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of outdated computer systems, the VA said it could not use the new guidelines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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