The Veterans Administration is broken. Let’s fix it!

American veterans of military service are entitled to the highest quality medical care and treatment this country can provide when they need it and where the need it.

The VA medical system is a citadel of inefficiency and a monument to bureaucracy. It’s procedures are a Gordian knot of red tape. A veteran who needs medical care and treatment must navigate a labyrinth of checkpoints staffed by uncaring, unfeeling, and inept unaccountable individuals protected by the federal civil service and rewarded with benefits far beyond the value of their contributions to the members of our Armed Forces for whom they are supposed to be providing medical care and treatment.

The VA has forgotten the admonition of General Omar Bradley in 1945, “We are dealing with [veterans] not procedures; with their problems, not ours.”

Instead of high quality everywhere, the quality of medical care and treatment at any of the 1700 VA medical centers and outpatient clinics located throughout the country varies by facility and region

The VA is also supposed to provide non-healthcare benefits include disability compensation, vocational rehabilitation, education assistance, home loans, and life insurance. To some extent they do provide these services and they do provide burial and memorial benefits to eligible veterans and family members at 135 national cemeteries.

On March 4, 1865, as the War Between the States was coming to a bloody end, in his Second Inaugural Address, President Abraham Lincoln declared,
“With malice toward none, with charity for all, with firmness in the right as God gives us to see the right, let us strive on to finish the work we are in, to bind up the nation’s wounds, to care for him who shall have borne the battle and for his widow, and his orphan, ,,,” affirming the nation’s obligations to its veterans.

Recognizing that women fired cannons in the Revolutionary War, led troops in the Civil War , flew bombers in World War II, and recently have been fighting and dying in the Middle East, Congress in a frenzy of political correctness has suggested replacing Lincoln’s original words with “To fulfill President Lincoln’s promise to care for those ‘who shall have borne the battle’ and for their families, caregivers, and survivors.” Their efforts would be more meaningful if the provided the medical care and treatment that all American veterans, men and women, need and to which they are entitled.

The essentially unaccountable bureaucrats protected by civil service tenure who really run the VA medical system and the Senators and Representatives who care more about weapons procurement and contracts for campaign contributors than our men and women in uniform are responsible for the abject failure of the VA to provide high quality medical care and treatment for our veterans.

The dirty little secret VA policy

In the summer of 1981, during the Agent Orange litigation evidence of the horrendous treatment of Vietnam combat veterans was uncovered at the Los Angeles VA hospital. When the matter was brought to the attention of the Veterans Administration, their bureaucrats said, “The Vietnam combat veterans will just have to wait their turn; we still have veterans of World War II and the Korean War to take care of!”

Apparently the same attitude prevails today. The veterans of our wars in the Middle East and Afghanistan will have to wait until the Veterans Administration bureaucracy is finished with its lackadaisical and unenthusiastic treatment of the Vietnam combat veterans.

Apparently when President George W. Bush decided to go to war against Iraq, and later Afghanistan, he forgot to tell the Veterans Administration bureaucracy and the Congress to prepare for the casualties of those wars.

Subsequent Presidents and Congresses have done little, if anything, to remedy this oversight.

Wars, war wounds, and medical care and treatment for veterans

With each war the United States has fought since the American Revolution medical advances have saved the lives of seriously wounded combat veterans. The number of veterans surviving serious spinal cord injuries, multiple amputations, and traumatic brain injuries has increased exponentially from war to war.

Since the War in Southeast Asia medical science finally recognizes that the concussive power of modern ordinance can produce serious damage to the human nervous system without any clear evidence of physical trauma. The damage is a lot greater than tinnitus or ringing in the ears and loss of hearing. In addition, the stress of combat in a war without clearly defined goals and objectives to which our individual members of the armed forces can relate leads to serious problems when they return to civilian life and try to live among people who cannot understand much less appreciate the meaning of combat.

Vietnam combat veterans had to sue the VA in 1981

In 1981, the Vietnam combat veterans who brought the class action against Agent Orange took the VA to the federal courts (CV–81–0055, USDC/EDNY). The claim was simple: Vietnam combat veterans had a right to timely and complete medical care for any injury, disease or disability resulting from their service in Vietnam. They charged that VA policy as it affected Vietnam combat veterans, was so barbaric and unfeeling as to constitute the kind of “cruel and inhuman punishment” prohibited by the Eighth Amendment to the United States Constitution—part of the Bill of Rights; and those individual bureaucrats responsible for VA policy conspired to deny the constitutional rights of the veterans and their families.

Very little has changed at the Veterans Administration since 1981 as far as the humane and compassionate treatment of all our veterans is concerned.

Combat veterans earned the right to quality medical care throughout their lives

We must never forget our veterans.

VA disregard for our American combat veterans has been the same since they came home from the “Police Action” in Korea. “Frozen and Forgotten” (Korea), “Sprayed and Betrayed” (Vietnam), “Gassed and Harassed” (Gulf War I), or “Scattered Limbs & Scrambled Brains” (Afghanistan & Iraq). The indifference and lack of concern for the health and well-being of our American fighting men and women by VA Administrators must stop. Now.

The idea that an American combat veteran must prove that their illness, disease, or death, not otherwise attributable to some determinable event subsequent to combat is “service connected” is outrageous and demeaning. It is an insult to the integrity of the men and women who served our country without regard to whether they came home whole, crippled, or in a body bag.

Provide the medical care and treatment combat veterans need

It is time for our elected officials to remove the issue of what actually causes the illness, malaise, and deaths among our combat veterans from consideration by the VA or any other alphabet agency of government and leave it to the doctors who care for these veterans in their hometowns throughout the country.

Quality medical care and treatment for all combat veterans must be a right. An entitlement. It has been earned. It is not a reward and it is certainly not just some token of appreciation from a grateful nation.

The War in Southeast Asia

In 1979, when the Agent Orange litigation began, the American combat veterans of the War in Southeast Asia had been abandoned by their elected officials, their fellow Americans, and in some cases, even their families. In 1979, the VA was the most dangerous enemy a Viet Nam combat veteran faced since leaving the VC and NVA in the jungles of Southeast Asia.

It is different today because the Agent Orange litigation provided the focus that the Viet Nam veterans needed to come together and ask the questions that the media would eventually present first to the American People, then the Congress and the President of the United States. But before the real answers came, many veterans died and some of the veterans’ children suffered catastrophic polygenetic birth defects. All the while a solid phalanx of war contractors and government bureaucrats looked the other way.

The men and women who served during our most recent wars in Iraq and Afghanistan should not have to wait as long as the Viet Nam veterans did. They must not be required to grovel before a federal judge appointed for life and accountable to no one pleading for just the opportunity to present the evidence of their afflictions. Never again.

Solve the problem. Make the VA part of the DOD

The President of the United States should eliminate the position of Secretary of Veterans Affairs and its attendant bureaucracy from the Cabinet and bring the Veterans Administration under the direct supervision and control of the Secretary of Defense (SECDEF) as the Fourth Military Department.

The United States military is a family and its members should be cared for as a family from the time they enlist until their lives end. Treat the VA healthcare system as a unit of the Armed Forces of the United States and part of the Department of Defense.

SECDEF should immediately establish a command and control system for the Veterans Administration which is no less efficient and effective than that of the military.

To aid the integration of the VA into the Armed Forces, the House and Senate Committees on Veterans Affairs should become Subcommittees of the House and Senate Armed Services Committees.

Dismantle the VA bureaucracy from the top down

Just keep the dedicated health care providers and hardworking care givers!

Max Cleland, a triple amputee Vietnam combat veteran during the 1980s, and later, Eric Shinseki, another Vietnam combat veteran and former chairman of the Joint Chiefs of Staff, during their time as Directors of the VA were pilloried by Congressional demagogues for the failures of the essentially unaccountable bureaucrats protected by the federal civil service who really run the VA medical system. A more recent Veterans Affairs Secretary, David Shulkin, a medical doctor and former hospital executive and former undersecretary at the VA, was fired for moving too slowly to privatize the VA.

The Chairs of the three Military Departments of the DOD have direct authority over each and every man and woman in our armed services and each is responsible through the SECDEF only to the President of the United States as commander-in-chief.

The Secretary of Veterans Affairs, however, although a member of the President’s cabinet, has no real and meaningful authority over the essentially unaccountable bureaucrats protected by the federal civil service system who actually manage the day-to-day affairs of the VA medical system.

There is really no place for the federal civil service system in our Veterans Administration any more than there is any place for civil service rules and regulations in our Armed Forces.

A modest proposal

Eliminate the position of Secretary of Veterans Affairs and its attendant bureaucracy from the civilian Cabinet of the President and bring the Veterans Administration under the direct supervision and control of the Secretary of Defense as the fourth DOD Department.
Treat the VA healthcare system as a unit of the Armed Forces of the United States and a Department of the Department of Defense.
Establish a command and control system for the Veterans Administration which is no less efficient and effective than that provided for Special Operations units in the military.
Establish as the unwavering goal of the entire military healthcare system for veterans of military service integration of medical care and treatment with improvement in the quality of life and living for each veteran and expediting their return to substantial gainful employment in the national economy.
Integrate the VA hospitals, the VA nursing homes, the VA long-term care facilities, the VA outpatient clinics, and the VA dispensaries in a single DOD Department and impose military discipline and appropriate command and control systems.
Identify and review the function, authority, and exercise of power, authority, and control by every individual at every VA healthcare facility who does not provide direct healthcare to the veterans and in most cases eliminate their positions.
Integrate and consolidate the medical records of veterans with the established military medical record system. Utilize modern methods of data mining to determine the timeliness and effectiveness of the medical care and treatment provided to our veterans.
Assure that the medical treatment staff at VA health care facilities has an understanding and appreciation of service in the Armed Forces particularly the acute and chronic effects of combat by requiring every career health care professional to rotate at least “365 days” providing medical care and treatment in a war zone.
Promote and encourage sharing of information about the medical condition of a veteran among all the healthcare professionals who may be engaged in treating that veteran.
Provide procedures and promulgate rules and regulations for a civilian equivalent of a summary court-martial for any VA healthcare facility employee charged with neglect or incompetence in the care and treatment of individual veteran patients at their healthcare facility.

Any change in the administration and management of the Veterans Administration is doomed to failure, however, unless the ineffective procedures, rules and regulations which cripple military procurement practices and have led to overpriced, suboptimal weapons systems since the conclusion of the Korean war are overhauled and brought into conformity with modern business practices.

It is all about accountability

Just as our elected officials are supposed to be accountable to the sovereign people of the United States on Election Day, so must the myriad of self-perpetuating, self-sufficient agencies and officials of the federal bureaucracy remain accountable to the people. Unfortunately, the Veterans Administration has been responsible to no one but themselves, and essentially immune from criticism or public action.

One of the strange inconsistencies of bureaucracy and the entire Executive branch of federal and State government is their intransigent opposition to public scrutiny. Our investigative media have chronicled so many tales of evasion, suppression of information and a general policy of restricting public information that even assuming the best of motives on the part of bureaucrats and politicians can only be explained by a kind of totalitarian paternalism inconsistent with the Constitution.

The VA medical system, once the best in the nation, has fallen on hard times

America can no longer afford competing government health care systems which assure only marginal care for those who need medical attention and ever-increasing burdens on the taxpayers for a constantly expanding bureaucracy which is not accountable for the money it spends or the quality of the care it provides.

For those combat veterans who can no longer work, the Social Security Disability System should provide benefits to disabled veterans just as it does to alcoholics, drug addicts, and those whose antisocial attitudes and activities rise to the level of “behavioral disorders.”

We send the best and bravest of our young men and women to die for what our elected officials say we believe in. But when they return home, they are forgotten or worse.

We must always remember and never forget our combat veterans.