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A Federalist idea for fixing for the VA

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Anyone who watches the news has seen the years long scandals at the Veterans Administration- appointment wait times falsified, sloppy surgical procedures, and over prescription of pain killers among them.  Veterans who sacrificed for America were, in many cases, given sub-standard care and in some cases, lost their lives because of it.  The VA is the best example of why bureaucracy is the enemy of any successful government program.  Though the majority of VA employees share a calling to practice medicine and care for Veterans, they are confounded by the fact that the leadership of the VA values progress reports over actual progress.  Many post 9/11 Veterans, myself included, have given up on the VA as a source of medical care due to the chaos.

The VA scandals are not a partisan issue; the problems started under Pres Bush, worsened under Pres Obama, and persist under Pres Trump.  The root cause, of course, is the length of the War of Terror; seven years spent in Iraq (and now adding more) and the 16 years and counting in Afghanistan.  The decision to go to war usually includes an estimate of the cost for military operations, but the cost to care for our warriors after they return home is not included.  Pres Obama passed VA ‘fixes’ through Congress designed to alleviate the backlog of disability claims from the wars, and there were some modest improvements.  Pres Trump has pushed reform through executive as well as Congressional action, with an emphasis on protecting whistle-blowers, but faces push back from the entrenched federal employee unions.

Early America never had a coherent plan for dealing with war veterans.  After the Revolutionary War, individual states authorized pensions for those wounded or disabled by their service.  As the states coalesced into the United States, the federal government began paying benefits to soldiers and their widows, though the states still took the lead in establishing Veteran’s homes to care for those who had served.  The aftermath of the Civil War still saw Veterans mostly tended to by the states they enlisted with.  The turning point for the federal government to take over care of veterans from the states came a decade after World War One as the Great Depression set in- when a large assembly of Veterans descended on Washington DC to demand the bonuses they had been promised by Congress.  In 1930 the Veterans Administration was established, and in 1989 it became a cabinet level agency.  Today, the VA Health Administration employs about 300,000 employees, and the VA overall has another 75,000 in the areas of disability claims, GI bill benefits and transition assistance.  The VA is the largest federal department other than the Department of Defense itself.

And there lies the solution to the problems at the VA and a way to streamline the federal government.  The Veterans Administration should be folded into the Department of Defense.  The cost of providing health care and benefits to our Veterans is directly tied to the size of our military and the wars that our congress chooses to authorize.  The separation of the Department of Defense from the department that will care for the men and women it sends to war is an artificial one that makes no logistical sense.

Bringing the VA under the DOD would present numerous advantages.  While the VA suffers from an employee union that prevents the firing of employees charged with felony theft and falsification of records, the DOD is actively considering changing its policies to remove collective bargaining.  Uniting the military and Veterans into one care system would allow greater flexibility- Soldiers getting care at a VA facility and Veterans at a military hospital.  Moreover, medical assets- from doctors and nurses to equipment- could be shifted from military to Veteran care facilities based on patient volume and need.  There is currently no ability for the VA and military to share medical resources.  Combined with allowing routine medical care at civilian clinics, this streamlining offers a huge potential for cost savings while improving service.

The biggest unintended benefit of joining the war fighters with the Veterans would be a single format for medical records.  Many of the problems at the VA over the last decade have stemmed from one computer system at the Pentagon, and a different, incompatible system at the VA.  A Marine discharged after a tour in Afghanistan has to see all of his military medical records transcribed into the VA system before he/she can be diagnosed properly.  This is bureaucracy at its complete worst.

The last two advantages of moving the VA under the DOD are subtle but important.  First, the Veterans Administration has long been the shield that progressives hide under when conservatives ask what part of the Constitution justifies ridiculous federal spending programs.  “What part of the Constitution is the VA covered under?” they respond.  This is a valid point, and one that conservatives lack an answer to, since we are support Veterans by our patriotic nature.  Positioning the VA as part of the military removes that shield, and opens up the departments of Education, Housing and Urban Development, Energy and the EPA to the rightful criticism they deserve.  Any federalist effort to downsize the scope and role of the federal government will always hit the roadblock of the VA, so let’s take this arrow out of the opposition’s quiver.

Lastly, attaching the VA to the DOD has been an idea bantered around by progressives over the last few years.  Their reasoning for supporting this idea, not surprisingly, has more to do with reigning in the military and the use of it around the world than it does practicality.  Nonetheless, it’s a good likelihood that a federalist solution to the VA could be welcomed by conservatives and liberals alike, attracting more from the left side of the aisle to the federalist cause.

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