By Mike Andrew
The full story of the scandal enveloping Veterans Administration healthcare policies still waits to be written, but what is clear even now is that the real scandal lies at the feet of neo-con Republicans.
Many media venues simply repeated the surface story that veterans were being denied care and VA officials were falsifying reports to conceal that fact. They never asked how and why that would happen, and that is a scandal in itself.
Here are the facts:
In the 12 years the US has been at war in Afghanistan and Iraq, more than 2 million men and women have served in uniform.
Many returned home with complex medical issues, including traumatic brain injuries, multiple amputations, and PTSD (post-traumatic stress disorder). More than half of them served several successive tours of combat duty. According to the Iraq and Afghanistan Veterans of America, the suicide rate for Iraq and Afghanistan vets is three times that of the population as a whole.
On top of that, more than seven million Vietnam veterans are now seniors, and many require more care than they previously did.
While veterans who get their healthcare from VA hospitals report that standards of care are very good to excellent, wait times are too long and getting longer.
These circumstances have stressed the existing VA resources to the breaking point and created a demand for additional resources and funding.
In 2013 House Democrats proposed the Veterans Backlog Reduction Act, but it has languished without even a committee hearing due to opposition by Republican House leaders.
In February the Obama Administration proposed a bill to allocate an additional $24 billion in spending for the VA, which was to include funding for 27 new medical facilities to help meet the demand and relieve the overburdened VA system.
However, Republicans in the Senate blocked this effort too, because they opposed more federal spending. In fact, Republicans would not even allow debate on the administration’s proposal. With 41 of 45 Senate Republicans voting to block the bill, they successfully filibustered more VA funding.
Among those who voted to kill additional funding were many who later professed to be appalled that the VA failed to treat patients in a timely way.
There is an additional factor to think about: VA administrators get so-called “merit pay.” In other words, they operate under a kind of piece-work system for managers, where they get bonuses for booking a certain number of patients within a certain amount of time.
This turned out to be an open invitation to cook the books. Some officials set up elaborate schemes to falsify patients’ wait times in order to comply with VA rules about prompt treatment and thus earn “merit pay” bonuses.
According to internal VA investigations, pressure was placed by VA managers on schedulers to use phony lists or engage in other fraudulent practices to make wait times appear shorter.
One internal VA investigation revealed that at least 35 veterans had died while waiting for care at the Phoenix VA hospital. At least 1700 veterans at the Phoenix VA who asked for an appointment were never placed on an official wait list. Another internal VA audit identified 120,000 veterans who were left waiting or never got care.
The neo-con Republicans who were responsible for the wars in Afghanistan and Iraq (and parenthetically for the collapse of the Iraqi government they installed), tried to deal with the aftermath of those wars in the same way they tried to fight – on the cheap.
They sent men and women into combat initially without adequate equipment, forced them to serve multiple tours of duty in combat zones, and then refused to pay for their medical care when they returned.
They then pretended to be shocked – shocked! – that veterans were not getting timely care. Their actions are both shameful and shameless.
On June 10, the House passed a bill that would allow veterans to use non- VA facilities under certain conditions.
The next day, the Senate passed a similar bill sponsored by Sen. Bernie Sanders (I-VT) and Sen. John McCain (R-AZ). The bills now need to be reconciled by a joint House-Senate committee.
While these bills will help deal with the backlog of veterans who require medical treatment, they still do not deal with the long-term viability of VA healthcare services. There is also a danger that this stopgap system will become the new normal and that future efforts to fund the VA at a rational level will be put on the back burner.
The issue once again is whether Congress will address the needs of human beings – in this case, human beings who had to pay the price for a dreadful lapse in political leadership.