No to war; yes to veterans’ needs

By BILL ONASCH

 American socialists, in the tradition of the great Eugene V. Debs, oppose wars fought to advance the corporate and financial agenda of the American ruling capitalist class. That’s all of them since the last just war—the Civil War that eliminated slavery.

But while we object to the way they are used, we don’t view the ranks of the armed forces as part of our class enemy. They are mainly sons and daughters of the working class. In past wars they were mostly drafted. Today they are all volunteers.

They sign up for various reasons. In tough economic times, many young people are attracted by the security of “three hots and a cot” while earning the prospect of financial assistance for education. Some immigrants, and children of undocumented immigrants, volunteer in return for vague promises of citizenship as a reward.

But there was also a palpable surge of patriotic outrage after the 9-11 attacks that Washington blamed on the government of Afghanistan. Later, many initially volunteered to stop Iraq’s Saddam Hussein from using “weapons of mass destruction.” Both of these claims leading to two bloody wars, as well as attacks on civil liberties at home and squandering trillions of dollars, have since been proved to be lies.

Socialists have centered our opposition on the deceitful policy of the politicians and brass hats—not the ranks of the military who think they are serving their country. Because we genuinely care about these sisters and brothers we try to get them out of harm’s way by demanding they all be brought home where they belong now.And we further demand that society accept responsibility for assisting those re-entering civilian life, who did what they perceived to be their duty.

After World War II, the GI Bill did a good job in not only assuring health care for returning vets but also education and even loan guarantees for buying a house. These benefits played a crucial role in avoiding a return to economic depression as the war-time mobilization wound down.

Vietnam vets did not fare as well. For decades, the military resisted recognizing environmental disabilities caused by practices such as the widespread use of Agent Orange defoliants. And little was done to help the many who became addicted to drugs and alcohol “in country.”

Vets today are having a tougher time yet. The politicians and many in the media call them heros. But these heros have a much higher unemployment rate than the general population—over 20 percent for the 18-24 age group, 9.5 percent for 24-35. Ten percent of those who have jobs earn less than $10 an hour. On any given night, about 60,000 vets are homeless and 140,000 are incarcerated.

Advances in medical science have greatly lowered fatality rates among wounded and injured troops on the battlefield. Saving lives is a good thing, but one result is many more being left with varying degrees of debilitation that will require medical attention for life. Many of the 51,000 wounded in Iraq and Afghanistan fall into that category.

In addition to these physical wounds, hundreds of thousands more suffer from psychological afflictions such as PTSD. Active-duty soldiers with such disorders, which can lead to behavioral problems even in initial stages of treatment, are often given bad-conduct dishonorable discharges to deny them any VA benefits. There’s been little public attention given to this outrage.

As the VA faced record numbers needing their health services, bureaucrats issued directives that sounded great in press releases but were unrealizable in the real world. One was a commitment that no first time patient needing to see a doctor would have to wait more than two weeks for an appointment–an impossible objective with present resources. Some local administrators started cooking the books to hide normal waits as long as four months.

When CNN broke the story about this scandal in May, there was loud reaction in Congress. But it wasn’t to provide urgently needed resources for the VA to do their job. First was a proposal to make it easier for the top bureaucrats to fire subordinates. This fits into their broader blame-the-worker campaign, which is also being used to deny tenure to “bad” teachers.

But the main reason we are finally hearing about some chronic problems in veterans’ health care is that privateers of both parties see recent scandals in record keeping as an opportunity to shift VA patients and tax-payer subsidies to the private sector. Those of us who must deal with for-profit care providers would conclude that if what we have would be an upgrade, the VA system must be rotten to the core.

The truth is that the VA system is the best performing and most cost-efficient component of the shameful general state of health care in the USA. A recent article in the prestigious New England Journal of Medicine revealed, “Beyond access to care, health system performance should be evaluated on the basis of health outcomes, the quality and safety of the care delivered, patient satisfaction, and costs. In many of these domains, the VA has kept pace with or surpassed private-sector health systems. A 2010 systematic review comparing the quality of care in VA and non-VA settings found that the VA generally performed better on quality measures for medical conditions (e.g., blood-pressure control and diabetes management).”

The VA held their own in interventional procedures compared to the much more costly private sector. But what about patient satisfaction?

“On a 2013 patient survey, the American Customer Satisfaction Index, VA health care earned overall satisfaction indexes of 84 (out of 100) for inpatient services and 82 for outpatient care, while the U.S. hospital industry scored 80 and 83 in those categories, respectively. When asked how likely they would be to return to a VA medical center for outpatient care, veterans responded with a score of 95 out of 100, indicating strong likelihood of return for care.”

The core problem with VA services is that their resources have not kept pace with the growing numbers they must serve. The indicated solution is to provide the VA with the resources they need—not to dump Vets in to a private sector that has the worst outcome/cost performance record of any industrialized country.

This is not just a veterans’ problem. It is a solidarity issue for the working class, and the workers’ movement should be their advocate.