On The Other Hand

On one hand, the President signing an Executive Order to allow veterans to visit any medical facility and have their bills completely covered is extremely valuable to veterans it is what he is doing with his other hand that causes great concern to both veterans themselves and the remainder of the population of the US.

I cannot help being cynical and skeptical about how great such a move might be. The first factor is that this move is "damage control" for a poorly funded, poorly staffed VA medical system. The condition of VA medical services delivery exists at the lowest quality and quantity levels this country has ever seen. In some cases, private delivery of services might be the only care available to a veteran who  to date at the very least has been neglected by the system and at the very worst systematically denied coverage for their conditions.

Missing limbs, paralysis and sensory loss is easy to see and mitigate with hardware and training. Chronic pain, concussive brain damage, PTSD, chemical exposure and depression are essentially invisible and most be proven to be real for the VA to take action. Much of the rehabilitative services veterans need is not something readily available in the private medical sector.

Congress, weapons contractors and Presidents are far more interested in funding and supplying the hardware side of the war equation. They lack the concern and financial interest in dealing with the "residuals" of human disability as the result of their service in the military. Just like corporate missions versus externalizations, the military is expert in breaking people, places and things while being totally inept at making remedies for the people who have been broken. Congress has chronically underfunded the remedies needed by the men and women who now survive the battlefield to return to the civilian world where they cannot cope with the private sector.

The private sector consists of the housing sector, employers who demand 40-50 hours a week for 52 weeks a year, food suppliers, insurance companies and a transportation sector which fails to address the needs of veterans to get to their places they need to go. Not the least of the private sector hurdles is society's attitudes about damaged personalities and broken bodies.

Our Congressional leadership has been indebted to corporate interests who fund their re-election campaigns rather than their constituents. Those corporate interests are enamored of quantity of services over quality. They see the $$ in the numbers of clients served and not in the quality outcomes. As long as there are dollars to treat a condition, there are resources to be applied. Already we have seen Medicaid services being "capitated" and brokered. The broker is paid a fixed amount per client and it is up to the broker to decide how that funding is spent. With a lower outlay of funding for services, they derive a greater overall earnings.

Once the President's Executive Order begins to generate services for veterans there will be an even lower motivation to bring the VA health system up to acceptable standards. Men and women who up to present have not received timely appointments, therapies, and treatment will be shuffled into the general civilian population to compete with them for the services they had expected to get from the VA but now will not.

Going by contemporary evidence there will be zero investment in the private sector infrastructure and staffing levels to handle the influx of veterans who will allegedly be getting quality, timely services in the private sector. This lack of investment was one of the arguments against the ACA. Millions of people would flood the existing medical facilities and make it more difficult for affluent private pay and private insurance patients to obtain prompt services.

So, on one hand... making private services available to veterans is a good short term band-aid. It is not a viable remedy for comprehensive funding and overhaul of VA medical services delivery.