“If It’s Too Expensive, Don’t Send Them Off To War”: Instead Of Austerity And Slogans, VA Needs Full Funding And Accountability
The troubles at the Veterans Administration are not just a serious issue for veterans. They are a serious issue for every American who believes the federal government can and must meet the basic commitments necessary to maintain a civil society.
Unfortunately, that seriousness is not reflected in the frenzy of fingerpointing that has developed as a response to “the public’s outrage over excessive wait times and rigged recordkeeping at Veterans Affairs hospitals” — an outrage that the president of the American Federation of Government Employees (AFGE), the union that represents caregivers for vets refers to as “more than justified.”
There is no question that the VA has a problem that must be addressed.
The question is whether the politicians in Washington are ready to address it.
The most predictable of the political careerists, Republicans and Democrats, seem to think that firing VA Secretary Eric Shinseki will somehow “fix” things, or that the removal of a few failed managers will suddenly create a functional VA. But that is an absurdly insufficient response.
Depending on what reports regarding the agency reveal, there may well be a place for new leadership and a management shakeup. And those changes might briefly produce a fantasy of action and improvement. But that is all it could be: a fantasy. And a cruel fantasy at that.
Neither the immediate crisis, nor serious issues relating to the long-term future of the VA, will be settled with a mere reorganization of upper management. The real issues are closer to the ground. The VA needs to have enough doctors, nurses and aides to provide the care that is needed – and the doctors, nurses and aides who are now on duty must have the resources and the flexibility to assure that this care is delivered in a timely and responsible manner.
That is not now the case.
“When we look deeper into this issue of extended wait times for veterans to receive an appointment, we have to recognize that understaffing is a major culprit,” explains AFGE president J. David Cox Sr. “All around the country, medical facilities are understaffed, with numerous frontline care positions going unfilled. How can the VA expect to keep up with the growing needs of our nation’s heroes if it doesn’t properly staff its facilities?”
AFGE notes that, “According to the Independent Budget for the Department of Veterans Affairs, developed each year by leading veterans groups, funding levels will remain an estimated $2 billion short in FY 2015 and approximately $500 million short for FY 2016.”
Members of Congress – at least those who pay minimal attention to veterans issues – have for some time been aware of the funding shortfall. Yet, too many of them have resisted calls for action.
The reason is that the current Congress is packed with partisans who are more concerned with maintaining an austerity agenda than with caring for Americans who are in need.
Too many members of Congress continue to prattle on about how government is the problem, about how spending must be cut to meet their imagined bottom lines, about how the resources are not there to keep promises to vulnerable Americans – even if the resources are always there for wars of whim and a military-industrial complex that provides daily evidence of the extremes to which waste, fraud and abuse can be taken.
The current Congress includes a striking number of members who express open antipathy to meeting the guarantees that have been made to all Americans, including veterans. These members of Congress are so unthinking in their approach, so cruel in their budgetary calculus, that they casually, in some cases gleefully, presided over a government shutdown last fall.
Republicans get blamed for advancing the austerity agenda, but it is important to remember that more than a few Democrats have compromised with it. And the difference between those who promote austerity and those who make the compromises that allow for austerity means very little to Americans who are stuck on the waiting lists that are created by budgeting that owes more to Ayn Rand tomes than accounting textbooks.
The VA crisis is a wake-up call.
It is time to get serious. It is time to abandon austerity, and to recognize that core commitments cannot be compromised in order to maintain ideological fantasies.
Senate Veteran Affairs Committee chairman Bernie Sanders, I-Vermont, tried to get ahead of a host of issues concerning veterans in February, when he proposed comprehensive legislation to improve VA health care, education and job-training. Though it was strongly backed by the American Legion, Veterans of Foreign Wars, Disabled American Veterans, Iraq and Afghanistan Veterans of America and other organizations representing vets, the measure was blocked when most Senate Republicans opposed it. To Republicans who suggested the measure was too expensive, Sanders said, “”If you think it’s too expensive (to fund veterans programs), then don’t send them off to war.”
Last week, Sanders announced that he would reintroduce his plan to allocate $21 billion more for veterans initiatives over the coming decade. He is, as well, proposing a new VA accountability measure. The latter legislation removes bureaucratic barriers and makes it easier for the Secretary of Veterans Affairs to make management changes that are necessary to protect those who have served in the military.
The Sanders approach recognizes the need to move beyond the failed responses of America’s austerity-minded politicians while at the same time increasing accountability. It’s a smart long-term fix that eschews the easy sloganeering and empty promises of those who would politicize the VA crisis.
Conscious of the urgency of that crisis, the senator plans to move quickly to get both measures to the Senate floor. “In recent years, as a result of the wars in Iraq and Afghanistan, 1.5 million more veterans have entered the VA health care system,” says Sanders. “Congress must do everything possible to make certain that the VA has the financial resources and administrative accountability to provide the high-quality health care and timely access to care that our veterans earned and deserve.”
By: John Nichols, The Nation, May 25, 2014
“Let’s Not Be Misled”: In VA Scandal, Let’s Have Accountability For All — Including Congress
While Congress eagerly prepares its latest political stunt – a resolution to oust Gen. Eric Shinseki as Veterans Affairs Secretary – members might want to consider their own responsibility for the scandalous inadequacy of veterans’ health care. Unlike most of them, especially on the Republican side, Shinseki opposed the incompetent war plans of the Bush administration that left so many American service men and women grievously wounded. And unlike most of them, especially on the Republican side, Shinseki has done much to reduce the backlog of veterans seeking care, despite the congressional failure to provide sufficient funding.
Anyone paying attention knows by now that those secret waiting lists at VA facilities – which may have led to the premature deaths of scores of injured veterans – are a direct consequence of policy decisions made in the White House years before Barack Obama got there. The misguided invasion of Iraq, carried out with insufficient numbers of troops shielded by insufficient armor, led directly to thousands of new cases of traumatic brain injury, post-traumatic stress disorder (PTSD), and other physical and mental illnesses requiring speedy treatment.
A substantial portion of the estimated three-trillion-dollar price of that war is represented by the cost of decent care for veterans. But even as that war raged on, the Bush administration and Republicans in Congress repeatedly refused to appropriate sufficient funding for VA health care. This financial stinginess toward vets was consistent with Bush’s refusal to take any steps to pay for his expensive war (and to protect his skewed tax cuts instead). As Alec McGillis explained in The New Republic, legislators who voted for war while opposing expansion of the VA are hypocrites, particularly when they claim to care about veterans. So are the Republican governors who claim to care about vets but refuse to expand Medicaid, which would provide coverage for more than 250,000 impoverished veterans.
Breaking down the voting record, year after year, the pattern along party lines is clear: Republicans regularly seek cuts in VA funding and oppose Democratic efforts to increase that funding – a pattern that extends back to the first years of the Iraq and Afghan conflicts and continues to this day. As recently as last February, Senate Republicans filibustered a Democratic bill that would have added $20 billion in VA funding over the next decade, which would have built at least 26 new VA health care facilities. The Republicans killed that bill because Democratic leaders refused to add an amendment on Iran sanctions – designed to scuttle the ongoing nuclear negotiations – and because they just don’t want to spend more money on vets. Senator Bernie Sanders, the Vermont independent who chairs the Veterans Affairs Committee, said the costs of the expansion bill would be covered by savings from the end of troop deployments in Iraq and Afghanistan. But with cruel irony, according to The Washington Post, “Republicans indicated that they prefer to dedicate the savings toward deficit reduction” rather than improved services.
What those who have served should get is the kind of care that has made the VA among the most successful health systems in the world (for those who can access its services). Instead they will get political swaggering, as members of Congress seek to score points against President Obama by attacking Shinseki, and dogmatic opportunism, as right-wing ideologues insist the VA is just another big government program to cut or even abolish. The Republicans who are susceptible to such proposals should be very careful, lest they arouse the anger of the normally conservative American Legion and Veterans of Foreign Wars, whose leaders react with anger and outrage to the idea of privatization. As American Legion commander Dan Dellinger said in congressional testimony last week, his organization overwhelmingly “finds that veterans are extremely satisfied with their health care team and medical providers.”
So let’s not be misled about the VA by Washington’s loudmouths and poseurs – the warmongers who never face up to the price of their enthusiasm in lives and treasure. When politicians demand accountability from their betters, including a war hero like Eric Shinseki, let’s remember that they should be held accountable, too.
By: Joe Conason, Editor in Chief, NationalMemo.com; Featured Post, The National Memo, May 23, 2014
“The Comforting Feeling Of Rolling Heads”: It May Make You Feel Better, But Will The Issue Be Solved?
Since the firing of Health and Human Services Director Katherine Sebelius you no longer hear as much about repealing the Affordable Care Act (although certain candidates, most recently Scott Brown, continue to bring it up). But when her head rolled a lot of people seemed to feel better. Now the call is for the head of Veterans Affairs Secretary Eric Shinseki, after dozens of stories cited deaths allegedly related to delayed care for veterans at many of the nation’s 1700 veterans hospitals and treatment centers. If he is let go people may feel better. But will the issue be solved?
The so-called secret lists of veterans waiting for care is troubling, but if it is true then the system as a whole needs an overhaul. This has been apparent for some time and was previously highlighted by the conditions at Walter Reed Hospital and the delay in computerizing records. But these things most likely won’t follow merely by firing the secretary. And although Congress is calling for another investigation, at the same time recent budget proposals by the GOP reduce money for veterans, including cutting health benefits for veterans.
VA hospitals and clinics served 8.76 million veterans last year. In 2008, 37 percent of veterans sought treatment for PTSD and depression. But it is thought that at least half of all veterans suffer from these. Those who report PTSD usually also suffer from many other conditions, some of which do not manifest themselves until more than 5 years after service.
The VA is a huge bureaucracy which serves as the largest single health care system in the country. Along with men and women who served in Iraq and Afghanistan, it still serves veterans of World War II, Korea and Vietnam. Today’s veterans survive injuries that would have quickly killed veterans of earlier wars, including burns, amputations and traumatic brain injuries. And in the past ten years the numbers of vets seeking care has increased exponentially due to our most recent wars, with almost half of those veterans seeking disability compensation for their injuries.
For some perspective: In 2010 the Office of Inspector General for the Department of Health and Human Services reported that bad care contributed to 180,000 deaths of patients in Medicare alone. As many as 440,000 people nationwide suffer from some sort of preventable harm which could have contributed to their death. And that is in our civilian hospitals. Medical error is the third leading cause of death in the US.
Average wait time in hospital emergency rooms has risen. It can take two to four weeks to get an appointment with a specialist (In 2009 people waited an average of 20 days. In 2010 fifty percent of our population felt they could have avoided a trip to the ER if they had been able to get an appointment with their regular doctor People without insurance have received little or no care until recent changes with the implantation of the ACA. Before the passage of the ACA, as many as 45,000 uninsured died each year.
In many small towns, including Savannah, Georgia, waiting times to see a mental health specialist can be at least a month for a psychologist and three to six months for a psychiatrist. At the local VA clinic in Savannah, veterans wait no more than three weeks, and often less, for mental health care and walk-ins who are in crisis are treated immediately.
According to the Associated Press yesterday, a recent report indicated that the department’s internal watchdog found no evidence that delays have caused patient deaths. President Obama has appointed deputy White House chief of staff to review VA policies and procedures.
Further inquiries will be held and outrage will continue to mount until something concrete is done. This is not a new issue. But firing Shinseki is like providing palliative care for end-of-life patients: the patient will be more comfortable but he will still die. Any investigation into the VA has to result in major changes to the system as a whole which will not be possible if the problem is “solved” by yet another head rolling.
By: Lisa Solod, Washington Monthly Political Animal, May 17, 2014
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