VA Rationing, Rationale

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A year ago, it would have been difficult to believe that Obama could legitimately make McCain look bad on veterans’ issues. Then again, he’s had some help:

At a town hall meeting in Dover, N.H., McCain talked about the need to “concentrate” veterans’ health care on people with injuries that “are a direct result of combat.”

“Right now, there are people who drive a long way and they stand in line to stand in line to get an appointment to get an appointment,” McCain said.

McCain’s campaign press office did not return a telephone call asking for clarification of the remarks.

I think that probably sounds more draconian than it actually is; both campaigns acknowledge that there are massive problems with VA and in veterans’ care. And, having heard McCain speak passionately about the need to increase coverage for veterans’ mental health, it’s strange to hear him use the “direct result of combat” formulation. There are, unfortunately, a thousand different ways a soldier could come out of the military with PTSD; which ones would get priority under McCain’s formulation? Does having been shot at make you and more or less worth treating than, I don’t know, having been sexually traumatized?

As the Army Times reports, there’s still no clarification from his campaign. But the website doesn’t seem to reflect any kind of “rationing” policy. In fact, it talks about expanding access to veterans with very obviously non-combat-(directly)-related injuries, like lung cancer and substance abuse.

On the other hand, McCain instinctively leans toward linking length of service with benefits — his stated reason for opposing Webb’s “New GI Bill” — so perhaps that’s the direction of his thinking on VA care as well.

In any case, the Obama camp has wasted no time in staking a claim on the side of the righteous. From the campaign’s vet outreach director, Phillip Carter:

“While we respect John McCain for his service to our country, we disagree with him strongly on how our nation should care for its veterans. Limiting VA Care to veterans who have ‘injuries that are a direct result of combat’ is a dramatic shift in policy with potentially devastating effects on millions of veterans who currently depend on the VA. The VA does not distinguish between combat-related conditions and conditions caused by non-combat service. There is no difference between an injury caused on a battlefield and one caused on the deck of an aircraft carrier or in training. The VA should not start to ration care with this criterion. Barack Obama wants to honor the sacred trust we have with all our nation’s veterans and not ration care. When troops serve, they are not divided by priority groups. Yet, today the VA is picking and choosing which veterans to serve. Barack Obama is committed to ending the unfair ban on healthcare enrollment of ‘Priority 8’ veterans who often earn only modest incomes. As president, one of Barack Obama’s first acts will be signing an executive order reversing this ban.”