July 23, 2008

It seems hard to imagine a presidential candidate, running in the midst of two wars, openly speculate about cutting back on veterans’ healthcare. And yet, here we are.

Republican presidential candidate Sen. John McCain appeared Tuesday to suggest rationing of veterans’ health care may be needed so combat veterans can receive the care they deserve.

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.

Well, that’s not good at all.

The Washington Monthly ran a terrific cover story a couple of years ago, heralding the success of the VA system, and the quality of the medical care veterans receive. McCain may hold some kind of ideological grudge against the VA system — it is, after all, a form of socialized medicine — but even raising the prospect of rationing veterans’ health care seems like a remarkably bad idea. It’s not good policy, and it’s certainly not good politics.

Time’s Ana Marie Cox noted, “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 [from McCain].”

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?

What’s more, it offers us an opportunity to consider McCain’s record of veterans’ issues in a broader context.

[McCain] received a grade of D from the Iraq and Afghanistan Veterans of America and a 20 percent vote rating from the Disabled Veterans of America; Vietnam Veterans of America noted McCain had “voted against us” in 15 “key votes.”

As for the American Legion and the Veterans of Foreign Wars — with whom McCain claims to have a “perfect voting record” — both groups vigorously supported Sen. Jim Webb’s (D-VA) GI Bill that McCain tirelessly opposed.

And Phillip Carter, Barack Obama’s National Veteran Vote Director (and himself an Army veteran of the war in Iraq), explained why McCain’s suggestion is a mistake:

“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.”

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