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The Leavenworth Times - Leavenworth, KS
  • LV Times columnist: Origins of the VA health care crisis

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  • One of the perennial delusions of national leaders in the aftermath of a long, costly war is the idea the end of hostilities will yield a large financial “peace dividend.”
    This “peace dividend” almost never materializes because long, costly wars mean the nation will incur the heavy expenses involved in taking care of veterans of the war. And, not only are these expenses quite heavy, they go on for a very long time.
    It's been nearly 150 years since Lee surrendered to Grant in 1865, but there is still one quite elderly woman getting money from the Veterans’ Administration for her father’s service in the Civil War. It's been 116 years since the end of the Spanish-American War, but there are still 18 people getting regular payments from the VA for the service of a relative in that war.
    According to the Census Bureau, there were 21.4 million U.S. veterans in 2012. Most of these veterans fall into one of the following three groupings, and each of these groups have certain special health needs that drive up costs of VA hospitals:
    • World War II and Korean War veterans. These men and women are in their 80s and 90s,
    and are vulnerable to the often quite heavy medical expenses associated with a final illness.
    • Vietnam veterans. These individuals are in their 60s for the most part — they are at the
    age when the body begins to wear out and medical expenses start to rise rapidly. Also, in
    the case of Vietnam veterans, medical issues such as Agent Orange Syndrome and
    PTSD were often not acknowledged for a long time, meaning that when the reality of these
    conditions was finally accepted as real, the health of the afflicted individual had seriously
    deteriorated.
    • Veterans of Desert Shield/Desert Storm, the Iraq War, and Afghanistan War. These
    veterans have two special health problems: First, major improvements in battlefield
    medicine have meant that a much higher percentage of severely wounded soldiers survived
    than in earlier wars, but this higher survival rate also means there are a large number of
    severely injured veterans who are going to need extensive medical care for the rest of their
    lives.
    Second, in Vietnam most veterans served one tour of duty — in the Iraq and Afghanistan
    wars it's not uncommon for soldiers to have served three or four tours of duty. And, the
    longer soldiers are in combat zones, the greater the likelihood they will be diagnosed with
    PTSD.
    Anyone remotely familiar with the situation of the nation’s veterans has known for some time that these three cohorts of veterans, each with special medical needs, was putting an enormous strain on the inadequately funded VA hospital system.  So, the current scandal of poor treatment of veterans by the VA does not come out of nowhere — it has been building for quite some time.
    Page 2 of 2 - Why then was this growing crisis “swept under the rug?”
    The answer,  I feel, is rooted in certain characteristics of the contemporary U.S. political class.
    Right now, in Congress, there is the lowest percentage of veterans since before World War II — the representation of veterans in Congress has been steadily falling for more than two decades.
    The House and Senate that voted in September 2002 to authorize the invasion of Iraq had 535 voting members — of these 535 members, exactly one had a son or daughter in the military. Put simply, there is a vast gulf between those who make the decisions to go to war and those who are sent to war.
    With the almost universal lack of personal contact on the part of those in power with those who serve it is not surprising there is such a lack of awareness of the festering VA crisis.
    There is no quick, easy answer to this gulf in U.S. society, but one practical suggestion I would make is for people in the political class to spend some time developing personal ties with people on active duty in the military.
    And, by personal ties I do not mean the superficial “photo ops” members of the political class love to do with soldiers — don’t just get your picture taken with these men and women, spend time getting to know them.

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