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The real scandal

Congress refuses to fully fund the VA at a time when the number of veterans needing care has skyrocketed


Robert Miller of Brattleboro is feeling angry and frustrated these days.

A combat veteran of World War II, Miller recently turned 90, and is in reasonably good shape for his age. He lost most of his hearing when he suffered a head wound in an artillery barrage during the battle for Monte Cassino in Italy in 1944.

And, for the next seven decades, he received care from the hospitals and clinics of the Department of Veterans Affairs.

So when he reads and hears news stories about politicians attacking the VA medical system, Miller gets even more angry.

“Goddamned place saved my life, and I am taking all this personally,” he told me on the morning of Memorial Day. “My total experience with the VA from the time I got out of the Army in 1945 to now couldn’t have better.”

The recent allegations of manipulated data by administrators to cover up long waits for treatment at VA hospitals around the country — long waits that may have cost the lives of dozens of veterans — are disturbing, and Miller believes that those responsible for the cover-ups should be held accountable.

But the political grandstanding in Congress ignores the obvious fact that the VA is underfunded and under-resourced at a time when the number of veterans needing care has skyrocketed.

Since President Obama took office, the VA budget has gone from $100 billion to $154 billion, which sounds good until you see that the number of people who are eligible for VA care has risen to nearly 6.2 million — up from 4.3 million in 2002 — due to two wars in Iraq and Afghanistan that called upon the service of 2.6 million service members over the past 13 years.

Thanks to better body armor and better battlefield medicine, the survival rate of soldiers in combat has increased dramatically. However, that means more veterans with multiple amputations, traumatic brain injuries, and post-traumatic stress disorder.

The cost of caring for these men and women for the rest of their lives will not be cheap. The VA has 152 hospitals, 900 clinics, 300 mental health centers, and many other facilities scattered around the nation. It takes care of more than 230,000 people a day.

* * *

Despite this huge demand for highly specialized care — care that private-sector hospitals simply can’t deal with — there has been a constant struggle in Congress to adequately fund the VA.

The same people howling for more defense spending have regularly proposed cuts for the VA system since the start of the Iraq and Afghan wars, and they have long sought to privatize the VA.

Miller thinks conservatives in Congress and their allies in the media have trumped up a scandal to accomplish this.

“The VA is an enormous bureaucracy that has to take care of millions of people,” Miller said. “Can you think of another large organization that doesn’t make mistakes?”

Certainly, private medicine is capable of making mistakes, enough to kill more than 400,000 a year in U.S. hospitals. But since the VA is a public entity, it is held to a higher level of accountability.

The stories of battling the VA bureaucracy to become eligible for care and the long wait times for getting it are nothing new. The surprising thing to those not familiar with the VA is that once veterans enter the system, they overwhelmingly say, as Miller does, that the quality of care they receive is second to none.

In 2012, the RAND Corporation, in its study of the VA, found that it delivered health care that was as good or better than that available in the private sector, and that the VA controlled costs better than its private-sector counterparts. Several other studies over the past few years echo that conclusion.

But Republicans in Congress are ignoring that information, because these truths stand in the way of a long-cherished public-policy goal.

The VA is the largest single-payer health care system in the United States. It delivers quality health care at a cost that is lower than the private sector.

So if Republicans can succeed in discrediting the VA as an incompetent, ineffective, and inefficient health-care provider, it can help discredit any efforts at enacting single-payer health care for years to come.

* * *

And starving the VA is just the tip of the Republican iceberg of heartlessness toward veterans.

Recent cuts to the food stamp program affected 900,000 veterans, and the refusal by Republican-controlled states to expand Medicaid under the Affordable Care Act has left an estimated 258,000 people who served this country without health care.

An innovative pilot program to treat traumatic brain injuries is set to end soon because Congress is dragging its heels to approve funding.

As recently as February, Senate Republicans filibustered a bill to expand health, education, and job training for veterans.

The problems at the VA didn’t happen overnight. Years of underfunding the system, coupled with a surge of new patients, has stretched the system to its limits. Yet too many people in Washington would rather play politics than do the right thing for the veterans they claim to honor and cherish.

The costs of the wars in Iraq and Afghanistan, which were never fully funded from the start, could reach up to $6 trillion when you factor in the costs of pensions and health care for the veterans of those conflicts. That means we need to spend more — much more — on the VA in the coming years.

As Sen. Bernie Sanders, I-Vt., said earlier this year to the flag-wavers and sunshine patriots in the Republican Party, “If you can’t afford to take care of your veterans, then don’t go to war.

“These people are bearing the brunt of what war is about. We have a moral obligation to support them.”

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Originally published in The Commons issue #257 (Wednesday, June 4, 2014). This story appeared on page C1.

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