- While no one joins the military with a goal to be a millionaire, we do seek financial stability through our pay and benefits.
- If the VHA continues to be starve of needed funding, its staffing levels will further decline and then its nationwide network of public hospitals and clinics will be in jeopardy.
- Most constructive VA critics know that outsourcing of veterans’ care is not the answer.
Recently, I received an inquiry regarding the difference (if any) between a “military service member” and a “veteran.” Often, the term veteran or vet is used as a catch all term for both active duty, retired and former service members. President Abraham Lincoln established the framework of the Department of Veterans Affairs with this quote “to care for him who shall have borne the battle and for his widow, and his orphan.”
My brief explanation is simply to say that military members “are” serving while vets “have” served. Nonetheless, the Departments of Defense (DOD) and Veterans Affairs (VA) share a close relationship. They are inextricably linked and bound to each other. The two Departments share the some of the same personnel with all veterans starting as military service members.
Look at combat as a funnel between the largest and second largest federal government organizations. Entering at the top of the funnel, via the Department of Defense (DOD), are working-class men and women who enlist in the military, often to escape difficult economic circumstances.
During their tours of duty, hundreds of thousands of service members end up sustaining great physical and psychological harm. Ironically, many experience further complications due to financial distress. While no one joins the military with a goal to be a millionaire, we do seek financial stability through our pay and benefits. Later, the need for disability benefits or health care—“workers’ compensation” as it’s called in the civilian world—is met, at the other end of the funnel, by the Department of Veterans Affairs (VA).
Since the DOD has a far bigger fan club on Capitol Hill than the VA, it gets a larger budget. Meanwhile, the VA runs the Veterans Health Administration (VHA), which delivers integrated healthcare to over nine million patients and is severely underfunded. When the DOD (or the White House acting on its behalf) asks for a bigger budget, the House and Senate—with few dissenters—vies for which body can allocate more money faster.
Rick Weidman, Executive Director for Government and Policy Affairs at the Vietnam Veterans of America and personal friend, is a leading defender of the VHA who notes, with wry understatement, that “the military is a collection of very dangerous occupations.”
Obviously, the best-known hazards of military service are encountered in combat. Service men and women assigned to front-line duty in Iraq, Afghanistan, or elsewhere have returned with gun/shrapnel wounds, lost limbs, traumatic brain injuries, PTSD or Military Sexual Trauma (MST) and respiratory problems from burn-pits and who knows what type of other exposures. During non-combat duty, even more military personnel suffer job-related injuries or illnesses similar to those experienced by millions of blue-collar workers in civilian life.
If the VHA continues to be starve of needed funding, its staffing levels will further decline and then its nationwide network of public hospitals and clinics will be in jeopardy. Currently, there are over 49,000 VHA existing vacancies.
The VHA is a critical benefit to veteran wellness. Veterans who qualify for VHA medical benefits get a disability rating based on a particular service-related illness or injury. Veterans in the VHA system become eligible for unrelated treatment, then or later–from hip replacements to cancer surgery and hospice care.
VHA patients get the benefit of an integrated national network of public hospitals and clinics. All VHA doctors, nurses, and therapists are salaried, not paid on a “fee for service” basis. About a third of the VHA’s 300,000 staff members are veterans themselves. This helps create a unique culture of empathy and solidarity between patients and providers that has no counterpart in American medicine.
Combat veterans often suffer from mental health issues, like PTSD. Even men now in their eighties or nineties, who witnessed nightmarish scenes of death and destruction many decades ago in Korea or World War II, seek VHA help for disturbed sleep today. Veterans who suffer from mental and behavioral health problems—whether acquired in or exacerbated by military service— are more prone to substance abuse, particularly opioid use if chronic pain is involved.
They also become a bigger suicide risk. An estimated 20 veterans a day kill themselves, although three-quarters of those have never been to the VHA for treatment. Between 2006 and 2015, the number of veterans receiving specialized mental health care at the VHA rose from 900,000 annually to 1.6 million, a reflection of the ongoing “Price of Freedom”.
VHA caregivers are trained to identify and treat these very specific wounds of war. Every VHA employee receives training in how to better recognize and assist patients who are suicidal. Thousands of VHA mental health providers are taught the latest evidence-based treatments for PTSD. Outside the VHA, only 30% of private sector providers use such treatments.
VHA Primary care providers and specialists are better trained to recognize the kind of diseases produced by toxic exposures, such as Agent Orange related diabetes or burn-pit created respiratory problems.
Most constructive VA critics know that outsourcing of veterans’ care is not the answer. That’s why VHA care givers, and their unions and allied veterans organizations, are opposed to VA privatization.
This is not just a fight to maintain decent medical coverage for eligible veterans. It’s a struggle to defend an obligated national healthcare system for in those (in my words) who have “Borne the Burden of Battle, Felt the Sting of Combat and will Forever Recall the Sounds of Shots Fired in Anger.”