As I watched Dr. Ben Carson’s interview on The Dave Ramsey Show, where he suggested that “we don’t need a Department of Veterans Affairs,” and that “the Department of Veterans Affairs should be folded in under the Department of Defense,” it became apparent to myself and anyone else who understands how the two agencies work that Dr. Carson should have been given a crash course on their respective missions before asserting his view on how we need to fix programs and services intended to help veterans. Hopefully, the following will serve this purpose.
The Department of Defense has a mission to win wars and maintain troop readiness. The Department of Veterans Affairs (VA) provides benefits and lifelong care for those who no longer serve in uniform. To conflate the two is simply a misguided notion born from ignorance of what each department does akin to suggesting the Department of Labor and Social Security Administration ought to merge since both deal with aspects of unemployment.
Dr. Carson’s point, while impractical, did highlight the need to make the transition smoother for service members leaving the military and evaluate the impact of rough transitions, in the form of benefit claims backlogs and health care wait lists. He was also right about the impact it has on recruitment for the military of the future and the need for programs that address needs well before discharge. Had he stopped there, his points would have made for a more realistic and productive discussion on how best to serve veterans.
However, there are more insidious dangers in diminishing the role that the VA has historically played since the Continental Congress approved pensions and built medical facilities for disabled veterans in the Eighteenth Century. Perhaps the most critical function carried out by VA today is delivering health care to veterans, many with catastrophic disabilities and profound cognitive impairment. Giving a veteran a “health savings account” so he can shop around for a provider of his choice, as Carson and others have suggested, essentially takes the public off the hook. It puts the onus on the veteran for finding the health care, navigating through the system, determining whether it meets the standard of care, and dealing with the consequences if it goes awry in some way. In doing so, the country in general and Congress in particular will face a decreased obligation to “care for him who shall have born the battle” beyond ensuring the health care voucher made it to the veteran’s mailbox. I am fairly certain that was not what our forbearers intended when they conceptualized a support system for the patriots who sacrificed while defending the homeland.
Dr. Carson’s suggestion to combine the Departments of Defense and VA has a modicum of validity in this way: it is called TRICARE. TRICARE is health insurance provided by the Department of Defense to retired service members and eligible family members. TRICARE beneficiaries can find their own providers and share the cost of their care with the government. But many veterans are not eligible for TRICARE. Also, many of those who are eligible turn to VA because of the department’s time-tested expertise in providing specialized care that has little-to-no private-sector alternatives. Carson did acknowledge that specialized care for severe conditions like traumatic brain injury and amputations should remain in VA. But he overlooks the fact that specialized care systems are not self sustaining and rely on the availability of well resourced tertiary, or supportive, services like oncology and surgery. By eroding those systems through diminished demand as veterans opt for non-VA care, specialized care suffers as well. Simply put, most veterans with the greatest need—veterans with spinal cord injuries, traumatic brain injuries, polytraumas—do want a choice in health care, and that choice is VA. For those veterans, we bear a responsibility to make that choice a viable one.
Those who insist “we don’t need a Department of Veterans Affairs” are likely people who in fact do not need VA care because of good health or cannot access VA care due to ineligibility, as is the case with Dr. Carson. However, frustration in reaction to problems in VA combined with ignorance about what VA does and how it works are not the ingredients for a recipe of success where fixing the department is concerned. Neither is ignoring a 240-year tradition of placing the “affairs of veterans” at the same level of national importance as defending the nation, collecting taxes, managing national parks, and overseeing agricultural matters. Burying the problem underneath another bureaucracy will not make the problem go away.
Sherman Gillums Jr., U.S. Marine, Deputy Executive Director of Paralyzed Veterans of America and paralyzed veteran
Read the story at this link.
See the Dave Ramsey interview at this link.