On Memorial Day, as the United States withdraws its remaining troops from Afghanistan, concluding the one of longest conflicts in US history (the other being Iraq), the question whether perennially “starving the beast” and denying the Veterans Health Administration (VA) the vital funding it needs to care for our wounded soldiers is the best way we can honor veterans.
Problems with the VA extend back decades. In 2001, before two unfunded wars radically increased utilization demands on the VA, the General Accounting Office (GAO) reported that wait times for medical services at VA clinics were excessive. With the two wars, the National Center for Veterans Analysis and Statistics (NCVAS) reported in August 2013 that even while the number of veterans has decreased from 29 million to 23 million over the past decade, the number of disabled veterans has skyrocketed from 2.5 million to 3.5 million.
The cost to serve the survivors of Iraq and Afghanistan is far higher, for while technological advances in battlefield medicine have allowed more fighters to survive initial injuries, it has meant that returning soldiers are coping with more serious injuries and disabilities than ever before. The three-fold spike in Traumatic Brain Injuries (TBI) alone has been devastating to soldier and hospital alike. In 2001, the average Total Disability Compensation Expenditures for a disabled soldier was 1 million dollars; now it is $3 million per veteran.
With nearly half of all returning veterans from Iraq and Afghanistan filing disability claims, the VA has been strained beyond a breaking point. Political will in Washington, DC is lacking to adequately increase funding to meet the demand.
The bureaucracy broke as the VA was strained to a tipping point. The Phoenix, AZ scandal shows how officials who misrepresented their performance so as not to suffer the ire of poor performance, and consequent careers. If indeed they lied and cheated on their reports, they ought to pay the consequences, and one facility leader already has been put on administrative leave
However the root cause of false reporting has less to do with inappropriately ambitious bureaucrats, and more to do with inadequate VA funding. Clearly the administrators dreadfully invented results when the truth was terrible.
However nothing will lead to higher performance and lower wait times more than funding. Successful private hospitals understand this concept well. At Beth Israel Hospital (BIDMC) in Boston, fundraising is an integral part of BIDMC’s operations. Every elevator, every room, and every unit and section of the hospital is named after a donor.
By contrast funding for the VA comes solely from Congress, and Congress has been notably stingy meeting vastly increasing demands. While funding cuts and sequestration did not subtract from the VA’s budget, they did not add to desperately need for additional funds. Ironically those in Congress who most loudly declaim the VA’s present travails are the very same budget-hawk GOP congressmen who have also been chicken-hawks, and who previously actively promoted the dual trillion dollar incursions into Iraq and Afghanistan.
Whereas one might think these politicians would have some shame for their stunning hypocrisy, this series of scandals plays into their political playbook.
Alas, the leader of the Veterans Affairs, General Eric Shinseki, happens to be the very same general who previously embarrassed advocates of the Iraq invasion testifying before Congress the occupation would demand hundreds of thousands of troops. Though proven right, he consequently was in a permanent political bull’s eye, not unlike Gary Larson’s cartoon of two deer, one with target, the other quips, “Bummer of a birthmark, Hal.”
Eric Shinseki didn’t create the compounding problems at the VA, nor did he make the matter worse. He was unfortunately politically naïve enough to take the assignment President Obama awarded him. It was meant as an honor to validate General Shinseki’s political bravery, truth in the face of power, but the general forgot that our most brave soldiers, Congressional Medal of Honor winners, often do not survive the stunning courageous feats for which they are honored.
Douglas Christian was born in Germany and grew up in Boston. He spent a great deal of time growing up with his grandfather, Arthur T. Gregorian, a notable Oriental Rug dealer and importer in Newton Lower Falls, MA. With him, Douglas traveled the world buying rugs in places as diverse as Iran and India. Later, Douglas produced a few books on Oriental Rugs; one was on Armenian Oriental Rugs and the other was published by Rizzoli and co-authored by his uncle entitled, Oriental Rugs of the Silk Route. Douglas attended the Park School in Brookline and Putney School in Vermont, a tiny progressive school in Vermont. He became enthralled with photography and rebuilt a 4×5 camera at Putney. Later during college, he attended the Ansel Adams Workshop at Yosemite, where he determined to pursue photography. He transferred to the School of the Museum of Fine Arts and received a BFA from Tufts. He ran a photographic studio for decades and photographed an array of people including politicos such as William F. Buckley, Jr., George McGovern, Edward Teller and Cesar Chavez. His photography URL is www.photographystudio.com. The pull of life away from family pulled him to try another profession closer to home and he ran a bookstore for several years and later recruited scientists such as Biostatisticians for pharmaceutical companies. His twitter feed is @xiwix His LinkedIn account is
www.linkedin.com/in/proanalysis/. He relocated to Washington, DC with his wife, Ayda Pourasad, a broadcast media librarian.