The V.A. (continued)

Linking to Part 2 of Phillip Longman's assessment of medical care at the V.A.:

Now let’s consider another, more serious, and often conflated wait time issue surrounding the VA—one that also been bringing forth all kinds of claims and accusations that are in desperate need of being put into context. I’m talking about the huge backlog of vets caught in the often protracted process of just trying to establish their eligibility for VA care.

This issue is confusing to most people, including many in the military, because they assume that vets are legally entitled to VA care, just like most seniors are entitled to Medicare or Social Security. But VA care is not an entitlement. Rather, reflecting the public’s deeply conflicted and often changing views about veterans, access to VA care is limited to vets who can establish that are “deserving” according to convoluted, arcane, and often impossible-to-prove sets of ever evolving metrics and standards.

. . . 

The fundamental reason for the still huge backlog of cases does not lie with inefficiencies of the VA’s bureaucrats, most of whom are vets themselves. Nor does it come from an increase in the numbers of vets because, as explained in my last post, the number of veterans is actually shrinking dramatically. Rather, it fundamentally lies with the American people and their representatives in Congress, who despite all their fine talk about honoring those who have served their country, have tasked the VA with administering laws and regulations that presume most vets don’t deserve VA care unless they can prove otherwise.

It wasn’t always so. As I describe in my book, the Clinton Administration opened the doors to the VA in 1996 to anyone with an honorable discharge, and many folks who got in then remain grandfathered. But the Bush Administration slammed that door shut again in 2003, and while it has reopened a bit under Obama, we are still spending enormous resources enforcing policies designed to exclude most vets from VA care.