Category: Veterans’ Affairs Department

(Part 3 of a series. Part 1 can be found here; part 2, here.)

IMO one of the biggest problems with the VA today is blindingly simple.  Unfortunately, that problem will be very difficult to correct.

The VA doesn’t really know what it’s trying to do as an organization.  The problem begins with the VA’s mission statement itself – and as a result, permeates the agency.

Compounding the problem, the VA is also trying to do too damn much. It’s become unmanageable.

. . .

The VA traces its origin to this lofty phrase from President Abraham Lincoln’s Second Inaugural Address:

“. . . . to care for him who shall have borne the battle, and for his widow, and his orphan . . . .”

Indeed, the VA’s formal mission statement includes exactly this phrase – and not a helluva lot else.  It’s the VA’s formally-stated raison d’être.

But what does that phrase really mean?

I regard Abraham Lincoln as the one of the two truly indispensable figures in all of US history; the other IMO was George Washington. Without either IMO today we would not have a United States.

With all due respect to Lincoln, remember:  he was also a politician.   Politicians deal in flowery phrases that, on analysis, are ambiguous as hell by design. It’s simply what they do, and how they get elected.  Then as now, good “sound bites” worked – even when they actually said nothing.

Lincoln’s statement above was no exception. That fine-sounding phrase? It means pretty much whatever the hell you want it to mean.

And that’s IMO essentially what the VA has done:  whatever.  It’s “chased the latest bright shiny object” for the last 50 years..

Just about every time the “good idea fairy” has flitted by during the last 40 or 50 years, the VA seems to have listened to her – cost be damned. Congress and the US public has gone along with it.  Hell, Congress has even added some extra stuff from time to time.

. . .

Theoretically, the VA is organized into a HQ (plus associated staff elements) and three major functional elements:  the Veterans Health Administration, the Veterans Benefits Administration, and the National Cemetery Administration.  A formal organizational chart may be found here.

However, IMO that chart doesn’t really tell anyone very much about what the VA actually does.  So allow me to try.  I’ve looked over their website and done a cursory analysis of what benefits they provide – and what functions the VA actually performs.

In addition to the normal internal administrative and management functions that any large organization performs to maintain itself (payroll, HR, IT, legal, etc . . . ), VA does a whole lot more.  Here’s what I believe is a partial list of what the VA does today to “care for” veterans. I say “believe is a partial list” because I’m pretty sure I’ve missed something.

• Determines who qualifies for VA benefits, and the benefits for which they qualify – including an extensive appeals system
• Conducts or reviews physical examinations to determine/verify physical disability connected with military service
• Provides counseling on available benefits
• Determines who qualifies, for VA benefits purposes, as a POW (this one really p!sses me off – but it’s actually part of Federal law)
• Provides healthcare and dental services
• Operates and maintains hospitals and other healthcare facilities
• Maintains medical records
• Runs pharmacies (traditional and mail-order)
• Provides mental health care services
• Provides or brokers life insurance coverage
• Provides health insurance coverage (CHAMPVA)
• Provides disability compensation, including additional allowances for dependents
• Provides additional grants and allowances for the severely disabled
• Provides financial assistance to defray costs associated with those veterans needing full-time assistance (Aid and Assistance)
• Runs Community Living Centers (formerly VA Nursing Homes)
• Makes arrangements with other, non-VA nursing homes and/or assisted living facilities to care for eligible veterans
• Provides needs-based financial assistance for destitute or nearly-destitute veterans and their dependents or survivors
• Provides counseling services (of various types other than mental health)
• Provides counseling services (of various types) for dependents of selected deceased veterans
• Provides financial benefits to the dependents of selected deceased veterans
• Provides financial assistance for the education for veterans and selected veterans’ dependents
• Operates and maintains perpetual care cemeteries
• Guarantees home loans for qualifying veterans and their survivors
• Provides limited employment placement services for veterans
• Monitors the financial affairs (at least theoretically, thru proxies) of mentally-incompetent veterans receiving financial benefits
• Provides financial assistance to help defray the cost of veteran’s funerals
• Provides headstones for veteran’s graves
• Provides burial flags for veteran’s funerals

Looking at that list, I’ll just be damned if I can figure out just what kind of “business” the VA is running. They determine eligibility for benefits. They hand out money left and right – for a sh!tload of different reasons. They run hospitals, clinics, and pharmacies. They store records. They provide mental health care. They run nursing homes and contract for nursing home services. They run cemeteries and provide headstones. They guarantee loans. They provide counseling services of various types.  They provide health and life insurance. They even provide funeral flags.

It’s not quite the IPhone with it’s ubiquitous “there’s an app for that” slogan.  But it’s pretty close.  If you can think of it, there’s a damn good chance the VA has a program that somehow can help do it.

If you qualify, of course.

At one point, I thought I’d come up with at least two things the VA would not help do:  send someone to go buy vets’ groceries, and walk vets’ dogs.  Then I realized that arguably they even do that too. The VA has a program that provides what are called “Aid and Assistance” payments to qualifying veterans or veterans’ dependents.  These payments are to help defray additional expenses for qualifying veterans and/or their dependents needing full-time assistance with daily living.  I guess some of those Aid and Assistance funds could be used to send someone to go buy the vets’ groceries or walk their dog.

The common thread? If there is one besides “the individual is a veteran or a veteran’s dependent”, I’ll be damned if I can find one. I just don’t see any business case connection.

. . .

Bluntly put: the VA today appears to be trying to be “all things to all people”. And maybe I’m wrong, but IMO it just isn’t possible to do that and to do it successfully.  There’s no wonder the VA has problems in managing all of those things simultaneously.

Further, doing each function takes money – lots of money.  And, bluntly, a lot of them have essentially nothing to do with military service or any disability an individual may have incurred due to such service.

But each function justifies a part of the VA’s budget. Doing more different functions justifies more dollars. So you tell me: unless forced, is the VA ever going to stop doing anything?

I’ll answer myself: “When pigs fly.” IMO the VA today is pretty close to a real-life example of the term “self-licking ice cream cone.”

(Part 2 in a series. Part 1 can be found here.)

OK, now it’s time to start p!ssing people off.  (smile)

IMO there’s another basic problem with the VA, too. Who does the VA work for?

I don’t mean who heads the agency.  And I don’t mean the POTUS, who in theory at least is responsible for all executive agencies of the Federal government.

What I’m asking is:  as an agency, who does the VA work for?

If asked, I’d bet long odds that most would say that since the VA “exists to care for and serve veterans”, that vets are the VA’s “boss”. This will p!ss off a lot of folks, but I hold that is 100% wrong.

The VA indeed exists because of vets. It indeed exists to provide specified services to vets. However, the VA does NOT work for us vets.   We vets are not the VA’s “boss”.

Rather, the VA works for the US taxpayer. Not for the Congress, not for the POTUS, not for themselves (though some certainly act as if that’s the case), not for us vets. The VA works for the US taxpayer.

Why? Because it’s the US taxpayer that pays for every damn thing the VA does. The VA thus owes the US taxpayer – not us vets – its primary loyalty.

It seems to me that at times, the VA forgets that simple fact.

Today, vets are only a rather small fraction of US taxpayers.  In 2012, only a bit over 21 million of the US’s population of over 300 million were vets.

The VA is charged with providing specified services to veterans, while also being “good stewards of public resources”. The first half of that is the part everyone loves – and hates, when it’s being done poorly.. When done successfully, it makes the American public (and US politicians) feel good; it p!sses those same groups off when it goes awry.

It’s also an easy sell to those paying the bills. After all, what could be an easier sell than “helping those who’ve defended the country”?

However, that second part – “good stewardship of public resources” – is equally important. But it’s not as much “fun”, and doesn’t make people feel as good. Indeed, doing that (being a good steward) means you have to tell some people, “I’m sorry, but you just don’t qualify for that benefit.” Yet that too is sometimes necessary if the VA is to faithfully serve and protect the taxpayer’s interests.

And when the media, the public, or politicians hear about such cases, well . .  out come the knives. “How dare they mistreat those poor veterans! They served!”

To an extent, the same is true for any government agency. Any government agency does (or is supposed to do) precisely two things: (1) provide a clearly specified public service of some type, while simultaneously (2) ensuring public funds are efficiently, effectively, and legitimately used. The VA is no different.

This in turns yields a certain internal conflict within the VA. The VA exists to “care for veterans”. But they also have a duty to ensure that public money is spent wisely – and legitimately.

People want to help. That’s natural. They want to see people get “what’s coming to them”. And most VA employees are no different in this respect than anyone else.

But there’s a danger in being overly “helpful” when spending (or approving  spending) public money, particularly when it’s being done to “help people”.  Because where there’s money to be had, there always will be those who try to get some of that money any way they possibly can.

Lord knows we’ve seen that enough times here at TAH. I’ll spare you the examples that come immediately to mind; search this site if you need a few.

So part of the VA – the part that determines eligibility and ratings – IMO absolutely has to be cold-hearted, ruthless, and cynical. They have no other choice. Why? Because they’re the gatekeepers that prevent fraud. In military terms, they’re the perimeter security.

Yet there’s pressure for the VA not to emphasize that role, or to do it at all.  That pressure comes from multiple sources.

The media loves to write about “those poor, mistreated veterans who are getting ignored by the VA” – regardless of whether those folks are truly getting screwed, or are even actually veterans at all. (Read Burkett and Whitley’s book Stolen Valor if you doubt that – or just spend an hour or two poking around on this website.) Ditto the American public, and Congress.

Veteran Service Organizations (VSOs) similarly lobby for their members to get them benefits.  Got turned down?  Get a VSO to help.  Better yet, get them to help in the first place!

VSOs are quite good at this.  They’re also good at lobbying for new bennies for vets.

Did I mention that we vets are a pretty vocal group, too?  And we can be pretty demanding?

Further:  Congress loves to throw money at things.  For the VA, this has come in the form of new benefits, liberalization of criteria, and a general push to “make it easier” for vets to “get their due”.

And I won’t event touch on the issues of dirty insiders and institutional corruption. Both exist, and both cost Uncle Sam a pretty penny.

Hell, part of that pressure is even internally generated. Why? A growing number of vets “helped” means more justification for the VA’s budget in future years. So there’s huge internal pressure working in favor of passing out more money or doing other stuff to “help veterans” with only a cursory examination of the individual’s application.  More bodies helped (or waiting to be helped) means more justification future budget.

In summary: at least part of the VA needs to behave as if it’s an IRS auditor looking over Al Capone’s business records – because they are protecting the US taxpayer from being robbed, and there are those who will try to steal the US taxpayer blind given half the chance. But there’s a great deal of pressure on the VA to act instead like a cross between Mother Teresa and Santa Claus with a full wallet after he’s had half a dozen stiff belts from his hip flask. And for some parts of the VA, that mindset is appropriate.

The VA’s boss – the US taxpayer – demands and deserves both, simultaneously. That’s a damn difficult thing to make work.

It’s even more difficult when an agency doesn’t really understand who they work for, and neither do those who depend on that agency’s services.  And when no one seems to want to hear the words, “Sorry, but you don’t qualify” spoken about anyone.

This subject has been mentally fermenting with me for a while, so I thought it was about time to “bottle it” – so to speak.

I’ve written a short series of articles giving my thoughts on current VA issues – and why they exist.  The first part follows this introduction.

BLUF: IMO the VA today is fundamentally broken. Bluntly, IMO it’s so badly broken and so dysfunctional that as it’s currently structured I’m not sure it can be fixed.

But the VA nonetheless performs a necessary function. It fulfills a moral obligation our nation has to vets who were sickened or injured in the service of our nation. So we can’t simply throw up our hands, say, “F**k it!”, and disband it either. At least some of what the VA does needs to be done.

And I’ll give everyone fair warning: as a group, IMO we vets aren’t blameless, either.

I will absolutely guarantee that at least some of what I say will p!ss off some – and maybe all – of TAH’s readers. So be it.

That’s OK. Freedom is messy sometimes. But I think I can also guarantee that what I say will make you think, at least a little. Maybe collectively we can begin to figure out how to start fixing the problem.

The first 5 articles will discuss some current issues with the VA. I’ve got those written; they’ll be posted over the next few days.

The follow-on articles aren’t yet written. In them, I plan to provide my thoughts on how to bring some sanity to the current chaos. Those ideas won’t be painless. They might or might not be half-baked, or workable at all. But hell, maybe they’ll also stimulate some serious thought – and discussion on how to fix the problem.

Lord knows, the VA needs fixing. Badly.

Without more ado, here’s part one.

VA Issues, Part I: It Ain’t A Resource Problem

First, let’s discuss what the problem with today’s VA is not.

So, tell me:  what is the VA’s annual budget? How much do they spend?   And how much has that gone up since 9/11?

I ask that because I’ll virtually guarantee we’re likely to see claims from the VA that “we need more resources to fix things” due to the recent scandals.  And as we all know Congress loves throwing money at problems, real or imagined – even though as a nation we’re already as broke as a young E4 with a nonworking spouse, 2 kids, and a car payment living “on the economy” in a high-cost area about 2 days before payday.

The underlying question is nonetheless a fair one: does the VA have the resources to do the job it should be doing? IMO, the answer to that question is “Yes – in spades.”

Here’s why I say that.

• In FY2001, which ended on 30 Sep 2001, the VA’s total budget (adjusted for inflation with 2012 as the reference year), was just under $61.45 billion.
• In FY2009, which ended on 30 Sep 2009, the VA’s budget (again adjusted for inflation with 2012 as the reference year) was just under $102.43 billion. That’s an increase of over 2/3 (66.68%) in 8 years.
• This fiscal year, the VA is projected to spend just under $147.95 billion (again, adjusted for inflation with 2012 as the reference year; the actual amount in current dollars is higher). That’s an additional increase over 2009 of 44.44% – in 5 years.
• Next fiscal year (which ends on 30 Sep 2015), the VA is projected to spend over $156.69 billion – again, adjusted for inflation with 2012 as reference.

From 30 Sep 2001 to 30 Sep 2015, the VA’s budget will have grown (in inflation adjusted dollars) from roughly $61.5 billion to nearly $156.7 billion.

That’s an increase of 155% in 14 years.

Let that sink in for a moment. Today, the VA spends over 2 and 1/2 times as much money IN REAL TERMS (that is, after inflation is taken into account) as it did 14 years ago. That is a REAL growth rate of approximately 6.7% a year for 14 years.

Has DoD’s growth mirrored that? Has your paycheck grown similarly, in real terms? The answer to the former is “hell no”.  And I’ll be willing to bet that for virtually everyone reading this, the answer to the second is likely a resounding “no” as well.

If that continues, in another 17 years the VA’s budget will roughly equal – or exceed – that of DoD.

That’s not affordable.

I’m sorry, but we do NOT have over 2.5 times as many veterans today than we did in 2001. Nor, frankly, do we have over 2.5 times as many disabled veterans today than we had in 2001.  So I’m forced to conclude that the VA gets enough money – or maybe more than enough – to do the job it should be doing.

Indeed, the last 14 years has been the greatest sustained period of massively increasing VA spending in US history. Even the period of US involvement in Vietnam (1962-1975) did not show this large a proportional increase. VA spending during that 14-year period did not double, increasing by only approximately 91.3%. And a helluva lot more people were in the military during Vietnam than has been the case during the last 14 years.

Only the immediate aftermath of World War II comes close. And while VA spending was (in 2012 dollars) huge for about 6 years after the war, it peaked in 1947 – and declined by nearly 60% by 1952.

The problem IMO is not caused by a lack of money. The VA is now spending close to 1/3 annually of what DoD spends. And the VA doesn’t employ nearly 2.3 million people full-time, plus another million (or thereabouts) part-time.

And if the cause of the problem isn’t a lack of money, then obviously it’s something else.

 . . .

Notes on Data Sources

VA Budget Data, 1940-2012: https://www.fas.org/sgp/crs/misc/RS22897.pdf

VA budget data for 2013-2015: http://www.va.gov/budget/docs/summary/Fy2015-FastFactsVAsBudgetHighlights.pdf

CPI Inflation Adjustment Factors for 2013-2014: http://data.bls.gov/cgi-bin/cpicalc.pl

Inflation for the current year (affecting the 2015 VA budget’s purchasing power next year) is currently projected to be approx. 1.3%.

ROS sends us a link to Fox News which tells the story of 89-year-old Milton Rackham who never gave up applying for his VA benefits despite the fact that his records were lost in the Missouri fire, and finally scored on his last attempt;

Rackham, who grew up herding cattle in Rigby, Idaho, said he enlisted in the Navy when he was 17 years old — against the wishes of his mother. He fought aboard the PT Boat 81 in the Aleutian Islands for his first year. He later transferred to the South Pacific, where he was severely injured while defending a U.S. ammunition supply ship during a Japanese kamikaze attack. The explosion caused Rackham serious shrapnel wounds that nearly led to the amputation of an arm and leg.

After spending two years in Navy hospitals in Hawaii and Manila, Rackham returned to civilian life in Rigby.

Apparently, the VA had the same information when he applied in 2008 as they had when they awarded him his $800 benefit and $7000 back pay.

“What drove me crazy was that they had the same information in 2008 and they denied me,” he told FoxNews.com. “That’s what blows me out of the water. Ever since 1974, when I first asked for benefits, they’ve had the same information.”

“Sometimes the truth is stranger than fiction,” Rackham said.

[…]

Rackham also indicated that he was advised by friends to appeal the $822 and the $7,000, which amounts to 10 months in back pay, but he opted not to, saying, “I won’t live long enough to go through the VA process one more time.”