours, Seaborn said, his benefits were restored, and a representative from Georgia’s Division of Family and Children Services, which administers federal benefits programs, called to apologize.

    Douglas said the governor’s office “had no involvement in Mr. Seaborn’s case.” The insurance company did not respond to requests for comment.

    Pathways enrollees must submit paperwork every month proving they had completed the requirements necessary for coverage: 80 hours of work, study or volunteering. But the state says it is not verifying the information on a monthly basis — only during enrollment and upon annual renewal.

    Seaborn said that after his coverage was restored, his insurance company told him he would no longer have to file his work hours monthly; the next time he would need to submit such documentation would be during his annual reenrollment. Nevertheless, Seaborn said he signed up for text and email notifications from the Pathways program so that he wouldn’t be caught off guard if requirements changed again.

    Even so, technical glitches and more red tape caused him to lose his coverage once more, he said. He stopped receiving texts from the Pathways program in February. When he logged in to the digital platform in early March to make sure everything was in order, a notice informed him that his benefits would be terminated on April 1. The reason: he had missed filing an annual income statement. He said the surprise requirement had popped up on the digital platform even though his coverage was not up for renewal.

    “My head exploded,” he said. “I didn’t get a text or an email. I did what I was supposed to, but that wasn’t good enough.”

    Seaborn said he went ahead and filed the information, although it was late. He tried to call his insurance provider again for an explanation — and help. He reached out to the Division of Family and Children Services as well. This time, however, he said no one called him back.

    In April, Seaborn paid out of pocket for his and his son’s prescription medications, an extra $40 that he said is difficult for him to afford.

    Ellen Brown, a spokesperson for Georgia’s Division of Family and Children Services, would not say why Seaborn’s benefits were terminated.

    “We are sorry to hear this happened and are looking into how we can better serve our customers and resolve communication gaps in the future,” Brown said in a written statement Friday. “Every Georgian that seeks our services is important, and we take these matters very seriously.”

    Meanwhile, Seaborn received a phone call that day from the same Division of Family and Children Services representative who had apologized to him after he was kicked off Pathways last fall. He said she told him she would make sure he got his coverage back. The representative did not respond to a request for comment from The Current and ProPublica.

    On Monday evening, Seaborn received a text message to alert him to a notification in the Pathways digital platform. He logged on: A notice confirmed that he had been reenrolled, a change of fortune that he credited to The Current and ProPublica’s questions to state officials about his predicament because he had already given up on contacting people for help.

    “I am so frustrated with this whole journey,” Seaborn said. “I’m grateful for coverage. But what I don’t understand is them leaving me like a mushroom in the dark and feeding me nothing, no information, for more than a month.”

    This post was originally published on ProPublica.

  • This article was produced for ProPublica’s Local Reporting Network in partnership with The Current. Sign up for Dispatches to get stories like this one as soon as they are published.

    When the state of Georgia handed Deloitte Consulting a $10.7 million marketing contract last July to promote the nation’s only Medicaid work requirement program, the initiative was in need of serious PR.

    At the time, a year after the program’s rollout, less than 2% of those eligible for Georgia Pathways to Coverage had enrolled, well short of state targets.

    To get the word out, the state turned again to the firm that it had relied on to build and manage the program. About 60% of the marketing contract went toward creating and placing ads about Pathways on television and radio, including during NFL games and morning talk shows.

    Much of the remainder of the seven-month contract would go toward two efforts: $250,000 per month for Deloitte-trained teams to hand out brochures and Pathways-branded merchandise at community events and $300,000 a month for Deloitte to produce reports about its own performance.

    When Deloitte’s publicity campaign ended in February, enrollment in Pathways remained less than 3% of the approximately 250,000 Georgians who are potentially eligible.

    The marketing contract is part of a larger suite of services that Georgia has commissioned from Deloitte for its Medicaid experiment. Deloitte has made at least $51 million as of Dec. 31 to manage Pathways, including creating and maintaining its problematic software platform, as The Current and ProPublica previously reported. It is also earning at least $3 million more to oversee the state’s relationship with federal regulators, including its application to extend the experiment beyond its expiration this fall.

    Deloitte’s outsize — and unusual — role in promoting the program it has built has allowed the firm to keep pulling in payments despite Pathways’ struggles. And there is virtually no public accounting of how well it is increasing enrollment, a key goal of the policy experiment.

    An excerpt of Deloitte’s marketing contract shows its $300,000 per month expenditure on reports on its own performance, $250,000 per month for community outreach and $10.7 million total budget. (Obtained by The Current and ProPublica. Highlighted by ProPublica.)

    The marketing contract, obtained through a public records request, allows Deloitte to charge the state nearly half a million dollars for a final report on its publicity campaign, which was due to be submitted in February. When The Current and ProPublica requested the monthly and final performance reports, the state said they needed to be “reviewed” first and demanded $900 for that work. The news outlets did not pay because previous responses to public records requests for Deloitte’s Pathways contracts were heavily redacted, with the general counsel’s office at the Department of Community Health citing “confidential/trade secret.” The agency did not charge for those records.

    The state recently approved another $10 million to Deloitte, Fiona Roberts, spokesperson for the Department of Community Health, Georgia’s Medicaid agency that oversees Pathways, said in response to questions about the effectiveness of Deloitte’s marketing efforts. The new marketing contract, which runs until November, includes more community meetings and a text message campaign by Salesforce Marketing Cloud rolling out in May to potentially eligible Georgians, Roberts said.

    “In 20 years of researching these kinds of programs, I can’t think of another instance like this” in which a state has selected a for-profit company to both manage and market a federal benefit program, said Joan Alker, executive director for Georgetown University’s McCourt School of Public Policy Center for Children and Families, where researchers have concluded that Medicaid work requirements prevent people from accessing health insurance.

    Deloitte has designed and managed Medicaid and other benefit programs for many states, including Georgia, making the firm one of the nation’s experts in government health policy. But Alker said that when states want to educate and enroll residents in federal safety net programs, they typically select local nonprofits that have established relationships with low-income communities. Georgia’s arrangement with Deloitte raises questions, she said, about “whether the state is more committed to spending money on consultants or poor people.”

    Deloitte, which has been in charge of the Pathways communications strategy for the past three years, declined to answer questions about its Georgia Pathways work, referring requests for information to the Department of Community Health. A contract signed in 2023 worth approximately $7 million stipulates that Deloitte would “develop first draft of response to media inquiries” on behalf of the Department of Community Health, but that responses “will be submitted by DCH and not Deloitte.” Deloitte’s duties also include drafting talking points for media interviews, including for the governor.

    Roberts declined repeated requests for an interview with agency officials. When asked about Deloitte’s marketing and outreach work and whether the firm has met the state’s goals, she described the effort as a “robust, comprehensive awareness and outreach campaign throughout the state” that has generated 1.6 million visitors to the Pathways website since the campaign’s August 2024 launch.

    “The state has invested heavily in marketing and outreach to reach Georgians potentially eligible for Pathways,” Roberts said in a written statement.

    In 20 years of researching these kinds of programs, I can’t think of another instance like this.

    —Joan Alker, executive director for Georgetown University’s McCourt School of Public Policy Center for Children and Families

    Gov. Brian Kemp has described Pathways as an innovative alternative to expanding Medicaid, something 40 other states have done. By contrast, Georgia’s program covers only the poorest individuals who can prove they are working, studying or volunteering at least 80 hours a month. Congressional Republicans are pointing to similar work requirements as a model in their budget negotiations.

    In early 2024, less than a year after Pathways’ launch, however, Georgia legislators — including some of Kemp’s Republican allies — considered ending the experiment and instead expanding Medicaid without any work requirements. Georgia’s uninsured rate was 11.4%, or 1.2 million people, compared to the national average of 8% in 2023, the latest data available, according to KFF, a nonprofit focused on national health issues. State data showed that Pathways enrollment was well under the first-year target of 25,000 published in Georgia’s agreement with the federal government. As of April 25, approximately 7,400 Georgians were enrolled, according to the Department of Community Health.

    An independent evaluation team commissioned by the state recommended ways to boost enrollment in a December 2024 report. The evaluators, Public Consulting Group, highlighted North Carolina’s strategy of allowing residents from rural communities and communities of color to help create outreach campaigns for its expanded Medicaid program in 2023. North Carolina Medicaid officials told The Current and ProPublica that they designed their outreach efforts to maximize participation in the new program, with a two-year target of enrolling 600,000 people. They achieved that goal within one year.

    Georgia and Deloitte, however, took a different tack. The $10.7 million marketing contract does not lay out specific enrollment goals as a way of measuring the success of Deloitte’s efforts. The purpose of Pathways “is not and has never been to enroll as many Georgians as possible,” according to the state’s application to the federal government to continue the experiment.

    The contract budgeted $247,000 to create up to four testimonial videos featuring satisfied Pathways clients; only one can be found on the state Medicaid agency’s YouTube channel, where it has received approximately 350 views since it was posted in January. The state did not respond when asked how many testimonials Deloitte produced.

    Few people stopped by the Georgia Pathways booth at the Washington County Health Fair in Sandersville, Georgia, in March. (Nicole Craine for ProPublica)

    Meanwhile, another part of Deloitte’s marketing strategy has also failed to catch wind: Deloitte had sent public relations teams to dozens of community events including farmers markets, a school Christmas pageant and a catfish festival to plug Pathways and encourage applications.

    In March, one such team drove two hours from Atlanta to a health fair in Central Georgia’s rural Washington County. At the Pathways booth, the Deloitte team barely looked up from their phones for three hours. Residents largely bypassed the team to chat with locals staffing other kiosks where they could receive diapers, information on subsidized in-home nursing care and blood pressure screenings. Of those who stopped at the Pathways booth, only a handful asked about enrollment.

    Other public events were tied to the state’s pursuit of federal permission to extend the Pathways program beyond September, when its original five-year mandate expires. Georgia is once again paying Deloitte to ensure that happens.

    The monthslong process, managed by Deloitte, requires opportunities for public comment. A summary of these comments must be submitted with the application, which Deloitte is drafting. Health advocacy organizations say public outreach for this effort, especially to Black Georgians, has been superficial at best.

    The only notice for two virtual public meetings appeared on a Department of Community Health web page that was not linked from the agency’s homepage. During both virtual events, health care advocates criticized the program’s inequitable access, but state officials did not engage with the speakers.

    A third event — an in-person meeting in the rural 10,000-person town of Cordele — was added later and posted on the same website just one week before it was scheduled to occur. Only about a dozen people, some traveling for more than 80 miles, showed up to the noon meeting on St. Patrick’s Day.

    Georgians traveled up to 80 miles to speak at a public meeting about Pathways held by the Georgia Department of Community Health in Cordele in March. (Nicole Craine for ProPublica) The town of Cordele has a population of around 10,000 people. (Nicole Craine for ProPublica)

    The low attendance reflected the meeting’s out-of-the-way location and holiday timing, not a lack of public interest, said attendee Sherrell Byrd, executive director of Sowega Rising, a community advocacy group based in the majority Black town of Albany.

    Inside the one-story cinder block building, three state health officials sat along a table at the front of the largely vacant room. One by one, attendees rose to the microphone to complain of technical glitches in the Pathways enrollment process, the lack of customer service and the generational health care inequalities faced by Black Georgians.

    Tanisha Corporal, who lives approximately 140 miles away in Atlanta, was the only person to participate virtually. She told the Department of Community Health officials that she had submitted a Pathways application three times over the Deloitte-built digital portal only to have her file disappear. The licensed clinical social worker whose nonprofit job ended in January 2024 said state agencies offered her little enrollment support.

    Grant Thomas, deputy commissioner for the Georgia Department of Community Health, sits in the back of the room during a public meeting on the Georgia Pathways program in Cordele. (Nicole Craine for ProPublica)

    The state health officials did not respond to any of the speakers during the meeting. Grant Thomas, Kemp’s former health policy advisor and deputy director of the state Medicaid agency, sat in the back of the room and did not interact with the attendees. Thomas declined to speak on the record.

    “There is a lot of disdain for real-life problems of Georgians who look like us,” Byrd said.

    Robin Kemp of The Current contributed reporting.

    This post was originally published on ProPublica.

  • President Donald Trump is conducting an “unprecedented and illegal” broadside against science and scientists that will have devastating consequences for regular Americans, according to a report released Tuesday by Sen. Bernie Sanders, an Independent from Vermont. The report, which casts Trump’s actions as a “war on science” that will lead to “preventable suffering” and “needless loss of…

    Source

    This post was originally published on Latest – Truthout.

  • On May 31, a large coalition of labor and community groups is holding a nationwide day of action to demand a national single payer healthcare system. Clearing the FOG speaks with Kay Tillow, an organizer of the action and member of the leading organization, NationalSinglePayer.com. Tillow speaks about the current healthcare crisis in the United States and why it is imperative that people organize now for a solution, such as national improved Medicare for all. Tillow critiques the Medicare for All legislation that was recently introduced in both houses of Congress and what we need to do to move the bills forward.

    The post National Day Of Action To Demand Health Care, Not Profit appeared first on PopularResistance.Org.

    This post was originally published on PopularResistance.Org.

  • House Republicans late Sunday unveiled legislation that analysts said would rip Medicaid coverage from millions of low-income Americans — including children and people with disabilities — to help fund tax breaks that would disproportionately benefit the wealthy. The bill text released by the House Energy and Commerce Committee is a section of the sprawling budget reconciliation package that…

    Source

    This post was originally published on Latest – Truthout.

  • ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published.

    In the U.S., the price of Revlimid, a brand-name cancer drug, has been increasing for two decades. It now sells for nearly $1,000 a pill. In Europe, the price has been consistently lower — in some countries by two-thirds.

    I started reporting on Revlimid after I was prescribed the drug following a diagnosis of multiple myeloma, an incurable blood cancer. Stunned by the high price, I found that the drugmaker, Celgene, had used Revlimid as its own personal piggy bank for more than a decade, raising the price in the U.S. whenever it saw fit.

    Even with lower prices in Europe, Celgene still made a profit there, a former executive told Congress. That added to the more than $21 billion in net earnings the company made after Revlimid was introduced in 2005.

    Of course, Revlimid isn’t the only drug with a price disparity. Americans pay more in general for prescription drugs than people in other wealthy countries. And costs keep going up, saddling patients with crippling debt or forcing them to choose between filling prescriptions or buying groceries. So why do we pay so much more? And is anything being done about it?

    In most other wealthy countries, governments set a single price for a drug that is usually based on analysis of the therapeutic benefit of the medicine and what other countries pay. In the U.S., drug companies determine what to charge for their products with few restraints. Insurance companies can refuse to cover a drug to try to negotiate a lower price, but for some diseases like cancer, that poses a risk of public backlash. Cancer is a “very politically charged disease,” said Dr. Aaron Kesselheim, a Harvard Medical School professor who studies drug pricing and regulation. Some states also mandate that insurers cover certain cancer drugs.

    Pharmaceutical companies have consistently argued that American drug prices reflect the cost of research and development. Americans may pay more, but they also benefit from having first-line access to cutting-edge treatments. (Celgene has since been acquired by Bristol Myers Squibb, which says its price for Revlimid, which it increased in the U.S. last year by 7%, “reflects the continued clinical benefit Revlimid brings to patients, along with other economic factors.”)

    Dr. Hagop Kantarjian, a leukemia specialist at MD Anderson Cancer Center who studies drug pricing, said that pharmaceutical companies often overstate the cost of developing drugs and that many drug discoveries originate in hospital and academic labs funded through government grants. Funding from the U.S. National Institutes of Health contributed to all but two of the 356 drugs approved by the Food and Drug Administration from 2010 to 2019, according to a Bentley University study. Companies also don’t spend all their profits on innovation: The 14 largest drug companies in the world spent more on stock buybacks and dividend payments to investors than on research and development, according to a 2021 analysis by the U.S. House Oversight Committee.

    One possible solution to bring down costs: tie American prices to what drugmakers charge in other wealthy countries. The Congressional Budget Office found last year that this would have the biggest impact on reducing costs of seven proposals it studied. It’s an idea with bipartisan support.

    Sens. Josh Hawley, R-Mo., and Peter Welch, D-Vt., introduced a bill this week that would penalize pharmaceutical companies that sell their drugs at higher prices than the average of the prices in Canada, France, Germany, Japan, Italy and the United Kingdom. Companies that sell above the average would face civil penalties equal to 10 times the difference between the U.S. list price and the average price in those other countries.

    President Donald Trump has advocated for similar actions. During his first term, he issued an executive order directing the Medicare program to employ a “most favored nation” approach in paying for drugs. The administration later developed a rule directing Medicare to select the lowest price from a basket of similar countries and make that the maximum amount the agency would pay for 50 drugs administered by doctors. A court blocked the rule from being implemented in the last days of the first administration.

    Now, according to reports this week, the administration is pushing plans to tie Medicaid and Medicare prices to lower prices charged in other countries.

    Linking U.S. prices to those in other countries is opposed by industry groups who say it would leave decisions on medications to the government rather than doctors and patients.

    “Government price setting in any form is bad for American patients,” said Alex Schriver, a spokesperson for the Pharmaceutical Research and Manufacturers of America, an industry group. He said efforts should be focused on fixing “the flaws in the U.S. system,” including money that flows to intermediaries such as pharmacy benefit managers.

    Some critics also warn so-called international reference pricing can be gamed and allows foreign governments to essentially set the value of medicines sold in the U.S.

    The Trump administration is expected to announce drug pricing plans as early as next week, according to a report. The White House did not respond to a request for comment.


    This content originally appeared on ProPublica and was authored by by David Armstrong.

    This post was originally published on Radio Free.

  • ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published.

    The pain jolted me awake. It was barely dawn, a misty February morning in 2023. My side felt as if I’d been stabbed.

    I had been dealing with pain for weeks — a bothersome ache that felt like a bad runner’s cramp. But now it was so intense I had to brace myself against the wall to stand up.

    A few hours after arriving at the emergency room, I heard my name. A doctor asked me to follow him to a private area, where he told me a scan had uncovered something “concerning.”

    There were lesions, areas of bone destruction, on top of both of my hip bones and on my sternum. These were hallmarks of multiple myeloma. “Cancer,” he said.

    Multiple myeloma is a blood cancer that ravages bone, leaving distinctive holes in its wake. Subsequent scans showed “innumerable lesions” from my neck to my feet as well as two broken ribs and a compression fracture in my spine. There is no cure.

    I walked out of the ER in search of fresh air. I sat on a metal bench and did what many patients do. I turned to Google. The first link was a medical review stating that the average lifespan of a newly diagnosed patient was three to five years. My stomach churned.

    I soon learned that information was outdated. Most patients today live much longer, in large part due to a drug with a horrific past. It was a doctor at the hospital who first told me I would likely take a thalidomide drug as part of my treatment.

    That couldn’t be possible, I told him.

    I knew the story of thalidomide, or at least I thought I did. It represented one of the darkest chapters in the history of modern medicine, having caused thousands of severe birth defects after it was given to pregnant women in the 1950s and 1960s. The drug was banned in most of the world, and the scandal gave rise to the modern-day U.S. Food and Drug Administration.

    It turns out the drug once relegated to a pharmaceutical graveyard had new life as a cancer fighter.

    That drug I take is called Revlimid. It is a derivative of thalidomide, a slightly tweaked version of the parent compound.

    Revlimid is now one of the bestselling pharmaceutical products of all time, with total sales of more than $100 billion. It has extended tens of thousands of lives — including my own.

    But Revlimid is also, I soon learned, extraordinarily expensive, costing nearly $1,000 for each daily pill. (Although, I later discovered, a capsule costs just 25 cents to make.)

    That steep tab has put the drug’s lifesaving potential out of reach for some cancer patients, who have been forced into debt or simply stopped taking the drug. The price also helps fuel our ballooning insurance premiums.

    For decades, I’ve reported on outrageous health care costs in the U.S. and the burden they place on patients. I’ve revealed the tactics used by drug companies to drive sales and keep the price of their products high.

    Even with my experience, the cost of Revlimid stood out. When I started taking the drug, I’d look at the smooth, cylindrical capsule in my hand and consider the fact I was about to swallow something that costs about the same as a new iPhone. A month’s supply, which arrives in an ordinary, orange-tinged plastic bottle, is the same price as a new Nissan Versa.

    I wanted to know how this drug came to cost so much — and why the price keeps going up. The price of Revlimid has been hiked 26 times since it launched. Some of what happened was reported at the time. But no one has pieced together the full account of what the drugmaker Celgene did, how federal regulators failed to rein it in and what the story reveals about unrestrained drug pricing in America.

    What I discovered astonished even me.

    My journey started with an indefatigable New York City lawyer on a quest to give her dying husband a chance.

    Tiny and Terrifying

    Beth Wolmer’s story begins on a moon-splashed beach in the Cayman Islands in the winter of 1995. She and her husband, Ira, were holding hands as they walked in the sand, enjoying a rare break from a hectic life as parents to a 1-year-old daughter and demanding jobs as 30-something professionals in New York City.

    They had met through friends and clicked from the start. On Sunday mornings, they sat together for hours, sharing sections of the newspaper and eating bagels. They planned trips to Europe and outings to the Metropolitan Museum of Art.

    Ira was an interventional cardiologist who followed his father into medicine. Beth was a lawyer at the high-powered firm Skadden Arps.

    “We had a great life,” Beth told me. “I specifically remember coming home on the bus and thinking: ‘My life is just perfect, perfect. I’m not going to change a thing.’”

    As they walked that night in the Caribbean, Ira felt a sharp pain in his cheekbone. The pain flared several more times during the trip, becoming so intense that it brought tears to his eyes.

    When he got home, Ira made an appointment to figure out what was wrong. Imaging tests revealed multiple myeloma. The prognosis was grim. The couple was told Ira had two years to live.

    Specialists recommended treatments that would only provide a brief reprieve. The couple searched for someone who could offer something more. That’s when they found Dr. Bart Barlogie in Little Rock, Arkansas.

    I’ve never been more scared of a spouse of a patient than I was of her.

    —Dr. David Siegel, who treated Ira Wolmer

    Barlogie had been recruited to the University of Arkansas for Medical Sciences from the more prestigious MD Anderson Cancer Center in Houston. In Texas, Barlogie had been frustrated by a medical culture that he viewed as too timid in its approach to multiple myeloma.

    He remembers working on a Sunday when a newly diagnosed patient was admitted to the hospital. With few options, Barlogie decided to put the patient on a taxing, four-drug chemotherapy cocktail used for lymphoma patients. It didn’t work. The patient died from a sepsis infection, a known complication of the treatment.

    The attending physician later admonished him, Barlogie said, saying, “Bart, we have to learn to treat myeloma gently.” Barlogie said he thought to himself, “Fuck you.”

    In Arkansas, Barlogie was in charge. He quickly developed a reputation as a practitioner willing to try anything to fight the fatal disease. Patients from around the world — including the actor Roy Scheider from the movie “Jaws” — flocked to his clinic.

    Beth and Ira heard Barlogie before they saw him. The cowboy boots he’d taken to donning since his time in Houston clacked down the linoleum hallway floors. A short, slight man, Barlogie had a booming voice with a German accent. He wore leather jackets and round, red-framed glasses on his bald head.

    When he strode into the exam room, he hugged Beth and Ira and told them they had come to the right place.

    Now retired, Barlogie recalls being struck by Beth’s intensity. He said she told him “you must do something” to help Ira.

    I met Barlogie at his home in Little Rock. We sat in his office, which is filled with photos of the red Ducati motorcycle he used to ride to work. An old license plate with the letters “MMCURED” sat on a shelf, reflecting his goal to find a cure for multiple myeloma.

    When Beth and Ira found him, Barlogie told me, he had been having some success with a novel approach that put patients through two stem cell transplants a few months apart, which he called a tandem stem cell transplant. With a transplant, a patient is bombarded with high-dose chemotherapy to kill the cancerous plasma cells. The patient is then infused with healthy stem cells that travel to the bone marrow.

    The intense chemotherapy can be grueling and poses a small risk of death.

    Ira underwent three transplants. Each time, he relapsed. By the fall of 1997, after two years of treatment, Ira’s thick black hair was gone. He was losing weight. Then he had a stroke. His kidneys failed and required dialysis. He developed pneumonia and had to be intubated.

    Beth was determined to keep him alive long enough for their toddler daughter to remember him. With a photograph of Ira smiling with their baby as motivation, she applied her lawyer’s tenacity to the case. She pored over medical journals and peppered oncologists with questions about why what they were trying wasn’t working or quizzing them about a promising study. When doctors told her there was nothing more they could do for her husband, she refused to accept it.

    “She is a tiny person, but she is terrifying,” said Dr. David Siegel, part of the team that treated Ira in Arkansas. “I’ve never been more scared of a spouse of a patient than I was of her.” He meant it as a compliment.

    By late fall in 1997, Ira was dying and Beth was desperate.

    A researcher told her about the work of Dr. Judah Folkman, a surgeon and researcher at Boston Children’s Hospital. Folkman believed the growth of cancerous tumors could be stunted by starving them of a supply of new blood vessels.

    “Thank You, God”

    Folkman was a workaholic who, when he wasn’t in the operating room or the research lab, was traveling across the world to promote his novel theory of how to attack cancer. Peers had ridiculed his idea since he first proposed it in the 1970s. The prevailing belief at the time was that tumors didn’t need a new blood supply to grow.

    A young researcher in his lab, an ophthalmologist named Robert D’Amato, was at work on the top question Folkman had posed. Could they come up with a drug, in pill form, that blocks the growth of new blood vessels?

    Folkman has since died, but it wasn’t difficult for me to track down D’Amato. He still works at Boston Children’s Hospital, where he has his own lab and holds the Judah Folkman Chair in Surgery. Now in his early 60s, D’Amato has a youthful energy and speaks in a rapid, matter-of-fact clip.

    D’Amato told me that he had set out to find existing drugs that block blood vessel growth. He started by thinking of his own body and side effects caused by certain drugs. A drug that causes hair loss might be the result of the blood supply to hair follicles being shut off, for example. But this exercise wasn’t producing any viable candidates.

    After giving it some thought, D’Amato realized he had myopically narrowed his search. What about a woman’s body? There were drugs that stopped menstrual cycles. Then there were drugs that caused birth defects in pregnant women. In both of those cases, it was possible the drug was inhibiting blood vessel growth. He came up with a list of 10 drugs. At the top of the list was one with a devastating history: thalidomide.

    Beginning in the 1950s, pregnant women in Europe, Australia and other countries were frequently prescribed thalidomide as a treatment for morning sickness and to help them sleep. The drug was thought to be harmless and in Germany was sold over the counter. An advertisement for thalidomide in the United Kingdom claimed it could “be given with complete safety to pregnant women and nursing mothers without adverse effect on mother or child.”

    They were wrong.

    The drug was eventually linked to birth defects in more than 10,000 babies. Those babies were born without limbs or with shortened limbs, malformed hands, disfigured faces and damage to internal organs. Nearly half died within months of being born.

    By the early 1960s, the drug was widely banned, considered a shameful chapter in the history of pharmaceuticals. It was never sold in the U.S. thanks to the unwavering objections of a resolute reviewer at the FDA named Frances Oldham Kelsey. The close call, however, prompted Congress to require more rigorous safety and efficacy data from drug manufacturers and empower the FDA to monitor the industry more closely.

    D’Amato theorized that the thalidomide birth defects were the result of the drug stopping the growth of new blood vessels that the fetus needs to develop. He walked me through his experiments: He cracked a fertilized chicken egg on a glass petri dish and placed thalidomide on the surface. After two days, if no blood vessels grow on the embryo, a halo should appear around the thalidomide sample, showing the drug worked. It didn’t.

    Folkman told D’Amato to move on. But D’Amato couldn’t shake the disappointing results. He did more research and realized thalidomide needs to first be broken down in the body to have an effect on humans. He purchased metabolites of thalidomide, repeated the test and this time found a halo around the sample.

    He kept experimenting and in 1994 published a paper finding that thalidomide had “clear implications” for treating tumors.

    So when Beth called three years later, Folkman told her they should try it.

    Barlogie told me he didn’t think it would work. Beth said she had to convince him to try it.

    Barlogie agreed to test it on Ira and two other patients who were out of treatment options in early December.

    I wanted him alive forever.

    —Beth Wolmer

    The drug did not work for Ira. Beth said just before he died, Ira sat up in bed, kissed her and smiled. It was March 10, 1998. He was 38.

    After years of frantically searching for anything that would help, the finality of his death was difficult to accept, she said. “I wanted him alive forever.”

    It is unclear what happened with the second patient. The third patient, however, started to get better.

    His name was Jimmy. Little more is known about him except that he was a patient of another oncologist at the hospital, Dr. Seema Singhal, and near death before he started the drug. “I told him it might work, but at the very least it would help him sleep,” Singhal said. Shortly after Jimmy took his first dose of thalidomide, Singhal left for a vacation.

    Dr. Bart Barlogie and Dr. Seema Singhal (Painting by James Lee Chiahan for ProPublica)

    When she returned two weeks later, her mailbox was full of lab results for Jimmy. He was still alive. She sat down to double-check the results, which showed declining amounts of a cancer marker. “For 30 minutes, I was the only person in the world who knew this worked,” she said.

    Singhal walked down to Barlogie’s office to give him the news. “He took me by the hand, opened a window and shouted, ‘Thank you, God,’” she said.

    “Violent Arguments”

    Word of Jimmy’s stunning recovery in Arkansas quickly made its way to the offices of Celgene Corp., located in a small corporate park in a rural patch of northern New Jersey.

    The company had just wrapped up a brutal year-end accounting, which showed losses of $27 million on revenue of just $1.1 million. Money was so tight that executives engaged in what one of them called “violent arguments” over whether to charge employees for coffee.

    Celgene had acquired the rights to thalidomide patents held by researchers at Rockefeller University in 1992. The company, which was new to pharmaceuticals, planned to use the experience of obtaining FDA approval for thalidomide to develop other drugs.

    “It wasn’t meant to be a blockbuster,” said Sol Barer, who started at the company in 1987 and later became CEO.

    When Celgene announced plans to develop the disgraced drug for new uses, the only analyst following the company on Wall Street dropped coverage and told Celgene officials they didn’t know what they were doing.

    The company thought the largest market would be as a treatment for AIDS patients experiencing dangerous weight loss. To win approval of the drug, however, Celgene selected a use that was already in practice in parts of the world for a small group of patients.

    In July 1998, the FDA approved thalidomide for the treatment of a painful complication of leprosy. It was a momentous decision, coming just a few decades after the drug caused so much harm.

    The market for leprosy was tiny, but what happened with Jimmy in Arkansas changed everything for the company.

    Blocked Exits

    The Arkansas doctors had been busy since first testing thalidomide on Ira Wolmer, Jimmy and the other patient. They quickly got approval to conduct a larger experiment funded by a grant from the U.S. National Institutes of Health. Now, in December 1998, they were ready to share their initial findings at the annual meeting of the American Society of Hematology.

    It had been three decades since a new therapy for multiple myeloma had been approved, and there was a buzz among the oncologists gathered in Miami Beach for the conference. So many doctors crowded into the room for the presentation that the fire marshal had to intervene several times to clear exit ways. Word had already spread among multiple myeloma specialists about Jimmy. Now, the assembled doctors wanted to know whether it had been a fluke or a discovery that would fundamentally change how they practiced.

    Singhal was tasked with presenting the data. It was a big stage for the 32-year-old doctor, who had only been practicing in the U.S. for two years.

    It completely changed the treatment landscape.

    —Dr. Seema Singhal

    The 89 patients in the study were high-risk cases who had undergone prior treatment. They were patients who, like Ira, had run out of options. Now, after thalidomide treatment, one-third had declines in myeloma activity.

    Those were stunning numbers, unlike anything seen before in the treatment of multiple myeloma. When Singhal finished, the room erupted in applause.

    “It completely changed the treatment landscape,” she said.

    I wasn’t able to track down Jimmy, but I have a sense of how he might have felt when he realized the treatment was working.

    After my initial emergency room visit, it took time to confirm my diagnosis and do some additional testing. While I waited, the pain worsened. Painkillers barely made a dent. All I could picture was this cancer eating away at my bones, doing more damage every day.

    David Armstrong (Painting by James Lee Chiahan for ProPublica)

    Some patients wait months for care. I was lucky enough to meet my oncologist within weeks. He had a script for Revlimid ready to go, part of a regimen of four drugs I would take as standard induction therapy, and I was able to start it within days.

    The initial dose of Revlimid cost $18,255 for a month’s supply, and my insurance covered the cost.

    Within a month, my blood tests showed a massive drop in a key cancer indicator.

    My pain gradually subsided too. By the end of April, I wrote in my journal that the pain was a 3 or 4 instead of the usual 9 or 10. “It doesn’t hurt to get out of bed anymore,” I wrote.

    A Piggy Bank

    The discovery in Arkansas made thalidomide, which Celgene sold as Thalomid, an instant hit.

    As a result, Celgene’s revenue increased nearly sevenfold to $26.2 million in the year after the Miami presentation. It sold its thalidomide pills for $7.50 each.

    From those modest beginnings, Celgene took a slightly altered version of that pill and turned it into one of the bestselling and most expensive prescription drugs in history. Celgene’s success with Thalomid was the result of remarkable good fortune, a case where the heavy lifting of discovery and initial testing had already been done, by Beth Wolmer, D’Amato, Barlogie, Singhal and others.

    The development of the drug that would become Revlimid took me deep into the confounding, sharp-elbowed world of drug patents, which ostensibly protect drugmakers, allowing them to recoup the massive investments they made in developing a new product. Celgene drew on patent law, a drug safety system and even patient assistance programs to guard the exclusivity of its prized drug and the massive revenue it generated.

    Those tactics, detailed in reams of court filings, allowed Celgene to treat Revlimid like a piggy bank, tapping it whenever it wanted.

    There was a common internal theme at Celgene that cancer patients were willing to pay almost any amount Celgene charged.

    —David Schmidt, a former Celgene executive

    Amid the early success of Thalomid, Celgene identified two potential threats: One was obvious. Thaldiomide caused birth defects, a looming risk that could result in it being pulled from the market.

    The other was that Celgene held limited patents on the drug. Patents are exclusive legal rights to inventions, and researchers file them on nearly every aspect of drug development as soon as they can, locking up everything from specific sets of ingredients to the way the drug is used and administered. The more robust patents a company has, the longer it can potentially ward off competitors.

    Thalidomide was an old drug and Celgene’s patents did not cover the active ingredient, leaving it open to competition. The patents it did have, covering items such as the optimal dosages and its use in treating particular diseases, were considered weaker and open to a court challenge. If Celgene could create a new version of thalidomide — ideally one that didn’t cause birth defects — the company could seek more and stronger patents that would extend beyond those of the original drug.

    So researchers at Celgene tested analogs of thalidomide, which are drugs that have a similar effect but are different from the parent compound in minor ways, such as having one less oxygen atom. The analogs are also more potent than the original, meaning they can achieve a similar effect at lower doses.

    Celgene was not alone in its efforts. D’Amato was also studying thalidomide analogs and filing patents on their use, which he and Boston Children’s Hospital licensed to a Celgene competitor, EntreMed Inc.

    With dueling patents, the companies sued each other in 2002.

    Celgene was newly flush with cash from rising sales of thalidomide. EntreMed, on the other hand, was burning through money as it focused most of its resources on developing other drugs discovered in Folkman’s lab.

    In December of 2002, the companies settled.

    Celgene agreed to pay Boston Children’s Hospital royalties from future sales of Revlimid. In exchange, the hospital and D’Amato licensed their patents of thalidomide analogs to Celgene. Celgene also agreed to pay EntreMed $27 million.

    For Celgene, the fight with EntreMed was a valuable experience. It learned that competition can be neutralized.

    The Rise of Revlimid

    Celgene had kept the price of Thalomid low when it was initially intended for AIDS patients, CEO John Jackson told investors in 2004, as the company “didn’t want huge numbers of people demonstrating in front” of its office.

    That wasn’t a problem with cancer patients. There was “plenty of room for very substantial increases” in the price of the drug now, Jackson told investors.

    It is time for us to take Jimbo to the wood shed.

    —A senior Celgene official discussing a doctor critical of Revlimid

    Just two days earlier, Celgene had hiked the price of Thalomid to $47 a pill.

    “There was a common internal theme at Celgene that cancer patients were willing to pay almost any amount Celgene charged,” wrote David Schmidt, a former national account manager at the company, in a whistleblower lawsuit he filed after his employment was terminated in 2008. The lawsuit was voluntarily dismissed by Schmidt. (Jackson didn’t respond to requests for comment; Schmidt declined to talk to me.)

    When Celgene launched Revlimid in December of 2005, it set the initial price at $55,000 a year, or $218 a pill, which was about double what analysts expected.

    Seven months later, when the FDA approved the drug for multiple myeloma, the price jumped to $70,560 a year, or $280 a pill.

    The Price of Revlimid Has Increased 26 Times Since FDA Approval

    Each dot indicates a new manufacturer list price per pill.

    (Source: AnalySource)

    The cost to manufacture each Revlimid pill, meanwhile, was 25 cents. I found a deposition marked “highly confidential” in which a top Celgene executive testified that the cost started at a quarter and never changed.

    Even on Wall Street, which cheered higher pricing, the initial cost of Revlimid prompted concern among analysts who tracked the company that such aggressive maneuvering would cause insurers to push back. In the U.S., that is one of the only real checks on the price of prescription drugs.

    That fear turned out to be unfounded, and Celgene would repeatedly test the bounds of how high it could go.

    At the same time, Celgene worked to mute any criticism of Revlimid.

    In 2005, Celgene received reports that Los Angeles oncologist Dr. James Berenson was “bashing” Revlimid in presentations sponsored by patient groups.

    In one email, a senior company official said, “it is time for us to take Jimbo to the wood shed.” The company discussed a range of options for dealing with the doctor, from taking legal action to arranging a sit-down with Celgene’s chief executive.

    Ultimately, the company appears to have decided on a friendlier course of action. Berenson became a frequent paid speaker and consultant for the company, with payments totaling at least $333,000, according to Celgene disclosures. Berenson declined to comment.

    He wasn’t the only doctor the company befriended. Payment records show that between 2013 and 2018, Celgene paid doctors $11 million for speaking engagements and consulting work related to Revlimid. At one point, Celgene rented a suite at the Houston Astros baseball stadium to throw a party for the entire multiple myeloma department at the MD Anderson Cancer Center, according to court testimony. The center said it was unable to verify any of those details.

    They remind me of an octopus with many, many tentacles, and at the end of each tentacle is a wad of cash.

    —David Mitchell, president of Patients For Affordable Drugs

    Celgene went on to spread its largess across the multiple myeloma world. It funded patient groups, sponsored medical meetings and contracted with prestigious academic medical centers.

    “They remind me of an octopus with many, many tentacles, and at the end of each tentacle is a wad of cash,” said David Mitchell, a former Washington, D.C., communications executive who launched a nonprofit organization to fight for lower prices after he was diagnosed with multiple myeloma. “Everybody relies on the money.” Mitchell said his group, Patients For Affordable Drugs, does not accept donations from any entity that profits from the development or distribution of pharmaceuticals.

    At the same time it showered doctors and patient groups with money, Celgene was shutting Beth Wolmer out. She told me that John Jackson, the CEO at the time, had promised her a paid board seat at the company as a way of compensating her for her role in the discovery before the company cut off communication.

    Wolmer sued Celgene in federal court in 2009, seeking $300 million or more for alleged misappropriation of her idea and what she termed the “unjust enrichment” of Celgene.

    Celgene said it never promised to compensate Wolmer. The company also suggested she greatly inflated her role in the discovery and, in any event, waited too long to take legal action.

    In 2010, a judge granted Celgene’s motion for summary judgment in the case, agreeing that the statute of limitations had expired while at the same time expressing “admiration” for Wolmer’s “contribution to the struggle against this terrible disease.”

    Ira and Beth Wolmer in the Cayman Islands (Painting by James Lee Chiahan for ProPublica)

    Wolmer has remarried and changed her name to Jacobson. She remains disappointed about the way she was treated by Celgene. “There was no ambiguity about who found the purpose of this drug, and I’m thrilled that it’s helping so many people,” she said. “Why they treated me that way? I don’t know.”

    The Generic Threat

    After the FDA approved Revlimid in late 2005, it also granted Celgene something else: seven years of market exclusivity because the drug treats a rare disease. In those seven years, Celgene raised the price of the drug nine times, increasing the price per pill by 82% to $397 in 2012.

    The company also fended off challengers by claiming its patents protected the drug from competition until 2027.

    But by 2010 generic makers were already working on copies of the drug, preparing to challenge those patents and enter the market earlier. A government analysis has found that generics generally lower the price of brand name drugs by an average of 85% after just one year.

    Celgene was well aware of the danger generics posed and warned in a 2012 financial filing that their entry into the market could have a “material adverse effect” on its finances. At that point, Revlimid sales made up 70% of the company’s revenue.

    Celgene needed another move.

    The drug still posed a risk of birth defects like the parent compound. In approving the drug, the FDA had mandated a strict safety program to control its prescription and distribution.

    Celgene realized early on that this could also be a tool to thwart competition. An internal company presentation at the time noted that the safety program could make it “more difficult for generic companies to access” thalidomide for testing.

    Generic drug makers are required by the FDA to test their version against the brand name drug, so they need to buy small amounts of Revlimid from the company.

    By 2012, at least six generic makers had requested to purchase Revlimid for testing. In every case, Celgene refused.

    Federal regulators took notice. The FDA had warned Celgene that it could not use the safety program “to block or delay approval” of generic competitors. Now, it appeared to be doing just that.

    The Federal Trade Commission, which enforces antitrust laws, had been investigating Celgene for years and in June of 2012 notified the company it was poised to take action.

    In a previously unreported letter, the FTC said that its staff had recommended filing a legal complaint against the company for refusing to sell to competitors, thereby keeping them out of the marketplace.

    The commission’s patience is wearing thin.

    —FTC official Richard Feinstein to a Celgene attorney

    In its letter, the FTC noted that while Celgene refused to sell its drugs to potential competitors, it routinely provided Revlimid to other third parties around the world, including researchers and universities studying the drug.

    Then, in August of 2012, the FDA directed Celgene to sell a small amount of Revlimid to a generic competitor.

    With both federal agencies bearing down on Celgene, a closed-door meeting was held at FDA headquarters at the end of August. The FTC sent five lawyers, and 11 FDA staffers attended. Celgene showed up with a large contingent that included in-house lawyers and outside counsel.

    Celgene started by denying it was using the safety program to block generics, according to minutes of the meeting. (The minutes were filed in a court case against Celgene, and it is unclear if they were prepared by the agencies or the company.) Citing the threat of birth defects, the company said that it had legitimate safety concerns about selling Revlimid to generic companies and that it needed to protect its investment in the drug.

    Jane Axelrad, an associate director for the FDA, told Celgene that it was raising safety concerns because “the company does not want generics on the market,” according to the minutes. She declined to comment.

    The meeting ended without a resolution. The FDA had no way of enforcing its directive to Celgene. The FTC staff, however, was still determined to act. The agency had spent more than two years investigating Celgene. It hired experts, deposed Celgene officials and obtained internal company documents.

    The staff drafted a complaint alleging the company engaged in unfair actions to maintain a monopoly, hoping either that it would push the company to agree to sell to competitors to avoid legal action or that Celgene would be forced to do so by the courts, according to a person familiar with the agency’s stance.

    “The commission’s patience is wearing thin,” FTC official Richard Feinstein wrote to the company’s lawyer in February 2013. “We have reached a point where the staff may be instructed in the very near future to commence litigation.” (Feinstein did not respond to emails seeking a comment.)

    Celgene appeared to relent, telling the FTC that it would sell to generic makers, as long as the FDA approved their safety plan. In July, the FDA approved the safety protocols of generic maker Mylan.

    Still, Celgene refused to sell.

    Jon Leibowitz, who was the chairman of the FTC at the time, told me that Celgene’s promise to cooperate, even if it didn’t result in any sales to generic makers, lessened interest in the case among his fellow commissioners. Three of five commissioners need to vote in favor of commencing litigation. Now, in retrospect, he said that “if we knew then what we know now” about the delays, “we certainly would have brought a case.”

    The agency would close its case in 2017 without taking any action.

    With would-be generic competitors sidelined by Celgene’s refusal to sell drugs for testing, the company continued to raise the price of Revlimid.

    They could raise their price any time they wanted to.

    —Francis Brown, former Celgene sales executive

    On a Saturday morning in early March of 2014, Celgene President Mark Alles sent an internal email complaining of disappointing first quarter Revlimid sales. Revenue from the star drug, which had surpassed $1 billion the previous quarter, was down by about 1% — or $11.4 million.

    “I have to consider every legitimate opportunity available to us to improve our Q1 performance,” he wrote. But the only idea he proposed was a familiar one: raise the price of the drug.

    Alles said he wanted a meeting the following Monday to discuss an immediate 4% price increase, followed by another increase of 3% at the beginning of September.

    The company implemented those hikes, along with a third in December. It brought the price of Revlimid to $9,854 a month, or $469 a pill, and helped boost Revlimid sales for the year to $5 billion. Alles didn’t respond to my requests for comment.

    “They could raise their price any time they wanted to,” said Francis Brown, a former sales executive at the company, in a 2015 deposition. I wasn’t able to reach Brown for comment.

    Celgene found a solution to the generic threat when it struck a deal to settle a lawsuit brought by generic maker NATCO Pharma in 2015. NATCO could bring a generic to market, Celgene agreed, but not for seven more years — in March 2022. Even then, the generic would be limited to less than 10% of the total market for Revlimid in the first year, with gradual increases after that.

    The deal set the bar for deals with other rivals for limited generic sales, and it ensured that unlimited generic competition — and lower prices — would not arrive until 2026.

    The delayed entry of generics may have been bad news for patients and health care payors, but there was one constituency that was thrilled with the 2015 deal. Celgene’s stock jumped nearly 10% the day after it was announced.

    “Ridiculous,” “Ugly” and “Killer”

    Revlimid turned out to be a unicorn for Celgene, a drug whose financial success proved impossible to replicate.

    In October of 2017, Celgene announced it was abandoning a once-promising effort to develop a drug for Crohn’s disease. Shares of Celgene declined by 11%.

    As it had done so many times in the past, Celgene tapped Revlimid to try to mitigate the damage. The day it announced the failure of the Crohn’s drug, it quietly raised the price of Revlimid by 9%.

    By the end of the year, Celgene had cumulatively raised the cost 20% to $662 a pill, the largest one-year increase in the drug’s history.

    That made Revlimid the most expensive Medicare drug that year, with the government insurance program spending $3.3 billion to provide it to 37,459 patients.

    At Celgene, the brash increases triggered rare internal dissent. Betty Swartz, the company’s vice president of U.S. market access, objected to the measures in a pricing meeting with the CEO, who at the time was Alles, and other top executives. She said her concerns were swiftly dismissed, according to a whistleblower lawsuit she filed and later dismissed.

    “Why would you be afraid to take an increase on our products?” she said the CEO told her. “What could be the worst thing that happens … a tweet here or there and bad press for a bit.” Swartz declined to comment.

    The price increases added to the burden faced by many patients. In online groups, patients use words like “ridiculous,” “ugly” and “killer” when talking about the financial pain they have experienced related to the high costs associated with Revlimid. Some have taken out mortgages, raided retirement funds or cut back on everyday expenses like groceries to pay for Revlimid. Others have found overseas suppliers who ship the drug for pennies on the dollar, although doctors caution there’s no way to guarantee quality. Some just decide not to take the drug.

    By increasing the price of Revlimid, Celgene executives in several instances boosted their pay. That’s because bonuses were tied to meeting revenue and earnings targets. In some years, executives would not have hit those targets without the Revlimid price increases, a congressional investigation later found.

    In total, Celgene paid a handful of top executives about a half-billion dollars in the 12 years after Revlimid was approved.

    Robert Hugin, who worked as Celgene’s CEO and then executive chairman, received $51 million in total compensation from 2015 to 2017. Hugin retired in 2018 to launch an unsuccessful Senate bid.

    Even sales reps earned more than $1 million a year and were rewarded with trips to resorts such as the Four Seasons in Maui. That pay is more than two times what the average oncologist earns.

    I connected with Hugin just before Christmas while he was driving. He was ardent in his defense of the pricing of Revlimid. He told me the drug passes any cost-benefit analysis because of its impact on multiple myeloma patients like myself. “People recognize when you have a breakthrough therapy and you have an opportunity to deliver that, you want to deliver that across the world,” he said. “And I think Revlimid is an example of a product that ends up to be a global lifesaver because of what it did.”

    Hugin told me that when Revlimid has unlimited generic competition, the price will be “cheaper than aspirin” and patients will benefit from that low price for many decades.

    Celgene also cited the cost of developing drugs and its expansive research efforts as reasons for the high cost of Revlimid. Celgene said it spent $800 million to develop Revlimid and spent several hundred million more on additional trials to study the use of the drug in other cancers. Those combined figures represent about 2% to 3% of Revlimid sales through 2018.

    The drug didn’t get any better. The cancer patients didn’t get any better. You just got better at making money. You just refined your skills at price gouging.

    —Former Rep. Katie Porter, D-Calif.

    By the end of 2018, Celgene’s stock was down 56% over the past 15 months amid development failures. Despite the raft of bad news, Alles’ total pay that year increased by $3 million to $16.2 million.

    Celgene tried desperately to boost its flagging stock price by buying back $6 billion of its own shares that year.

    Ultimately, the buyback was not enough. Just days into the new year in 2019, Celgene announced it had agreed to be acquired by Bristol Myers Squibb in a deal valued at $74 billion.

    As part of a severance agreement, top Celgene executives stood to make millions once the deal closed. For Alles, that meant a potential estimated payday of $27.9 million.

    In the fall of 2020, Alles appeared before the House Oversight Committee, which was investigating the high cost of prescription drugs. He said pricing decisions “reflected our commitment to patient access, the value of a medicine to patients and the health care system, the continuous effort to discover new medicines and new uses for existing medicines, and the need for financial flexibility.”

    When it came time for questions, then-Rep. Katie Porter, D-Calif., quizzed Alles in rapid-fire style about Revlimid. Did the drug change as the price increased? Did it work faster? Were there fewer side effects? The drug was the same, Alles responded.

    “So, to recap here,” Porter said. “The drug didn’t get any better. The cancer patients didn’t get any better. You just got better at making money. You just refined your skills at price gouging.”

    The Drumbeat Continues

    High prices have consequences beyond individual patients. While there have been tremendous advancements in the treatment of my disease, there is still no cure. The specter of relapse hovers over every blood test, every new ache or pain.

    The day I learned I was in remission, in November 2023, was bittersweet. I wrote at the time that I didn’t get to ring a bell — the traditional sign that a cancer patient has finished treatment. Instead, my doctor explained the next step: “maintenance” treatment.

    This includes not only continuing Revlimid, but making monthly visits to my cancer center to get a shot of a bone-strengthening drug, have another drug injected into my stomach and blood drawn for lab tests.

    “The visit,” I wrote that day, “only reinforced the fact that I’m a patient, and I always will be.”

    For most of us, cancer will return at some point after treatment. And for most patients, the drugs eventually stop working.

    Revlimid can also be difficult to live with. Some patients quit the drug after developing severe gastrointestinal issues, infections or liver problems. The drug also poses an increased risk of stroke, heart attack and secondary cancers.

    Those are the trade-offs for keeping multiple myeloma in check.

    Meanwhile, the drumbeat of price increases continues under Bristol Myers Squibb, helping the company bring in $48 billion in revenue from Revlimid since it purchased Celgene. Bristol said its pricing “reflects the continued clinical benefit Revlimid brings to patients, along with other economic factors.” The company said it is “committed to achieving unfettered patient access to our medicines” and provides some financial support for eligible patients. “While BMS develops prices for its medicines, we do not determine what patients will pay out of pocket.”

    Last July, the cost of my monthly Revlimid prescription increased by 7% to $19,660.

    At the beginning of this year, my insurer switched me to generic Revlimid. I didn’t fight it, thinking it would result in a dramatic decrease in what ProPublica’s health plan pays for the drug.

    It turns out it is not much of a savings: The generic costs $17,349 a month.

    Alec Glassford contributed research.

    This post was originally published on ProPublica.

  • Earlier this year, doctors at Veterans Affairs hospitals in Pennsylvania sounded an alarm. Sweeping cuts imposed by the Trump administration, they told higher-ups in an email, were causing “severe and immediate impacts,” including to “life-saving cancer trials.” The email said more than 1,000 veterans would lose access to treatment for diseases ranging from metastatic head and neck cancers…

    Source

    This post was originally published on Latest – Truthout.

  • ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up for Dispatches, a newsletter that spotlights wrongdoing around the country, to receive our stories in your inbox every week.

    Two years after Arizona officials revealed a $2.5 billion Medicaid fraud scheme that targeted Native Americans seeking treatment for addictions, the state has recovered just a fraction of the taxpayer funds lost to fraud.

    The Arizona attorney general’s office is leading the criminal investigation into the network of behavioral health providers and sober living homes that from 2019 to 2023 exploited the American Indian Health Program to obtain inflated Medicaid payments. Investigators found fraudulent operators didn’t provide the services they’d billed for and sometimes allowed patients to continue the substance use for which they had sought treatment.

    The state has so far indicted more than 100 individuals and recouped $125 million — or about 5% of the funds the state estimates it paid to bad actors.

    Attorney General Kris Mayes said in a May 1 press conference that she hopes to retrieve “at least hundreds of millions” from fraudsters. But she warned that “it’s hard, because what happens is these … criminals get the money, they buy lavish homes, they buy multiple expensive cars, they hide the money offshore, they spend the money in ways that is unrecoverable.”

    “My team is working day in and day out to seize those assets,” Mayes said.

    The Arizona Health Care Cost Containment System struggled to rein in the rampant fraud under two governors, leaving more than 11,000 people vulnerable to the chaos that followed. Prior reporting by the Arizona Center for Investigative Reporting and ProPublica found that at least 40 Indigenous residents of sober living homes and treatment facilities in the Phoenix area died as the state fumbled its response.

    The damage also rippled out through the state’s behavioral health industry, which was nearly brought to a standstill when the agency suspended some 300 providers and enacted policies that halted or substantially delayed payments to those still operating. Those reforms included enhanced scrutiny when screening and reimbursing providers.

    Gov. Katie Hobbs, a Democrat, recently signed legislation further increasing oversight of sober living homes by requiring the facilities to promptly report resident deaths. But advocates like Reva Stewart, a Diné activist who has helped Indigenous victims of the scheme through her group Stolen People Stolen Benefits, don’t think the state has done enough.

    “I feel like I’m on a hamster wheel, and we’re still at the beginning,” Stewart said. “They have a lot of indictments and people being charged, but at the same time … they’re just getting a slap on the wrist.”

    The U.S. Department of Justice has also indicted several individuals and is conducting parallel investigations into the fraudulent billing schemes under federal statutes.

    Yet despite these state and federal efforts, it’s likely that most of the stolen taxpayer money won’t be recovered.

    From 2019 to 2023, the Arizona Health Care Cost Containment System allowed about 13,000 unlicensed providers to enter its system, including some that exploited weak oversight by overbilling or charging for services that were never delivered.

    The agency also didn’t act decisively when solutions to stem the fraud were proposed internally. It initially yielded to pressure from special interest groups connected to the behavioral health industry, which argued that reforms to the fee-for-service American Indian Health plan would threaten their financial interests.

    Now, AHCCCS says its efforts to unravel the crisis could take many years, describing its investigation as a “highly complex and manual process.”

    Officials must review improper payments, whether they were obtained by fraud or not, on a case-by-case basis. Though providers are required to repay AHCCCS as soon as they become aware of overpayments, they often cannot do so in one lump sum. Repayments may occur over months or years.

    Because state Medicaid agencies receive much of their funding from the federal government, improper payments come with added financial consequences: States must repay the federal government for its share.

    In Arizona, the federal government covered 70% to 76% of Medicaid costs between 2019 and 2023. The rate was even higher for people who received services through the American Indian Health Program.

    AHCCCS has repaid $49.1 million to the federal government since January 2023, according to spokesperson Havona Horsefield, who has since left the agency. That amount will likely grow as AHCCCS continues to review fraudulent cases.

    The agency is not, however, required to reimburse the federal government for overpayments made to facilities that are now bankrupt or out of business. Of the 322 providers suspended on suspicion of fraud, 90 have closed, according to AHCCCS.

    The agency could not provide an estimate of how much those providers were overpaid, but said it notifies the attorney general when a provider goes out of business and provides information to support criminal cases against them.

    State Sen. Theresa Hatathlie, a Democrat from Coal Mine Mesa on the Navajo Nation, has been critical of the state’s response and continues to call for stricter regulation of sober living facilities. During a March floor vote, she expressed frustration over the reforms Hobbs later signed into law, contending they did not go far enough.

    “It’s time to stop protecting bad actors or even those people who continue to allow bad actors to keep coming back,” she said.

    As the state slowly works to untangle the fraud and recover taxpayer funds, national debates over Medicaid’s future are intensifying. Republican majorities in both Arizona’s Legislature and Congress are pushing to cut Medicaid to offset President Donald Trump’s proposed tax cuts. Among their justifications are fraud and abuse of the system.

    Health policy experts, however, say that most Medicaid spending pays for legitimate care, and that fraud is typically committed by a small number of providers — not patients.

    Instead of the current system where the federal government covers a larger share of Medicaid costs in lower-income states, conservatives are advocating to cap Medicaid funding tied to inflation, a model that would shift more of the cost to state budgets.

    Arizona is one of nine states where such a change could trigger the end of Medicaid expansion, which currently insures 648,000 low-income residents, or about 30% of AHCCCS recipients.

    Despite Medicaid’s uncertain future, Arizona officials are pressing forward with efforts to address the lasting damage the fraud scandal inflicted on tribal communities. In November, Mayes announced a $6 million grant initiative offering up to $500,000 per organization to fund victim compensation and housing support for those displaced or otherwise affected by fraudulent treatment centers. Recipients include tribal nations and Native health organizations.

    But Stewart says the state’s work is far from over, and many of those harmed have yet to see real accountability or support.

    “They call it a travesty … and they want to get justice,” she said. “But where’s the justice when it comes to the amount of deaths that we have, the amount of Native relatives that are still missing?”

    Christopher Lomahquahu, a Roy W. Howard fellow at the Arizona Center for Investigative Reporting, contributed reporting.

    This post was originally published on ProPublica.