TRUMP AND CLINTON TAKE UP ARMS
There’s nothing like veterans’ issues to make politicians go a little loopy.
It’s partly guilt. Most candidates for high office are grateful to veterans for their service, and a little uneasy if they didn’t serve themselves. That second part is not true of Donald Trump, who stressed that he had made “a lot of sacrifices” for his country during his fight with the parents of a slain military hero. Pressed on the nature of said sacrifices, he mentioned something about real estate development.
Hillary Clinton has on occasion told a story about having gone to a Marine recruiting office when she was 26 or 27, and being rejected as too old to sign up. This was when she was teaching law in Arkansas, and about to get married. She’s never explained what was on her mind. There is no sign that Clinton went away feeling she had just made a lot of sacrificies for her country.
While plans for fighting ISIS are the most exciting part of the military debate, one of the most interesting questions we’re currently facing is what to do about veterans’ health care. Almost anybody who received an honorable discharge can sign up for the program, which has small deductibles and extremely generous prescription drug benefits.
The bills are soaring. VA medical care cost the nation about $42 billion in 2010. This year it’s more than $65 billion. While the Veterans Health Administration has a well-deserved reputation for the care of the mentally and physically wounded, its resources are going more and more toward geriatrics. The median age of the roughly 9 million veterans’ health care users is around 65.
Trump and Clinton both promise to eliminate “waste, fraud and abuse.” I believe I speak for everyone when I say we are totally on board.
Trump — who you will be stunned to hear is planning to “make the VA great again” — says he’s going to take care of the problem by firing corrupt and incompetent executives. This is one of those great concepts that doesn’t always work out in the real world. Two years ago, Congress passed a bipartisan bill that gave the VA the power to quickly fire anyone who had been involved in the extensive effort to cover up all those long wait times. So far nine people have been canned.
Bureaucracies are hard to move, and the VA’s is a particularly immobile variation. On Wednesday, the chairman of the House Veterans’ Affairs Committee, Jeff Miller, complained that he was still not getting a straight story on art purchases. While art is definitely a wonderful thing, a cost-conscious bureaucrat would not, in the current political environment, have spent $670,000 on two sculptures that were placed at a rehabilitation center for the blind.
Beyond the war on waste, fraud, abuse and expensive artwork, Clinton and Trump veer off in different directions. Clinton wants the VA to come up with a system that plans every veteran’s individual health care program, using resources in the private sector whenever they’re appropriate. Trump wants to give 9 million VA health clients cards that will allow them to go to any doctor or hospital that treats Medicare patients.
Hillary Clinton hates “privatizing the VA.” In a way, this is a little like the argument over charter schools. Choice is good. But if a big government program loses all its most active, demanding clients, the program can wind up as a shell, serving the most desperate and needy, while political pressure to pay the bills dwindles.
Fans of the VHA — well, fans on the left — point to it as an example of how good socialized medicine could be. The patients, according to most reports, are satisfied. The care is in many cases excellent. And the costs, while astronomical, are still often lower than in the private sector.
Veterans’ health care for everybody! But maybe with less art.
The New York Times