On Veterans Day, remember that civilians serve too

On Veterans Day, the nation thanks those who have served honorably in the United States armed forces in both peacetime and wartime. It should also be a time to remember that not all of the veterans of America’s foreign wars wear uniforms.

Civilians serve too.

Modern warfare, especially the counterinsurgency and nation-building missions that the armed forces have been called upon to perform in recent years, requires a range of civilian expertise.  This can involve base management or intelligence analysis.  It has also meant going outside the wire to be part of Provincial Reconstruction Teams, which work to bolster the performance of local governments as part of ongoing nation-building missions. This work is vital to the military’s exit strategy, and hence getting the troops home.

As I show in my book To Build as well as Destroy: The American Experience of Nation-Building in South Vietnam, civilians have been deploying to war zones for a long time.  In fact, the practice reached its postwar height in the Vietnam War.  This is something it is easy to miss if we rely on the standard history books and movies to gain our understanding of the war.

As well as a brutal guerrilla war, Vietnam was also a war of nation-building. The issue over which the war was fought was the governance of South Vietnam. Would it be united with Communist North Vietnam, or would it develop an independent, non-Communist government?  The latter was the U.S. preference, and over the course of the war over ten thousand civilians deployed to Southeast Asia to try to shape the development of South Vietnam’s government to enable it to defend itself from the Communist challenge.

They came from a variety of backgrounds and agencies – the State Department, the CIA, the Agency for International Development, even the Peace Corps. In the early years, some hitchhiked from postings elsewhere in Asia to join the nation-building mission.  Many were inspired by the ideals of development with an almost missionary zeal – they wanted to save the people of South Vietnam from the corruption, mismanagement and brutality of their own government. They often served deep in the countryside, where no American had ever gone before.

As American involvement in the Vietnam War expanded in the late 1960s, this nation-building apparatus grew in size as well.  In 1967, the Johnson administration created the Office of Civil Operations and Revolutionary Development Support (CORDS) to expand the nation-building mission. CORDS was headed by a civilian, and throughout its ranks thousands of military and civilian personnel worked side by side on the same mission, being exposed to the same dangers and writing each other’s efficiency reports.  Its “sandwich” structure meant that civilians gave orders to military personnel and vice-versa.

It was an experiment without precedent in American history and has not been repeated on such a scale since.

Civilians who have served in war zones have faced some unique burdens, both during the Vietnam War and today. They are all volunteers who usually must be granted permission by their host agencies to go overseas. Often these agencies see such deployments as a distraction from the “real” jobs their employees are supposed to be doing at home, and so serving can be harmful to careers.  As a result, the military has often struggled to attract enough volunteers. As of July 2018, 70% of the necessary positions for civilians in Afghanistan were unfilled.

So, this Veterans Day, spare a thought for these “expeditionary civilians”. They often serve in the shadows, and some pay the ultimate price.  They deserve to be honored, too.

to build as well


 

About the author of this blog post: Dr. Andrew J. Gawthorpe is Lecturer in History and International Studies at Leiden University in The Netherlands.  He has written for publications including Stars and Stripes, Foreign Affairs, and more.

On Veterans Day, remember that civilians serve too

Cornell University Press to Publish New York History

The journal of record for the history of the Empire State will continue in collaboration with the New York State Museum

Ithaca, New York, November 15, 2018.  Cornell University Press announces that, beginning in 2019, the Press will publish the century-old journal, New York History. Working in association with an editorial team at the New York State Museum, Cornell University Press will expand the scope of the journal to include public history and museum studies. The first issue published under this new arrangement will appear, in both print and electronic formats, in July.

“This marks a new start for this venerable journal and the transition in proprietorship comes at a critical moment for the research, writing, curation, and teaching of the history of New York State,” commented Michael J. McGandy, Senior Editor at Cornell University Press.

“Scholarship is changing in methods and media, while public history is becoming more important. Beginning with volume 100, New York History will reflect these changes in the historical profession and better meet the needs of New York State citizens.”

New York History, founded in 1919 as The Quarterly Journal of the New York State Historical Association, is the foremost scholarly journal addressing the state’s past. The New York State Historical Association, now known as Fenimore Art Museum, created and supported the journal. Since 2012, an editorial group based at the State University of New York at Oneonta—currently composed of Thomas D. Beal, Susan Goodier, and Danny L. Noorlander—has overseen the daily operations of the journal and managed its transition to digital publication.

“Our long history with New York History, and in particular the distinguished editorship, from 1964 to 1999, of Wendell Tripp, compelled us to seek a proprietorship that would ensure that the journal  continues to thrive and satisfy the needs of the historical community,” said Dr. Paul S. D’Ambrosio, Fenimore Art Museum President and CEO.

“We believe that Cornell University Press and the New York State Museum will take New York History to new heights in the years to come and to show our confidence in them, we intend to provide financial support for the journal for the first three years of this transition.”

With the active collaboration of New York State Historian, Devin Lander, and Chief Curator of History at the New York State Museum, Jennifer Lemak, the mission of the journal will have a new focus and the editors aim to unify the diverse field of New York State history and meet the needs of a growing historical community.

“I think we have a great opportunity with the journal to bring the diverse New York State historical community together for the betterment of the field,” Lemak noted.” Devin and I are excited to be a part of the future of New York History.”

For Cornell University Press, the acquisition of New York History is part of a growing publishing program addressing the history, arts, culture, science, politics, and current events of New York State. “The aims of New York History fit well with Cornell’s land grant mission, which includes sharing knowledge so as to make a difference in New York State, the United States, and the world,” said Dean J. Smith, Director of Cornell University Press.

“From our books on citizen science in New York State to our regional trade imprint, Three Hills, Cornell University Press is a key contributor in a network of institutions generating historical, social and cultural, and scientific knowledge relevant to the state.”

New York History, now published twice a year, will present articles dealing with every aspect of New York State history, as well as reviews of books, exhibitions, and media projects with a New York focus. Lander and Lemak invite article submissions (NYHJ@nysed.gov) and Cornell University Press encourages current and past subscribers, both individuals and institutions, to inquire about subscriptions (nyhjournal@cornell.edu).


For more information, contact Cheryl Quimba, 607-882-2248 or cq43@cornell.edu

Cornell University Press to Publish New York History

#SWYW: You spoke, we listened!

More than five hundred authors, professors, and readers spoke their minds in our Say What You Want campaign. And we listened. So, what did we learn?

Well, first of all, that people are not averse to answering surveys, at least not if you can offer a good reward for it. Cleo O’Brien-Udry was the lucky winner of our $250 in #CornellPress books raffle, and was excited to share the news on her Twitter feed:

CLEO SWYW Tweet

Second, that authors will prioritize quality, overall prestige, and reputation in their specific fields as the most important attributes when choosing a publisher for their books. The relationship with their acquiring editor and the marketing efforts and resources available for promoting the book are also extremely valuable, and some authors even pointed out the preference for a specialized series that make sense for their book.

Third, we learned that almost 60 percent of readers and CUP customers find their next reads in blog posts, book reviews, or articles in digital newspapers or magazines, and that more than 58 percent of them do so through social media. This finding indicates that our digital efforts are not in vain and suggests that ads in printed media have little value in the discovery of books. Moreover, we found out that our customers are price sensitive, and when it comes to buying a book, considerations of subject matter and cost are at the top of their list. Last but not least, it turns out that 98 percent of the readers appreciate special discount and promotions, saying that campaigns like Pay What You Want and our End of the Year sale help them get their hands on their wish-list books!

Regarding professors, we found out that 90 percent of those who took the survey assign books for course adoption, and that only 12 percent of them would consider assigning an ebook to their class that costs more than $30. Students matter to them and they are aware of the fact that books they choose need to be both affordable and accessible to that public.

Authors, readers, and professors spoke. And we listened.

Based on these first takeaways, and because your Say What You Want responses mean a lot to us, we are happy to announce that we are slashing our ebook pricing by 50%!

FLYER FOR EBOOKupdated

All in all, #SWYW helped us discover trends that speak of the publishing industry and where academic publishing is going, and that there is much ground for improvement in what we do here at CUP too. Looking into the future, we are excited to continue to analyze these results and act on the insights that we gained from this campaign; always striving to become the best University Press that we can be.


About the author of this blog post: Adriana Ferreira is the Social Media Coordinator at Cornell University Press. Ebooks helped her hour-long train commutes when she was living in Madrid seem short, fun, and even eventful!

#SWYW: You spoke, we listened!

VETERANS’ DAY Book GIVEAWAY @CornellPress

One thing I appreciate about meeting with Cornell University Press’ Director Dean J. Smith, is that I always leave his office with some kind of insight or anecdote. He seems to be a natural story-teller, and last week he told me how he gave a free copy of Suzanne Gordon’s new book Wounds of War, to a veteran who walked into Sage House. The conversation moved Dean and he decided he wanted to do something special for veterans. His words resonated with me.

For those who are not familiar with her work, Suzanne is an award-winning healthcare journalist and author who spent more than thirty years researching health care delivery and nursing in the American private, profit-driven marketplace. And even though she is not a veteran herself, she is genuinely concerned by the move towards outsourcing veterans’ care. Last month, Suzanne wrote a blog post for our website about the dangers of privatizing the Veterans Health Administration (VHA), emphasizing the need to protect a system that manages the healthcare of a vulnerable population that is, “at high risk for mental health and substance abuse problems, suicide, chronic pain, homelessness, and legal issues, to name a few.” Her fight is one born out of personal motivation; as a civilian, she has nothing to gain from the political debate around the VA.

All this said, and in anticipation of #VeteransDay in the US this Sunday, we have decided to celebrate all veterans, their families, and caregivers, with a special book giveaway! And we are inviting them to share a flyer on Facebook or Twitter, for the chance to enter to win a FREE copy of Suzanne Gordon’s new release Wounds of War.

Additionally, we’ll send a free copy of Suzanne’s previous book, The Battle for Veterans’ Healthcare, to the first 500 people who email us at cupress-sales@cornell.edu on November 11th*. Please type “Veterans’ Day Promo” in the subject of your email.

At #CornellPress, we believe that it is our duty to spread knowledge and support the men and women who have served this country, showing them our appreciation with these two promotions. We hope that everybody participates and enjoys their new books!

VETERANS DAY GIVEAWAY upload

*By sending an email to get a free copy of The Battle for Veterans’ Healthcare, you agree to receive mail notifications with the latest updates from Cornell University Press. Promo valid in the US only.

For more information on Wounds of War, listen to the following interviews with Suzanne Gordon on Frontlines of Freedom and the Radioactive Broadcasting show:

http://frontlinesoffreedom.com/2018/10/13/show-564-1st-hour/

http://radioactivebroadcasting.com/directory/itemlist/category/310-urgent-care

About the author of this blog post: Adriana Ferreira is the Social Media Coordinator at Cornell University Press. She is excited to extend this offer to veterans and hope that they can celebrate their day in a special way!

VETERANS’ DAY Book GIVEAWAY @CornellPress

Fashion Cycles

The language of fashion has long been used to dismiss various forms of literary scholarship. Most recently, that charge has been made against types of “post-critique”—methods of reading that seek alternatives to interrogating and demystifying a text’s unstated ideological commitments or implications. Yet, for decades, conservative critics have used the language of fashion to dismiss literature and scholarship that focuses on race, gender, sexuality, and other categories of difference, or that engages “theory,” which usually means poststructuralist thought and its legacies. Ironically, however, some of the canonical works and movements that those literary traditionalists champion were also charged with being fashionable. Modernism, in particular, was parodied as modish before it was canonized, due in part to modernist writers’ preoccupation with style. In all of these cases, to be unfashionable or anti-fashion is to be aligned with more substantial and lasting social and political ideals and aims. But these claims disavow the critic’s own inevitable entwinements with fashion.

Many modernists themselves decried fashion as the epitome of superficial, commodified change.

But, as I argue in Modernism à la Mode: Fashion and the Ends of Literature, they also turned to fashion to consider what stylized objects might do in midst of war, imperialism, global capitalism, and on-going racial violence. In the work of Virginia Woolf, D.H. Lawrence, W.E.B. Du Bois, Nella Larsen, and F. Scott Fitzgerald, fashion is treated as a collective mood, a set of influential material objects, as well as a target of critique. Through these authors’ engagements with fashion, their writing becomes a means to understand and generate shared forms of feeling, to excite and animate readers’ bodies, or to imagine alternatives the very economic and political structures that fuel the global fashion system.

Via fashion, modernism becomes of the moment once again.

That is because modernist treatments of fashion intersect with contemporary work in literary and cultural studies that investigates the nature and force of collective emotions, the power of supposedly inanimate objects, as well as the way that beauty and style might fuel various political projects. Virginia Woolf’s treatment of fashion as a shared mood, for example, provides contemporary scholars of affect with ways to describe how seemingly personal feelings emerge with and through specific material, historical, and social conditions. In her anti-war essay Three Guineas, Woolf also provides a timely critique of the ways that seemingly liberal states disavow their fascist, imperialist underpinnings in part by celebrating uniforms—and, we might add, suits—as rational, utilitarian garments that supposedly transcend the vagaries of fashion.

As this example suggests, modernists treatment of fashion help us to reconsider facile distinctions between what is lasting and what is a passing phenomenon.

Given the on-going public disinvestment in higher education, demands that humanities research justify itself in market terms, and the virtual collapse of the “job market” in literary studies, it can seem urgent to champion what is unfashionable. But such a stance usually relies upon caricatures of literature, literary study, and of fashion. Instead, taking fashion seriously can help us to grapple with what it means to do work in the humanities right now.

modernism a la mode


 

About the author of this blog post: Elizabeth Sheehan is Assistant Professor of English and Women, Gender, and Sexuality Studies at Oregon State University. She is the author of Modernism à la Mode: Fashion and the Ends of Literature and co-editor of Cultures of Femininity in Modern Fashion, and will be attending The Modernist Studies Association Conference “Graphic Modernisms” in Columbus, Ohio, this November 8-11, 2018.

Fashion Cycles

The One-Week Bookstore @CornellPress opens its doors this Nov 5th!

A few weeks ago our team got an email from the Marketing Director that read: “Mahinder (our Editor in Chief) just sold a book! In Sage House. To a real customer. Fun.” A couple lines later in the same email, we found out that we were having a pop-up bookstore right here at Cornell University Press. The ball was rolling.

So as a result of this random but wonderful happening of selling a book in-house, on November 5th at 10:00am and for one week only, our doors will be open, our bookshelves will be filled, and Ithacans will march through the grand, old entrance to get their wishlist titles from our very first pop-up store.

There’s not much more to it. Walk in, choose your next reads, pay cash, check or credit card, and carry your books home. Or as our Exhibits Coordinator David put it: “Cash, credit, check, and carry!” Paperbacks will be $10, hardcovers will be $15. Taxes included. It’s a one one-time deal to make knowledge more accessible to professors, students, and all book lovers in the community. Plus, the chance to wander about Cornell University Press, and experience the magic of publishing books in the beautiful Sage House mansion.

I was not supposed to write this blog post. But the person that volunteered to do it is busy putting everything together for next week, so I stepped in. Looking for inspiration on what to write, I stumbled upon an article that said that “… pop-up retail tickles the parts of one’s brain that likes new things”. I instantly understood what had happened. At #CornellPress, we just love new ideas. And the opportunity to bring our customers face to face with the books we love, in our own backyard, and in such a spontaneous format, sold it for us.

The invitation is up: This November 5th through November 9th, stop by Sage House on 118 Sage Place to take part in The One-Week Pop-Up Bookstore, and get the books you want.

In the meantime, we’ll be busy preparing for it: part of our staff is being trained in the world of sales and retail, flyers are being distributed all over town, and books are piling up downstairs, growing our pop-up inventory. And as everybody’s doing their bits and pieces, I am curious to see what excitement, feedback and results our first and one time only pop-up bookstore will bring.

FLYER copy


About the author of this blog post: Adriana Ferreira is the Social Media Coordinator at Cornell University Press. Her birthday is November 9th, so if you happen to stop by the pop-up bookstore that Friday, make sure to give her your best wishes!

The One-Week Bookstore @CornellPress opens its doors this Nov 5th!

Ideas and Things

Can we be forgiven for feeling overwhelmed by American culture and politics? Daily we read or more like hear about political polarization, deep ideological divides, a politicized Supreme Court, protests over race and history. Of course, there are histories and context to each issue and conflict, but sometimes what we need is something more fundamental. Behind all these things are ideas.

Intellectual historians have attracted larger and larger audiences that are hungry for explanations about the origins, contexts, and consequences of ideas that seem more powerful than ever. How do we understand a society riddled by profound contradictions—a society that transitioned, most recently, from Barack Obama to Donald Trump?

Ideas matter. A lot. Most people recognize as much. Intellectual history—the study of ideas in the past—thus has a lot to offer people. With my colleague Andrew Hartman, we have co-edited a collection conceived with this basic fact in mind.

We asked the authors to consider the following question: How might the methods of intellectual history shed light on contemporary issues with historical resonance? Their answers, while rigorous, original, and challenging, are eclectic in approach and temperament. For example, to understand the battle for the soul of the Democratic Party between the left and liberals (or supporters of Bernie Sanders and Hilary Clinton, respectfully), Hartman argues we need to grapple with the idea of freedom: “The left’s mission—the reason for its existence—was to expand the idea of political freedom, which was limited and went by the name of liberalism, to include economic freedom, a broadened conception that went by the name of socialism. The route to such freedom was class struggle.”

In another essay, David Sehat helps us locate a position from which to look critically at “originalism” or the idea that seems to capture the politicized nature of the present U.S. Supreme Court better than any other. Sehat explains: “Intellectual historians, like all historians, recognize [the] reality of historical change and growth, which is why they have tended to be some of the strongest critics of originalism. They know that the past is different than the present; that time is corrosive of meanings, arrangements, and cultural ideas at particular moments; that its corrosiveness leaves only remnants from the past that historians must pick over to make sense of now-lost worlds; and that the reconstruction of the past is always, as a result, only provisional and partial. As such there is not, historians have suggested, a set of interpretive rules to be followed by which original meaning will be revealed, since that meaning was contested at the founding and has evolved over the centuries.”

But when we come right down to the most pressing questions of our age, we all want to know “why Trump?”

In her essay tracing the genealogy of conservatism, Liza Szefel wonders in an era that is “post-truth” what good is intellectual history to such a question? She offers an answer: “A line of inquiry gaining traction attempts to move beyond rise and fall narratives to examine conservatism not merely as an ideology, grass roots social movement, or party, but as a sensibility, temperament, and mentality. Casting conservatism as an orientation brings into relief values shared by the left and right.” Indeed, intellectual history uses the tools of social history and cultural history to look at the world—as well as world views—of Trump’s working-class supporters. By doing so, Szefel demonstrates how intellectual history identifies the ideas behind all sorts things, including Donald Trump.


 

About the author of this blog post: Raymond Haberski, Jr. is Professor of History and Director of American Studies at Indiana University-Purdue University Indianapolis. He is the co-author of the upcoming #CornellPress title American Labyrinth: Intellectual History for Complicated Times. Take a closer look and pre-order your copy here.

Ideas and Things

The Gospel According to John Cleese

A friend of mine once put forward the theory that art and religion developed to pay homage to, or to pray for, good hunting. He’d been talking about the prehistoric cave paintings at Lascaux—the idea being that hunting was so central to these folks’ survival that they didn’t just choose, but were compelled, to create the art that today evokes in us so deep a sense of wonder. Of course, if this art sprang from such an elemental well, so too would have the engineering of weapons for the hunt: the triangles of pointed rock, the straight charcoal lines of spears arcing toward their prey. Art and design; geometry and engineering. Sounds something like what we do at Cornell.

And then there is John Cleese, Cornell’s longtime professor-at-large. Since 1999, he’s been visiting, lecturing, listening, and making us laugh. He has been our most surprising tutor, our unexpected long-term guest. Yet as well-known as he is, many Cleese fans (and even Cornellians) have no idea what he’s about outside of his day job. Professor at Large, a new collection of Cleese’s public talks at Cornell, presents a portrait of a mind at work. His topics are wide-ranging, from psychology to religion to screenwriting. But over and over, what reappears in different contexts is a fascination with the creative process, and (usefully) his interest in how to get there, as well as pitfalls to avoid, on the path to the “relaxed, attentive, open, and inquiring states of mind,” that allow creativity to flourish.

As it turns out, Professor at Large is, on one hand, a kind of how-to book for students of creativity. One could unearth a decent cache of listicle points from its pages, if need be. (My favorite, which happens to be from the screenwriter William Goldman: “Read it five or six times, each time with a different color pen.”) It’s also an argument shouted against prevailing winds. Cleese pays due respect to “the practical workaday thinking” that “relies on the application of reason and logic to known data.” However, he warns against a common bias toward “fast, purposeful, logical thinking,” not only in how we pursue success in business and academics, but also in our search for personal happiness.

(Listicle point: Get a cat. “The nice thing about cats is when they grow up, they don’t blame you for everything.”)

The quiet, open space, both physical and metaphorical, that Cleese defines as necessary for creative production will be familiar to practitioners of meditation, to solitary wanderers, and to those seeking to understand with humility the sacred writings of their chosen religion. It (surprisingly) comes as no surprise that much of Professor at Large has to do with religion and mysticism. Cleese makes it clear that they are not necessarily synonyms and are frequently at odds. He is against the certitude of doctrine because of what it stifles: the same openness of mind that summons up creative insight. One might call his writing the Gospel According to Brian, which in fact is the subject of an essay that’s both amusing and profound.

My friend told me that the Neanderthals buried their dead with amulets of sharpened stone. The better to hunt in the afterlife, he said. I’m no scholar, and I don’t know if it’s true, but it makes a good story.

cleese cover


About the author of this blog post: Elizabeth Kim is marketing designer for Cornell University Press, where she continues to look on the bright side of life.

*Original source of featured image: Empire

 

The Gospel According to John Cleese

East Asia’s unicorn builders: different strategies in Hong Kong, Singapore and Taiwan

Unicorns are increasingly running the streets of East Asia. In fact, policymakers in Singapore and Hong Kong wave the flag of their first unicorns with pride and Taiwan is on track to have its own unicorn. I am not talking the mythical animals adorning children’s storybooks. In the world of start-ups and venture capital, since 2013 a “unicorn” is understood to be a privately-owned (technology) start-up that achieves valuations in excess of $1 billion. A unicorn is also a validation that a start-up ecosystem is succeeding, and a key performance indicator used by governments.

From myth to reality: unicorns in Singapore, Hong Kong and (soon) Taiwan

Singapore has unicorns inhabiting its island, with Garena, Lazada, and Razer all comfortably achieving $1 billion valuations. But the ever-active and promoting Singaporean state isn’t stopping there. On Monday, October 2nd, the Singaporean parliament approved the “variable capital companies” (VCC) bill in an effort to further project the Lion City’s position as leading destination for asset management firms, particularly venture capital funds, to domicile and operate. In explaining the power of the new VCC structure, the Bill will provide a mechanism for overseas funds to be constituted as Singaporean. The Business Times asserts that one of the benefits to Singapore is that it “enhances Singapore’s position as a full-service international fund management centre”. This is a time-tested strategy in the Lion City.

GoGoVan, a logistics company, excited Hong Kong start-up enthusiasts in September 2017 as it achieved unicorn status. Finally, Hong Kong – and its government – had something to show for the rising support of start-ups and innovation (and within two years of the promotion of the Innovation & Technology Commission to Bureau level status).

For Taiwan, in May 2018 an electric scooter company called “Gogoro” was being picked as the likely candidate. This unicorn excitement came as the Taiwanese government announced in early 2018 that it promised to incubate its first unicorn by 2020 (Japan made a similar promise, through its J-Start-up program which launched in June 2018, that it would help build 20 unicorns by 2023).

These unabashed efforts to build unicorns is not a new phenomenon. In The Venture Capital State: The Silicon Valley Model in East Asia, I detail how each country purposefully, but differently than one another, helped catapult its local VC market to world-class size and operations. They don’t copy the real or imagined Silicon Valley model either. Even the “core elements” of the American legal and tax environment within which Silicon Valley VC emerged were not deployed in each case. Here’s a visual of the unique “yellow brick roads to Oz” – or, policies implemented with the aim of building a local VC market akin to Silicon Valley:

SILICON VALLEY

Why variation amidst convergence?

Though each country had the same aim – of building a local VC market that could support the growth of its local unicorn population – they all took different paths. The phenomenon reminds me of the Seinfeld-inspired play “I love you, you’re perfect, now change”. Each country’s policymakers fell in love with the idea of building Silicon Valley-like venture capital markets. This, they concluded, was part of the recipe for creating innovative firms, as well as ensuring vibrant financial markets. But after falling in love with the model, they changed it.

The Venture Capital State systematically explores why and how this change occurred as it has in these East Asian nations. And crucially, it explains that this adaption has been essential to success in East Asia, as elsewhere. It’s not about copying Silicon Valley in order to build local unicorns. It’s about local competitive advantage and approaches that reflect distinct environments.


 

About the author of this blog post: Robyn Klingler-Vidra is a lecturer in Political Economy at King’s College London, and the author of The Venture Capital State: The Silicon Valley Model in East Asia

East Asia’s unicorn builders: different strategies in Hong Kong, Singapore and Taiwan

Open wound: privatizing the Veterans Health Administration (VHA)

After spending more than 30 years researching health care delivery and nursing in the American private, profit-driven health care marketplace, I decided to explore how the Veterans Health Administration (VHA) delivers healthcare to 9 million of the nation’s veterans. Although neither I, nor anyone in my family is a veteran, I knew that the VHA had made impressive strides in implementing healthcare teamwork and improving patient safety. I knew the system was more accountable than the settings in which I –a non-veteran– get my healthcare. I had, however, no idea how impressive the system really is.

Nearly five years observing and interviewing veterans, their families, and their caregivers, showed me how the VHA delivers excellent care –at far lower cost than is available in the private sector– to the nation’s most complex patients.

In Wounds of War, I introduce you to the veterans who receive this care and the dedicated employees who deliver it. I take you into exam rooms, hospital wards, therapy groups, homeless and legal programs, and even cooking classes where the VHA caregivers are interacting with their patients.

And you’ll find that while our broader healthcare system delivers fragmented healthcare services, the VHA is grounded in an integrated model.

It has perhaps the only functioning mental and behavioral health system in the United States and delivers high quality geriatric and end of life care, all while simultaneously addressing patients’ housing, employment, and legal problems.

True, we should all have this kind of integrated care; but it is critical to veterans. After all, military training and service places them at high risk for mental health and substance abuse problems, suicide, chronic pain, homelessness, and legal issues, to name a few.

The VHA has done something really rare in American medicine. Today, many hospitals may advertise team-based care, but will not spend their resources to teach people to work together. The VHA has devoted enormous time and energy to train employees to work on teams. You’d be surprised to find out that a veteran’s primary care provider will actually consult with his or her mental health therapist or orthopedist, social worker, dietician, or physical therapist in a face-to-face conversation –not only through notes entered into a shared electronic medical record–, in order to determine the best plan of care.

Over and over again, I am reminded how lacking this kind of integrated care is outside the VHA.

The other day, a friend who’d been suffering for years from back pain, consulted with a high- priced orthopedic specialist. The specialist peered at his X-rays and declared that he wasn’t a candidate for surgery. Maybe, the physician told my friend, PT would work, or chiropractic, or acupuncture, or even yoga.  Check it out, he advised, as he rushed on to his next appointment. My friend was on his own.

If my friend was a veteran, he would have been scheduled for a visit with an integrative pain team. He would have been helped to enroll in the kind of pain classes that significantly reduce patients’ perceptions of pain and enhance daily function. He would have been scheduled for physical therapy and even signed up for classes of yoga and mindfulness meditation. And all of this would have been coordinated by caregivers, not left in the hands of a vulnerable patient.

Plus, it wouldn’t cost the veteran one dime.

Today, President Donald J. Trump and Congressional Republicans are attacking and trying to privatize the entire system, rather than to improve and strengthen it. They are following the game plan of ultra right wing-libertarian billionaires like the Koch brothers, who have carefully crafted a narrative of a broken government-run healthcare system. Aided and abetted by some Democrats who fail to understand the promise and problems of the VHA, they have passed legislation like VA MISSION and VA Accountability Acts. These laws will outsource more VHA care to the private sector, starve the system of resources, close facilities, vilify VHA employees and shift billionaires of tax payer dollars into the hands of private sector hospitals, doctors, mental health practitioners, medical equipment companies, and even real estate developers.

That’s why I hope you will not only read Wounds of War but also join me and the veterans, healthcare reform groups, and unions that are fighting for the VHA. We owe it to the veterans who have sacrificed for their country to maintain and improve a healthcare system designed to serve their specific needs. And it would also be an important step towards promoting the kind of successful models of care that should ultimately be available to all of us, not just veterans.


For more information on Wounds of War and the VHA, listen to our latest #1869podcast:

 

About the author of this blog post: Suzanne Gordon is an award winning journalist and author who writes about healthcare delivery, health care systems and patient safety. Her last book, The Battle for Veterans’ Healthcare: Dispatches from the Front Lines of Policy Making and Patient Care was published by Cornell University Press in May of 2017.  She received the Disabled American Veterans (DAV) Special Recognition Award for her work covering veterans’ healthcare. Ms. Gordon is the Senior Policy Fellow at the Veterans’ Healthcare Policy Institute.

Open wound: privatizing the Veterans Health Administration (VHA)