What makes this a particular shame is that in the Clinton years, veterans’ health care — like the Federal Emergency Management Agency — became a shining example of how good leadership can revitalize a troubled government program. By the early years of this decade the Veterans Health Administration was, by many measures, providing the highest-quality health care in America. (It probably still is: Walter Reed is a military facility, not run by the V.H.A.)
But as with FEMA, the Bush administration has done all it can to undermine that achievement. And the Walter Reed scandal is another Hurricane Katrina: the moment when the administration’s misgovernment became obvious to everyone.
The problem starts with money. The administration uses carefully cooked numbers to pretend that it has been generous to veterans, but the historical data contained in its own budget for fiscal 2008 tell the true story. The quagmire in Iraq has vastly increased the demands on the Veterans Administration, yet since 2001 federal outlays for veterans’ medical care have actually lagged behind overall national health spending.
To save money, the administration has been charging veterans for many formerly free services. For example, in 2005 Salon reported that some Walter Reed patients were forced to pay hundreds of dollars each month for their meals.
More important, the administration has broken longstanding promises of lifetime health care to those who defend our nation. Two months before the invasion of Iraq the V.H.A., which previously offered care to all veterans, introduced severe new restrictions on who is entitled to enroll in its health care system. As the agency’s Web site helpfully explains, veterans whose income exceeds as little as $27,790 a year, and who lack “special eligibilities such as a compensable service connected condition or recent combat service,” will be turned away.
So when you hear stories of veterans who spend months or years fighting to get the care they deserve, trying to prove that their injuries are service-related, remember this: all this red tape was created not by the inherent inefficiency of government bureaucracy, but by the Bush administration’s penny-pinching.
But money is only part of the problem.
We know from Hurricane Katrina postmortems that one of the factors degrading FEMA’s effectiveness was the Bush administration’s relentless push to outsource and privatize disaster management, which demoralized government employees and drove away many of the agency’s most experienced professionals. It appears that the same thing has been happening to veterans’ care.
The redoubtable Henry Waxman, chairman of the House Committee on Oversight and Government Reform, points out that IAP Worldwide Services, a company run by two former Halliburton executives, received a large contract to run Walter Reed under suspicious circumstances: the Army reversed the results of an audit concluding that government employees could do the job more cheaply.
And Mr. Waxman, who will be holding a hearing on the issue today, appears to have solid evidence, including an internal Walter Reed memo from last year, that the prospect of privatization led to a FEMA-type exodus of skilled personnel.
Oh how we need hearings and subpoenas.