Tuesday, December 4, 2018

Keeping Promises to Veterans


Since the beginnings of our continuing wars in the Middle East, 2400 US soldiers have been killed in Afghanistan and 4550 in Iraq, and nearly 54,000 officially listed as wounded in action. Those numbers do not include the more than 300,000 who have suffered traumatic brain injuries. As of 4 years ago, 970,000 disability claims have been filed by veterans of these two wars. Many other physical and psychological injuries have not been reported by the 2.7 million US service members who deployed to Iraq and Afghanistan since 2001. Caring for those wounded veterans, and the many millions of older vets who need medical attention, is a major American political problem.

Politicians routinely gush over veterans and promise to do everything they can to reward their service. Veterans are honored by parades and special supplements to newspapers. Then how is it that the primary vehicle for delivering help to wounded veterans, the Veterans Administration, is such a mess?

Behind the pious words that come so easily to politicians’ lips has been a nasty fight over how much money to spend on veterans. Just last week, a new controversy broke into the open about how the VA reimburses veterans who are using housing benefits as students. The Forever GI Bill went into effect in August, with specific instructions on how to calculate housing benefits for student veterans. Because of outdated computer systems, the VA said it could not use the new guidelines until December 2019, and some veterans have been complaining that they have not gotten any payments at all. An undetermined number of veterans have maxed out credit cards, fallen behind on mortgage payments, or borrowed from their families.

This is merely the latest in a long series of VA failures, most notably the delay in getting to see doctors in VA facilities. In 2012, a VA emergency room physician, Dr. Katherine Mitchell, sent a message to her superiors that the wait times at the Phoenix hospital were dangerous. She was soon transferred out of the ER. But her courageous warning took two years to mushroom into a national scandal, when it was revealed that the VA had falsified records of average wait times, which could stretch to months.

In 2014, the Veterans Access, Choice and Accountability Act was passed, allowing veterans who would have to wait for a VA appointment to seek out private health care that the VA would pay for. But in 2016, the average wait time for veterans seeking health care was still 51 days.

A program put in place by President Obama in 2010 attacked the persistent problem of homeless veterans, whose number fell from 74,000 to about 40,000 by 2016. That number is still far too high: the proportion of veterans who are homeless is nearly 3 times that of the rest of the population. The reduction in homelessness seems to have stopped, since the 2017 estimate is slightly higher than 2016.

It took decades after the end of the Vietnam War for the government to acknowledge that Agent Orange had caused health problems for thousands of soldiers, meaning that their injuries should be covered by the VA. The controversy continues: Navy veterans who served on ships in Vietnamese waters are not yet covered, and the VA opposes extending coverage to them. A so-called “blue water bill” passed the House unanimously in June, but now enough Republican Senators oppose it that it seems unlikely to pass in this session. But even the House bill is hardly generous: it would fund increased expenditures on Navy vets by increasing fees to disabled vets trying to buy homes with VA loans.

The VA is an organization with enormous responsibilities. It is the largest integrated health-care system in the US, responsible for 9 million veterans. It has 350,000 employees, a budget of $177 billion, and runs 1250 health care facilities.

Familiar ideological struggles over government spending are at the heart of the problems of the VA. Republicans target all social programs for cuts, claiming too much government spending will cause the deficit to balloon. During the administration of George Bush, Republicans and Democrats fought continuously over appropriations for the VA. The Washington Post reported in 2005, “Leaders of the American Legion, the Paralyzed Veterans and the Disabled American Veterans all noted a striking partisan division in Congress on veterans issues, with Democrats giving them much more support than Republicans.” Proposals like that of Bernie Sanders in 2014 to allocate more money to veterans’ health care have died in the Republican Congress. Then Republicans passed the giant tax cut, which will push annual deficits over $1 trillion.

Under Trump, the VA has been an administrative nightmare. The Secretary of Veterans’ Affairs, David Shulkin, had to resign, because he used government funds to pay for a lavish European tour for himself and his wife, one of several Trump Cabinet members who have used taxpayers’ money like their own bank accounts. Top VA officials engaged in a civil war of attempts to privatize some VA functions, a priority for the Koch brothers, major donors to the Republican Party. Trump tried to appoint the White House doctor, Ronny Jackson, as the new Secretary, but a slew of allegations of misconduct and his lack of experience in leading a giant organization derailed that effort.

Trump promised “to take care of our vets like you’ve never been taken care of before.” But Trump’s first budget proposal in 2017 cut all funding for the Limb Loss Resource Center and the Paralysis Resource Center, major sources of help for injured vets. Other cuts he proposed in many social programs, like food stamps, student loans, and Medicaid, would directly impact veterans.

While the Trump administration and Congressional Republicans have supported increases in VA funding to improve the delivery of care to veterans, the source of funds has led to the usual political struggle. Republicans insist that new funds for the VA be taken out of existing programs elsewhere.

I am not a veteran. I think there are as many heroes among teachers and journalists as among former soldiers. But our society has the responsibility to care for all those who served in uniform, especially when their health problems were directly caused by their military service. The way to reduce expenditures on veterans’ health care is to stop fighting useless and unwinnable wars.

Steve Hochstadt
Jacksonville IL
December 4, 2018

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