Saturday, November 19, 2016

Veterans

Veterans Day was over a week ago, so please forgive me for being tardy in bringing up this subject.

There is talk that privatization of the Veterans Administration is on the table.  Here's a good, lively and fairly short debate on the topic, although the link above should also be perused if you have time.

Donald Trump is considering Jeff Miller to head the VA.  Miller has been a stern critic of the VA in recent years.  On the one hand, should privatization fix the problem of long wait times for veterans awaiting medical care, that would be a net positive.  On the other hand, should privatization destroy a system that is frequently held to be of a higher quality than most providers of healthcare, that would be a very bad thing for those who have fought for their country.  (It is worth noting that the quality of care provided by the VA varies widely by facility and that therefore sweeping comments either way about the quality of VA care need many qualifiers.)

Concerned Veterans for America, funded by the Koch brothers, advocates for privatization.  Other organizations are less sanguine about the prospect:

Large veterans service organizations and a nonpartisan commission that examined the issue have been less than enthusiastic about the prospect of widespread use of outside doctors, warning that the high cost could siphon so much money from veterans hospitals that they would soon become dysfunctional. (emphases added mine)

Veterans have suffered through a lot in the past decade and a half plus, and are well within their rights to feel aggrieved.  Many of them supported Donald Trump and might expect, rightfully, reform of the VA and more generous treatment in the modern social contract generally.

It turns out that during the campaign, Donald Trump had a 10-point plan for veterans.  It is worth considering point by point:

1. Appoint a VA Secretary whose sole purpose will be to serve veterans. Under a Trump Administration, the needs of D.C. bureaucrats will no longer be placed above those of our veterans.

Hard to argue with this.

2. Use the powers of the presidency to remove and discipline the federal employees and managers who have violated the public's trust and failed to carry out the duties on behalf of our veterans.

3. Ask that Congress pass legislation that empowers the Secretary of the VA to discipline or terminate any employee who has jeopardized the health, safety or well-being of a veteran.

Hard to argue with these points either.  Incompetents in any given organization should generally be dismissed, especially when they have violated the public trust.

4. Create a commission to investigate all the fraud, cover-ups, and wrong-doing that has taken place in the VA, and present these findings to Congress to spur legislative reform.

Certain Congressional inquiries have in the past been very effective at rooting out fraud.  Others have been deceitful and pointless.  So this one can go either way.

5. Protect and promote honest employees at the VA who highlight wrongdoing, and guarantee their jobs will be protected.

Ok.

6. Create a private White House hotline, which will be active 24 hours a day answered by a real person. It will be devoted to answering veteran's complaints of wrongdoing at the VA and ensure no complaints fall through the cracks.

Agreed, veterans deserve a real customer service representative and not some automated nonsense, as well as vigorous follow-through on their complaints.  I hope this comes to pass.

7. Stop giving bonuses to any VA employees who are wasting money, and start rewarding employees who seek to improve the VA's service, cut waste, and save lives.

Agreed, people who waste money should not be given bonuses.  This is true in the VA and in any organization.

8. Reform the visa system to ensure veterans are at the front of the line for health services, not the back.

What does this really mean?  Is Trump referring to an intention to require businesses to give veterans preferential treatment with regards to hiring?  If so, that's very hard to argue with.  But what does it have to do with the VA?  Anything?  It's fair to ask whether this point amounts to policy or is just a bunch of words that sound good.

9. Increase the number of mental health care professionals, and allow veteran's to be able to seek mental health care outside of the VA.

There are issues with "choice" leading to a dilution of the strength of the VA itself, discussed above.  However, the premise of increasing the number of mental health care professionals for the VA is a wonderful idea.  It would be nice to see mental health care become more accessible and affordable for all Americans, period.

10. Ensure every veteran has the choice to seek care at the VA or at a private service provider of their own choice. Under a Trump Administration, no veteran will die waiting for service.

Again, "choice" is discussed above.  If increased choice does not terminally cripple the VA, then it would, of course, be great for veterans.  If it does cripple the VA, it might mean that veterans get shoved off into the general American healthcare system, which is not good.

On the whole, it sounds like things could go either way for the VA in coming years.  Hopefully President-elect Trump will improve the situation of medical care for our veterans.  The recent track record of his party in this regard is not reassuringThis summary does not mince words.  In the interest of balance, it should be noted that Democrats have played games with veterans' benefits before.

This is a complex topic and I hope I get the chance to return to it soon.  For now, if you're bored, here's a nice rundown of VA scandals past and present, or at least, fairly recent.  I won't pretend to have any insight into the mind of a veteran, but I certainly hope Donald Trump gets this issue right, as I hope he gets infrastructure right, foreign affairs, you name it.

We'll see!





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