When Johnny Comes Marching Home
“Sometimes
you wonder", the Republican asked,
“would there be some way to introduce some private sector competition” into
veterans’ care? What? Who said that? It was 2012, and it was Mitt Romney, famous
non-veteran and spokesperson for "Corporations are people, my
friend!" As "W" before
him, Romney, laissez- faire capitalism's
perpetual bitch, couldn't stay away from the idea that privatization is a cure for anything. One
recalls that Bush II wanted to look at
privatization of Social Security which, considering the 2007-8 faux mortgage
debacle and subsequent market collapse, would have been catastrophic.
More recently, another expert on things
military, Ben Carson , floated a similar notion “We
don’t need a Department of Veterans Affairs!”
This, despite the VA’s record of
excellence, and the fact that the VA system as a whole outperforms the rest of
the health care system by just about every metric. Amidst even the harshest recent
criticism, all
recent surveys also show that
veterans give VA hospitals and clinics a higher customer satisfaction than
patients give private-sector hospitals.
Yeah. I know..."So what?" I mention these things because as usual, in
this seemingly interminable pre-election group bitch slapping exhibition, one
significant factoid continues slipping by under the radar; that being the all
too familiar phenomenon of ignorant citizens rabidly supporting candidates who
do not have their best interests at heart. In this cycle we're seeing
ex-military, military wannabees and generally unwashed militia dropouts all
clamoring their support for Republican candidates who have little or no regard
for any aspect of their life except their vote.
As a military retiree, I have been
confounded for years by this contradictory behavior by many former peers. The subtleties of the
current attitude of Republican establishment money men against the VA are far
off the radar of the general public, but
reflect the very worst of self serving and venal attitudes of those who won't
serve, but will happily feast on the bones
those who did
The Commission on Care, created in 2014 was established to review and evaluate Veterans medical issues. Since many members were appointed by Congress, it follows that it is partisan in nature, and recent overt and covert actions reflect that bias. It just so happens that four of the 15 members of the commission are executives with major medical centers that stand to gain from the outsourcing of veterans’ care. Another works for CVA (Concerned Veterans of America, a Koch brothers-backed group) and yet another for an organization allied with CVA. Last month these six commissioners plus a seventh were discovered to have written a secret draft of the commission’s recommendations – in which they call for full privatization of the VA by 2035 – in possible violation of the Sunshine and Federal Advisory Committee Acts. This revelation infuriated the other commission members. It also led prominent veterans’ groups, including the American Legion and Veterans of Foreign Wars, to send a letter to the commission chair slamming the secret draft and expressing their united opposition to privatizing the VA.
Over the last year, every major GOP
candidate with the exception of Trump has made a vote whoring pilgrimage to
gatherings put on by Concerned Veterans for America (CVA), an almost non-entity
just four years ago, having barely
formed during the 2012 primary cycle. Whereas candidates back in the day were
under pressure from the old-line veterans’ groups to promise undying support
for the Department of Veterans Affairs (VA) and its nationwide network of
hospitals and clinics, the opposite has been true this season. Candidates at
CVA rallies are now out shouting each other to badmouth the VA and its allegedly shabby
treatment of veterans. And all have pledged support for the CVA’s goal of
moving as many vets as possible out of the VA into private care. Even Trump is
calling for more “choice.”
All this raises several questions to a
reflective thinker. I warn you, that
some of my suggestions will offend liberals and conservatives alike.
"Is
the VA medical system as it is today, reflective of the reasons it was
established in the first place?"
I would suggest that the answer is, "Yes,
but should it be?" As originally incepted, the VA was intended to
guarantee that no American who was wounded or disabled in the active service of
his country should ever suffer from lack
of availability of medical care. This dates back to pre-Civil War times, when
even revolutionary veterans were supported by the community in many cases if disabled
or indigent. At that time several significant factors that are relevant today
didn't exist, those being Social Security (and the availability of disability),
Medicare/Medicaid, and the proliferation of Health care insurance.
Let's consider two men. One graduated
high school, entered college and avoided the Vietnam debacle. The other
graduated high school, did not go to college, was drafted and served his two years
as a telephone switchboard operator at an army base in Arizona. Both, by age 25 were healthy and working. The College man works 40 years and
has a major heart attack. He is dependent on private health insurance and, in
the worst case, Medicaid, and maybe even social Security disability. The
draftee, who never left the US, and left the Military in perfect health, suffers
the same trauma 40 years later and has cost free VA medical care. Why? What is the consequence of this non-service
related coverage?
Understand, I believe that any person
who does service for his country, draftee (not any more) or volunteer, deserves
full and lifetime medical
coverage at a VA facility for any service connected medical
condition or disability - physical or emotional . Having said that, we are currently reading of
VA hospitals (as in Phoenix, a retirement
haven) crammed with men and women who simply choose to go there in spite of the
fact that they were, in many cases, physically unaffected by military
service and have no service connected
issues at all.
In like manner, back before retirees of 20
years' service or more had health insurance for life (Tricare, which at 65
becomes the best Medicare supplement on the planet), there was a more legitimate
reason for retirees to use VA facilities. That is simply
no longer true, but in Wisconsin alone, for example, about 11,000 retirees with superb
health care insurance (Tricare or Medicare/Tricare) who should be using private medicine and facilities, clog up VA clinics ,
not because they must, but because they can. I live in the Villages, Florida, and have a
friend, retired from the Navy on 24 years and the General Services
administration for an additional 20. This person insists on using the VA for
most routine, and some extensive medical services, although he has no service
connected health issues. With retirement in the 100K annually range and ultra premium
health care coverage via Medicare and Tricare, I believe this to be wrong, as
every minute spent by the VA on this person who has no need of VA care is taken
from a deserving veteran whose financial straits may make the VA his provider
of last resort.
I must point out that my late brother, a
two year draftee, was treated for non service related medical issues at the VA.
I am glad that he was, because like far too many Americans, he could not afford
high quality health insurance, but should he have been ? I honestly believe
not. His medical issues had absolutely
nothing to do with his military service of 40 years earlier.
So privatizing the VA without changing
eligibility requirements simply adds more profit money to our already bloated medical
establishment, since the VA is non-profit, and all else is definitely not! If the desire is to streamline the VA and
insure top quality care for those who actually deserve it, make a few simple
rule changes, grandfathering those already in the system, of course.
1.
Continue lifetime VA accountability for any and all service connected medical
conditions or disabilities but, if the member is discharged in good physical
and emotional health (as the majority are, since only about 15% actually are deployed in overseas military operations, and about
half of those might ever see combat or hostile fire) that should terminate the
health care relationship between the member and the service. Period. It simply
strikes me as ludicrous that a discharged service person in good health can be
injured on a civilian work site 36 years later and the VA is responsible for
them, rather than Workman's Comp. and the employer. Yet it happens all too frequently. If a condition emerges 10
years after separation, allow for VA reevaluation for service connectedness.
2.
Retirement as a healthy individual from the military, with the attendant
premium healthcare associated with retirement should also sever the medical responsibility
of the VA, unless an emergent condition is identified as having service
connection. VA hospitals are crowded with terminal lung cancer patients whose
decision to smoke for 50 years after a two year draft period has zero to do
with the military and everything to do with a bad life style choice.
3. Of
course, single payer universal health care would make all this irrelevant!
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