OAKLAND, Calif., Mar. 18, 2010—The U.S. Department of Veterans Affairs (VA) has decided to reexamine the rejected claims of veterans purportedly suffering from “Gulf War syndrome.” Although these cases were closed nearly two decades ago, reopening them may be the first move toward providing compensation to as many as 210,000 veterans for this illness, whose origin remains uncertain in spite of the $340 million put into research. Arriving in time to deliver insight into this unusual health care investigation, a new report divulges the historical precedent of inefficiency and negligence that has plagued the VA since its genesis.
Failure to Provide: Healthcare at the Veterans Administration (March 2010) by Independent Institute Research Fellow Ronald Hamowy sheds light on the role of the VA by following the course of its inception and development. Hamowy, Emeritus Professor of History at the University of Alberta, explains that because the VA is a public organization, the health care provided by its facilities has always lagged behind the standards of private medical institutions. Additionally, he finds that the VA “was a giant first step in undermining the notion of private responsibility for one’s medical treatment.”
Before World War I, the federal government was almost entirely uninvolved in providing direct medical care to veterans, although generous pensions comprised 41.5 percent of the federal budget by 1893. After the war, advocates of nationalized health care for veterans argued that it “would constitute the most efficient and least traumatic system for continuing the care veterans had received while on active duty.”
The Veterans Bureau was consequently established in 1921, but was abolished nine years later due to extensive corruption, and replaced by the Veterans Administration. The VA was given responsibility not only for health care—which was extended to include outpatient and psychiatric services, substance abuse treatment, and care for non-service related illnesses—but also for all other veterans affairs. Additional legislation passed after World War II even contained measures such as unemployment compensation and educational allowances.
While the VA’s budget, payroll, and number of facilities expanded rapidly to become “by far the most extensive [medical program] in the country,” its standard of care stagnated, and complaints of inefficiency and negligence mounted. A 1949 commission “uncovered a staggering amount of waste,” a result of the highly political nature of the VA’s health care system.
The VA was raised to a Cabinet department in 1989, although Hamowy argues that there was “not one substantive argument put forward” that justified doing so. The Cabinet position offered no lasting changes to address the extensive waste and inferior care. Conditions further deteriorated as the U.S. began to intervene in Iraq and Afghanistan, “substantially increasing the number of veterans needing medical care” from an already dilapidated system. Hamowy finds that “the lifetime costs of providing disability benefits and medical care to the veterans of these two wars . . . will amount to between $350 and $700 billion.”
The VA has clearly overstepped its original role as a health care provider for veterans with service-related disabilities, a raison d'être that the author believes “was extremely weak to begin with.” As new evidence of the VA’s inefficiency reaches the news daily, such as having to reconsider the Gulf War syndrome cases, Failure to Provide presents a compelling examination of the rationale behind the administration that “paved the way for instituting a national system of socialized medicine.”
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